MATERNAL-FETAL MEDICINE
AND REPRODUCTIVE GENETICS
Louise Wilkins-Haug, MD, PhD, Director
DIVISION MEMBERS
David Acker, MD
Daniela Carusi, MD, MSc
Karen Davidson, MD
Lisa Dunn-Albanese, MD
Katherine Economy, MD, MPH
Mehmet Genc, MD, PhD
Katherine Bennett, RN
Virginia Silva, RN
Maureen Fagan, RN
Barbara Ludman, RN, FNP
Karen McCarthy, RN
Laurie Rapson RN
Brenda Tangney-Brown, RN
Thomas McElrath, MD, PhD
Rosemary Reiss, MD
Julian Robinson, MD
Thomas Shipp, MD
Joaquin Santolaya, MD, PhD
Ruth E. Tuomala, MD
Fellows
Deidre McCullough, MD
Alison Cape, MD
Corrina Oxford, MD
Nicole Smith, MD
Chole Zera, MD
MISSION
The Division strives to provide quality obstetrical care to high-risk patients, contribute
substantially to the knowledge base of the discipline and train leaders in the field of maternalfetal medicine and reproductive genetics.
We are dedicated to the care of women who require evaluation, treatment or hospitalization for a
wide range of pregnancy complications. Physicians across New England transfer almost 300
women yearly for antepartum hospitalization, delivery and postpartum care. Over 2,000 patients
are referred annually for ambulatory consultation while off-site consultative sessions bring
ultrasound and perinatal care to patients in their communities. We provide clinicians and
researchers an opportunity to explore translation of genetic advances into patient care. Clinical
subdivisions include the Faculty Ambulatory Obstetrics Practice, the Center for Fetal Medicine
and the Center for Labor and Birth. The diversity of interests and skills within the Division
reflects the complexity of our patients’ needs.
ACCOMPLISHMENTS IN FY 2008-2009
CLINICAL HIGHLIGHTS
 Dr. Daniela Carusi initiated a program to build a surgical OB infrastructure of physicians,
interventional radiology and support systems to manage complicated deliveries especially
those with abnormal placentation.
 The ultrasound unit on Labor and Delivery completed its second year under the direction of
Drs. Rosemary Reiss and Louise Wilkins-Haug. A full complement of sonography services
is available including the capacity for amniocentesis. An ultrasound service has been
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instrumental in assuring patient safety and facilitates education and consistent
documentation.
Under Drs. David Acker, Julian Robinson and Katherine Economy a comprehensive
service for multifetal pregnancies entered its fifth year. Early consultation, co-management
or transfer can facilitate care of monochorionic pregnancies that are at increased risk for
discordant congenital anomalies, growth aberrancies and preterm labor. Surveillance and
treatment of twin-to-twin transfusion is now operational.
Under Dr. Karen Davidson’s direction Drs. Economy, Reiss and Genc provided
ultrasound, consultative services and supervision of genetic counselors at North Shore
Medical Center and Emerson and Exeter Hospitals. Expansion is underway at Emerson
Hospital.
Under Dr. Julian Robinson the program at Newton-Wellesley Hospital completed its sixth
year and continues to grow. Dr. Dunn-Albanese now provides NWH/MFM ultrasound and
consultation three days a week and remains on the BWH campus two days. Dr. Economy
provides high risk services one day.
Multi-departmental subspecialty sessions expanded focusing on cervical incompetence (Dr.
Thomas McElrath), diabetes in pregnancy (Dr. Ruth E. Tuomala) and maternal cardiac
disease (Dr. Katherine Economy).
RESEARCH AND TEACHING HIGHLIGHTS
 A combined 4 year fellowship received approval providing individual eligibility for both
maternal-fetal medicine and genetics boards. Program directors are Louise Wilkins-Haug,
MD, PhD at BWH and Amy Roberts, MD and Mira Irons, MD at Children’s Hospital
Boston.
 Under Dr. McElrath, MFM completed a large research initiative, POPPS (Prediction of
Preeclampsia in Pregnancy Study), to assess specific maternal serum markers at four points
in pregnancy. Prediction or early detection will set the groundwork for understanding the
biologic variability of preeclampsia and potential interventions. A cohort of 1800 women
with normal and adverse pregnancy outcomes was recruited and is being followed by a
second cohort, Lifecodes, with similar recruitment and attainment of serial biologic markers.
Paternal samples, placental biopsy and cord blood will be added, with the focus of this latter
cohort on genetic variations of adverse pregnancy outcomes.
 Daniela Carusi, MD is participating in the development of a multicenter study to assess
current understanding of placenta accreta from biologic basis to imaging to clinical
implications.
 Drs. Janine Chin and Yael Hoffman-Sage were accepted as fellows for July 2009. Drs.
Nicole Smith and Chloe Zera completed their first year of fellowship with transitions
planned to second year and a Master of Public Health. Corinna Oxford, MD, second year
fellow, was granted an extension of her fellowship to allow for a one year critical care
training program. Dr. Alison Cape transitions to her third year. Dr. Deidre McCullough
completed her third year and returned to her active Air Force commitment.
 Louise Wilkins-Haug, MD, PhD completed her tenure on the American College of
Obstetrics and Gynecology Committee on Genetics with involvement in their recent position
statement on Aneuploidy Screening and Preimplantation Genetic Screening.
 Division faculty and fellows were active participants as presenters at national and
international meetings, postgraduate courses, regional CME forums and within the Harvard
system.
GOALS FOR AY 2009-2010
 Further development of maternal critical care and a high acuity postpartum service, with
recruitment of faculty and emphasis on coordination of multidisciplinary services for
management of complex cases.
 Development of Life Codes research infrastructure is paramount; allocation of resources,
development of clinical and specimen databases and accessing funding are on-going with
incorporation of a perinatal epidemiologist into the infrastructure. Exploration of underlying
genetic mechanisms for adverse events and the role of genetic variation and epigenetics in
outcomes remains a unifying focus.