High-Risk Obstetrics Research

Lucile Packard Children's Hospital Obstetrics physicians are also faculty members at the Stanford University School of Medicine. One of our roles as faculty is to perform research to ultimately improve outcomes for expectant mothers and their babies.
 

Influencing Obstetric Research and Practice at the National Level

In April 2011, the Division of Maternal-Fetal Medicine and Obstetrics at Packard Children's Hospital was accepted into the National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) network. The network’s 14 academic medical centers jointly conduct large clinical trials to investigate the most important problems in obstetrics. Our MFMU network participation continues Packard Children's and Santa Clara Valley Medical Center's collaborative, randomized clinical trials that were started in 1996.
 

Current Research

Our current research activities include investigating:
 
Prenatal Genetic Testing

• The use of new genetic techniques to improve prenatal diagnosis
• The best ways to educate women about prenatal testing options

Prenatal Imaging

• Alternative ultrasound techniques to improve visualization of fetal anatomy in obese women
• Prenatal MRI to improve diagnosis of fetal birth defects

Preventing and Treating Preterm Labor

• Stress and preterm labor in twin pregnancies 
• Comparison of different drugs used to treat preterm labor

Managing Complications of Pregnancy and Childbirth

• The most effective drugs and drug dosages to treat chorioamnionitis and blood clots (venous thromboembolism (VTE) )
• Optimal treatment for placental abruption
• Placenta accreta management and treatment. This is a multi-center study.
• Placental development disorders in women with preeclampsia
• Two tests (7-day continuous glucose monitoring vs. a one-hour glucola) to see which more accurately diagnoses gestational diabetes
• Techniques to reduce scar tissue and long-term complications from Cesarean sections
• Auto-immune diseases and pregnancy

We also participate in the California Maternal Quality Care Collaborative (CMQCC) and the California Pregnancy-Associated Mortality Review (CA-PAMR).
 
Mental Health During Pregnancy

• Diagnosis and treatment of depression during pregnancy
• The influence a fetus’s genetic makeup has on its risk of birth defects caused by antidepressant medications

Training and Education

• Effects of simulation training on physicians’ and nurses’ performance in the Labor and Delivery Unit 

We are also building a library of samples for future research and testing. With patient consent, we collect:

• Blood samples to help us find ways to non-invasively diagnose problems
• Amniotic fluid to look for preterm labor indicators
• Placentas to look for fetal growth problem or preeclampsia indicators

 

Clinical Trials

Some of the studies listed above are in clinical trials. Clinical trials test whether treatments, tests or procedures are effective, which individuals respond to one over another, and why. The Stanford University School of Medicine and Lucile Packard Children’s Hospital provide patients with access to state-of-the-art maternal-fetal care in a monitored setting through these clinical trials. View a list of our clinical trials.
 
 

Awards and Publications

Our team’s work has received national and international recognition, including:

• The prestigious Roy A. Pitkin award, given to four of the year’s outstanding research articles published in Obstetrics and Gynecology (2008)
• Invitations to deliver oral presentations at the Society for Maternal-Fetal Medicine Annual Meeting. This honor is given to less than 10 percent of studies submitted worldwide to this preeminent conference (2005, 2006, 2007, 2008, 2009).
• An invitation from the American College of Obstetricians and Gynecologists to be one of nine centers to develop a national obstetric simulation program

Some of our recently published papers that have received national media coverage include:

• Prenatal testing for Down syndrome and other chromosomal disorders using a single blood test
• No benefit from drug widely used to prevent premature births
• Effects of a couple’s race on pregnancy-related risk factors
• Antibiotics can aid the recovery from severe tearing that occurs in vaginal tissues during some births

 

Research Opportunities for Students

College undergraduates and medical students who are looking for research opportunities are welcome to contact us. Our positions are unpaid, but do allow students to actively participate in our maternal-fetal medicine research projects. Please contact Mary E. Norton, MD, Director of Perinatal Research, at menorton@stanford.edu for more information.