Yale Ob/Gyn Researchers Discuss Their Work at Annual Scientific Meeting in Chicago

Members of Yale’s Department of Obstetrics, Gynecology & Reproductive Sciences (Yale Ob/Gyn) presented preliminary results from their research at the annual scientific meeting of the Society for Maternal-Fetal Medicine Feb. 1-6 in Chicago, Illinois. The following is a look at three of these studies. (The full articles are available on the “Health and Medicine” channel of the Yale Office of Public Affairs website: http://opa.yale.edu.)

Yale-developed test can help predict and diagnose preeclampsia

Yale Ob/Gyn researchers led by Dr. Irina Buhimschi have developed a simple urine test to rapidly predict and diagnose preeclampsia, a common, but serious hypertensive complication of pregnancy. Dubbed the “Congo Red Dot Test,” it accurately predicted preeclampsia in a study of 347 pregnant women, allowing health care providers to offer better preventive care to pregnant women.

Based on a common red dye originally used to stain textiles, the Congo Red Dot test can also be used as a marker for assessing misfolded proteins. Previous studies by Buhimschi and her team have found that preeclampsia is a pregnancy-specific protein misfolding disease.

“In this new work, we have seen a link between preeclampsia and other disorders caused by misfolded proteins such as Alzheimer’s or prion disease,” says Buhimschi. “This may provide the foundation for new therapeutic approaches to reduce the burden of this disorder.”

Researchers may have uncovered the mechanism by which progesterone prevents preterm birth

Yale Ob/Gyn researchers led by Dr. Errol Norwitz believe they may have discovered how the hormone progesterone acts to prevent preterm birth, which is delivery prior to 37 weeks gestation.

Several recent studies have suggested that progesterone supplementation from weeks 16-20 of gestation through 36 weeks may prevent preterm birth in about one-third of high-risk women, but the molecular mechanism by which progesterone acts was not known until now.

One-third of preterm birth is linked to premature rupture of the fetal membranes. Prior studies have suggested that rupture results from weakening of the membranes by apoptosis (programmed cell death).

“We were able to demonstrate that progesterone prevents apoptosis in an artificial environment in the laboratory in which we stimulated healthy fetal membranes with pro-inflammatory mediators,” says Norwitz. “Interestingly, and somewhat unexpectedly, we also saw an inhibition of apoptosis under basal conditions without the presence of pro-inflammatory mediators. This suggests that the same mechanism may also be important for the normal onset of labor at term.”

Screening for short cervix could improve pregnancy outcomes and reduce preterm birth

Using ultrasound to screen all pregnant women for signs of a shortening cervix improves pregnancy outcomes and is a cost-effective way to reduce preterm birth, according to Yale Ob/Gyn re­searchers led by Dr. Erika Werner.

Shortened cervical length increases the likelihood of a preterm birth, but screening is not often given to low-risk pregnant women. Werner and her team developed a computer model to mimic the outcomes and costs that occur when women are screened routinely, compared to when no screening occurs. They found that universal screening was cost-effective when compared to routine care.

— Stories by Karen Peart

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Karen N. Peart: karen.peart@yale.edu, 203-432-1326