Path to Better Health Reducing the perils of preterm birth

Developing tools to better understand, predict preterm birth

by Helen Feltovich

Collaborators

  • Helen Feltovich, Obstetrician at Intermountain Healthcare, Utah, and UW-Madison Faculty Member in Medical Physics
  • Melissa Skala, Morgridge Principal Investigator
  • Kayvan Samimi, Morgridge Postdoctoral Fellow
  • Tim Hall, UW-Madison Professor of Medical Physics and Biomedical Engineering

About the Project:

Preterm birth is a global health problem without a solution. Dr. Helen Feltovich wants to develop non-invasive, safe imaging tools to better identify the risk of preterm birth. She teamed up with Melissa Skala’s Optical Microscopy in Medicine Lab to take a closer look at placental membranes during pregnancy and delivery.

Optical Microscopy in Medicine Lab:

Melissa Skala’s Lab at Morgridge develops photonics-based imaging technologies that are used to combat diseases including cancer, blindness, and others.

As a high-risk obstetrician, also known as a maternal-fetal doctor, I run out of Kleenex in my office every single day. Women come to me when they are at risk of a preterm birth, which has recently surpassed infectious diseases as the leading cause of death in children under five years old. This is a critical global problem, yet we still don’t have a fix on what’s causing it.

A preterm birth is defined as delivery that occurs before 37 weeks, and an early preterm birth is under 32 to 34 weeks. Babies born preterm can have lifelong health problems, such as vision or hearing loss, cardiovascular issues, or cognitive learning disabilities. This is something that touches all areas of society, not just the baby but also their family and their community.

The situation is pretty desperate. Globally the pre-term birth rate ranges from about 6 percent to 16 percent, and about 10 percent in the United States. There are some things that can reduce the risk of a preterm birth in some women, but they’ve been around a very long time, like progesterone supplementation. The best thing we have for defining risk for women, which is measuring the cervix, is basically no better than flipping a coin.

Fortunately, an exciting new area of research is emerging. In pregnancy we’re dealing with two people, the mother and the baby, and a third entity with a life unto itself called the placenta. Three entire systems are interacting in amazing ways, and we are just beginning to understand the complexities. The National Institutes of Health recently opened up the Human Placenta Project to support this kind of research.

Although my clinical practice is primarily with Intermountain Healthcare in Utah, I also have a faculty appointment at the University of Wisconsin-Madison in the medical physics department because I can’t find the imaging expertise anywhere else in the world to dial down on the very specific problem of imaging the complexities of pregnancy tissues.

I’m working with Kayvan Samimi and Melissa Skala at the Morgridge Institute for Research to understand what is going on in the placental membranes during pregnancy and delivery. Kayvan is focusing on trying to figure out the difference between the membranes that overlay the cervix and the other areas in the uterus to figure out if he can tell the difference in membranes that break too early versus on time or too late. He is then trying to figure out how can we design non-invasive safe imaging technology so that we can look at those membranes inside the uterus during a pregnancy.

Kayvan Samimi, a Morgridge postdoctoral researcher, tests the structural properties of placental tissues in an effort to better understand what goes awry during preterm labor.

My optimism has exploded since working with Kayvan and Melissa because I’ve seen there are other imaging methods we can use in combination with ultrasound to find out what’s going on.

Basic research is the foundation of everything. I consider myself to be an accidental researcher because I’ve learned how critical it is to work together. The truth is that babies are dying, and we need smart people to come together to fix this. And that’s how things happen. It’s what grabs you and what steals your heart and what keeps you up at night. Those are the kinds of problems that I think researchers get involved with and pursue.

Through my collaboration with people like Kayvan and Melissa at Morgridge, and my very strong partnership on ultrasound with Tim Hall at the University of Wisconsin, for the first time I’m confident that we’ll see progress in my lifetime. I may still need plenty of Kleenex in my office, but at least I’ll be able to say, “This is what we’re going do to find out what’s going on with you.”

Collaborators

  • Helen Feltovich, Obstetrician at Intermountain Healthcare, Utah, and UW-Madison Faculty Member in Medical Physics
  • Melissa Skala, Morgridge Principal Investigator
  • Kayvan Samimi, Morgridge Postdoctoral Fellow
  • Tim Hall, UW-Madison Professor of Medical Physics and Biomedical Engineering

About the Project:

Preterm birth is a global health problem without a solution. Dr. Helen Feltovich wants to develop non-invasive, safe imaging tools to better identify the risk of preterm birth. She teamed up with Melissa Skala’s Optical Microscopy in Medicine Lab to take a closer look at placental membranes during pregnancy and delivery.

Optical Microscopy in Medicine Lab:

Melissa Skala’s Lab at Morgridge develops photonics-based imaging technologies that are used to combat diseases including cancer, blindness, and others.

Path to Better Health

Path to Better Health

The series explores the tremendous stakes involved in biomedical research and why a fundamental understanding of biology is needed to improve human health. Learn more about the challenges of predicting preterm births, developing protections against viruses, fighting a devastating tropical disease, and keeping babies safe under anesthesia.

Learn more >