Labor & Delivery

About the Program

The state-of-the art facilities of the Hutzel Women’s Hospital Labor and Delivery Unit include:

  • Approximately 4,000 deliveries per year
  • High-risk population
  • Seventeen birthing rooms and 4 obstetrical operating rooms
  • Maternal Special Care Unit (MSCU)
    • Five-bed unit offering telemetry and high risk monitoring
    • The only maternal ICU in Michigan
  • Fetal therapy procedure rooms for clinical training in cordocentesis, intrauterine fetal transfusions, fetal endoscopy and radiofrequency ablation
  • Fellow participation in the care of fetuses with lethal, non-lethal malformations and genetic syndromes
  • Opportunities for clinical research and education:
    • Design and participate in clinical research
    • Collaboration with Neonatology, Cardiology, and Critical Care Pediatrics
    • Daily Research Rounds: presentation and discussion of current cases, patient management, and review of pertinent scientific literature

Objectives

  • To study the mechanisms of disease of the Great Obstetrical Syndromes: preterm labor, preeclampsia, preterm prelabor rupture of membranes, fetal growth restriction, and fetal demise
  • Study of the progress of normal and abnormal labor
  • Implementation of perinatal clinical research protocols
  • Clinical training of MFM fellows

Research Questions

  • Characterization of the interaction between inflammation and angiogenesis in normal and complicated pregnancies
  • Identification of women with preterm labor and intra-amniotic infection/inflammation using High-Dimensional Biology techniques
  • The relationship between inflammation and preterm parturition
  • The role of adipocytokines in the development of adverse pregnancy outcomes
  • The role of the vascular endothelial growth factor (VEGF) pathway in the pathogenesis of preeclampsia
  • The role of infection and inflammation in fetal death
  • The molecular basis of fetal growth restriction
  • Identification, localization, and function of novel growth hormones in human pregnancy
  • Idopathic vaginal bleeding as a clinical manifestation of intra-amniotic infection

Important Points & Discoveries

  • Intra-amniotic infection and/or inflammation can lead to the Fetal Inflammatory Response Syndrome (FIRS) and is a major mechanism of disease responsible for numerous perinatal and infant morbidities including, neurologic handicap and cerebral palsy
  • Characterization of the role of adipokines in normal pregnancy, preeclampsia, small for gestational age neonates, gestational diabetes, pyelonephritis, and spontaneous preterm labor
  • Identification of placental growth hormone in the fetal circulation with novel implications for fetal growth
  • The use of both cervical length and fetal fibronectin improves the prediction of preterm delivery in patients with preterm labor and intact membranes
  • Failure of physiologic transformation of the spiral arteries in patients with preterm labor and intact membranes

Selected Publications

  • Mazaki-Tovi S, Romero R, Vaisbuch E, Kusanovic JP, Erez O, Gotsch F, Chaiworapongsa T, Than NG, Kim SK, Nhan-Chang CL, Jodicke C, Pacora P, Yeo L, Dong Z, Yoon BH, Hassan SS, Mittal P. Maternal serum adiponectin multimers in preeclampsia. J Perinat Med 2009;37:349-63.
  • Mazaki-Tovi S, Romero R, Kusanovic JP, Vaisbuch E, Erez O, Than NG, Chaiworapongsa T, Nhan-Chang CL, Pacora P, Gotsch F, Yeo L, Kim SK, Edwin SS, Hassan SS, Mittal P. Maternal visfatin concentration in normal pregnancy. J Perinat Med 2009;37:206-17.
  • Mittal P, Romero R, Kusanovic JP, Edwin SS, Gotsch F, Mazaki-Tovi S, Espinoza J, Erez O, Nhan-Chang CL, Than NG, Vaisbuch E, Hassan SS. CXCL6 (granulocyte chemotactic protein-2): a novel chemokine involved in the innate immune response of the amniotic cavity. Am J Reprod Immunol 2008 Sep;60:246-57.
  • Mittal P, Hassan SS, Espinoza J, Kusanovic JP, Edwin S, Gotsch F, Erez O, Than NG, Mazaki-Tovi S, Romero R. The effect of gestational age and labor on placental growth hormone in amniotic fluid. Growth Horm IGF Res 2008 Apr;18:174-9.
  • Mittal P, Espinoza J, Hassan S, Kusanovic JP, Edwin SS, Nien JK, Gotsch F, Than NG, Erez O, Mazaki-Tovi S, Romero R. Placental growth hormone is increased in the maternal and fetal serum of patients with preeclampsia. J Matern Fetal Neonatal Med 2007 Sep;20:651-9.