Developing safe imaging tools to better identify the risk of preterm birth

Dr. Helen Feltovich is a high-risk obstetrician, also known as a maternal-fetal doctor, and she sees women when they are at risk of a preterm birth. Preterm birth recently surpassed infectious diseases as the leading cause of death in children under five years old. It's a critical global problem, with no easy fix.

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.

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 doctors 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 doctors are 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.

Although Feltovich's clinical practice is primarily with Intermountain Healthcare in Utah, she 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," Feltovich says.

She's 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. Samimi 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.

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."

Dr. Helen Feltovich, high-risk obstetrician

Through Feltovich's collaboration with Morgridge, and her partnership on ultrasound with Tim Hall at the University of Wisconsin, for the first time she's confident that she'll see progress in her 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,'" Feltovich says.