When I first started my training in Ob/Gyn, I never thought I’d end up wanting to pursue laboratory-based research. But…I also didn’t realize that there’s so much basic knowledge in obstetrics that we don’t understand. People have been sent to the moon and the human genome has been cloned, but as just one simple example of the deficiency of knowledge in obstetrics, we have no idea why humans go into labor.
I became fascinated/frustrated with pregnancies complicated by severe fetal growth restriction after caring for specific patients during my residency and fellowship. Fetal growth restriction occurs when a fetus is unable to meet its genetically predetermined growth trajectory, and in the majority of cases, occurs because of suboptimal placental function. In severe cases, patients often need to be delivered preterm, sometimes as early as four months before their due dates, with even worse complications of prematurity than infants that are normally grown. In these pregnancies, clinical data show that outcomes are not really improved by current obstetric management, despite all the clinical tools at our disposal. Furthermore, even if infants survive and do not have any long-term complications as a result of prematurity, we now also know that they are at higher risk for developing medical problems such as obesity and cardiovascular disease later in life.
Our lab is focused on understanding the molecular foundation that determines whether placental function is optimized or impaired. More specifically, we are interested in what regulates normal and abnormal placental blood flow. Because the placenta is also a valuable repository for cells that can potentially be used to treat other conditions, we are also interested in a specific population of cells – placental endothelial progenitor cells – and their potential role in improving conditions of abnormal blood flow, both within the placenta and in other organs such as the heart. Ultimately, we hope that a better understanding of molecular causes of fetal growth restriction and investigation of novel therapeutic modalities stemming from normal placentas will actually help to improve and optimize the outcome of these infants.