Current Environment: Production

Medical Services

Programs & Services

Languages

  • English

Education

Undergraduate School

Madison College

1976, Harrisonburg, VA

Graduate School

Medical College of Virginia

1981, Richmond, VA

Medical School

Stanford Medical School

1985, Stanford, CA

Internship

University of Colorado

1986, Denver, CO

Residency

University of Colorado

1989, Denver, CO

Fellowship

Brigham & Women's Hospital

Maternal Fetal Medicine

1992, Boston, MA

Certifications

  • American Board of Obstetrics and Gynecology
  • American Board of Obstetrics and Gynecology (Maternal and Fetal Medicine)
  • American Board of Pediatrics (General)

Professional History

With early career training in human genetics, I saw the unfolding of our understanding of the deep connection between human genetics and pregnancy outcomes – both those pregnancies which proceed without complication and those with unexpected complications such as preterm delivery, preeclampsia or a fetal condition. In these settings, helping a woman and her family navigate the vast information available, prepare for her delivery and develop a support system to sustain her through this process is a challenge and a privilege. My participation with multispecialty care teams provides me daily re-enforcement of their value and the need for patients to be informed as they face a life-changing experience.

As a geneticist, we are only beginning to understand the vast range of genomic contributions to pregnancy outcomes. Continuing to explore how genetics influences a pregnancy is critical. And that what was once considered dogma should always be open for re-analysis. A highlight of my time working in the field of congenital anomalies has been with our fetal cardiac intervention program. Involving a range of specialists, our team showed that the accepted version of a birth defect as a static and predetermined event may not always be true. Some birth defects may result from progressive change through a pregnancy. For a subgroup of fetuses with hypoplastic left heart syndrome, we demonstrated that stenosis of the aortic valve can be the primary event. As the pregnancy continues progressive loss of fetal left ventricle function occurs and results in a newborn with classic HLHS. Most importantly, “in utero” valve dilation of the aortic valve stenosis can prevent further damage to the left ventricle. Over the past 15 years, this team has worked on perfecting and minimizing maternal risks of the procedure, identifying key imaging criteria, and explored at the biologic level how to differentiate the degree of fetal heart damage. As the primary fetal interventionist for this team since 2000, the progress made in both the technique and the outcomes for these children has been a gift.

Publications

  1. Routine Prenatal cfDNA Screening for Autosomal Dominant Single-Gene Conditions. Clin Chem. 2025 Jan 03; 71(1):129-140. View Abstract

  2. Maternal Vascular Malperfusion and Anatomic Cord Abnormalities Are Prevalent in Pregnancies With Fetal Congenital Heart Disease. Prenat Diagn. 2024 Aug 30. View Abstract

  3. The bright future of fetal cardiology. Prenat Diagn. 2024 06; 44(6-7):676-678. View Abstract

  4. The patient experience of a postpartum readmission for hypertension: a qualitative study. BMC Pregnancy Childbirth. 2024 May 14; 24(1):358. View Abstract

  5. Technical Success and Serious Adverse Events for Fetal Aortic Valvuloplasty in a Large 20-Year Cohort. JACC Adv. 2024 Mar; 3(3):100835. View Abstract

  6. High-Resolution and Noninvasive Fetal Exome Screening. N Engl J Med. 2023 11 23; 389(21):2014-2016. View Abstract

  7. Prenatal vs postnatal diagnosis of 22q11.2 deletion syndrome: cardiac and noncardiac outcomes through 1 year of age. Am J Obstet Gynecol. 2024 03; 230(3):368.e1-368.e12. View Abstract

  8. Unique Challenges of NIPT for Sex Chromosome Aneuploidy. Clin Obstet Gynecol. 2023 09 01; 66(3):568-578. View Abstract

  9. Transuterine Ultrasound-Guided Fetal Embolization of Vein of Galen Malformation, Eliminating Postnatal Pathophysiology. Stroke. 2023 06; 54(6):e231-e232. View Abstract

  10. Postnatal genetic testing on cord blood for prenatally identified high-probability cases. Prenat Diagn. 2023 08; 43(9):1120-1131. View Abstract

  11. Single gene non-invasive prenatal screening for autosomal dominant conditions in a high-risk cohort. Prenat Diagn. 2023 08; 43(9):1110-1119. View Abstract

  12. Redesigning Care for the Management of Postpartum Hypertension: How Can Ob-Gyns and Primary Care Physicians Partner in Caring for Patients after a Hypertensive Pregnancy? Am J Perinatol. 2024 05; 41(S 01):e1352-e1356. View Abstract

  13. The hypergonadotropic hypogonadism conundrum of classic galactosemia. Hum Reprod Update. 2023 03 01; 29(2):246-258. View Abstract

  14. Overcoming roadblocks in clinical innovation via high fidelity simulation: use of a phantom simulator to achieve FDA and IRB approval of a clinical trial of fetal embolization of vein of Galen malformations. J Neurointerv Surg. 2023 Dec; 15(12):1218-1223. View Abstract

  15. Prenatal diagnosis of sex chromosome aneuploidy-What do we tell the prospective parents? Prenat Diagn. 2023 02; 43(2):250-260. View Abstract

  16. Technically successful fetal aortic valvuloplasty acutely improves left heart output. Prenat Diagn. 2022 10; 42(11):1466-1470. View Abstract

  17. Hemodynamic and anatomic changes after fetal aortic valvuloplasty are associated with procedural success and postnatal biventricular circulation. Prenat Diagn. 2022 09; 42(10):1312-1322. View Abstract

  18. Percutaneous transuterine fetal cerebral embolisation to treat vein of Galen malformations at risk of urgent neonatal decompensation: study protocol for a clinical trial of safety and feasibility. BMJ Open. 2022 05 24; 12(5):e058147. View Abstract

  19. ISPD 2021 debate - All in vitro fertilization cycles should involve pre-implantation genetic testing to improve fetal health and pregnancy outcomes. Prenat Diagn. 2022 07; 42(8):1015-1021. View Abstract

  20. International Society for Prenatal Diagnosis Updated Position Statement on the use of genome-wide sequencing for prenatal diagnosis. Prenat Diagn. 2022 05; 42(6):796-803. View Abstract

  21. Counseling for personal health implications identified during reproductive genetic carrier screening. Prenat Diagn. 2021 Oct; 41(11):1460-1466. View Abstract

  22. Problems with Using Polygenic Scores to Select Embryos. N Engl J Med. 2021 07 01; 385(1):78-86. View Abstract

  23. Utility of noninvasive genome-wide screening: a prospective cohort of obstetric patients undergoing diagnostic testing. Genet Med. 2021 07; 23(7):1341-1348. View Abstract

  24. Late gestation predictors of a postnatal biventricular circulation after fetal aortic valvuloplasty. Prenat Diagn. 2021 03; 41(4):479-485. View Abstract

  25. General practitioners' knowledge about pregnancy complications associated with long-term cardiovascular risk. Gac Med Mex. 2021; 157(1):47-51. View Abstract

  26. Opportunities and challenges for international societies in the COVID-19 era. Prenat Diagn. 2020 12; 40(13):1753-1754. View Abstract

  27. Effect of In Utero Non-Steroidal Anti-Inflammatory Drug Therapy for Severe Ebstein Anomaly or Tricuspid Valve Dysplasia (NSAID Therapy for Fetal Ebstein anomaly). Am J Cardiol. 2021 02 15; 141:106-112. View Abstract

  28. International Society for Prenatal Diagnosis Position Statement: cell free (cf)DNA screening for Down syndrome in multiple pregnancies. Prenat Diagn. 2021 Sep; 41(10):1222-1232. View Abstract

  29. Gene and Stem Cell Therapies for Fetal Care: A Review. JAMA Pediatr. 2020 10 01; 174(10):985-991. View Abstract

  30. Special issue on "Feto-Maternal Genomic Medicine": a decade of incredible advances. Hum Genet. 2020 Sep; 139(9):1119-1120. View Abstract

  31. Genetic innovations and our understanding of stillbirth. Hum Genet. 2020 Sep; 139(9):1161-1172. View Abstract

  32. Fetal Aortic Valvuloplasty for Evolving Hypoplastic Left Heart Syndrome: A Decision Analysis. Circ Cardiovasc Qual Outcomes. 2020 04; 13(4):e006127. View Abstract

  33. Fetal cardiac intervention-Perspectives from a single center. Prenat Diagn. 2020 03; 40(4):415-423. View Abstract

  34. Caring for Women After Hypertensive Pregnancies and Beyond: Implementation and Integration of a Postpartum Transition Clinic. Matern Child Health J. 2019 Nov; 23(11):1459-1466. View Abstract

  35. Fetal phenotypes emerge as genetic technologies become robust. Prenat Diagn. 2019 08; 39(9):811-817. View Abstract

  36. Fetal cardiac abnormalities: Genetic etiologies to be considered. Prenat Diagn. 2019 08; 39(9):758-780. View Abstract

  37. Randomized Trial to Reduce Cardiovascular Risk in Women with Recent Preeclampsia. J Womens Health (Larchmt). 2019 11; 28(11):1493-1504. View Abstract

  38. Prenatal Genetic Testing Options. Pediatr Clin North Am. 2019 04; 66(2):281-293. View Abstract

  39. Improved technical success, postnatal outcome and refined predictors of outcome for fetal aortic valvuloplasty. Ultrasound Obstet Gynecol. 2018 08; 52(2):212-220. View Abstract

  40. Biological explanations for discordant noninvasive prenatal test results: Preliminary data and lessons learned. Prenat Diagn. 2018 05; 38(6):445-458. View Abstract

  41. Have we done our last amniocentesis? Updates on cell-free DNA for Down syndrome screening. Pediatr Radiol. 2018 04; 48(4):461-470. View Abstract

  42. Early hemodynamic changes after fetal aortic stenosis valvuloplasty predict biventricular circulation at birth. Prenat Diagn. 2018 03; 38(4):286-292. View Abstract

  43. When ultrasound anomalies are present: An estimation of the frequency of chromosome abnormalities not detected by cell-free DNA aneuploidy screens. Prenat Diagn. 2018 03; 38(4):250-257. View Abstract

  44. Myocardial injury in fetal aortic stenosis: Insights from amniotic fluid analysis. Prenat Diagn. 2018 02; 38(3):190-195. View Abstract

  45. Should embryos with autosomal monosomy by preimplantation genetic testing for aneuploidy be transferred?: Implications for embryo selection from a systematic literature review of autosomal monosomy survivors. Prenat Diagn. 2017 12; 37(13):1273-1280. View Abstract

  46. Communicating risk with aneuploidy screening: things are never as simple as they appear to be. BJOG. 2018 02; 125(3):277. View Abstract

  47. The influence of noninvasive prenatal testing on gestational age at time of abortion for aneuploidy. Prenat Diagn. 2017 Jul; 37(7):635-639. View Abstract

  48. Antepartum management and obstetric outcomes among pregnancies with Down syndrome from diagnosis to delivery. Prenat Diagn. 2017 Jul; 37(7):640-646. View Abstract

  49. Sex chromosome aneuploidy detection by noninvasive prenatal testing: helpful or hazardous? Prenat Diagn. 2017 May; 37(5):515-520. View Abstract

  50. Confined placental mosaicism for 22q11.2 deletion as the etiology for discordant positive NIPT results. Prenat Diagn. 2017 Apr; 37(4):416-419. View Abstract

  51. Sonographic Pulmonary Abnormalities in Fetuses With Hypoplastic Left Heart Syndrome and Intact Atrial Septum Undergoing Attempted Atrial Septostomy In Utero. Ultrasound Q. 2017 Mar; 33(1):82-85. View Abstract

  52. Neurodevelopmental Outcome in Children after Fetal Cardiac Intervention for Aortic Stenosis with Evolving Hypoplastic Left Heart Syndrome. J Pediatr. 2017 05; 184:130-136.e4. View Abstract

  53. Structural Chromosomal Rearrangements Require Nucleotide-Level Resolution: Lessons from Next-Generation Sequencing in Prenatal Diagnosis. Am J Hum Genet. 2016 Nov 03; 99(5):1015-1033. View Abstract

  54. Patient choice and clinical outcomes following positive noninvasive prenatal screening for aneuploidy with cell-free DNA (cfDNA). Prenat Diagn. 2016 May; 36(5):456-62. View Abstract

  55. In Reply. Obstet Gynecol. 2016 Apr; 127(4):804. View Abstract

  56. Percutaneous umbilical blood sampling: current trends and outcomes. Eur J Obstet Gynecol Reprod Biol. 2016 May; 200:98-101. View Abstract

  57. What is the role of the 11- to 14-week ultrasound in women with negative cell-free DNA screening for aneuploidy? Prenat Diagn. 2016 Mar; 36(3):260-5. View Abstract

  58. A Multi-State Analysis of Early-Term Delivery Trends and the Association With Term Stillbirth. Obstet Gynecol. 2015 Dec; 126(6):1138-1145. View Abstract

  59. Obstetrician and gynecologists' population-based screening practices. J Matern Fetal Neonatal Med. 2016 Mar; 29(6):875-9. View Abstract

  60. International Fetal Cardiac Intervention Registry: A Worldwide Collaborative Description and Preliminary Outcomes. J Am Coll Cardiol. 2015 Jul 28; 66(4):388-99. View Abstract

  61. Noninvasive Prenatal Testing and Incidental Detection of Occult Maternal Malignancies. JAMA. 2015 Jul 14; 314(2):162-9. View Abstract

  62. The effect of mode of conception on obstetrical outcomes differs by body mass index. Reprod Biomed Online. 2015 Oct; 31(4):531-7. View Abstract

  63. Recognition by Women's Health Care Providers of Long-Term Cardiovascular Disease Risk After Preeclampsia. Obstet Gynecol. 2015 Jun; 125(6):1287-1292. View Abstract

  64. The North American Fetal Therapy Network Consensus Statement: prenatal management of uncomplicated monochorionic gestations. Obstet Gynecol. 2015 May; 125(5):1236-1243. View Abstract

  65. Angiogenic markers in pregnancies conceived through in vitro fertilization. Am J Obstet Gynecol. 2015 Aug; 213(2):212.e1-8. View Abstract

  66. Recurrent enlarged nuchal translucency: first trimester presentation of a familial 15q26?qter deletion. Am J Med Genet A. 2015 Mar; 167A(3):612-6. View Abstract

  67. Comparison of genome-wide and gene-specific DNA methylation between ART and naturally conceived pregnancies. Epigenetics. 2015; 10(6):474-83. View Abstract

  68. Current controversies in prenatal diagnosis 4: pre-conception expanded carrier screening should replace all current prenatal screening for specific single gene disorders. Prenat Diagn. 2015 Jan; 35(1):23-8. View Abstract

  69. The North American Fetal Therapy Network consensus statement: prenatal surveillance of uncomplicated monochorionic gestations. Obstet Gynecol. 2015 Jan; 125(1):118-123. View Abstract

  70. Detection of triploid, molar, and vanishing twin pregnancies by a single-nucleotide polymorphism-based noninvasive prenatal test. Am J Obstet Gynecol. 2015 Jan; 212(1):79.e1-9. View Abstract

  71. Fetal aortic valvuloplasty for evolving hypoplastic left heart syndrome: postnatal outcomes of the first 100 patients. Circulation. 2014 Aug 19; 130(8):638-45. View Abstract

  72. Consensus expert recommendations for the diagnosis and management of autosomal recessive polycystic kidney disease: report of an international conference. J Pediatr. 2014 Sep; 165(3):611-7. View Abstract

  73. Percutaneous fetal cardiac interventions for structural heart disease. Am J Perinatol. 2014 Aug; 31(7):629-36. View Abstract

  74. Does the addition of a specialized postpartum clinic improve the care of women with preeclampsia? Obstet Gynecol. 2014 May; 123 Suppl 1:39S. View Abstract

  75. Technical challenges of atrial septal stent placement in fetuses with hypoplastic left heart syndrome and intact atrial septum. Catheter Cardiovasc Interv. 2014 Jul 01; 84(1):77-85. View Abstract

  76. The association of body mass index with serum angiogenic markers in normal and abnormal pregnancies. Am J Obstet Gynecol. 2014 Sep; 211(3):247.e1-7. View Abstract

  77. Management of a Woman With Maple Syrup Urine Disease During Pregnancy, Delivery, and Lactation. JPEN J Parenter Enteral Nutr. 2015 Sep; 39(7):875-9. View Abstract

  78. Eliminating first trimester markers: will replacing PAPP-A and ßhCG miss women at risk for small for gestational age? J Matern Fetal Neonatal Med. 2014 Nov; 27(17):1761-4. View Abstract

  79. The effect of obstetric practice change to reduce early term delivery on perinatal outcome. J Perinatol. 2014 Mar; 34(3):176-80. View Abstract

  80. Obstetricians and gynecologists' practice and opinions of expanded carrier testing and noninvasive prenatal testing. Prenat Diagn. 2014 Feb; 34(2):145-52. View Abstract

  81. Review: cell-free fetal DNA in the maternal circulation as an indication of placental health and disease. Placenta. 2014 Feb; 35 Suppl:S64-8. View Abstract

  82. Absent fetal nasal bone: what does it mean for the euploid fetus? J Ultrasound Med. 2013 Dec; 32(12):2131-4. View Abstract

  83. Integration of noninvasive DNA testing for aneuploidy into prenatal care: what has happened since the rubber met the road? Clin Chem. 2014 Jan; 60(1):78-87. View Abstract

  84. Maternal plasma DNA testing for aneuploidy in pregnancies achieved by assisted reproductive technologies. Genet Med. 2014 May; 16(5):419-22. View Abstract

  85. Hyperreactio luteinalis (enlarged ovaries) during the second and third trimesters of pregnancy: common clinical associations. J Ultrasound Med. 2013 Jul; 32(7):1285-9. View Abstract

  86. First trimester PAPP-A levels correlate with sFlt-1 levels longitudinally in pregnant women with and without preeclampsia. BMC Pregnancy Childbirth. 2013 Apr 04; 13:85. View Abstract

  87. Clinical diagnosis by whole-genome sequencing of a prenatal sample. N Engl J Med. 2012 Dec 06; 367(23):2226-32. View Abstract

  88. Does the ex utero intrapartum treatment to extracorporeal membrane oxygenation procedure change outcomes for high-risk patients with congenital diaphragmatic hernia? J Pediatr Surg. 2012 Jun; 47(6):1053-7. View Abstract

  89. Self-reported alcohol and drug use in pregnant young women: a pilot study of associated factors and identification. J Addict Med. 2011 Sep; 5(3):221-6. View Abstract

  90. Postnatal left ventricular diastolic function after fetal aortic valvuloplasty. Am J Cardiol. 2011 Aug 15; 108(4):556-60. View Abstract

  91. 2010 Report from the ISPD Special Interest Group fetal therapy: fetal cardiac interventions. Prenat Diagn. 2011 Mar; 31(3):249-51. View Abstract

  92. Aortic stenosis and severe mitral regurgitation in the fetus resulting in giant left atrium and hydrops: pathophysiology, outcomes, and preliminary experience with pre-natal cardiac intervention. J Am Coll Cardiol. 2011 Jan 18; 57(3):348-55. View Abstract

  93. Monochorionic diamniotic twin gestations discordant for markedly enlarged nuchal translucency. Prenat Diagn. 2011 Mar; 31(3):299-306. View Abstract

  94. Assessment of left ventricular endocardial fibroelastosis in fetuses with aortic stenosis and evolving hypoplastic left heart syndrome. Am J Cardiol. 2010 Dec 15; 106(12):1792-7. View Abstract

  95. Contemporary management of monochorionic diamniotic twins: outcomes and delivery recommendations revisited. Am J Obstet Gynecol. 2010 Aug; 203(2):133.e1-6. View Abstract

  96. Cerebral blood flow characteristics and biometry in fetuses undergoing prenatal intervention for aortic stenosis with evolving hypoplastic left heart syndrome. Ultrasound Med Biol. 2010 Jan; 36(1):29-37. View Abstract

  97. Reversible ductus arteriosus constriction due to maternal indomethacin after fetal intervention for hypoplastic left heart syndrome with intact/restrictive atrial septum. Fetal Diagn Ther. 2010; 27(1):40-5. View Abstract

  98. Use of array comparative genomic hybridization for prenatal diagnosis of fetuses with sonographic anomalies and normal metaphase karyotype. Prenat Diagn. 2009 Dec; 29(13):1213-7. View Abstract

  99. Optical properties of human amniotic fluid: implications for videofetoscopic surgery. Fetal Diagn Ther. 2010; 27(2):87-90. View Abstract

  100. Predictors of technical success and postnatal biventricular outcome after in utero aortic valvuloplasty for aortic stenosis with evolving hypoplastic left heart syndrome. Circulation. 2009 Oct 13; 120(15):1482-90. View Abstract

  101. In utero valvuloplasty for pulmonary atresia with hypoplastic right ventricle: techniques and outcomes. Pediatrics. 2009 Sep; 124(3):e510-8. View Abstract

  102. Outcome of fetuses with a prenatal ultrasound diagnosis of isolated omphalocele. Prenat Diagn. 2009 Jul; 29(7):668-73. View Abstract

  103. Epigenetics and assisted reproduction. Curr Opin Obstet Gynecol. 2009 Jun; 21(3):201-6. View Abstract

  104. Cardiac anomalies in the fetus. Clin Perinatol. 2009 Jun; 36(2):439-49, xi. View Abstract

  105. Isolated fetal omphalocele, Beckwith-Wiedemann syndrome, and assisted reproductive technologies. Birth Defects Res A Clin Mol Teratol. 2009 Jan; 85(1):58-62. View Abstract

  106. Results of in utero atrial septoplasty in fetuses with hypoplastic left heart syndrome. Prenat Diagn. 2008 Nov; 28(11):1023-8. View Abstract

  107. Assisted reproductive technology, congenital malformations, and epigenetic disease. Clin Obstet Gynecol. 2008 Mar; 51(1):96-105. View Abstract

  108. Changes in left heart hemodynamics after technically successful in-utero aortic valvuloplasty. Ultrasound Obstet Gynecol. 2007 Oct; 30(5):715-20. View Abstract

  109. Pathophysiology, management, and outcomes of fetal hemodynamic instability during prenatal cardiac intervention. Pediatr Res. 2007 Sep; 62(3):325-30. View Abstract

  110. Workshop report: evaluation of genetic and epigenetic risks associated with assisted reproductive technologies and infertility. Fertil Steril. 2007 Jul; 88(1):27-31. View Abstract

  111. Ex utero intrapartum treatment with placement on extracorporeal membrane oxygenation for fetal thoracic masses. J Pediatr Surg. 2007 Feb; 42(2):420-5. View Abstract

  112. Ex utero intrapartum treatment with extracorporeal membrane oxygenation for severe congenital diaphragmatic hernia. J Pediatr Surg. 2007 Jan; 42(1):98-104; discussion 104-6. View Abstract

  113. Estimates of prenatal abstinence from alcohol: a matter of perspective. Addict Behav. 2007 Aug; 32(8):1593-601. View Abstract

  114. Stages of change and prenatal alcohol use. J Subst Abuse Treat. 2007 Jan; 32(1):105-9. View Abstract

  115. Brief intervention for prenatal alcohol use: the role of drinking goal selection. J Subst Abuse Treat. 2006 Dec; 31(4):419-24. View Abstract

  116. Factors affecting technical success of fetal aortic valve dilation. Ultrasound Obstet Gynecol. 2006 Jul; 28(1):47-52. View Abstract

  117. Identifying risk drinking in expectant fathers. Birth. 2006 Jun; 33(2):110-6. View Abstract

  118. Confined placental mosaicism as a risk factor among newborns with fetal growth restriction. Prenat Diagn. 2006 May; 26(5):428-32. View Abstract

  119. Alcohol use by pregnant women: partners, knowledge, and other predictors. J Stud Alcohol. 2006 Mar; 67(2):245-51. View Abstract

  120. Fetal fatty acid oxidation defects and maternal liver disease in pregnancy. Obstet Gynecol. 2006 Jan; 107(1):115-20. View Abstract

  121. Social support and prenatal alcohol use. J Womens Health (Larchmt). 2006 Jan-Feb; 15(1):70-6. View Abstract

  122. Risk during pregnancy--self-report versus medical record. Am J Obstet Gynecol. 2005 Dec; 193(6):1981-5. View Abstract

  123. In-utero intervention for hypoplastic left heart syndrome--a perinatologist's perspective. Ultrasound Obstet Gynecol. 2005 Oct; 26(5):481-6. View Abstract

  124. Aortic valvuloplasty in the fetus: technical characteristics of successful balloon dilation. J Pediatr. 2005 Oct; 147(4):535-9. View Abstract

  125. Brief intervention for prenatal alcohol use: a randomized trial. Obstet Gynecol. 2005 May; 105(5 Pt 1):991-8. View Abstract

  126. Fetal surgery in otolaryngology: a new era in the diagnosis and management of fetal airway obstruction because of advances in prenatal imaging. Arch Otolaryngol Head Neck Surg. 2005 May; 131(5):393-8. View Abstract

  127. Balloon dilation of severe aortic stenosis in the fetus: potential for prevention of hypoplastic left heart syndrome: candidate selection, technique, and results of successful intervention. Circulation. 2004 Oct 12; 110(15):2125-31. View Abstract

  128. Expectant management in spontaneous preterm premature rupture of membranes between 14 and 24 weeks' gestation. J Perinatol. 2004 Oct; 24(10):611-6. View Abstract

  129. Creation of an atrial septal defect in utero for fetuses with hypoplastic left heart syndrome and intact or highly restrictive atrial septum. Circulation. 2004 Jul 20; 110(3):253-8. View Abstract

  130. Fetuses subsequently born premature are smaller than gestational age-matched fetuses not born premature. J Ultrasound Med. 2003 Apr; 22(4):359-63. View Abstract

  131. GPC3 mutation analysis in a spectrum of patients with overgrowth expands the phenotype of Simpson-Golabi-Behmel syndrome. Am J Med Genet. 2001 Aug 01; 102(2):161-8. View Abstract

  132. Clinical picture: Multicolour karyotyping. Lancet. 2001 Apr 21; 357(9264):1240. View Abstract

  133. Chemotherapy for a patient with advanced non-small-cell lung cancer during pregnancy: a case report and a review of chemotherapy treatment during pregnancy. Oncology. 2001; 61(3):175-83. View Abstract

  134. Obstetrician-gynecologists' opinions and attitudes on the role of genetics in women's health. J Womens Health Gend Based Med. 2000 Oct; 9(8):873-9. View Abstract

  135. Separation of conjoined twins with the twin reversed-arterial-perfusion sequence after prenatal planning with three-dimensional modeling. N Engl J Med. 2000 Aug 10; 343(6):399-402. View Abstract

  136. A brief intervention for prenatal alcohol use: an in-depth look. J Subst Abuse Treat. 2000 Jun; 18(4):365-9. View Abstract

  137. Gynecologists' training, knowledge, and experiences in genetics: a survey. Obstet Gynecol. 2000 Mar; 95(3):421-4. View Abstract

  138. Brief intervention for alcohol use in pregnancy: a randomized trial. Addiction. 1999 Oct; 94(10):1499-508. View Abstract

  139. Prenatal alcohol consumption. Self versus collateral report. J Subst Abuse Treat. 1999 Jul-Sep; 17(1-2):85-9. View Abstract

  140. Considerations for delivery of infants with congenital abnormalities. Obstet Gynecol Clin North Am. 1999 Jun; 26(2):399-412, vii. View Abstract

  141. The TWEAK: application in a prenatal setting. J Stud Alcohol. 1999 May; 60(3):306-9. View Abstract

  142. Genetics in obstetricians' offices: a survey study. Obstet Gynecol. 1999 May; 93(5 Pt 1):642-7. View Abstract

  143. Identifying prenatal alcohol use: screening instruments versus clinical predictors. Am J Addict. 1999; 8(2):87-93. View Abstract

  144. Unexplained elevated maternal serum alpha-fetoprotein: what is the appropriate follow-up? Curr Opin Obstet Gynecol. 1998 Dec; 10(6):469-74. View Abstract

  145. Alcohol use and pregnancy: improving identification. Obstet Gynecol. 1998 Jun; 91(6):892-8. View Abstract

  146. Pregnant women with negative alcohol screens do drink less. A prospective study. Am J Addict. 1998; 7(4):299-304. View Abstract

  147. Cost-effectiveness of strategies used in the evaluation of pregnancies complicated by elevated maternal serum alpha-fetoprotein levels. Obstet Gynecol. 1997 May; 89(5 Pt 1):660-5. View Abstract

  148. Oligospermic men: the role of karyotype analysis prior to intracytoplasmic sperm injection. Fertil Steril. 1997 Apr; 67(4):612-4. View Abstract

  149. The association of early-onset fetal growth restriction, elevated maternal serum alpha-fetoprotein, and the development of severe pre-eclampsia. Prenat Diagn. 1997 Apr; 17(4):305-9. View Abstract

  150. Teratogen update: toluene. Teratology. 1997 Feb; 55(2):145-51. View Abstract

  151. Successful thoracoamniotic shunting and review of the literature in unilateral pleural effusion with hydrops. J Ultrasound Med. 1997 Feb; 16(2):153-60. View Abstract

  152. Antepartum screening in the office-based practice: findings from the collaborative Ambulatory Research Network. Obstet Gynecol. 1996 Oct; 88(4 Pt 1):483-9. View Abstract

  153. Fluorescence in situ hybridization for the detection of aneuploidy from archived fetal cells. Obstet Gynecol. 1996 Oct; 88(4 Pt 2):684-7. View Abstract

  154. Sonographic appearance of placental villous hydrops associated with Beckwith-Wiedemann syndrome. J Ultrasound Med. 1995 Jan; 14(1):61-4. View Abstract

  155. Confined placental mosaicism and intrauterine growth retardation: a case-control analysis of placentas at delivery. Am J Obstet Gynecol. 1995 Jan; 172(1 Pt 1):44-50. View Abstract

  156. Toluene embryopathy: clinical delineation and developmental follow-up. Pediatrics. 1994 Feb; 93(2):216-20. View Abstract

  157. Origin of extraembryonic mesoderm in experimental animals: relevance to chorionic mosaicism in humans. Am J Med Genet. 1993 Jun 15; 46(5):542-50. View Abstract

  158. The emerging genetic theories of unstable DNA, uniparental disomy, and imprinting. Curr Opin Obstet Gynecol. 1993 Apr; 5(2):179-85. View Abstract

  159. Progression of exencephaly to anencephaly in the human fetus--an ultrasound perspective. Prenat Diagn. 1991 Apr; 11(4):227-33. View Abstract

  160. Toluene abuse during pregnancy: obstetric complications and perinatal outcomes. Obstet Gynecol. 1991 Apr; 77(4):504-9. View Abstract

My job as a high-risk obstetrician and geneticist combines my passion for understanding complex conditions and translating that information into compassionate and patient centered care. While the individual circumstances of a specific complication and family are always unique, a team approach assures compassionate, broad reaching and patient specific support.

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