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 Factors Affect Quality in Obstetric Care?
Mark Clapp, MD, MPH, a fellow in Maternal-Fetal Medicine, is focusing on understanding factors that affect patient outcomes during labor and delivery and identifying metrics that reflect high-quality obstetric care. Among his studies, he is investigating the causes and characteristics of women who are readmitted after childbirth. An analysis of 1,517,683 patients from 1,228 hospitals nationwide showed that 17,508 readmissions had occurred within 30 days, due to factors such as hypertension, wound infection, endometritis, hemorrhage, urinary tract infection, sepsis, thrombotic disease, mastitis and psychiatric disease. His work is helping providers and hospitals identify women at high risk for rehospitalization and guiding health policies to reduce maternal readmissions.
Can We Improve Pain Management in C-section?
Malavika Prabhu, MD, a Maternal-Fetal Medicine fellow, is studying how to improve pain management after cesarean section and minimize the need for narcotics, given the opioid epidemic that is sweeping the nation. She is leading a new study on the experience of women who are receiving long-acting anesthetic in their C-section incision to understand if this is an effective new strategy to minimize opioid use. The results of this study will help to inform future directions in optimizing pain control after C-section, the most common surgery in the United States.
How Can We Prevent Pre-term Birth?
Ingrid Liff, MD, a high-risk obstetrician and a Vincent fellow in Maternal-Fetal Medicine, centers on causes of preterm birth. For women at risk, obstetricians often administer the hormone progesterone to help prevent preterm delivery. But the underlying mechanisms behind this benefit are not known. Her studies in pregnant mice show that IL-10, a protein signal known to reduce inflammation, is increased when progesterone is given. This area of study will result in a better understanding of the effect of progesterone and may lead to new anti-inflammatory drugs to prevent preterm birth.