Maternal Fetal Medicine (MFM) Fellowship
Educational Objectives
The Maternal Fetal Medicine Program at Women & Infants is designed to provide an in-depth experience in both clinical medicine and research. As the referral center for the state, we act as consultants to a wide variety of clinical problems. We provide comprehensive care throughout pregnancy for patients with chronic medical problems and fetal anomalies requiring specialized care.
The large clinical volume and environment allows ample patient volumes to address research questions for both common and uncommon problems. With its close relationship with Rhode Island Hospital and Brown University many opportunities are available to interact with established researchers in both clinical and basic science research. The nature of a sub-specialty hospital providing female and neonatal health care fosters a close working relationship among its divisions. The program also offers an opportunity to obtain a masters in public health during fellowship for individuals interested in health outcomes based research.
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Library
The Edward Cardillo Health Sciences Library, situated on the 3rd floor of Women & Infants next to the MFM academic offices, provides free access to a host of electronic databases for literature search and retrieval. Our connection with Brown University provides access to over 3000 electronic online journals as well as older periodicals. Assistance in obtaining other print material can be obtained through our library. Journals are available through links to other libraries and University facilities. Access to these databases is available from individual offices and thru networked computers.
The University offers individualized training for fellows and faculty on the use of scientific informatics’ resources. The library staff provides reference retrieval services, such as interlibrary loan, for obscure or out-of-date publications and books.
The library also has computer workstations, scanners, and photocopying facilities. Additional learning opportunities are provided through numerous electronic teaching and educational resources.
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Research Facility Laboratory
Basic and translational research is performed at the Kilguss Research Building. The Kilguss Research Institute is a 30,000 square foot wet laboratory, multiuser facility. Investigators from Women & Infants use this facility to address specific research questions in Reproductive Biology and Women’s Health. Investigators have access to core facilities and equipment. The facility has PCR machines, Real-Time PCR, Flow Cytometer, Histology Work Station, Cell Culture Stations (BL-1 and 2), Flexi-Cell System, Dark Room, Image Documentation, Microscopes (Upright and Inverted), Plate Readers, and cold room facility that are shared among investigators.
The MFM Division has approximately 1000 square feet of wet lab space dedicated to basic and translational research. The space at Kilguss is currently being used to study problems such as Cervical Remodeling, Preterm Labor, Inflammation, Hypertension in Pregnancy, and Gestational Diabetes.
Animals are housed in a neighboring facility that is operated by Rhode Island Hospital. This facility in the Jewelry District is adjacent to the hospital campus. The Jewelry District houses core research laboratory facilities for Brown University, Rhode Island Hospital and Women & Infants allowing for the pooling of resources. Each of these facilities is within 1-2 blocks of each other providing access to specialized equipment for genetic, proteomic, and structural analysis.
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Research Programs
The Division of MFM is involved in a number of multi-centered clinical trials. The Division is an active member of the Maternal Fetal Medicine Units Network sponsored by the NICHD. As a member the hospital participates in various clinical trials related to improving pregnancy outcomes. As a member institution, many of the resources are available to Fellows to answer management questions. The Division is also a lead member of the Stillbirth Collaborative Research Network sponsored by the NICHD. This network is interested in investigating the causes of stillbirth as well as possible interventions in decreasing the incidence. The Division continues to participate in the international study-Hyperglycemia and Adverse Pregnancy Outcome (HAPO). The Division was a participant in the FASTER trial evaluating the use of ultrasound and serum screening for the detection of Trisomy 21.
The Department of Obstetrics and Gynecology has received four institutional awards to assist in collaborative research and faculty development. The BIRWCH program is an award given to the department by the NIH provides funds and facilities for performing translational and epidemiologic research. In addition funds are allocated for faculty development and salary support for junior faculty to provide protected time in the early stages of an individual’s academic career. The COBRE award in Reproductive Biology (NIH) provides infrastructure and salary support for translational and basic research projects. This award also is used to provide salary support for individual investigators early in their career. The Department and University has been designated a Center of Excellence in Women’s Health. This designation provides financial support for improving Women’s Health. The program provides funds for education programs as well as small pilot projects. One of the goals of this award is to develop interdisciplinary research directed at improving Women’s Health. The WRHR (Women’s Reproductive Health Research) program is sponsored by the NIH.
The program is designed to develop obstetricians into competitive investigators. The award provides support for up to three junior faculty members trained in obstetrics and gynecology. The award provides salary support, protected time, and financial support for research. This is ideal for sub-specialty trained individuals for continuing their research program development during the early phases of their career. The Department and Hospital provide research support through the Research Division. The Research Division provides statistical support and consulting for individuals interested in running clinical trials. They assist in research design and provide space for seeing and evaluating enrolled patients.
Women & Infants is an affiliate and teaching hospital for Brown University. We are involved in medical education at multiple levels through the University and have access and support to many of the research facilities at Brown and our neighboring institution, Rhode Island Hospital. These institutions have COBRE awards in Cancer Biology, Genomics, and Proteomics. The affiliation provides easy access to the Basic Sciences and other Clinical Sciences in Medicine. Brown University is located within one mile of the Hospital Campus providing easy access to other departments such as Engineering, History, Community Health, etc..
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Clinical Facilities - Inpatient
The Labor and Delivery Suite is located on the 2nd floor of the hospital and has 20 labor/delivery/recovery rooms. In addition there is an alternative birthing center for low risk deliveries on the ground floor. The hospital operating rooms are adjacent to the labor and delivery suite where 3 operating rooms are committed to obstetrics. All rooms are equipped with central fetal monitors. The unit has 24-hr. Anesthesia coverage and the ability for invasive monitoring. Portable ultrasound machines are available on the unit with color and pulsed Doppler capability.
Patients with Invasive monitoring can be followed in the post-anesthesia care unit (which is adjacent to the main operating rooms) or in the Intensive Care Units at Rhode Island Hospital which is physically connected to Women & Infants.
The Antepartum unit is located in the West Wing of the 5th floor. All rooms are single rooms. The unit is equipped with fetal monitors so that NST’s or UAT's can be performed at the bedside. Portable ultrasound machines are available on the unit.
Detailed ultrasound exams can be performed in radiology using state of the art equipment. Invasive fetal procedures are performed in the operating rooms with trained personnel. The fetal surgery program operates at Rhode Island Hospital.
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Clinical Facilities - Outpatient
The Maternal Fetal Medicine Service provides antenatal care for high risk pregnancies at the Women’s Primary Care Center on the fifth floor of the Outpatient Medical Facility, 2 Dudley Street. Clinics occur on various half days throughout the week. The clinic is staffed by diabetic nurse educators, nutrition, and perinatal nurses. A portable ultrasound unit is available for use to practitioners. Blood drawing, obstetrical ultrasound, and antenatal testing facilities are also located immediately adjacent to our outpatient offices.
The Prenatal Diagnosis Center is a comprehensive center run by the Maternal Fetal Medicine division that performs prenatal diagnosis, counseling and testing. It is a targetted Ultrasound Facility equipped with GE Voluson 730 3-D, and Toshiba machines. The unit is staffed by RDMS certified technologists. The ALI system is used for image storage and allows for quick image retrieval. This unit also provides amniocentesis, chorionic villus sampling, fetal cardiac scanning, Doppler evaluation and other complex ultrasound exams. The director of the unit is Dr. Stephen Carr, M.D. Trained genetic counselors are available 5 days a week and provide counseling by appointment or urgent basis when necessary. Counselors provide follow up and referral services when needed. The Prenatal Diagnosis Center also provides antenatal testing including NST's and BPP's and is open 5 days per week. This unit is staffed with trained perinatal nurses who perform amniotic fluid assessments and biophysical profiles.
The Maternal Fetal Medicine Division provides Prenatal Diagnosis Center Offsite services at locations in Rhode Island and Massachusetts. Our New Bedford and Foxborough facilities are owned and operated by the Division and provides mainly Obstetrical and Gynecologic Ultrasound to the local community. Targeted ultrasound is provided on a limited basis. Additional services are provided through special agreement with Charlton Hospital in Fall River, MA, and South County Hospital in Wakefield, RI.
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