New insights into opioid alternatives to treat postpartum pain and medication to delay preterm labor, as well as breakthroughs in spina bifida surgery, were among the topics of research presented at the Society for Maternal-Fetal Medicine’s (SMFM) 39th Annual Pregnancy Meeting by faculty, students, and staff from The University of Texas Health Science Center at Houston (UTHealth).
Research presented by more than 20 UTHealth physicians and researchers at the event, which was held in Las Vegas, was published in the American Journal of Obstetrics and Gynecology.
“Our maternal-fetal medicine specialists are on the front lines ensuring healthy pregnancies and deliveries for moms and babies every day,” said Sean C. Blackwell, MD, chair of the Department of Obstetrics, Gynecology, and Reproductive Sciences at McGovern Medical School at UTHealth and outgoing president of the Society for Maternal-Fetal Medicine. “They are also performing novel research that could change the way that we understand and manage pregnancy complications for years to come and ultimately save lives. I am proud of the impactful work our team is doing in maternal and fetal medicine research.” Blackwell holds the Emma Sue Hightower Development Board Professorship and The Berel Held, MD, Professorship in the Department of Obstetrics, Gynecology, and Reproductive Sciences.
Jenifer Dinis, MD, a clinical instructor in the OB-GYN department at McGovern Medical School, presented findings from a randomized comparative effectiveness trial that showed women who received non-opioid pain relievers after C-section had lower pain scores than women receiving opioids. Additionally, the study showed adding opioids to the pain regimen increases the likelihood of drug-related side effects, like addiction. Baha Sibai, MD, professor, was senior author. Co-authors were Eleazar Soto, MD, assistant professor, and Suneet P. Chauhan, MD, professor.
“The results of our study are concerning because they show physicians were prescribing too many pills for women having cesarean delivery and they are not needed,” Sibai said. “This will have a major impact on reducing the rate of prescribed narcotics leading to addiction, and I hope it will force prescribers to be aware of their contribution to this problem.”
Sibai also served as senior author on a study presented by Monica Longo, MD, PhD, associate professor, which evaluated the efficacy of medication combinations used to delay preterm labor.
“Currently, physicians prescribe the same medication to everyone to stop preterm labor, despite the fact that patients may have different responses to different doses,” said Sibai. “This study provides information that can be used for the future design of studies using different drugs and doses, alone or in combination, to treat individuals with personalized medicine.”
Ramesha Papanna, MD, MPH, an associate professor with McGovern Medical School, presented a breakthrough relating to in utero spina bifida patients. Spina bifida is a condition in which the spine and spinal cord do not develop properly. It affects nearly 1,700 babies every year, according to the Centers for Disease Control and Prevention.
Papanna, with Lovepreet K. Mann, MBBS, research instructor, and their team, found that using a graft of the human umbilical cord (HUC) as a patch after surgery could promote regeneration of the protective layers around the spinal cord and improve neurological function in animal models.
“This development could be a game changer for in utero spina bifida repair,” said Papanna. “Any time a surgeon has access to the brain and spinal cord through surgery, scar tissue develops as a result, and it often causes the spinal cord and nerves to get entrapped in the spinal column, called tethering, which typically requires repeat surgeries to repair. Using the HUC to spark natural regrowth helps prevent tethering. Ultimately, we hope this breakthrough will lead to the ability for spina bifida babies to walk.”
Additionally, Papanna and several other researchers discovered that amniotic fluid is preventing skin regeneration in fetal wounds after in utero repair.
“This negative effect from the amniotic fluid is a discovery relating to the biology of pregnancy,” said Papanna. “We didn’t know until now why the fetal wounds after surgery weren’t healing properly. We now know it is the exposure of the wound site to amniotic fluid that prevents the skin cells from multiplying.”
Other UTHealth presenters at the conference included: Farah H. Amro, MD, Clifton O. Brock, MD, Eric P. Bergh, MD, Lisette D. Tanner, MD, Kayla A. Lash, MD, Michal Fishel Bartal, MD, Jacqueline G. Parchem, MD, Matthew J. Bicocca, MD, Morgen S. Doty, DO, Oscar A. Viteri, MD, Megha Gupta, MD, Arlene Bury-Fiol, MD, Arunmani Mani, PhD, Suneet P. Chauhan, MD, Corey Clifford, DO, MBA, Conisha M. Holloman, MD, and Anushka M. Chelliah, MD. Presenters included affiliated physicians and staff from UT Physicians, the clinical practice of McGovern Medical School, and UTHealth Services, the clinical practice of Cizik School of Nursing at UTHealth.
“We are truly at the center of research to improve outcomes of fetal surgery,” said Papanna. “That’s the mission of maternal-fetal medicine researchers at UTHealth, The Fetal Center at Children’s Memorial Hermann, and our lab at McGovern Medical School at UTHealth. We are working to gain a better understanding of biology and trying to harness some of the properties of regenerative medicine to improve outcomes. We are doing our due diligence in a systematic fashion and working toward long-term progress to improve health outcomes of both mother and baby.”
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