Maternal-Fetal Medicine Fellowship Program...•Obstetrical Ultrasound and Fetal Echocardiography...

Maternal-Fetal Medicine Fellowship ProgramDetroit Medical Center

Wayne State University School of Medicine

Perinatology Research Branch of NICHD, NIH, DHHS

Copyright © 2020 Perinatology Research Branch

“The Perinatology

Research Branch was

created to bring all

talent, clinical and

basic, to solve the

problems that affect

pregnant women and

their unborn babies.”

Roberto Romero


• Director, DMC / WSU / PRB

Maternal-Fetal Medicine Fellowship Program

• Associate Director

Combined Maternal-Fetal Medicine /

Medical Genetics and Genomics Fellowship Program

• Director of Fetal Cardiology

Perinatology Research Branch, NICHD, NIH, DHHS

• Professor, Division of Maternal-Fetal Medicine

Department of Obstetrics and Gynecology


WELCOME

Lami Yeo, MD, FACOG, FAIUMWelcome to our Maternal-Fetal Medicine

Fellowship Training Program. Our goal is to

train individuals to provide specialized

patient care in Maternal-Fetal Medicine, as

well as to prepare candidates for a career

in academic medicine as physician-

scientists. This is a combined program

sponsored by the Detroit Medical Center,

Wayne State University, and Perinatology

Research Branch of NICHD, NIH, DHHS.

Since 1983, our Fellowship has emphasized a diverse and multi-

disciplinary approach to complications of pregnancy. Fellows have

access to state-of-the-art equipment, dedicated laboratory and

research space, and the opportunity to foster close relationships

with those in other disciplines. The Fellowship emphasizes clinical,

translational, and basic science research. The Perinatology Research

Branch publishes approximately 50 peer-reviewed papers per

year and has received numerous awards for both clinical and

translational research.

The Program is accredited by the ACGME and approved for seven

positions total. Ideal candidates for the Program are well-trained

individuals who thrive in a rigorous, intellectual, and challenging

environment and who are goal-oriented and self-motivated. Many

graduates of our Program are leading academicians, physician-

scientists, and researchers in our field. We invite you to become a

valued member of our incredible team.


Roberto Romero, MD, D.Med.Sci.

• Chair and Frank P. Iacobell Professor

Department of Obstetrics and Gynecology


• Specialist-in-Chief, Obstetrics and Gynecology

Detroit Medical Center, Hutzel Women’s Hospital

• Project Site Manager - contract between Wayne

State University and NICHD

• Director, Perinatal Research Initiative

Wayne State University

Chaur-Dong Hsu, MD, MPH, FACOG

• Chief, Perinatology Research Branch

Director, Division of Obstetrics and Maternal-Fetal Medicine

Intramural Division, NICHD, NIH, DHHS

• Professor, Department of Obstetrics and Gynecology

University of Michigan

Department of Epidemiology and Biostatistics

Michigan State University

Center for Molecular Medicine and Genetics

Wayne State University

• Editor-in-Chief for Obstetrics

American Journal of Obstetrics & Gynecology


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Our Maternal-Fetal Medicine (MFM) Fellowship Program

combines the resources of: 1) the Detroit Medical Center, the

largest medical facility in Michigan; 2) the dynamic research

and teaching expertise of faculty at the Wayne State

University School of Medicine; and 3) the Perinatology

Research Branch of NICHD, NIH, DHHS. Ours is the only MFM

Fellowship Program affiliated with the NICHD/NIH.

Fellowship Goals and Objectives:

• Train physicians to provide specialized patient care in

Maternal-Fetal Medicine

• Prepare candidates for a career in academic medicine as

physician-scientists

The Fellowship Program is housed at the Detroit Medical Center

and Wayne State University campus in Detroit, Michigan,

where the Perinatology Research Branch is located. The

Program is approved by the ACGME for seven positions.

A combined Maternal-Fetal Medicine / Medical Genetics and

Genomics Fellowship is also available. Candidates may also

opt to complete a PhD degree, which is based in the

Department of Physiology at Wayne State University.

INTRODUCTION: Maternal-Fetal Medicine Fellowship Program


Detroit Medical Center facilities include:

• Michigan’s only Maternal Special Care Unit

• Five-bed specialized Intensive Care Unit

• 20 Mother/Baby Units

• Neonatal Intensive Care Unit reserved for

critically ill newborns

• Prematurity Prevention Unit

At the Detroit Medical Center, the obstetrical and high-risk

antepartum services, as well as incoming maternal transports lead

to diversity and a high volume of complicated pregnancies. Both

MFM Division faculty and other selected subspecialists supervise

the Fellows and offer mentorship and guidance throughout the

training period to prepare them for independent practice within

the subspecialty. There is a strong emphasis on the prenatal

diagnosis of congenital anomalies using ultrasound, and on the

performance of antepartum procedures, intrapartum procedures,

and invasive procedures, such as amniocentesis. Fellows are also

expected to gain competence in understanding the effects of

pregnancy on the fetus/neonate.

Clinical Rotations include:

• High-Risk Maternal-Fetal Medicine (outpatient, inpatient)

• Obstetrical Ultrasound and Fetal Echocardiography

• Labor and Delivery

• Intensive Care Unit

• Elective rotations (e.g. Obstetric Anesthesiology, Pediatric

Cardiology, Gynecologic Ultrasound)

Clinical Curriculum


The Fellowship includes a weekly comprehensive, broad, and

diverse educational program, which includes a daily Research

Rounds forum that is unique to our institution. Special lecturers

from around the world are regularly invited to discuss their

work and advances within the field. Education of Fellows is

an important priority of the Program.

Educational opportunities:

• MFM Fellowship Course Curriculum Lecture Series

• PRB Ultrasound Conference

o Journal Club

o Fetal Echocardiography

o Fetal Magnetic Resonance Imaging

o Ultrasound teaching lectures

o Abnormal fetal case reviews and lectures

• Perinatal/Neonatal Conference

• Department of Obstetrics and Gynecology Grand Rounds

• Annual OB/GYN Ultrasound Symposium

• Research Rounds at the PRB

• Special lectures hosted by the PRB

• Annual Wayne Day Conference

• Other Conferences and Scientific Meetings at the PRB

Educational Curriculum


Neutrophil extracellular traps in the human chorioamniotic membranes


Research

Fellows complete 18 months of research in state-of-the-art

facilities and laboratories. The Perinatology Research Branch

has both clinical and laboratory divisions available, including

an animal facility. The Program has laboratories focusing on

placental pathology, molecular biology, immunology, and

cytogenetics. There is a focus on original clinical, translational,

and basic research in parturition, reproductive immunology,

microbiology and infectious disease, placental pathology and

biology, biomarker discovery, and systems biology in

reproduction. Novel and advanced research is also conducted

in fetal and maternal sonography, fetal cardiology, and fetal

MRI. Scientific publications are a strong emphasis. Our Program

provides Fellows with one of the most well-developed

academic environments available in Maternal-Fetal Medicine.

Fellows are mentored by the Faculty in combination

with a multidisciplinary team of experts. It is

expected that a research thesis project will be

completed before graduating from the Program.

Databases in multiple disciplines (e.g. imaging,

placental pathology) are available, as well as a

Perinatal Epidemiology Unit providing epidemiology

and biostatistical expertise.

Placental vascular cast


Created in collaboration with the NICHD, the Center for

Advanced Obstetrical Care and Research (CAOCR) is

situated within Hutzel Women’s Hospital of the Detroit

Medical Center. The CAOCR is a state-of-the-art facility

that utilizes the most advanced surveillance and

ultrasound techniques. The Center evaluates high-risk

pregnancy conditions by conducting ongoing research

and providing specialized patient evaluation. Research

protocols focus on women who have a history of, or who

are at risk for:

• Preterm birth

• Pregnancy loss

• Small- or large-for-gestational-age fetus

• Twin gestation

• Pre-eclampsia

Fellows participate in the implementation of all research

protocols and have the opportunity to learn about the

design, execution, and analysis of longitudinal studies.

Fellows also gain experience in the design and execution

of randomized clinical trials.

Center for Advanced Obstetrical Care and Research (CAOCR)


The C.S. Mott Center for Human Growth and

Development, a basic research facility housing

more than 28,000 square feet of laboratory

space, is located on the campus of Wayne

State University School of Medicine. This facility

is specifically dedicated to laboratories where

research in Obstetrics and Gynecology is

conducted. The primary mission is to foster

basic and clinical biomedical research on

reproduction and development.

C.S. Mott Center for Human Growth and Development

In addition to investigator labs, offices, and animal

facilities, the C.S. Mott Center houses:

• Research laboratories of the PRB

• Clinical Research area of the Department of

Obstetrics and Gynecology

• Vivarium

• Implantation Laboratory of the Reproductive

Biology and Medicine Branch, NICHD Intramural

Research Division

• Wayne State University Genomics Facility

• Bioinformatics Center

• Systems Biology section Fetal mouse


Research Divisions of the Perinatology Research Branch

• Study the mechanisms of disease of

the Great Obstetrical Syndromes

• Study the progress of normal and

abnormal labor

• Define the progesterone-regulated

mediators that allow for the

maintenance of uterine quiescence

across gestation

• Identify novel circulating factors

that may serve as early predictive

biomarkers for an increased risk of

premature labor

Labor and Delivery

• Develop novel and innovative

diagnostic techniques in fetal and

maternal imaging

• Conduct research of the fetus

and mother utilizing three- and

four-dimensional imaging, MRI,

and other sonographic modalities

• Study the role of fetal and

maternal imaging for the

prediction of perinatal outcome

Fetal and Maternal Imaging Placental Laboratory

• Study the relationship between

placental lesions and adverse

pregnancy outcomes

• Determine the mechanisms of

disease underlying placental

lesions

• Study the role of fetal

membranes in pregnancy

complications


• Perform anatomic and

functional evaluation of the

fetal heart in normal and

high-risk pregnancies using

ultrasound

• Improve prenatal diagnosis

of congenital heart defects

• Develop algorithms to allow

trained clinicians to generate

key views to examine the

fetal heart after acquiring

sonographic volume datasets

Fetal Cardiology

• Conduct basic research on the

immunological pathways that lead

to obstetrical disorders

• Improve understanding of the

immune mechanisms of disease

• Develop methods for the early

diagnosis, monitoring, treatment,

and prevention of pregnancy

complications, with an emphasis on

preterm birth

• Train post-graduate and

graduate-level professionals in

perinatal immunology

Perinatal Immunobiology


• Study the mechanisms of disease

in pregnancy complications

• Develop novel diagnostic,

therapeutic, and preventative

strategies to reduce perinatal

morbidity and mortality

Biomarkers


• Apply advanced computational

biology and bioinformatics

methods to the study of clinical

conditions in Maternal-Fetal

Medicine

• Interpret biological data

obtained via high-throughput

technologies such as gene and

miRNA microarrays, methylation

and PCR arrays, exon arrays,

and sequencing technologies

• Perform gene ontology and

pathway analyses

Bioinformatics and

Computational Biology

• Characterize the perinatal microbiome

longitudinally across pregnancy

• Elucidate potential interactions between

vaginal, oral, and intestinal microbiomes

and microbial invasion of the amniotic

cavity

• Identify and evaluate specific microbial

biomarkers of obstetrical syndromes,

especially preterm labor and clinical

chorioamnionitis

• Manage the perinatal microbiome to

prevent adverse pregnancy outcomes

Perinatal Infectious Disease and

Human Microbiome


• Study the expression and regulation of

different biomarkers involved in maternal

and fetal disease

• Conduct high-throughput technologies,

such as PCR and ELISA, multiplex,

Western blot, cell culture, protein

biochemistry, and molecular biology, as

well as animal work

Perinatal Translational

Science Laboratory


• Assess the relationship between

maternal, placental, neonatal,

and perinatal risk factors and

subsequent infant outcomes

• Monitor trends in survival and

the incidence of various

neonatal disease entities related

to perinatal risk factors,

interventions, biochemical and

biophysical markers of diseases,

and fetal growth

Neonatology

• Investigate the antecedents,

distributions, consequences, and

opportunities for the prevention of

pathological perinatal outcomes,

including childhood handicap with

roots in pregnancy

• Provide training on optimal study

designs, analytic methods, and

interpretations in the observational

investigations of epidemiology and

the prevention of pathological

perinatal outcomes

Perinatal Epidemiology


• Conduct original research on the

evolution of human placentation

and its relationship to disease

• Use the tools of molecular

evolutionary biology to understand

the biology of normal pregnancy

and adverse pregnancy outcome

Molecular Evolution of Reproduction


• Study immune responses of the mother and fetus to

understand physiologic and pathologic pregnancy

conditions

• Conduct translational and basic science research

relevant to normal and abnormal pregnancy

conditions

• Perform immunophenotyping by polychromatic flow

cytometry

• Sort cells with a high-speed flow cytometer

Cytomics


• Develop quantitative magnetic resonance

imaging (MRI) techniques to assess fetal and

neonatal brain physiology and injury

• Apply resting-state functional connectivity

MRI to study the earliest forms of cerebral

connectivity in the human brain

• Apply multi-modal MRI to discover and

characterize fetal functional and structural

brain development in health and disease

Fetal Magnetic Resonance Imaging


Scholarly ActivityFellows are exposed to research design, grant

writing, research methodology, and scientific writing

through a breadth and depth of resources:

Educational Courses and Lectures:

• University of Michigan Summer Session in

Epidemiology

• Lectures on biostatistics, conceptual statistics,

perinatal epidemiology, perinatal research, and

bioinformatics/data analysis

• Lectures on basic science techniques (e.g.

immunohistochemistry, proteomics)

• Eunice Kennedy Shriver NICHD Annual Young

Investigator’s Conference on Maternal-Fetal-

Neonatal-Reproductive Medicine

Other Scholarly Activity:

• Oral or poster presentations of scientific work at

local/national meetings and conferences

• Attendance at the Society for Maternal-Fetal

Medicine and other scientific meetings

• Authorship in scientific publications


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Hernandez-Andrade E, Maymon E, Luewan S, Bhatti G, Mehrmohammadi M, Erez O,

Pacora P, Done B, Hassan SS, Romero R. A soft cervix, characterized by shear-wave

elastography, in women with short or with normal cervical length at 18-24 weeks is

associated with a higher prevalence of spontaneous preterm delivery. J Perinat Med

2018;46:489-501.

Conde-Agudelo A, Romero R, Da Fonseca E, O’Brien JM, Cetingoz E, Creasy GW,

Hassan SS, Erez O, Pacora P, Nicolaides KH. Vaginal progesterone is as effective as

cervical cerclage to prevent preterm birth in women with a singleton gestation, previous

spontaneous preterm birth, and a short cervix: updated indirect comparison meta-

analysis. Am J Obstet Gynecol 2018;219:10-25.

Tarca AL, Romero R, Gudicha DW, Erez O, Hernandez-Andrade E, Yeo L, Bhatti G,

Pacora P, Maymon E, Hassan SS. A new customized fetal growth standard for African

American women: the PRB/NICHD Detroit study. Am J Obstet Gynecol 2018; 218:S679-

S691.e4.

Krishnamurthy U, Yadav BK, Jella PK, Haacke EM, Hernandez-Andrade E, Mody S, Yeo

L, Hassan SS, Romero R, Neelavalli J. Quantitative flow imaging in human umbilical

vessels in utero using nongated 2D phase contrast MRI. J Magn Reson Imaging

2018;48:283-289.

Romero R, Conde-Agudelo A, El-Refaie W, Rode L, Brizot ML, Cetingoz E, Serra V, Da

Fonseca E, Abdelhafez MS, Tabor A, Perales A, Hassan SS, Nicolaides KH. Vaginal

progesterone decreases preterm birth and neonatal morbidity and mortality in women

with a twin gestation and a short cervix: an updated meta-analysis of individual patient

data. Ultrasound Obstet Gynecol 2017;49:303-314

Gomez-Lopez N, Romero R, Xu Y, Garcia-Flores V, Leng Y, Panaitescu B, Miller D,

Abrahams VM, Hassan SS. Inflammasome assembly in the chorioamniotic membranes

during spontaneous labor at term. Am J Reprod Immunol 2017;77:10.1111

Erez O, Romero R, Maymon E, Chaemsaithong P, Done B, Pacora P, Panaitescu B,

Chaiworapongsa T, Hassan SS, Tarca AL. The prediction of late-onset preeclampsia:

results from a longitudinal proteomics study. PLoS One. 2017;12:e0181468.

Pique-Regi R, Romero R, Tarca AL, Luca F, Xu Y, Alazizi A, Leng Y, Hsu CD, Gomez-

Lopez N. Does the human placenta express the canonical cell entry mediators for

SARS-CoV-2? Elife 2020;9:e58716.

Tarca AL, Romero R, Pique-Regi R, Pacora P, Done B, Kacerovsky M, Bhatti G, Jaiman

S, Hassan SS, Hsu CD, Gomez-Lopez N. Amniotic fluid cell-free transcriptome: a

glimpse into fetal development and placental cellular dynamics during normal

pregnancy. BMC Med Genomics 2020; 13:25

Jaiman S, Romero R, Pacora P, Jung E, Bhatti G, Yeo L, Kim YM, Kim B, Kim CJ, Kim JS,

Qureshi F, Jacques SM, Erez O, Gomez-Lopez N, Hsu CD. Disorders of placental villous

maturation in fetal death. J Perinat Med 2020 Apr 1.

Yeo L, Romero R. New and advanced features of fetal intelligent navigation

echocardiography (FINE) or 5D heart. J Matern Fetal Neonatal Med 2020:1-19.

Bhatti G, Romero R, Cherukuri K, Gudicha DW, Yeo L, Kavdia M, Tarca AL. Fetal

growth percentile software: a tool to calculate estimated fetal weight percentiles for 6

standards. Am J Obstet Gynecol 2020; 222:625-628.

Gomez-Lopez N, Romero R, Xu Y, Miller D, Arenas-Hernandez M, Garcia-Flores V,

Panaitescu B, Galaz J, Hsu CD, Para R, Berry SM. Fetal T cell activation in the amniotic

cavity during preterm labor: a potential mechanism for a subset of idiopathic preterm

birth. J Immunol 2019;203:1793-1807.

Theis KR, Romero R, Winters AD, Greenberg JM, Gomez-Lopez N, Alhousseini A, Bieda

J, Maymon E, Pacora P, Fettweis JM, Buck GA, Jefferson KK, Straus JF 3rd, Erez O,

Hassan SS. Does the human placenta delivered at term have a microbiota? Results of

cultivation, quantitative real-time PCR, 16S rRNA gene sequencing, and metagenomics.

Am J Obstet Gynecol 2019;220:267.e1-e39.

Romero R, Gomez-Lopez N, Winters AD, Jung E, Shaman M, Bieda J, Panaitescu B,

Pacora P, Erez O, Greenberg JM, Ahmad MM, Hsu CD, Theis KR. Evidence that intra-

amniotic infections are often the result of an ascending invasion – a molecular

microbiological study. J Perinat Med 2019;47:915-931.

Select Publications


Select Publications

Korzeniewski SJ, Romero R, Chaiworapongsa T, Chaemsaithong P, Kim CJ, Kim YM, Kim

JS, Yoon BH, Hassan SS, Yeo L. Maternal plasma angiogenic index-1 (placental growth

factor/soluble vascular endothelial growth factor receptor-1) is a biomarker for the

burden of placental lesions consistent with uteroplacental underperfusion: a longitudinal

case-cohort study. Am J Obstet Gynecol 2016;214:629.e1-629.e17

Tarca AL, Hernandez-Andrade E, Ahn H, Garcia M, Xu Z, Korzeniewski SJ, Saker H,

Chaiworapongsa T, Hassan SS, Yeo L, Romero R. Single and Serial Fetal Biometry to

Detect Preterm and Term Small- and Large-for-Gestational-Age Neonates: A

Longitudinal Cohort Study. PLoS One 2016;11:e0164161

Hsu C-D, Cohn, I, Caban, R. Reduction and sustainability of Cesarean section surgical

site infection: an evidence-based, innovative, and multidisciplinary quality improvement

intervention bundle program. Am J Infect Control 2016; 44:1315-1320

Krishnamurthy U, Neelavalli J, Mody S, Yeo L, Jella PK, Saleem S, Korzeniewski SJ,

Cabrera MD, Ehterami S, Bahado-Singh RO, Katkuri Y, Haacke EM, Hernandez-

Andrade E, Hassan SS, Romero R. MR imaging of the fetal brain at 1.5T and 3.0T field

strengths: comparing specific absorption rate (SAR) and image quality. J Perinat Med

2015;43:209-220

Mazaki-Tovi S, Vaisbuch E, Tarca AL, Kusanovic JP, Than NG, Chaiworapongsa T, Dong

Z, Hassan SS, Romero R. Characterization of visceral and subcutaneous adipose tissue

transcriptome and biological pathways in pregnant and non-pregnant women: evidence

for pregnancy-related regional-specific differences in adipose tissue. PLoS One

2015;10:e0143779.

Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM. Acute

chorioamnionitis and funisitis: definition, pathologic features, and clinical significance.

Am Obstet Gynecol 2015;213:S29-52.

Romero R, Miranda J, Chaiworapongsa T, Korzeniewski SJ, Chaemsaithong P, Gotsch F,

Dong Z, Ahmed AI, Yoon BH, Hassan SS, Kim CJ, Yeo L. Prevalence and clinical

significance of sterile intra-amniotic inflammation in patients with preterm labor and

intact membranes. Am J Reprod Immunol 2014; 72:458-474

Neelavalli J, Mody S, Yeo L, Jella PK, Korzeniewski SJ, Saleem S, Katkuri Y, Bahado-

Singh RO, Hassan SS, Haacke EM, Romero R, Thomason ME. MR venography of the fetal

brain using susceptibility weighted imaging. J Magn Reson Imaging 2014;40:949-957

Romero R, Dey SK, Fisher SJ. Preterm labor: one syndrome, many causes. Science

2014;345:760-765

Yeo L, Romero R. Fetal intelligent navigation echocardiography (FINE): a novel method

for rapid, simple, and automatic examination of the fetal heart. Ultrasound Obstet

Gynecol 2013; 42:268-284

Chaiworapongsa T, Romero R, Korzeniewski SJ, Kusanovic JP, Soto E, Lam J, Dong Z,

Than NG, Yeo L, Hernandez-Andrade E, Conde-Agudelo A, Hassan SS. Maternal plasma

concentrations of angiogenic/antiangiogenic factors in the third trimester of pregnancy to

identify the patient at risk for stillbirth at or near term and severe late preeclampsia. Am

J Obstet Gynecol 2013;208:287.e1-287.e15

Hernandez-Andrade E, Hassan SS, Ahn H, Korzeniewski SJ, Yeo L, Chaiworapongsa T,

Romero R. Evaluation of cervical stiffness during pregnancy using semiquantitative

ultrasound elastography. Ultrasound Obstet Gynecol 2013; 4Z:152-161

Thomason, M.E., Dassanayake, M.T., Shen, S., Katkuri, Y., Alexis, M., Anderson, A.L., Yeo,

L., Mody, S., Hernandez-Andrade, E., Hassan, S.S., Studholme, C., Jeong, J.W., &

Romero, R. Cross-hemispheric functional connectivity in the human fetal brain. Science

Translational Medicine 2013;5:17324

Romero R, Nicolaides K, Conde-Agudelo A, Tabor A, O'Brien JM, Cetingoz E, Da Fonseca

E, Creasy GW, Klein K, Rode L, Soma-Pillay P, Fusey S, Cam C, Alfirevic Z, Hassan SS.

Vaginal progesterone in women with an asymptomatic sonographic short cervix in the

midtrimester decreases preterm delivery and neonatal morbidity: a systematic review

and meta-analysis of individual patient data. Am J Obstet Gynecol 2012;124.e1-19

Kannan S, Dai H, Navath RS, Balakrishnan B, Jyoti A, Janisse J, Romero R, Kannan RM.

Dendrimer-based postnatal therapy for neuroinflammation and cerebral palsy in a

rabbit model. Sci Transl Med 2012;4:130ra46


Select Publications

Yeo L, Romero R, Jodicke C, Ogge G, Lee W, Kusanovic JP, Vaisbuch E, Hassan S.

Four-chamber view and "swing technique" (FAST) echo: a novel and simple algorithm to

visualize standard fetal echocardiographic planes. Ultrasound Obstet Gynecol 2011;

37:423-431.

Lee J, Romero R, Xu Y, Kim JS, Topping V, Yoo W, Kusanovic JP, Chaiworapongsa T,

Hassan SS, Yoon BH, Kim CJ. A signature of maternal anti-fetal rejection in spontaneous

preterm birth: chronic chorioamnionitis, anti-human leukocyte antigenantibodies, and

C4d. PLoS One 2011;6:e16806

Mittal P, Romero R, Tarca AL, Draghici S, Nhan-Chang CL, Chaiworapongsa T, Hotra J,

Gomez R, Kusanovic JP, Lee DC, Kim CJ, Hassan SS. A molecular signature of an arrest

of descent in human parturition. Am J Obstet Gynecol 2011;204:177.e15-33

Hassan SS, Romero R, Vidyadhari D, Fusey S, Baxter J, Khandelwal M, Vijayaraghavan

J, Trivedi Y, Soma-Pillay P, Sambarey P, Dayal A, Potapov V, O'Brien J, Astakhov V,

Yuzko O, Kinzler W, Dattel B, Sehdev H, Mazheika L, Manchulenko D, Gervasi MT,

Sullivan L, Conde-Agudelo A, Phillips JA, Creasy GW; for the PREGNANT Trial.

Vaginal progesterone reduces the rate of preterm birth in women with a sonographic

short cervix: a multicenter, randomized, double-blind, placebo-controlled trial.

Ultrasound Obstet Gynecol 2011; 38:18-31

Espinoza J, Lee W, Comstock C, Romero R, Yeo L, Rizzo G, Paladini D, Viñals F, Achiron

R, Gindes L, Abuhamad A, Sinkovskaya E, Russell E, Yagel S. Collaborative study on 4-

dimensional echocardiography for the diagnosis of fetal heart defects: the COFEHD

study. J Ultrasound Med 2010; 29:1573-1580

Conde-Agudelo A, Romero R. Antenatal magnesium sulfate for the prevention of

cerebral palsy in preterm infants less than 34 weeks' gestation: a systematic review

and metaanalysis. Am J Obstet Gynecol 2009;200:595-609

Kim MJ, Romero R, Kim CJ, Tarca AL, Chhauy S, LaJeunesse C, Lee DC, Draghici S,

Gotsch F, Kusanovic JP, Hassan SS, Kim JS. Villitis of unknown etiology is associated

with a distinct pattern of chemokine up-regulation in the feto-maternal and placental

compartments: Implications for conjoint maternal allograft rejection and maternal anti-

fetal Graft versus Host Disease. J Immunol 2009;182:3919-3927.

Lee W, Balasubramaniam M, Deter RL, Hassan SS, Gotsch F, Kusanovic JP, Gonçalves LF,

Romero R. Fractional limb volume--a soft tissue parameter of fetal body composition:

validation, technical considerations and normal ranges during pregnancy. Ultrasound

Obstet Gynecol 2009;33:427-440.

Espinoza J, Gonçalves LF, Romero R, Nien YK, Stites S, Kim YM, Hassan S, Gomez R, Yoon

BH, Chaiworapongsa T, Lee W, Mazor M. The prevalence and clinical significance of

amniotic fluid “sludge” in patients with preterm labor and intact membranes. Ultrasound

Obstet Gynecol 2005; 25:346-352.

Condon JC, Jeyasuria P, Faust JM, Wilson JW, Mendelson CR. A decline in the levels of

progesterone receptor coactivators in the pregnant uterus at term may antagonize

progesterone receptor function and contribute to the initiation of parturition. Proc Natl

Acad Sci USA 2003;100:9518-9523.

Gonçalves LF, Lee W, Chaiworapongsa T, Espinoza J, Schoen ML, Falkensammer P,

Treadwell M, Romero R. Four dimensional ultrasonography of the fetal heart with

spatiotemporal image correlation. Am J Obstet Gynecol 2003;189:1792-802.

Kim YM, Bujold E, Chaiworapongsa T, Gomez R, Yoon BH, Thaler HT, Rotmensch S,

Romero R. Failure of the physiologic transformation of the spiral arteries in patients with

preterm labor and intact membranes. Am J Obstet Gynecol 2003;189:1063-1069.

Jacques SM, Qureshi F. Chronic chorioamnionitis: A clinicopathologic and

immunohistochemical study. Hum Pathol 1998; 29:1457-1461.

Romero R, Yoon BH, Mazor M, Gomez R, Gonzalez R, Diamond MP, Baumann P,

Araneda H, Kenney JS, Cotton DB, et al. A comparative study of the diagnostic

performance of amniotic fluid glucose, white blood cell count, interleukin-6, and gram

stain in the detection of microbial invasion in patients with preterm premature rupture of

membranes. Am J Obstet Gynecol 1993;169:839-851

Romero R, Brody DT, Oyarzun E, Mazor M, Wu YK, Hobbins JC, Durum SK. Infection and

labor. III. Interleukin-1: a signal for the onset of parturition. Am J Obstet Gynecol

1989;160(5 Pt 1):1117-1123


The Division of Maternal-Fetal Medicine is comprised of

faculty members who are recognized internationally for

making seminal contributions to our discipline, and

provide expert evaluation and highly specialized care to

women with high-risk and complicated pregnancies.

Clinical care includes providing pre-conceptional and

prenatal consultation as well as performing advanced

techniques, such as:

• Obstetrical ultrasonography

• Antepartum fetal health assessment

• Amniocentesis

• Umbilical fetal blood sampling

• Fetal echocardiography

• Doppler assessment of the mother and fetus

MFM physicians are available for consultation 24 hours a

day, and provide Labor and Delivery services at Hutzel

Women’s Hospital. The education and training of

Maternal-Fetal Medicine fellows is an integral part of the

Division’s mission.

Division of Maternal-Fetal Medicine


The Wayne State University Department of Obstetrics

and Gynecology has been an internationally

recognized academic center in women’s health and

child development for more than 50 years. The

Department is committed to improving the health and

well-being of women, infants, and families of

Southeast Michigan and the surrounding areas.


Perinatology Research Branch Faculty

• In addition to our distinguished faculty, the Fellows

have the opportunity to collaborate with

international scholars, research associates, and

physician-scientists on sabbatical at the Perinatology

Research Branch

• The PRB has hosted Nobel Laureates, Royal Society

Fellows, members of the National Academy of

Medicine, and other esteemed visiting Professors

• While building strong connections with specialists

and scientists in the United States, the Fellows have

opportunities to collaborate on research projects

with global researchers and physicians. The PRB

works with a national and international network of

external collaborators (see below):Dr. Emanuel Friedman and PRB members

External Collaborators


Maternal-Fetal Medicine Fellows Fellow graduates from our Program have become Deans,

Chairs of Departments, Division Chiefs, and Academic leaders

within our discipline.

Select Publications During Fellowship:

Alhousseini A, Romero R, Benshalom-Tirosh N, Gudicha D, Pacora P, Tirosh D,

Kabiri D, Yeo L, Thachil J, Hsu CD, Hassan SS, Erez O. Nonovert disseminated

intravascular coagulation (DIC) in pregnancy: a new scoring system for the

identification of patients at risk for obstetrical hemorrhage requiring blood

transfusion. J Matern Fetal Neonatal Med 2020:1-16.

Varrey A, Romero R, Panaitescu B, Miller D, Chaiworapongsa T, Patwardhan M,

Faro J, Pacora P, Hassan SS, Hsu CD, Gomez-Lopez N. Human ß-defensin-1: A

natural antimicrobial peptide present in amniotic fluid that is increased in

spontaneous preterm labor with intra-amniotic infection. Am J Reprod Immunol

2018;80:e13031.

Lannaman K, Romero R, Chaiworapongsa T, Kim YM, Korzeniewski SJ, Maymon E,

Gomez-Lopez N, Panaitescu B, Hassan SS, Yeo L, Yoon BH, Jai Kim C, Erez O.

Fetal death: an extreme manifestation of maternal anti-fetal rejection. J Perinat

Med 2017;45: 851-868.

Tang X, Hernandez-Andrade E, Ahn H, Garcia M, Saker M, Korzeniewski SJ, Tarca

AL, Yeo L, Hassan SS, Romero R. Intermediate diastolic velocity as a parameter of

cardiac dysfunction in growth-restricted fetuses. Fetal Diagn Ther 2016;39:28-39.

Patwardhan M, Hernandez-Andrade E, Ahn H, Korzeniewski SJ, Schwartz A,

Hassan SS, Romero R. Dynamic changes in the myometrium during the third stage

of labor, evaluated using two-dimensional ultrasound, in women with normal and

abnormal third stage of labor and in women with obstetric complications.

Gynecologic and Obstetric Investigation 2015;80:26-37

Adekola H, Romero R, Chaemsaithong P, Korzeniewski SJ, Dong Z, Yeo L, Hassan

SS, Chaiworapongsa T. Endocan, a putative endothelial cell marker, is elevated in

preeclampsia, decreased in acute pyelonephritis, and unchanged in other

obstetrical syndromes. J Matern Fetal Neonatal Med 2015;28:1621-1632.


Gerald Feldman, MD, PhD, FACMG

Combined Maternal-Fetal Medicine / Medical Genetics and Genomics Fellowship

• Director, Combined MFM / Medical Genetics and Genomics Fellowship Program

• Director, Medical Genetics and Genomics Residency and Fellowship Programs

Detroit Medical Center / Wayne State University School of Medicine

• Professor, Center for Molecular Medicine and Genetics

Department of Pediatrics and Department of Pathology


About the Program:

• Four-year combined program

• Clinical training in Maternal-Fetal Medicine and Medical Genetics and Genomics

• Board eligibility through the American Board of Obstetrics and Gynecology,

Division of Maternal-Fetal Medicine, and the American Board of Medical

Genetics and Genomics upon completion of the program

• Broad exposure to clinical genetics and genomics, including prenatal, pediatric

and adult patients, diagnostic laboratory services (molecular genetics,

cytogenetics, and biochemical genetics) and maternal-fetal medicine

Educational Program:

• 6 monthly clinical rotations in Reproductive Genetics count for both MFM and

Medical Genetics + clinical genetics and MFM rotations

• 18 months of research rotations, with at least 6 months related to genetics

Medical Genetics and Genomics Objectives:

• Clinical skills in prenatal and postnatal genetic conditions

• Develop competency in the diagnosis and management

of conditions affecting women with complicated

pregnancies and patients with genetic diseases

• Develop competencies in the clinical genetic and genomic

basis of disease (both pediatric and adult), diagnostic

testing (molecular genetics, cytogenetics and biochemical

genetics) and dysmorphology

• Fellows are required to accumulate a logbook of 150

cases with genetic or possible genetic conditions involving

evaluation, counseling, and management of pediatric,

adult, prenatal, and cancer genetic patients


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Resources and Location

Detroit, known as the “Motor City”, is the

great American comeback city and is

experiencing a new era of growth and

renovation. An influx of commercial and

residential expansion has created an

ideal environment for young professionals

seeking opportunity. A number of

technology-based businesses and artisan

manufacturers alike have put down roots

only blocks away from the Detroit

Medical Center, adding to the pride and

community spirit of the city.

The flood of new residents are getting to

enjoy Detroit’s incredible cultural

offerings including the Fox Theater,

Detroit Institute of Arts, Charles H. Wright

Museum of African American History,

Henry Ford Museum of American

Innovation, and Greenfield Village.

Known for its musical legacy, Detroit is

often referred to as “Motown”, and is the

birthplace of Diana Ross, the Supremes,

the Temptations, and Smokey Robinson.

The Detroit Metro area features some

of the most vibrant, yet relaxing

neighborhoods to be found anywhere.

These communities include Bloomfield

Hills, Royal Oak, Birmingham, and

Grosse Pointe. Whether you enjoy

hiking, live music, boating, skiing, or

delicious cuisine, Michigan offers

something for everyone. The beautiful

shoreline of the Great Lakes, state

parks, and a healthy tourism industry

provide fun for all ages.


• Successful completion of an ACGME-approved residency program

• Curriculum Vitae

• USMLE: Parts 1, 2, and 3 (results)

• CREOG scores

• Three letters of recommendation

• One page summary of your goals:

o Rationale for pursuing Fellowship training and other aspects that you

consider helpful in assessing your application

o Future plans after completion of Fellowship training

• Describe any previous experience in research and whether this has led to a

degree (e.g. MPH, PhD)

• Registration for the specialty matching service of the National Resident

Matching Program (NRMP) must be completed

• Graduates from an approved or recognized medical school outside of the

United States, Canada, or Puerto Rico must present a valid ECFMG

Certificate from the Education Commission for Foreign Medical Graduates

Application Requirements for Maternal-Fetal Medicine Fellowship Program

• Formal Application:

o http://prb.med.wayne.edu/wp-content/uploads/2019/09/GME-Application_FINAL.pdf

o Applications are accepted through the Electronic Residency Application Service (ERAS)

o Applications must be submitted by MAY 31st


Maternal-Fetal Medicine Fellowship Program

Detroit Medical Center

Hutzel Women’s Hospital

3990 John R. Street, 4 Brush

Detroit, MI 48201

Phone: (313) 577-9320 Fax: (313) 577-8986 Email: [email protected] Website: prb.med.wayne.edu/


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Maternal-Fetal Medicine Fellowship Program...•Obstetrical Ultrasound and Fetal Echocardiography...

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