About the Program
Imaging is a powerful instrument for scientific discovery that has changed the practice of medicine – particularly in obstetrics. A major step forward in recent decades has been to transform the fetus from an “invisible” to a visible subject through the use of novel imaging methods. Challenges include using such techniques to gain insight into the anatomy, physiology, and biochemistry of pregnancy. The Fetal and Maternal Imaging Division is an essential part of the PRB, as it studies fetal anatomy, growth, and physiologic parameters, as well as maternal anatomy by using conventional and novel imaging methods [e.g. three- and four-dimensional (3D/4D) sonography, Doppler velocimetry, cervical elastography]. The Division has been specifically recognized for its experience and leading expertise in 3D/4D ultrasound to improve the detection of congenital anomalies, as well as fetal growth. There is a large clinical component, in which the Division is responsible for performing sonographic examinations on pregnant women receiving care at Detroit Medical Center, and on those who are referred for evaluation by other practices/institutions in the surrounding area.
- To improve the assessment of normal and abnormal anatomy / function of the human fetus using innovative imaging modalities (e.g. three- and four-dimensional ultrasound)
- To assess fetal growth, weight, and development (including soft tissue parameters) with the use of ultrasound and develop new methods for growth assessment
- To study maternal anatomy (e.g. uterine cervix, pelvic floor, Doppler velocimetry) using conventional and novel imaging techniques in normal and high-risk pregnancies and use such information to identify those at risk for adverse pregnancy outcomes
- To participate in imaging components of other protocols and cross-sectional / longitudinal studies conducted by the PRB (e.g. preterm labor, preeclampsia)
- To provide a strong clinical component – the Program performs imaging on pregnant women at our institution, as well as on those referred from other practices and institutions in the surrounding area
- To train Maternal-Fetal Medicine Fellows and other health care providers in fetal and maternal imaging
- Created a customized approach to cervical length assessment that considers relevant maternal characteristics and gestational age at sonographic examination
- Developed the new Detroit fetal growth standard for African-American women, customized for maternal height, weight, parity, and fetal gender
- Demonstrated that elastography of the uterine cervix can be used for risk assessment of preterm birth in the mid-trimester
- Prospective validation of new fetal weight prediction models that have combined two- and three-dimensional sonographic parameters
- Applied the novel fractional limb volume tool (soft tissue parameter for fetal growth) for IGA
- Developed a novel sonographic approach to evaluate fetal growth, known as Individualized Growth Assessment (IGA), as well as a freely available internet-based software application to allow personalized analyses of fetal growth based on IGA principles (Individualized Growth Assessment Program, or iGAP)
- Determined that amniotic fluid “sludge” is a sonographic biomarker for intra-amniotic infection and inflammation, as well as an independent risk factor for preterm prelabor rupture of membranes, and spontaneous preterm delivery
- Developed a novel approach to assess the risk for preeclampsia and small for gestational age fetuses in the second trimester which incorporates Doppler velocimetry of the uterine arteries
- Demonstrated the diagnostic capabilities and value of three-dimensional sonography during pregnancy
Select Publications, Journal Covers, Educational Material
- Reduced fetal growth velocity precedes antepartum fetal death. Pacora P, Romero R, Jung E, Gudicha DW, Hernande-Andrade E, Musilova I, Kacerovsky M, Jaiman S, Erez O, Hsu CD, Tarca AL. Ultrasound Obstet Gynecol 2020; online ahead of print.
- Optical ultrasound simulation-based training in obstetric sonography. Yeo L, Romero R. J Matern Fetal Neonatal Med 2020:1-16.
- Prediction of adverse perinatal outcome by fetal biometry: comparison of customized and population-based standards. Kabiri D, Romero R, Gudicha DW, Hernande-Andrade E, Pacora P, Benshalom-Tirosh N, Tirosh D, Yeo L, Erez O, Hassan SS, Tarca AL. Ultrasound Obstet Gynecol 2020;55:177-188.
- Individualized growth assessment: conceptual framework and practical implementation for the evaluation of fetal growth and neonatal outcome. Deter RL, Lee W, Yeo L, Erez O, Ramamurthy U, Naik M, Romero R. Am J Obstet Gynecol 2018;218:S656-S678
- Cervical strain determined by ultrasound elastography and its association with spontaneous preterm delivery. Hernande-Andrade E, Romero R, Korzeniewski SJ, Ahn H, Aurioles-Garibay A, Garcia M, Schwartz AG, Yeo L, Chaiworapongsa T, Hassan SS. J Perinat Med 2014;42:159-169.