97 21 1 15,000 240 20 2011 21 30 24 115 80 30 770 UT SOUTHWESTERN 424 2,200 Department of Obstetrics and Gynecology 15 1974 15 1 314,000 NUMBERS2011 DISTINGUISH US PEOPLE75 SET US APART 71,299 14,000 240 3.8 600,000 10 17 770 3 1943 97 50 12 22,900 4 800 5,894 200 1.3 10 0 10,000 1 24 6,500 Numbers Distinguish Us People Set Us Apart Dear Friends, I am proud—and humbled—to introduce you to the Department of Obstetrics and Gynecology at UT Southwestern Medical Center. For more than 50 years, our department has been acknowledged for its contributions to women’s — both in obstetrics and gynecology. Our mission has remained unchanged since the department’s founding in 1943. Daily we strive for excellence in patient care, teaching, and research.

In the clinical care realm, we provide comprehensive services in dual arenas—a private practice through the UT Southwestern Medical Center University and and a public practice at Parkland Health and System. This blend not only maximizes our services throughout different segments of the community in which we live and work, but also provides an invigorating environment for our students, residents, fellows, and faculty.

On the educational front, our faculty members are recognized as the authors of three major OB/GYN textbooks—Williams Obstetrics, Williams Gynecology, and Essential Reproductive . They are also responsible for the largest obstetrics and gynecology training program in the nation, with a combined total of 100 available residency positions in Dallas and Austin. We continuously work to create an educational environment that stimulates and challenges our students, residents, fellows, and ourselves to understand the fundamentals of our specialty and to critically analyze new evidence as it emerges.

On the research front, we are acknowledged for our dedication to evidence-based medicine through clinical research funded by the National Institutes of Health and other national organizations, as well as gratefully supported by endowments from individuals throughout the country. In 2010, with the recruitment of W. Lee Kraus, PhD, from Cornell University as Director of the Cecil H. and Ida Green Center for Reproductive Biology Sciences, our basic research program has been enhanced. Our continuing goal is to conduct research that makes significant and unique contributions to the body of knowledge of obstetrics and gynecology and to make “bench-to-bedside” research a reality.

Thank you for letting us share our work and accomplishments.

Steven L. Bloom, MD

P rofessor and Chairman, Department of Obstetrics and Gynecology UT Southwestern Medical Center

Page 1 5,894 10 770 6,500 100

and among the In 2011, Parkland BEST HOSPITALS U.S. News & World Report st rd 24 Memorial in the Dallas-Forth 97 ranked UT Southwestern 1 Hospital 3 Worth metropolitan area 40 35 24 770 99,266 2,200 80 1 3,259 13,151 50 22,900 2011 2,200 126,347 Our OB/GYN programs had In 2011, U.S. News & World Report MORE ranked women’s services at THAN 10 Parkland Memorial Hospital 351,600 21 OUTPATIENT VISITS IN 2010 st 4 250 40 IN 21THE NATION 24 500 and women’s services at 80 3 21 UT Southwestern th 3,259 IN 24THE NATION 3 133,483 600,000 24 71,299 5,894 770 2,200 351,600 97 21 3 1 PATIENT CARE CARING FOR THOUSANDS ONE AT A TIME

T he Department of Obstetrics and Gynecology is We pride ourselves on our comprehensive array of dedicated to providing accessible, quality patient care to services as well as the research that is conducted behind the women of Dallas and its surrounding communities. the scenes. We are committed to training medical professionals In the Southwestern Medical District of Dallas, our in the care of women and to identifying effective UT Southwestern University Hospitals and Clinics treatment options for our patients through rigorous program offers general gynecological and well-woman controlled clinical trials and basic research. care at the Lowe Foundation Center for Women’s With more than 351,600 outpatient visits annually in Preventative Health Care, the Comprehensive Obstetrics clinical practices in both the UT Southwestern Medical Center University Hospitals and Clinics and the Dallas County Parkland Health and Hospital System, we reach women across all socioeconomic strata and ethnicity.

Our clinical programs are consistently ranked among the best in the United States. In 2011, for example, U.S. News & World Report ranked our programs at University Hospital–St. Paul (our private-practice hospital) and Parkland Memorial Hospital 24th and 21st in the nation, respectively. In addition, in 2011 our hospitals were ranked in the top three in the Dallas-Fort Worth metropolitan area—underscoring our fundamental belief that both private and public clinical services can and must be done well.

GYNECOLOGY Robotic : smaller incisions, speedier recovery Our gynecology program is unique for its breadth Since 2009, our faculty have been our department. “This minimally and depth. With a core of dedicated gynecologists increasingly using robotic surgery invasive surgery provides many and subspecialists in gynecologic , pediatric- techniques in general gynecology, benefits. Women have a much adolescent gynecology, reproductive , , fertility, and speedier and easier recovery, and . Dr. Mayra are back in the workforce quicker and urogynecology, we offer comprehensive care Thompson, Associate Professor, and back to their families sooner,” to women from infancy through childhood and helped introduce this minimally Dr. Thompson said. adolescence, onto the childbearing years, and into the invasive surgical technique to onset of menopause and the golden years.

Page 3 “ The Lowe Foundation Center for THE LOWE FOUNDATION CENTER FOR Women’s Preventative Health Care WOMEN’S PREVENTATIVE HEALTH CARE is a valuable resource for women Founded with the post-reproductive, 40-plus-year- in their 40s, 50s, 60s, and beyond. old woman in mind, the Lowe Foundation Center for We offer women’s health care from perimenopause through menopause. Women’s Preventative Health Care is an endowed center Our first-rate multidisciplinary team and model for the advancement of care for peri- and provides an integrated approach to postmenopausal women. health care in a state-of-the-art facility.” Staffed by a team that includes specialists in reproductive endocrinology, minimally invasive –Karen Bradshaw, MD Professor and Clinical Director, surgery, and vulvar health, the Lowe Center provides the Lowe Foundation Center for preventative treatment for bone loss, mood disorders, Women’s Preventative Health Care postmenopausal , vulvar and vaginal problems, and other disorders affected by the aging process. also offer the latest advanced minimally invasive and robotic single-incision surgical techniques. and Gynecology Program, and the Multi-Specialty Gynecology , as well as the Pediatric-Adolescent FYERTILIT AND ADVANCED Gynecology Clinic at Children’s Medical Center. O ur Fertility and Advanced Reproductive Medicine team Inpatient services are provided at University Hospital–St. provides evaluation and treatment of as well Paul with day surgery available at the UT Southwestern as disorders affecting —treating Outpatient Building. Pediatric-adolescent gynecological women from puberty through menopause. are performed at Children’s Medical Center. Our services run the gamut of both medical and In 2010, our UT Southwestern gynecology program surgical treatments including in vitro fertilization (IVF) had more than 22,900 ambulatory visits, carried out and surgical alternatives such as robotic-assisted 3,259 non-obstetrical and bone density and advanced laparoscopy or examinations, and performed 770 surgical procedures. hysteroscopy. Our physician team provides services in Parkland Women’s and ’ Specialty Health service both the UT Southwestern and Parkland systems. We provides well-woman and gynecological care as well as also conduct a significant number of clinical research family-planning services at community-based Women’s trials dedicated to improving our understanding of Health Centers in neighborhoods throughout Dallas fertility disorders and developing new treatments. and the surrounding communities. These clinics are co- located with Parkland prenatal clinics to facilitate patient GYNECOLOGIC ONCOLOGY access to counseling and contraceptive . As part of the National Cancer Institute (NCI)- designated Harold C. Simmons Cancer Center, our Inpatient care is provided at Parkland Memorial Hospital gynecologic oncologists provide comprehensive with day surgery available at Parkland’s Simmons evaluation and treatment options to women with Ambulatory Surgery Center. suspected and diagnosed malignancies of the In 2010, our Parkland gynecology program had 126,347 reproductive system. outpatient visits and performed more than 2,200 Our specialists staff both the UT Southwestern and surgical procedures. Parkland gynecologic oncology services—providing Regardless of venue, all our patients have access to all women with the same access to specialist care. quality gynecological care as well as the latest medical Our membership in the NCI’s Gynecologic Oncology and surgical treatment options. Group also ensures that all our patients have access

Page 4 126,347 PATIENT VISITS in our Parkland Gynecology Programs in 2010

INCLUDING

71,299 PATIENT VISITS in our Parkland Clinics

Page 5 MORE THAN 22,900 GYNECOLOGICAL AMBULATORY VISITS at UT Southwestern in 2010

O ur Lowe Foundation Center for Women’s Preventative Health Care was founded with the post-reproductive 40-plus-year-old woman in mind.

Page 6 to the latest experimental treatment protocols for gynecological malignancies.

UT Southwestern’s oncology program received the NCI designation in 2010 and is the first and only medical center in North Texas to achieve this prestigious status.

U ROgynecology AND PELVIC FLOOR DISORDERS UT Southwestern has one of the largest divisions of urogynecology in the country. We offer patients in the UT Southwestern University Hospitals and Clinics and the Parkland Health and Hospital System access to a full range of both surgical and nonsurgical treatments for Left to right: Gynecologic oncologists Jayanthi S. Lea, MD, David Scott Miller, MD, Siobhan Kehoe, MD, Debra Richardson, MD urinary and pelvic-floor conditions, including treatment for pelvic organ prolapse, incontinence, voiding G ynecologic cancer research made possible dysfunction, constipation, interstitial cystitis, urinary with Fletcher endowment tract , pelvic pain, and . Our Established to honor the memory of “It is so gratifying to know that some urodynamics laboratory provides a comprehensive Patricia (Pat) Fletcher following her of the experimental protocols used death in 1998, the Patricia Duniven to treat my mom have ended up array of diagnostic studies to determine the cause Fletcher Distinguished Professorship benefiting other patients long after of urinary and and other pelvic- in Gynecological Oncology provides her passing,” said Ms. McCloskey. floor disorders. We provide the latest surgical and ongoing support for clinical and Generous gifts from families like the nonsurgical treatment options, including biofeedback, basic science research activities Fletchers have allowed UT South­ at UT Southwestern. Pat’s family, electrostimulation, and collagen implants. western to remain at the forefront including husband Robert Fletcher of cancer research and clinical PARKLAND GYNECOLOGY and daughter Karen McCloskey, care, helping us translate the latest AND WELL-WOMAN CARE established the endowment to scientific discoveries into innovative turn a personal family tragedy into At Parkland, our gynecology service rivals that of treatments that give patients and an ongoing mission to make a obstetrics in volume. Staffed by Parkland advanced their families hope. difference in the lives of women practice nurses supervised by OB/GYN faculty, family battling gynecologic cancers. planning and gynecological care are provided in neighborhood-based clinics to women in areas traditionally underserved. Patients with more complex or refractory gynecological problems are referred to FYAMIL -PLANNING PROGRAM clinics based in Parkland Hospital where a core team As the largest family-planning provider in the state of Texas, of gynecology faculty, fellows, residents, and advanced in 2010, our comprehensive family-planning program had practice nurses is dedicated to their care. a total of 71,299 patient visits in a network of eight Parkland Patients have access to such diagnostic modalities Community Women’s Health Centers in Dallas and nearby as sonohysterography. In 2010, 5,894 gynecological suburbs. We provide women with the full range of birth ultrasound procedures were performed in our American control options, as well as counseling, STD and HIV testing, Institute of Ultrasound in Medicine-certified facility at testing, and more. These services are also Parkland Memorial Hospital. available in each of our private-practice gynecology clinics. As members of the National Institutes of Health Female Contraceptive Clinical Trials Network, we also offer our patients access to newly developed contraception options.

Page 7 DYSPLASIA PROGRAM polycystic ovary syndrome, to reconstructive surgeries As part of our effort to make cancer prevention available for Müllerian anomalies. In 2010, we expanded our in underserved areas, we have developed an extensive program, recruiting Akilah Weber, MD, as the first OB/ dysplasia program. Offered at four Parkland community GYN faculty member to be totally dedicated to the health centers, as well as at Parkland Memorial Hospital, specialization of pediatric and adolescent gynecology. the program provides initial evaluation and follow-up to women who have abnormal Pap smears and possible pre-cancerous conditions. Colposcopy, cryotherapy, “We welcome Dr. Akilah Weber as the newest member of and other office-based procedures are provided by our Pediatric-Adolescent Gynecology Program. Dr. Weber specially trained nurse practitioners and residents who completed a two-year fellowship in pediatric and adolescent are supervised by OB/GYN faculty. With more than 6,500 gynecology at Cincinnati Children’s Hospital Medical Center. visits annually, the program has resulted in a relatively We know that her patients will benefit from her solid clinical low rate of cervical cancer in a population generally skills as well as her sensitive and caring manner.” considered at-risk. — Dr. Ellen Wilson, Associate Professor and Medical Director, Pediatric-Adolescent Gynecology Program PEDIATRIC-ADOLESCENT GYNECOLOGY PROGRAM I n partnership with Children’s Medical Center, our department provides consultative gynecological services for girls—ages newborn to 18. Staffed by OBSTETRICS gynecologists and reproductive endocrinologists, our A child is born every 30 to 35 minutes in our campus physician team specializes in the medical and surgical hospitals. To put this in perspective, in 2009, we management of gynecological conditions unique to delivered more babies on our campus than were born the pediatric-adolescent patient. We treat the spectrum in the District of Columbia and each of the following of medical conditions, from delayed and precocious ten states—Alaska, Delaware, Maine, Montana, New puberty, to refractory gynecological problems like Hampshire, North Dakota, Rhode Island, South Dakota, Vermont, and Wyoming.

In the Parkland Health and Hospital System, patients are seen in clinics at Parkland Memorial Hospital, as “Our dysplasia program provides well as at nine community prenatal clinics throughout prompt identification and treatment the Dallas area and nearby suburbs. Labor and delivery of pre-cancerous conditions of the services are provided at Parkland Memorial Hospital, as part of our comprehensive which in 2010 performed 13,151 deliveries. cervical cancer prevention program. Offering these services through our What may surprise many people, however, is that community clinics has improved 97 percent of the women delivering at Parkland women’s access to care because Hospital have received in the Parkland they have a choice in where they are system, with an average of 10 visits per patient. This screened and evaluated. As a result, we have seen a fairly low cervical achievement is the result of a team effort to provide cancer rate in what typically is an ready access to an organized prenatal system in at-risk population.” underserved neighborhoods.

In our UT Southwestern University Hospitals and Clinics –Claudia Werner, MD practice, we offer prenatal and in the Associate Professor and Lead Physician, Dysplasia Clinics Comprehensive Obstetrics and Gynecology and the

Page 8 MORE THAN 6,500 VISITS ANNUALLY TO OUR PARKLAND DYSPLASIA PROGRAM

Results indicate a low rate of cervical cancer in populations considered at-risk.

Page 9 More than 202,400 PRENATAL VISITS IN OUR HEALTH SYSTEMS IN 2010

O ur comprehensive team of advanced-practice nurses and OB/GYN physicians, complemented by our maternal-fetal medicine specialists, enables us to provide advanced obstetrical care to all our patients.

Page 10 High-Risk Pregnancy and Prenatal Genetics Programs. Our shunt placement. In 2010, our physicians performed labor and delivery service at University Hospital–St. Paul 11,380 obstetrical ultrasound procedures. averages 1,500 births annually. In 2008, we expanded our maternal-fetal medicine No matter where they receive their care, our patients services beyond the Southwestern Medical District with have access to a dedicated team of health-care the opening of a maternal-fetal medicine practice on professionals, obstetricians, and subspecialists in the campus of Children’s Medical Center at Legacy in maternal-fetal medicine—once again underscoring our Collin County, north of Dallas. commitment to public and private clinical service. Our growing multidisciplinary team includes specialists in COMPREHENSIVE GENERAL maternal-fetal medicine, , , OBSTETRICS AND GYNECOLOGY , and other pediatric subspecialities. This team Physicians in UT Southwestern Medical Center’s coordinates delivery at Parkland or University Hospital–St. Comprehensive Obstetrics and Gynecology Program care Paul if complex postnatal issues are anticipated. for women from their teens through menopause and Our faculty also includes specialists in . In beyond, and work to develop lasting relationships with 2010, we performed our first fetoscopic laser procedure their patients through all stages of life. to correct twin-twin transfusion syndrome (TTTS). A group of dedicated OB/GYN physicians, complemented PARKLAND OBSTETRICS AND by maternal-fetal medicine specialists, enables us to MATERNAL-FETAL MEDICINE provide advanced obstetrical care when needed. N inety percent of the deliveries on our campus take A significant number of our pregnant patients are place at Parkland Memorial Hospital. Averaging 15,000 referred to us by physicians from other UT Southwestern annually for the past 10 years, more than a departments who are treating them for a myriad of half million women have delivered babies at Parkland diseases and problems. A multidisciplinary approach to during the last 50 years. treatment allows us to co-manage their care, working But labor and delivery is just a piece of the story. What side-by-side to offer the best solutions. many people do not realize is that our obstetrics MATERNAL-FETAL MEDICINE program at Parkland spans a continuum of care— beginning in the prenatal period and continuing T he maternal-fetal medicine physicians in UT South­ through delivery and postpartum follow-up. western Medical Center’s High-Risk Pregnancy and Prenatal Genetics Program are recognized for their It takes a well-choreographed effort to manage our care and management of women with complicated volume. In addition to our large medical staff, our . In addition to consultative services, our team of health-care providers includes more than 100 subspecialists accept obstetrical patients and operate a highly dedicated certified nurse and nurse regional maternal transport service for the convenience practitioners, 20 ultrasonographers, and more than of obstetricians who want to transfer patients to our care. 500 nurses—all of whom play an integral role in this integrated -care system. The latest diagnostic modalities are used to evaluate and treat both maternal and fetal complications and Operating under protocol and in conjunction with OB/ include: preconceptional counseling and genetic testing GYN faculty, nurse practitioners and certified nurse to identify inherited and antenatal risks; high-resolution, midwives were responsible for 99,266 community 3- and 4-dimensional ultrasound to visualize the baby’s prenatal clinic visits in 2010. With 35 certified nurse development; prenatal diagnostic procedures such as midwives, our program—one of the largest in , chorionic villous sampling (CVS), and fetal the country—manages approximately 40 percent of the blood sampling; and intrauterine transfusions and fetal Parkland deliveries.

Page 11 Pregnant women throughout the system have access to National Institutes of Health Maternal-Fetal Medicine Units Network protocols as well as some of the latest high-tech diagnostic tools. Ultrasound services— certified by the American Institute of Ultrasound in Medicine—are provided in six community Women’s Health Centers and two sites inside Parkland. A digital imaging system enables to be reviewed in real-time from sites throughout Parkland and the community clinics. In 2010, 33,395 obstetrical ultrasound procedures were performed.

For women who are diagnosed with prenatal

Left to right: Julie Lo, MD, Michael Zaretsky, MD problems—including such complications as prior , , multiple gestations, , T eamwork at its best epilepsy, infectious diseases, psychological problems, When Stephanie and Shawn The baby girls, Brooke and post-term pregnancies, and hypertensive disorders— Studdard learned they would Kamryn, were born at Parkland on a central high-risk clinic capable of managing virtually be having twins after battling June 17, 2009, delivered by two every conceivable antenatal complication is located infertility problems for more than maternal-fetal medicine faculty, inside Parkland Memorial Hospital. a decade, they were ecstatic. But Dr. Zaretsky and Dr. Julie Lo, at 13 weeks, the couple’s “absolute along with the couple’s private The OB complications clinic is dedicated to caring joy turned to fear and confusion,” OB/GYN physician, and a team of for high-risk pregnancies and is staffed by more than they said. Medical tests showed more than 20 other professionals. a dozen maternal-fetal medicine faculty members, that one of the twins, Kamryn, had Both girls were stable and sent as well as maternal-fetal medicine fellows, OB/GYN a congenital diaphragmatic hernia to Parkland’s NICU. Brooke went residents, advanced practice nurses, and faculty from (CDH)—a severe abnormality home a week later. Two days in which an ’s organs are after birth Kamryn had surgery UT Southwestern’s Department of . In 2010, pushed up through a hole in the at Children’s Medical Center to patient visits to this clinic exceeded 45,550. diaphragm, decreasing the lungs’ repair damage from the CDH. She growth and capacity. went home in August. “When we first saw the Today, both are healthy, happy CARING FOR THOUSANDS – Studdards and diagnosed and growing. “Stephanie and ONE WOMAN AT A TIME Kamryn at 13 weeks, this set I couldn’t have been more I t is tempting to be mesmerized by the numbers—an off a multidisciplinary chain pleased with the care Kamryn average of 17,400 deliveries annually (that is 600,000 reaction and approach that’s received,” Shawn Studdard diapers a year), 54,000 ultrasound procedures, 2,900 necessary when caring for fetal said. “I truly believe this medical gynecological surgeries, 351,600 outpatient visits. But abnormalities. And in this case, it staff influenced her survival behind each one of these numbers is a woman who included coordinating care among tremendously, and our end result three institutions: UT South­ may not have been the same had entrusted her health to our care—a woman whose quality western Medical Center, Children’s we chosen to deliver elsewhere.” of life we affected.T hat is a humbling responsibility that Medical Center (Dallas and Plano), keeps us focused on caring for the individual. and Parkland Memorial Hospital,” said maternal-fetal medicine specialist and Assistant Professor Dr. Michael Zaretsky.

Page 12 AN AVERAGE OF 17,400 CHILDBIRTHS ANNUALLY ON OUR CAMPUS DURING THE PAST DECADE

Every 30 to 35 minutes, a child is born in our hospitals

O ur programs are consistently ranked among the best in the United States.

Page 13 115 50 80 80 240 100 20 17 15,000 21 OB/GYN RESIDENTS OUT IN THE UNITED OF STATES TRAINS AT 240 1 50 UT SOUTHWESTERN 40 314,000 1 240 21 115 15,000 2011 20 20 2011 21 1 1 80 2011 100 OF10 OUR GRADUATES HAVE BECOME CHAIRS OF ACADEMIC CLINICAL 21 100 240 DEPARTMENTS 17 115 50 15,000 graduate is currently a 240 1 U.S. Congressman 1 40 100 1 21 314,000 24 20 240 EDUCATION EDUCATING HUNDREDS TRAINING TOMORROW’S PHYSICIANS TODAY

I n addition to patient care, medical student, resident, and With more than 314,000 ambulatory visits and an fellow training is another mission of the department. In fact, average of 15,000 deliveries annually, Parkland Health UT Southwestern trains more new OB/GYN physicians and and Hospital System is the primary teaching venue for subspecialists than any other program in the United States. Ten graduates of our residency and fellowship programs have become chairs of academic clinical departments, and one is currently a U.S. Congressman.

Our department also participates in undergraduate in every year of with major efforts during the third and fourth years.

Members of our faculty have authored several of the most widely used OB/GYN textbooks in the nation— Williams Obstetrics, now in its 23rd edition; Williams Gynecology, 1st edition; and Essential Reproductive Medicine, 1st edition. In 2009, the British Medical Association Book Awards ranked Williams Gynecology first in the category of Obstetrics and Gynecology. D r. Marlene Corton teaches one of the country’s FELLOWS only OB/GYN pelvic anatomy courses UT Southwestern offers a total of 17 American Board of Building on her “passion for anatomy” The course—offered in four half-day Obstetrics and Gynecology-approved fellowship slots in while in medical school, Dr. Marlene weekly sessions each month—is Corton established and teaches one required for residents in both their four —maternal-fetal medicine, gynecologic of the country’s only pelvic anatomy second and third years. Small groups oncology, female pelvic medicine and reconstructive courses specifically forO B/GYN of two to three residents work on surgery, and reproductive endocrinology and infertility. residents. Designated the “Pelvic a fresh cadaver each session, with Fellows receive extensive training in patient care as well Anatomy and Laparoscopy Course each class assisted by one to two as basic and clinical research. with Fresh Cadaver Dissection,” the fellows and overseen by Dr. Corton. course includes hands-on surgical Biomedical illustration students often RESIDENTS operations, laparoscopic training, and watch, learn, and sketch procedures. UT Southwestern has the largest residency training program dissection of unembalmed cadavers. At the end of each course, residents The course’s mission is to “provide a make a 30-minute presentation in the nation with 80 approved positions in Dallas and tool to refresh residents regarding the on a gynecologic surgery topic another 20 positions in Austin. More than one out of every very complex pelvic anatomy,” says of their choice to OB/GYN faculty 50 OB/GYN residents in the country trains here. About a third Dr. Corton, Associate Professor. and fellows. of our residents pursue fellowships after graduation.

Page 15 Dr. Bruce Carr For OB/GYN, this relationship translates into a presence receives award for teaching in central Texas and an opportunity for growing our and research educational, research, and clinical base. It also enables collaborative educational research efforts with TU South­ W e are proud to recognize Dr. Bruce Carr as recipient of the western, Seton, and the University of Texas at Austin. Distinguished Researcher Award, MEDICAL STUDENTS 2009, from the American Society for Reproductive Medicine Annually, more than 240 medical students from (ASRM). Dr. Carr, Professor and UT Southwestern Medical School receive their introduction Director of the reproductive to women’s health care on our gynecological and endocrinology fellowship obstetrical services. Our department is involved in all program at UT Southwestern, four years of training, with particular emphasis in the is internationally known as an authority on reproductive third year, when students are required to spend six endocrinology, with hundreds of weeks on the OB/GYN service. During their fourth year, publications and lectures to his students are offered elective rotations that cover the credit. He is editor-in-chief of Seminars in Reproductive Medicine. gamut of obstetrical and gynecological subspecialties. Dr. Carr was cited by the ASRM for his success in training future Through our extern program, these clinical rotations also academicians as well as for his work in both clinical and basic research are open to students from other medical schools. in reproductive endocrinology. Dr. Carr’s basic research focuses on the regulation of steroidogenic enzymes, the regulation of ovarian and Our active involvement in medical student education adrenal production, hormone therapy and menopause, endometriosis, may be responsible for the fact that eight percent leiomyomas, and infertility. He currently is investigating the role of 17 of UT Southwestern Medical School graduates choose hydroxylase (CYP-17) in human granulosa and placental cells. OB/GYN as a specialty, compared with six percent nationally.

VOLUNTEER FACULTY Our department is fortunate to have more than 115 the UT Southwestern program. Here residents focus on volunteer faculty members who play an important role developing skills in intrapartum management, high-risk in the education of residents and students at several obstetrics, ultrasound, and prenatal care. Residents also hospitals in the Dallas-Fort Worth and Austin areas. gain experience in the treatment of a broad spectrum We are extremely grateful for the time our volunteers of disorders in gynecology, gynecologic oncology, spend training our residents and students and for their reproductive endocrinology, and urogynecology. partnership in helping us further our educational mission. Specialized curricula focus on pelvic anatomy, dysplasia, and laser treatment. Residents are introduced to advanced surgical procedures and hone their surgical EDUCATING HUNDREDS—TRAINING TOMORROW’S PHYSICIANS TODAY skills in a specialized simulation venue at UT South­ Operating the largest physician-training program in western’s Center for Minimally Invasive Surgery. the country is a big responsibility. It requires faculty In 2009, UT Southwestern entered into a partnership with members who are dedicated to teaching—faculty the Seton Family of Hospitals in Austin. As a result of this members who are as committed to learning as they association, our department has become responsible for are to educating others. We are humbled by the the graduate medical education program in Austin, which responsibility and proud to be today’s mentors of is currently comprised of 20 OB/GYN residents, overseen tomorrow’s doctors. by 20 UT Southwestern on-site faculty members.

Page 16 We currently have

010residents and

17fellows

We are one of the largest OB/GYN departments in the United States, with more than 100 faculty members.

Page 17 30 1974 12 30 14,000 12 200 12 20 239 1974 15 100,000 3NIH multi- center Network 1974 239 1974 12 Grants 15 14,000 82,336 239 NIH1 Program 12 2011 15 Project Grant 20 15 21 200 30 30 100,000 More 20 1974 2011 than papers200 published 15 in premier peer-reviewed 20 journals in the past ve years 30 12 239 14,000 2011 20 2011 12 30 20 12 82,336 RESEARCH ADVANCING KNOWLEDGE THROUGH BASIC AND CLINICAL RESEARCH

Our department maintains a robust research Our clinical faculty are dedicated to measuring program funded through private, government, and health-care outcomes to determine the most effective department sponsorships. Building on the legacies treatment protocols and are committed to rigorous of Jack Pritchard, MD, and Paul MacDonald, MD, we controlled trials intended to better define best believe that a partnership between clinicians and basic scientists is essential to understanding the underlying mechanisms that affect a woman’s health and to providing each woman with the most effective treatment options.

During the past five years, OB/GYN faculty members have published more than 200 papers in peer-reviewed journals, including nine in the New England Journal of Medicine, one in the Journal of the American Medical Association, and one in Cell.

Our research efforts have resulted in recognition by our peers. In both 2007 and 2008, the American College of Research leads to evidence-based care Obstetricians and Gynecologists awarded our faculty the In the division of Obstetrics/ “The foundation of our research, Roy M. Pitkin Award for outstanding research published Maternal-Fetal Medicine, Dr. Kenneth which is focused on health- in our field. Leveno, Professor and Division Chief, care outcomes as well as some In 2011, Lisa Halvorson, MD, Professor and a specialist leads a research endeavor that mechanisms of disease research, directly affects obstetrical patients is driven by the need for evidence- in reproductive endocrinology and infertility, received locally and nationally. As part of a based care and treatment,” said the President’s Achievement Award from the Society consortium funded by the National Dr. Leveno. for Gynecologic Investigation in recognition of her Institutes of Health for 15 years, According to Dr. Leveno, this outstanding scientific work. as well as other local supporters, research involves a large number of his team uses a combination faculty and fellows across several Clinical Research of research approaches—from departments who are committed to retrospective analysis to Our faculty currently serve as members of several the basic principles of the endeavor. prospective observational studies OB/GYN clinical research networks sponsored by the “This kind of health-care outcomes and randomized clinical studies— National Institutes of Health (NIH). These include the research brings the faculty together. to establish guideposts NIH Maternal-Fetal Medicine Units Network, the NIH It’s basically the underpinning of for obstetrical patient care at our identity as an academic entity, Gynecologic Oncology Group, and the NIH Female UT Southwestern and Parkland and I’m proud of what we have Contraceptive Clinical Trials Network. Memorial Hospital. accomplished,” he added.

Page 19 “ We are using molecular and cellular Basic Research techniques to identify how the female Complementing our clinical research program is a reproductive tract changes during well-focused basic research effort. Under sponsorship of pregnancy, , and afterwards. Using cultured primary human cervical the NIH and other organizations, our faculty members stromal cells, genetically altered mice, are conducting basic research in laboratories located and tissue samples from the human throughout the department, including those of the Cecil H. cervix and , our lab examines the and Ida Green Center for Reproductive Biology Sciences. balance between matrix synthesis and degradation during cervical ripening We recently received renewal of our multi-million dollar and the development of pelvic NIH program-project grant—the department’s longest organ prolapse. We hope that these studies will provide novel therapeutic standing grant. The goal of this program project— modalities in the treatment and prevention of preterm cervical ripening, designated Initiation of Human Labor: Prevention of pelvic organ prolapse, and anal incontinence after childbirth.” Prematurity—is to discover the biological mechanisms underlying the initiation of human labor. –R. Ann Word, MD Professor and Director, Urogynecology Research Laboratory Initially funded in 1974, the grant brought together obstetrician/gynecologists, biochemists, molecular biologists, and physiologists in an effort to elucidate the mechanisms of parturition and improve outcomes for newborns. Today, faculty members in the department and the Cecil H. and practices in our specialty. These studies run the gamut Ida Green Center for Reproductive Biology Sciences are of the health problems we treat. working on diverse aspects of female reproductive biology For instance, we are leading the $30 million effort of the and focusing on molecular mechanisms. Maternal-Fetal Medicine Units Network to screen 10,000 Continuing the effort to unravel the mechanisms of human women for subclinical hypothyroidism and to evaluate parturition, one of the areas of focus is identification of the the impact of treatment on child development. molecular events during pregnancy that cause remodeling In a local study to determine the risk of flu medications on of the cervix from a closed rigid structure to one that pregnant women and their babies, we evaluated 82,336 expands to enable passage of a term . medical records between 2003 and 2008 and identified Investigations are also under way to identify the 239 women with influenza who had been treated with mechanisms that cause fertility and infertility. antiviral medications during their pregnancy. We found Researchers are evaluating the role of the anterior no significant risk to mothers or their newborns. pituitary in the onset of fertility as well as its cessation Currently, one of our faculty members—a nationally during menopause. Others are examining the role of recognized expert on pandemic flu and pregnancy—is 17-hydroxylase (CYP-17) in polycystic ovary syndrome serving on the data safety monitoring board for the Bill (PCOS)—a hormonal disorder that can affect a woman’s and Melinda Gates Foundation-sponsored Field Trial of ability to become pregnant. Maternal Influenza Immunization in Nepal. Many women suffer from pelvic-floor disorders as a While disease increases risks during pregnancy, childbirth consequence of childbirth. Using animal models, faculty itself can lead to complications like pelvic organ prolapse members and fellows are studying the functional later in life. Today, we are investigating the potential anatomy of the pelvic floor, the effects of nerve injuries on protective effects of local estrogen on the connective voiding dysfunction and urinary and anal incontinence, tissues of the pelvic floor in postmenopausal women who and the effects of growth factors and myogenic stem cells are undergoing surgery for pelvic organ prolapse. on wound healing of the external anal sphincter.

Page 20 Multi-Million Dollar Program Project Grant Initially funded in

1974

The goal of this program project is to discover the biological mechanism underlying the initiation of human labor.

Page 21 the Cecil H. and Ida GREEN CENTER for Reproductive Biology Sciences has undergone a $12 MILLION renovation

and expansion TO A NEW

14,000 SQFT. LOCATION

Page 22 Cecil H. and Ida Green Center for “I am privileged to be a part of the Reproductive Biology Sciences Cecil H. and Ida Green Center for A cutting-edge research center, the Cecil H. and Ida Green Reproductive Biology Sciences, which has a long history of leading the way Center for Reproductive Biology Sciences was endowed by in reproductive biology research. It the Greens in 1974. Throughout the subsequent decades, is very exciting to be working in this the Green Center has been at the forefront of research into field as part of the Green Center, and female reproductive biology—with its current focus on to be mentoring and assisting other gene regulation, signaling, and genome functions. researchers with projects that have the potential to alter the practice of Established initially under UT Southwestern’s OB/GYN clinical medicine. Our research into Department, the Center became affiliated with the reproductive biology encompasses Department of Pharmacology from 1999 to 2009. In diverse areas and is executed by 2010, it transitioned back to the OB/GYN Department teams of basic scientists and clinical researchers who are creative and when a new director was recruited. W. Lee Kraus, PhD— experienced, and who possess an formerly Professor of Molecular Biology and Genetics inner drive to learn more.” and Pharmacology at Cornell University—heads the

Center, which has undergone a $12 million renovation –W. Lee Kraus, PhD and expansion to a new 14,000-square-foot location in Professor and Director of the OB/GYN Department. the Green Center

The new facility includes more than 10,000 square feet of laboratory space and houses Dr. Kraus’ lab, as well as labs for five new faculty members. In addition, the Green Center’s membership includes approximately 20 current UT Southwestern faculty members, whose labs are Research aims to eliminate located elsewhere in the department and across the the unexpected UT Southwestern campus. Determining why some women The Center’s mission is to address fundamental and experience unexpected preterm labor applied questions related to reproductive biology, and birth is the focus of Dr. Mala including oocyte maturation, fertilization, development, Mahendroo’s lab in the Cecil H. and Ida pregnancy, parturition, stem cells, endocrinology, Green Center for Reproductive Biology Sciences—thanks to a three-year, and oncology, as well as aspects of metabolism, $100,000 competitive grant from The inflammation, and immunity that relate to female Hartwell Foundation. reproductive biology. Dr. Mahendroo, an Associate Professor, is looking at changes in the collagen structure of the cervix using noninvasive second harmonic generation Advancing Our Knowledge Through (SHG) laser-based imaging in combination with endoscopy. Basic and Clinical Research Her lab’s goal is to develop an SHG endoscope to be used in animal Underlying our clinical practice and training programs models­­—and subsequently in women—to predict preterm birth so that is a continual quest for knowledge to help us define better strategies can be found to halt preterm birth and improve postnatal best practices. It drives us to measure outcomes and outcomes. She is collaborating with researchers in UT Southwestern’s conduct clinical trials. It leads us to foster cutting-edge, Department of Cell Biology, at the University of Texas at Dallas, and at integrative, and collaborative basic research. Whatever Johns Hopkins University. its form, research—as much as anything else—defines who we are as a department.

Page 23 PLANS FOR A NEW $800 MILLION state-of-the-art University Hospital at UT Southwestern Medical Center have been approved

The 424-bed facility is slated to open in 2015.

PARKLAND has broken ground on a new

2.5 MILLION square-foot campus

The $1.27 billion project is set for completion in 2014.

Page 2424 ENDOWMENTS INFINITE T he Department of Obstetrics and Gynecology is fortunate to have received solid financial funding over the POSSIBILITIES years for all three of its missions of education, research, and clinical care. More than 20 endowments are helping BUILDING THE FUTURE fuel the department’s national prominence. OF MEDICINE Endowed Funds: Norman F. Gant Chair in Obstetrics and Gynecology Annelle Ahmed, MD, Fund held by George D. Wendel, MD for Faculty Scholars in Obstetrics and Gynecology Mary Dees McDermott Hicks We look forward to the future when the Southwestern Chair in Medical Science Norman F. Gant Research held by Steven L. Bloom, MD Medical District in Dallas will have two new state-of- Fund in Obstetrics the-art hospitals with more than 3.8 million square feet and Gynecology Jack A. Pritchard Chair in Obstetrics and Gynecology devoted to inpatient care, medical education, and clinical The Cecil H. and Ida Green held by Kenneth Leveno, MD and translational research. Center for Reproductive Biology Sciences Helen J. and Robert S. Strauss and Diana K. and New University Hospital Green Center Training Richard C. Strauss Chair In 2010, the UT System Board of Regents and the Program in Reproductive in Women’s Health Biology Science Research Texas Higher Education Coordinating Board approved held by Karen D. Bradshaw, MD plans for an $800 million, 424-bed hospital to replace Rosann and Richard Gutman the aging University Hospital–St. Paul, which opened Fund for Clinical Excellence Professorships: and Career Enhancement Alvin “Bud” Brekken in 1963. This state-of-the-art hospital is designed to held by Siobhan Kehoe, MD Professorship in Obstetrics provide patient-centric care and incorporates space Lowe Foundation for Women’s and Gynecology to support clinical and translational research as well Preventative Health Care held by Jeanne Sheffield, MD as education and training. The 1.3 million-square-foot Frank C. Erwin Jr. Distinguished Chairs: complex will open in 2015. Professorship in Obstetrics Beatrice and Miguel Elias and Gynecology Parkland Memorial Hospital Distinguished Chair in held by Joseph I. Schaffer, MD Obstetrics and Gynecology Patricia Duniven Fletcher In 2008, the voters of Dallas County approved held by F. Gary Cunningham, MD construction of a new $1.27 billion, 2.5 million-square- Distinguished Professorship Amy and Vernon E. Faulconer in Gynecologic Oncology foot hospital to replace the current Parkland Memorial Distinguished Chair in Gillette Professorship in Hospital, which opened in 1954. The largest hospital Medical Science Obstetrics and Gynecology construction project in America today, the new facility Cecil H. and Ida Green held by Brian M. Casey, MD Distinguished Chair in will include 862 beds in private rooms as well as 48 labor- Arthur Grollman Professorship Reproductive Biology and-delivery rooms, and will increase the space of the in Obstetrics and Gynecology Sciences held by Barry E. Schwarz, MD emergency room, operating rooms, and the burn and held by W. Lee Kraus, PhD Luis Leib, MD, Professorship in neonatal intensive care units. Ground was broken in 2010, Paul C. MacDonald Obstetrics & Gynecology and the hospital is scheduled to open in 2014. Distinguished Chair in held by Robyn Horsager-Boehrer, MD Obstetrics and Gynecology held by Bruce R. Carr, MD Fellowships: Chairs: Jack and Signe Pritchard Fellowship in Maternal-Fetal Dallas Foundation Chair in Medicine Gynecologic Oncology held by David Scott Miller, MD F Aculty STAFF

Steven L. Bloom, MD Roderick Diggs, MD M. Ashley Hickman, MD Professors Emeritus Professor and Chairman Assistant Professor Assistant Professor Norman Gant, MD Dennis Factor, MD Robyn Horsager–Boehrer, MD Professor Emeritus Associate Professor Professor Basic Reproductive John Porter, PhD Biology Research— Heather Gardow, MD Naseem Jagani, MD Professor Emeritus The Green Center Assistant Professor Clinical Assistant Professor Peggy Whalley, MD W. Lee Kraus, PhD William Griffith, III, MD Julie Lo, MD Professor Emeritus Professor, Division Chief Associate Professor Associate Professor Xiaoying Bai, PhD Clarice Grimes, MD Bruce Meyer, MD A ustin Seton Faculty Assistant Professor Associate Professor Professor, Executive Vice President for Health System Affairs Charles Edward Brown, MD Xin Liu, PhD David Hemsell, MD Professor, Program Director Assistant Professor Clinical Professor Donald McIntire, PhD Professor Michael Breen, MD Mala Mahendroo, PhD Barbara Hoffman, MD Assistant Professor Associate Professor Associate Professor Mark Peters, MD Clinical Assistant Professor Alison Brooks-Heinzman, MD Carole Mendelson, PhD Farnaz Jahangiri, MD Assistant Professor Professor Assistant Professor Scott Roberts, MD (Primary Appointment Biochemistry) Professor Karl Buttermann, MD Irwin Kerber, MD Assistant Professor Associate Professor Vanessa Rogers, MD Female Pelvic Assistant Professor Kimberly Carter, MD Pamela Kothari, MD Assistant Professor Medicine and Assistant Professor Patricia Santiago–Muñoz, MD ReCOnstructive Surgery Assistant Professor Zachary Chipman, MD Xercerla Littles, MD Assistant Professor Joseph Schaffer, MD Associate Professor Jeanne Sheffield, MD Professor, Division Chief Professor Mark Crozier, MD Ann Lutich, MD Assistant Professor Marlene Corton, MD Assistant Professor Stephan Shivvers, MD Associate Professor Assistant Professor Robert Crumb, MD Dustin Manders, MD Assistant Professor David Rahn, MD Assistant Professor Diane Twickler, MD Assistant Professor Professor John Harkins, MD Robert McCrea, MD Assistant Professor Clifford Wai, MD Assistant Professor (Primary Appointment ) Associate Professor Chet Wells, MD Theodore Held, MD Elysia Moschos, MD Assistant Professor Associate Professor Clinical Professor Whitney Keller, MD Gynecology Core Mary Jane Pearson, MD George Wendel, Jr., MD Professor Assistant Professor Cherine Hamid, MD Associate Professor Assistant Professor Isaac Lavie, MD Robin Rosen, MD Kevin Worley, MD Assistant Professor Assistant Professor Kimberly Kho, MD Assistant Professor Assistant Professor Michael Nix, MD Frances Rosenbaum, MD Michael Zaretsky, MD Assistant Professor Assistant Professor Eddie McCord, MD Assistant Professor Associate Professor Raghu Shettigar, MD Mayra Thompson, MD Assistant Professor David Owens, MD Associate Professor P ediatric Gynecology Assistant Professor Alain Szyller, MD Tam Truong, MD Akilah Weber, MD Assistant Professor David Rogers, MD Associate Professor Assistant Professor Assistant Professor Rita Tsai, MD Claudia Werner, MD Assistant Professor Larry Word, MD Associate Professor Rep roductive Professor Endocrinology Ralph Upton, MD Tiffany Bogan Woodus, MD Clinical Assistant Professor Assistant Professor and Infertility Donna Villacis, MD Gynecologic Orhan Bukulmez, MD Clinical Assistant Professor Oncology Obstetrics/Maternal– Associate Professor, Division Chief Diana Wang, MD David Scott Miller, MD Fetal Medicine Gary Ackerman, MD Assistant Professor Professor, Division Chief Clinical Professor Kenneth Leveno, MD Amanda White, MD Siobhan Kehoe, MD Professor, Division Chief Victor Beshay, MD Assistant Professor Assistant Professor Assistant Professor James Alexander, MD Jayanthi Lea, MD Professor Karen Bradshaw, MD Assistant Professor Professor Faculty Associates Oscar Andujo, MD Rebecca Ames, CNM, MSN Debra Richardson, MD Associate Professor Bruce Carr, MD Assistant Professor Professor Susan Chew, CNM, MSN Morris Bryant, MD Maryann Faucher, CNM, MSN Associate Professor Kevin Doody, MD Clinical Associate Professor Carol Graham, CNM, MSN Obstetrics and Brian Casey, MD Gynecology—Generalists Professor Lisa Halvorson, MD Pamela Henry, CNM, MSN Professor Dena Howerton, CNM, MSN Barry Schwarz, MD Stephanie Chang, MD Professor, Division Chief Assistant Professor Karla Saner–Amigh, PhD Janice Lankford, CNM, MSN Assistant Professor Carolyn Sutton, MSN, RNC, WHCNP Evelina Alcalen, MD Susan Cox, MD Assistant Professor Professor, Regional Dean Ellen Wilson, MD Tracy Trenhaile-Sellers, CNM, CNS, MSN for Austin Programs Associate Professor Barbara Cambridge, PhD Pamela Ward, CNM, MS Associate Professor F. Gary Cunningham, MD Ruth Ann Word, MD Fuying Xu, CNM, MSN Professor Professor H. David Cook, MD Karen Zelman, CNM, MSN Associate Professor Jodi Dashe, MD Professor

Department of Obstetrics and Gynecology | UT Southwestern Medical Center 5323 Harry Hines Boulevard | Dallas, Texas 75390 | utsouthwestern.edu/obgyn-academics | utsouthwestern.org/obgyn