VINCENT FELLOWS IN MATERNAL-FETAL MEDICINE


Advancing Obstetric Care

Delivering more than 3,600 babies a year, the Vincent Obstetrics Program includes the subspecialty of Maternal-Fetal Medicine. These high-risk OB experts care for pregnant women with chronic health problems as well as unexpected issues such as early labor, bleeding or high blood pressure. They also monitor and treat at-risk babies before birth. Our fellows are working to solve key research questions in obstetric care.

What Is the Optimal Threshold at Which to Treat Postpartum Hypertension?

What Is the Optimal Threshold at Which to Treat Postpartum Hypertension?

Taylor Freret, MD, EdM, a Vincent Fellow in Maternal-Fetal Medicine, is studying the optimal time at which to initiate blood pressure medications in the postpartum period. Postpartum hypertension is a major cause of maternal morbidity, prolonged length of inpatient stay, and readmissions. To date, few studies have considered the optimal time to initiate treatment, with national organizations recommending waiting until a patient has moderate hypertension. Dr. Freret hypothesizes that waiting until moderate hypertension develops may be associated with worse maternal outcomes. She is studying whether initiating blood pressure medications earlier — when a patient has mild hypertension — is associated with reduced maternal complications.

Faculty Mentor

Ilona Goldfarb, MD MPH, Vice Chair of Quality and Safety and Assistant Professor of Obstetrics, Gynecology and Reproductive Biology, Division of Maternal-Fetal Medicine, Vincent Department of OB/GYN, Mass General

Career Path

MD, EdM:  Harvard Medical School, 2012–2017
OB/GYN Residency:  Brigham and Women’s Hospital/Massachusetts General Hospital Integrated OB/GYN Residency, 2017–2021
Vincent Fellowship:  2020–2023

Select Publications

Can Epidural Anesthesia Affect the Results of Peripartum Toxicology Tests?

Can Epidural Anesthesia Affect the Results of Peripartum Toxicology Tests?

Molly Siegel, MD, a Vincent Fellow in Maternal-Fetal Medicine, is studying how epidural anesthesia may impact the results of peripartum toxicology testing, which is routinely used in obstetrics and seen as an objective means of gathering data about recent substance use in pregnant individuals. In particular, she is investigating if epidural use of fentanyl to relieve labor pain may lead to a positive peripartum toxicology test, as this can have significant repercussions unique to pregnancy including anxiety and stigma, treatment program consequences for those with a history of substance-use disorder who are engaged in treatment, referrals to child welfare and custody decisions. It is therefore imperative to understand if medications routinely used in labor could impact the results of these toxicology tests. By measuring the amount of fentanyl in urine before and after epidural placement for pregnant women in labor and their newborns, Dr. Siegel hopes to understand if epidurals can lead to positive peripartum toxicology tests, as these results may be falsely attributed to non-prescribed opioid use.

Faculty Mentor
Sarah N. Bernstein, MD, Assistant Professor of Obstetrics, Gynecology, and Reproductive Biology, Vincent OB/GYN Division of Maternal-Fetal Medicine, Massachusetts General Hospital

Career Path
MD:  Harvard Medical School, 2012–2016
OB/GYN Residency:  University of California, San Francisco, 2016–2020
Vincent Fellowship:  2020–2023

Select Publications

How Does Positioning During Vaginal Delivery Impact Perineal Lacerations?

How Does Positioning During Vaginal Delivery Impact Perineal Lacerations?

Marti Soffer, MD, MPH, a Vincent fellow in Maternal-Fetal Medicine, is studying how positioning at the time of vaginal delivery may impact perineal lacerations. She is leading a randomized controlled trial of women in their first pregnancies to determine the impact of different positions at the time of crowning of the fetal head on perineal trauma. Should a simple change in position at the time of emergence of the fetal head lead to decreased or less morbid perineal lacerations, this work could help women worldwide delivering vaginally. In addition to this work, she is studying factors contributing to patient understanding and future decision-making following a history of primary cesarean section, and she also is examining the utility of serum biomarkers in screening for postpartum diabetes among women with pregnancies affected by gestational diabetes.

Faculty Mentors
Randomized controlled trial:
William H. Barth Jr., MD, Primary Investigator, Chief, Vincent OB/GYN Division of Maternal-Fetal Medicine
Cesarean section research:
Anjali J. Kaimal, MD, MAS, Vincent OB/GYN Division of Maternal-Fetal Medicine
Diabetes research:
Camille E. Powe, MD, Endocrinologist, Director of Diabetes in Pregnancy Program

Career Path
MD:  Icahn School of Medicine at Mount Sinai, 2015
OB/GYN Residency:  Icahn School of Medicine at Mount Sinai, 2015–2019
Vincent Fellowship:  2019–2022

Select Publications