Illinois Medicine

Combating Recurrent Miscarriage New ob/gyn clinic — only one of its kind in the Chicago area — focuses on vexing issue that affects as many as 5 percent of women Health Around the Globe Nobel Laureate celebrates 4th Annual World Health Day Symposium at COM N obel Peace Prize Laureate Jody Williams was the keynote speaker at the 4th Annual World Health Day Symposium, held April 10 and sponsored by the University of Illinois at Chicago Center for Global Health. She is the chair of the Nobel Women's Initiative and a Jane Addams Jody Williams Social Justice Fellow at UIC, and she spoke on "Women Forging Peace, Equality, Justice and Human Rights." Chris Stout, director of the Center for Global Initiatives, also spoke at the symposium on the topic of "Why Global Health Matters." Attendees had the opportunity to appreciate photos of global health initiatives taken by students, faculty and staff, who had entered their snapshots into a competition called "Fotos from the Field." The program, funded in part by the Institute for Policy and Civic Engagement, is an annual symposium addressing global health issues that is timed to coincide with the World Health Organization's annual World Health Day. T he College of Medicine has recruited a new head of obstetrics/ gynecology, Mary Stephenson, MD, MSc, FRCSC, FAGOC, ELAM, who's internationally renowned for her clinical and research expertise in recurrent pregnancy loss (two or more pregnancy losses at less than 10 weeks) and late pregnancy loss (any loss at 10 or more weeks). In July, the college opened the University of Illinois Recurrent Pregnancy Loss Program, the only program of its kind in Chicago. Physicians, nurses, genetics counselors and staff who specialize in complex reproductive medicine are combining their efforts to offer patient-centered care to improve the likelihood of a successful pregnancy Mary Stephenson outcome. They also provide compassionate care to deal with the mix of emotions, such as frustration, anxiety and depression, that often accompanies a history of recurrent pregnancy loss. Located on the fourth floor of the University of Illinois Hospital & Health Sciences System Outpatient Clinic, the RPL Program is adjacent to UI Health's In Vitro Fertilization Program and High Risk Obstetrical Program, both of which have physicians and other health care providers who work together to overcome infertility and pregnancy loss, and minimize maternal complications of pregnancy. The RPL Program's protocol begins with a one-hour consultation, during which a physician takes an extensive obstetrical and medical history and makes recommendations for evaluations, including blood tests and assessment of the uterine environment. Possible management options include antibiotics to over-combat uterine infections, hormone therapy to build up the endometrium, medications to correct thyroid imbalances and surgery to address issues related to the shape of the uterus. Stephenson has led the field in moving procedures such as hysteroscopy and uterine evacuation into the outpatient setting; patients generally prefer office procedures in regard to convenience of care and shorter recovery. "There are a variety of endocrine [hormonal] reasons for recurrent pregnancy loss, such as thyroid diseases, diabetes and obesity," she says. "In addition, there are inherited chromosome reasons, clotting issues, and endometrial and uterine factors. Patients with autoimmune diseases such as lupus have a much higher rate of miscarriage; therefore, we need to offer preventative care to reduce the risk of an adverse outcome." Once a woman becomes pregnant in the RPL Program, she is offered close monitoring during the first trimester, with frequent ultrasounds and visits with the RPL team. Patients and their partners return year after year for close monitoring of subsequent pregnancies. "We are always pleased to see them again and follow along with the building of their family," Stephenson says, adding, "During the first trimester, close monitoring and patient-centered care have been shown to improve outcomes over and over again for patients with recurrent pregnancy loss." illinois medicine | 5

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