Obstetrics - SSM Cardinal Glennon Children's Medical Center

SSM Maternity Care SUMMER 2012
FOCUS ON
Obstetrics
Medical News from SSM Maternity Care, SSM St. Mary’s Health Center
and the physicians of Saint Louis University School of Medicine
SM

ON THE COVER
Perinatal Genetics
Interventional Geneticist and OB/GYN Dr. Kimberly
Martin and Certified Genetic Counselor Darbey Raible,
MS, CGC, are an integral part of the genetics team at SSM
Maternity Care, evaluating, educating and supporting
patients who have been referred due to an increased risk for
fetal abnormalities from age, exposures or personal/family
histories. They, along with other specialists in maternal-fetal
medicine, offer consultation and a comprehensive array of
prenatal testing options. For these patients, Dr. Martin says
testing is a choice, and the main objective is to help patients
make an informed decision based on their values and goals.
FOCUS ON
obstetrics
SM
Editor In Chief
Sherlyn Hailstone
President
SSM Cardinal Glennon
Children’s Medical Center
Medical Editor
Gilad Gross, MD
Maternal-Fetal Medicine
Division Director
SSM St. Mary’s Health Center
Editor
Andrew Sutton
Physician Services Team Leader
SSM Maternity Care
Writer
Jessica Hedges
Physician Services Communications Specialist
SSM Maternity Care
For comments and suggestions, please email FocusOnObstetrics@ssmhc.com.

One-Stop-Shopping
for Continuing
Education
Opportunities
Education
2012
Connections -
a new CME/
CEU guide with
SSM Cardinal
Glennon, SSM
Maternity Care
and Saint Louis
University
School of Medicine educational
opportunities - was mailed to physician
offices in February 2012. If you did not
receive your guide or would like extras,
please e-mail
Jessica_Hedges@ssmhc.com.
To view a printable PDF of
Education Connections, go to
www.ssmhealth.com/maternity,
For Physicians, Education,
Education Connections.
First SSM
Maternity Care
High-Risk
Pregnancy Guide
Due Out This
Summer
Announcements
Expanded MFM Hours at SSM St. Clare
Health Center Coming in August
The Maternal-Fetal Medicine Specialists of SSM Maternity Care and
Saint Louis University School of Medicine: (top row, from left to right)
Gilad Gross, MD; Raul Artal, MD; Erol Amon, MD; Mike Vlastos, MD;
(bottom row, from left to right) William Holcomb, MD;
Thomas Myles, MD; Jaye Shyken, MD; and Dorothea Mostello, MD.
Beginning in August, MFM appointments will be available on Mondays,
Tuesdays, Wednesdays and Fridays from 7:30 a.m.-5 p.m.
Call 1-888-636-7642 to schedule an appointment with a maternal-fetal
medicine specialist at SSM St. Clare Health Center.
This
summer, two
additional maternal-fetal
medicine specialists joined
the Division of Maternal-Fetal
Medicine at Saint Louis University
School of Medicine and SSM Maternity
Care, comprising a team of 10 MFM
specialists. Look for a postcard about
the new physicians in the mail!
!
SSM St. Clare Health Center
St. Francis Building, Ste. G-10, 1011 Bowles Avenue
Fenton, MO 63026
Appointment Scheduling
Made Easy:
Fax Your Referrals
Look for the first issue of the SSM
Maternity Care Express Guide in your
mailbox this summer. The guide will be
published annually to include service
descriptions, locations, contacts and
physician information provided by
SSM Maternity Care, SSM St. Mary’s
Health Center, SSM Cardinal Glennon
Children’s Medical Center and
Saint Louis University School of
Medicine. To ensure your office is on
our mail list, please contact
Jessica_Hedges@ssmhc.com.
The Maternal Access Center Team (from left to right): Denise Hunker; Beth Miles;
Retha May, RDMS; Kathy Canchola, RN, BSN; and Jenny Michaelree.
With the SSM Maternity Care Access Center, we answer your calls quickly, but
you can skip the phone call completely with our secure fax scheduling service.
Just fax your patient order to 314-622-6472.
Our Maternal Access Center team will take care of the rest.
Go to www.ssmhealth.com/maternity, For Professionals,
Office Resources to print an MFM Referral Form.
1

It’s difficult to stay abreast of the latest high-risk maternal conditions and management options when complicated cases
only arise here and there. From diabetes in pregnancy to congenital heart defect screenings, take a refresher course online,
on your own time, while earning CME credit. And if it couldn’t get any better, it’s free!
New lectures available:
FREE CME!
“Management of Abnormal Pap Smears in Pregnancy”
– C. William Helm, MD, OB/GYN Oncology Specialist, SSM Maternity Care and
Saint Louis University School of Medicine
“Benign Thyroid Disease in Pregnancy”
– William Holcomb, MD, MFM Specialist, SSM Maternity Care
To view a presentation:
Log on to www.obstetricsondemand.com
Username: ds\r010-online
Password: webcme
To earn 1 CME Credit from St. Louis University School of Medicine:
Choose the link icon above the presenter’s window. Click TEST LINK.
Register (if you haven’t already), take the quiz and finish the evaluation.
Certificates are sent to your e-mail address within 48 hours.
To view neonatology lectures from SSM Cardinal Glennon Children’s Medical Center and Saint Louis University
School of Medicine neonatologists, log on to www.pediatricsondemand.com and follow the instructions above.
New neonatology lectures are posted monthly.
Sign-Up to Receive SSM Maternity Care News
on Demand for Obstetrical Updates
SSM Maternity Care News on Demand provides community OB/GYNs, nurses and office
staff with regular obstetrical updates that help you and your patients. The electronic newsletter
is e-mailed monthly. To receive the newsletter, send your e-mail address to Jessica_Hedges@ssmhc.com.
NOTE: We respect your privacy and are sensitive to the amount of electronic communication you receive.
Your e-mail address will not be shared with anyone outside the SSM Maternity Care Physician Services Department.
2

SSM Maternity Care Access Center
Proves Helpful to OB/GYNs and Staff
The Southern Illinois Healthcare
Foundation (SIHF) Team
From left to right: Dawn Feazel, Licensed Practical Nurse
Team Lead; Darryl Engeljohn, MD, OB/GYN;
Natalie Spruiel, Medical Assistant
"The Maternal
Access Center
process is quick and
simple. The person on
the other end is always
eager to help when we
call. It's a pleasure to
speak with such
friendly people."
- The SIHF Team
Call our dedicated Maternal Access Center:
• Maternal transports to SSM St. Mary's - The only
24-hour maternal transport team serving Metro
St. Louis, Metro East and the surrounding area
• MFM Consultations - 24/7 consultations with
maternal-fetal medicine specialists
• Direct Inpatient Admissions - Seamless
admission for high-risk patients to
SSM St. Mary's Health Center
• Outpatient Scheduling - Quick and easy
appointment scheduling at any
SSM Maternal & Fetal Care Center
Maternal & Fetal Care Centers:
SSM St. Mary’s Health Center • SSM St. Clare Health Center • SSM St. Joseph Hospital West
SSM DePaul Health Center • SSM St. Joseph Health Center • Anderson Hospital
3

SSM Maternity Care Launches
‘Your New Happy Born Here’ Campaign
The next time one of your
patients visits an SSM hospital
for maternity care, sees an
SSM Maternity Care ad in
her favorite magazine The
Bump or a billboard driving
down the highway, she may
notice a brand new look
and feel and messaging that
resonates with all moms and
moms-to-be.
Share our fun
“Which Mommy Are
You” quiz with your
patients and they’ll
receive a free
“Your New Happy”
tote bag.
Go to
www.whichmommy.com
to take the quiz.
4

Renovated Maternal & Fetal Care
Center at SSM St. Mary’s Health Center
Renovated Maternal & Fetal Care Center at SSM St. Mary’s Health Center (Page 5) (photo: St.
Mary’s MFCC, this should take up most of the article … since it’s just one sentence)
To schedule your patient to see a maternal specialist at the new Maternal & Fetal Care Center
space at SSM St. Mary’s Health Center, please call the Maternal Access Center at 1-888-636-7642.
To schedule your patient to see a maternal specialist at the
new Maternal & Fetal Care Center space at SSM St. Mary’s Health
Center, please call the Maternal Access Center at 1-888-636-7642.
Diversions
Andrew Sutton
Physician Services Team Leader
2008 Nalle Winery Reserve Chardonnay
The weather is warming up, and it’s time for long evenings on the patio with a group of good friends. One of the
friends you should bring to the party is the 2008 Nalle Reserve Chardonnay.
Nalle Winery is a tiny, family-owned operation in the Dry Creek Valley in Sonoma’s wine country. So tiny, in fact,
that it’s literally a mother, father and son that run the winery and make the wine. I had a chance to visit them this past
summer and fell in love with their laid-back attitude, and their simply outstanding Burgundy style wines.
The grapes are sourced from the Hopkins Ranch in Russian River Valley, where cool temperatures and fog allow the
grapes to develop slowly with just the right amount of acidity, and elegance. This wine shows fantastic nose of ripe
fruit, with a touch of vanilla, and a little bit of apple. Its mouth feel sways a little toward medium than light, showing
the kiss of oak from a short barrel fermentation, balanced by a touch of crispness and acidity. This is a very wellbalanced
wine that is an absolute joy to consume. Available through the Nalle website for $42, I would put this wine
up against a Premier Cru Burgundy any day of the week. YUM! www.nallewinery.com
5

Perinatal Genetics
Expert, Comprehensive Support through
Education, Diagnosis and Treatment
Pregnancy is a wonderfully exciting time for most
women, but the question “What if there’s something
wrong with my baby” crosses every mother’s mind,
even just once. At SSM Maternity Care, our team
of geneticists is available to you and your patients
for guidance, counseling, education, diagnosis and
treatment.
“We recognize that genetic testing is a choice,” says
Kimberly Martin, MD, SLUCare/SSM Maternity Care
Interventional Geneticist and OB/GYN. “We don’t
usually recommend specific testing. Instead, we help
each family understand their options and encourage
them to choose testing that’s right for them. Sometimes,
that’s no test at all.”
Dr. Martin and her team see up to 40 patients a day.
Some of these patients have been referred by their OB/
GYN because they are considered at increased risk for
a birth defect, while others may not be considered “at
risk,” but are interested in learning more about available
testing to determine whether their baby is healthy.
According to Dr. Martin, at least 3 percent of babies are
born with some type of birth defect or handicapping
condition. No matter the situation, the referring
obstetrician and patient can be assured that the utmost
importance is placed on communication and personal
coordination between the health care team.
“Because we offer such a wide variety of services, and
we see patients for a wide variety of indications, our
Looking up at the flat screen monitor of her baby boy in utero, Heather Hipkins can’t believe how much her son has grown since
her last ultrasound just a few weeks before.
SLUCare/SSM Maternity Care Maternal-Fetal Medicine Specialist Gilad Gross, MD, was happy to report that Heather’s little
guy is progressing well and at 16 weeks, anatomically, everything looks great.
6
Because of Heather and her baby’s hereditary bone condition, Trichorhinophalangeal Syndrome (TRPS), both mom and baby
will be monitored closely and co-managed by a multidisciplinary team that includes her primary obstetrician, an MFM, maternal
geneticist and certified genetic counselor. She sees Dr. Gross at the Maternal & Fetal Care Center at SSM St. Joseph Hospital
West (one of six locations) every few weeks, which is conveniently located near her home and office.

approach is absolutely tailored to each patient’s specific
needs. Obstetricians referring to our team can be sure
that we will work closely with them to provide the
appropriate, high quality and comprehensive care their
patients deserve,” says SLUCare/SSM Maternity Care
Certified Genetic Counselor Darbey Raible, MS, CGC.
Dr. Martin supports this notion. “Open communication
and a partnership with the primary health care provider
is critical,” she says. “Our goal is to keep the patient’s
care with the primary provider unless the condition
requires complete or specialized care.”
At 41 years of age, patient Heather Hipkins is at
increased risk to have a baby with a chromosome
abnormality, such as Down syndrome. But
Trichorhinophalangeal Syndrome (TRPS), the rare,
inherited bone disease she was born with, is the
main reason Heather was referred to SSM Maternity
Care. The disease does not allow Heather to properly
absorb calcium, which is cause for her numerous
hospitalizations, multiple surgeries and concern for
her developing baby. It is inherited in an autosomal
dominant fashion, meaning there is a 50/50 chance that
Heather’s baby will inherit the changed gene causing
TRPS. Heather first met with SLUCare/SSM Maternity
Care Maternal-Fetal Medicine Specialist Gilad Gross,
MD, to address her calcium intake while pregnant and
physical ability to carry and deliver her child. Her next
appointment was with the genetics team.
“I saw Darbey first,” Heather says. “We discussed
my family history and she explained what they try to
accomplish and broke down the details of my genetic
disorder. It was phenomenal, so detailed and interesting.”
Because most of the
information presented
to patients during the
genetics counseling session
is new and sometimes
overwhelming, Darbey
sets a conversational
tone and only discusses
information applicable
to the patient. “Assessing
what information is going
to be most important to
the patient I am working
with allows me to tailor
the discussion so that it is
personal and relevant to
them,” she says. “We often
use pictures and diagrams
to help make the concepts less abstract and make the
counseling session a conversation, where I’m not the
only one talking but the patient is explaining to me their
A chorionic villus sampling (CVS) taken by Dr. Martin in
Heather’s first trimester confirmed that her baby is affected
with the same rare bone disease she lives with.
Dr. Gross reviews Heather’s lab work that shows her
increased calcium supplements are working. Because of the
TRPS, she has difficulty retaining calcium.
Heather was relieved to know that Dr. Gross discussed her
prenatal care plan with her endocrinologist of nearly 30
years. “It’s important to me that he stays in the loop. He
knows a lot about my history and may be able to give Dr.
Gross some helpful information,” she says.
understanding of what has been discussed.” In addition,
take-away materials are provided so that the patient has
more time to digest the information after the meeting
and share with their partner, family, and other health
care providers if desired.
Based upon the information Darbey provided and after
meeting with Dr. Martin, Heather opted to go forward
with a test called chorionic villus sampling (CVS).
Performed as early as 10 weeks of pregnancy, the test
would determine whether the baby has the correct
number of chromosomes, and the sample could be tested
to determine if the baby
had inherited the TRPS
gene.
Dr. Martin explained
to Heather that it is not
unusual to have some
spotting after the CVS,
and that she could call
the SSM Maternity
Care team if she had
any worries. Heather
did have spotting and
naturally, was worried.
The Maternal & Fetal
Care Center (MFCC) at
SSM St. Joseph Hospital
West got Heather in to
see an MFM immediately. “I love Becky the ultrasound
technician,” Heather says. “She knew I was scared, so
she showed me right away that everything looked okay
7

on the ultrasound.” Heather also saw Dr. Gross who
reassured her that the light bleeding was normal and not
causing any trouble for the baby.
A few days later when Heather was still spotting, she
called the after hours physician exchange. Heather
continues, “Within minutes, Dr. Nguyen called me
back. He explained that since the blood was dark in
color, it was just my body recovering from the test.”
[Dr. Thinh Nguyen joined the SLUCare/SSM Maternity
Care MFM team this summer.] This team approach
to the care of one patient is everyday practice at SSM
Maternity Care.
“The team of SLUCare/SSM Maternity Care providers
are a compassionate, collegial group,” Dr. Martin says.
“With no exception, we all agree that the patient comes
first.”
Daily communication and monthly case conferences
are just a couple ways the team keeps the patient at the
forefront. “Our provision of patient care is very much
a collaborative effort,” Darbey says. “We frequently
consult one another on cases, which I believe raises the
expertise of everyone’s practice. In addition, our monthly
conferences allow us to review and critically assess recent
cases to identify ways to improve patient care.” Like the
old saying goes, “It takes a village to raise a child” – the
same could be said for a pregnancy.
“It takes a village to care for a pregnant woman,” Dr.
Martin says to Jarita Sanders during her latest visit to the
MFCC at SSM St. Mary’s Health Center.
Jarita is pregnant with her third child, and for the third
time was diagnosed with gestational diabetes early in her
pregnancy. She is being treated by the diabetes team of
SLUCare/SSM Maternity Care specialists that include a
maternal-fetal medicine specialist, diabetes educator and
dietician. Dr. Martin and Darbey met Jarita after one
of her first trimester ultrasounds showed a large nuchal
translucency measurement.
“Our team has had extra training and certification in
ultrasound evaluation for babies with birth defects,”
Dr. Martin says. “All babies have some fluid under the
skin at the back of the neck in the first trimester; but
“Congratulations! We were so worried about this little one, and now we are just checking things off the list,”
SLUCare/SSM Maternity Care Interventional Geneticist Kimberly Martin, MD, tells Jarita during an appointment.
Jarita’s baby girl had an abnormally large nuchal translucency measurement taken during a first trimester ultrasound
examination, but a CVS and later ultrasound revealed a structurally normal baby. Dr. Martin referred Jarita
to Fetal Cardiologist Renuka Peterson, MD, at SSM Cardinal Glennon Children’s Medical Center for a fetal
echocardiogram, which also proved normal.
“Dr. Peterson was wonderful,” Jarita says. “She explained everything she was looking for during the echo and said
everything looked fine.”
8

most babies have a small amount, the average being less
than 2 mm. Babies with chromosome abnormalities and
some other birth defects tend to have more fluid. To use
this measurement to determine individual risks for fetal
abnormalities, the nuchal translucency measurement has
to be very precise, and the SSM Maternity Care team has
extensive experience with this evaluation.” The nuchal
translucency measurement for Jarita’s baby was 4.6 mm.
“I was in utter shock when I learned this measurement
could mean my baby has Down syndrome,” Jarita says.
“Darbey and Dr. Martin were very kind and explained
the causes, risks and options for testing. Darbey said it
was completely up to me if I wanted to do the CVS and
that I should think about it.” Jarita did decide to have
the CVS performed by Dr. Martin and within a week,
she received good news. The CVS was normal and an
ultrasound 6 weeks later showed a nuchal measurement
of 5 mm, normal for the baby’s size.
“Families who are referred to me due to known or
suspected abnormalities are often very anxious. The
ultrasound test is not definitive, and that’s why some
families choose to go the extra step with CVS or
amniocentesis,” Dr. Martin says. “Most of the time I’m
able to give families a lot of reassurance, and then call
them with the normal results of diagnostic testing. If I
didn’t have the opportunity to call families with good
news, I couldn’t have stayed in this field of medicine for
20 years!”
Dr. Martin discusses how results will be communicated
with the family before the testing takes place. How and
when they want to receive the information is completely
up to them. “When there is a significant chance that
the results will be abnormal, I know it is often best that
the call come at a time when the couple is together, and
we are all at a time and place in our day when we can
talk openly,” she says, adding, “I notify their primary
OB/GYN provider first and then contact the family. If
the patient’s primary provider would like to deliver the
news, I make sure they know I’m available for questions.
The most important thing is that the family does not
feel alone. It’s not unusual for me to give the family and
Ultrasound photo of Jarita’s baby’s nuchal translucency
measurement in the first trimester. Since Jarita has early onset
gestational diabetes, and the measurement is large compared
to the baby’s size, Dr. Martin says the baby is at an increased
risk for birth defects.
An ultrasound six weeks later shows Jarita’s baby to have a
normal nuchal skin thickness in comparison to the baby’s
increased size.
SLUCare/SSM Maternity Care Certified Genetic
Counselor Darbey Raible, MS, CGC, uses a photo
to show Jarita what an enlarged nuchal translucency
measurement looks like and discusses the possible
chromosome abnormalities that might be present.
As a genetic counselor, Darbey collects and interprets patient histories and assists them in understanding the risks
for their babies and options available for prenatal screening or testing. “Throughout the entire process, we remain
available to patients as a source of information and support to make their situation a bit easier to navigate,”
Darbey says.
9

Molecular Cytogenetics Lab
at SSM Cardinal Glennon
Children’s Medical Center
State-of-the-art technology,
thorough testing, reliable results
The goal of the Molecular Cytogenetics Lab at SSM
Cardinal Glennon Children’s Medical Center is to
provide patients with the best diagnostic testing
in the shortest time possible. “We are fortunate to
have a molecular cytogenetics lab,” Dr. Martin says,
adding, “We work well together to determine the best
diagnostic testing for each family and provide reliable
and timely results.”
provider my cell phone number or to spend an hour on
the phone in the evening with a family.”
Whether the baby requires surgery or will need to see
a pediatric geneticist after birth, SSM Maternity Care
supports patients during and after pregnancy with
a multidisciplinary team of obstetric and pediatric
geneticists, maternal-fetal medicine specialists, fetal
surgeons, counselors and other pediatric sub-specialists.
The initial results of Heather’s CVS showed that her
baby did not have any chromosome abnormalities such
as Down syndrome, and that she was having a baby boy.
A few weeks later, the test for TRPS showed that the
baby had inherited Heather’s changed gene. Like most
genetic disorders, it is not possible to determine the exact
difficulties he will face until after he is born and begins
to grow. “We pass 75,000 genes to our kids and have
no control over which ones they get,” Dr. Martin says.
“Heather’s little boy is lucky to have such a remarkable
mother, and we will follow her baby closely to try to
avoid some of the difficulties Heather has conquered
with such courage and grace.”
Heather was disappointed to learn that her little boy will
face many of the same challenges she has throughout her
life, but her outlook remains positive. “This news won’t
change my pregnancy,” Heather says. “I will continue
to work out, eat healthy, get plenty of sleep and stay as
positive as possible.”
For someone who spent her childhood in a hospital and
has had seven surgeries in the last seven years, Heather
knows a thing or two about quality care. “I absolutely
love Dr. Martin and Darbey. Both my husband and I
have learned so much from them,” she says. “They are
very professional, extremely intelligent and helpful with
any questions that we have. I would recommend them to
anyone who may need their assistance.”
Genetic
Services Available
at SSM Maternity Care
High-resolution ultrasound
Diagnostic testing in pregnancy – chorionic
villus sampling, amniocentesis
First and second trimester screening for Aneuploidy
Fetal blood sampling and transfusion
10
Prenatal fetal surgery and therapy

The St. Louis Fetal Care Institute
at SSM Cardinal Glennon
Children’s Medical Center
Dr. Martin sees patients for genetic disorders at the
Maternal & Fetal Care Center at SSM St. Mary’s Health
Center as well as the St. Louis Fetal Care Institute (FCI)
at SSM Cardinal Glennon Children’s Medical Center.
“Patients I see at the Fetal Care Institute have often
received information that their baby has a birth defect or
other condition. They are referred to the FCI so they can
meet with the variety of specialists who may be involved
in the care of their baby,” Dr. Martin says. Typically,
the multidisciplinary team includes a fetal surgeon,
maternal-fetal medicine specialist, geneticist, patient-care
coordinator and in most cases a neonatologist and other
sub-specialized pediatric providers. Dr. Martin adds, “At
(From left to right) Pediatric and Fetal Surgeon Ed
Yang, MD, and Maternal-Fetal Medicine Specialist
Mike Vlastos, MD, co-direct the St. Louis Fetal
Care Institute, providing state-of-the-art diagnostic
services, evidence-based prognostic information and
appropriate fetal interventions. In this photo, Drs.
Yang and Vlastos perform a tracheal occlusion for a
fetus with Congenital Diaphragmatic Hernia (CDH).
They are the first in the world to successfully inject a
dissolvable hydrogel in the fetus’ trachea instead of a
detachable balloon.
SSM Cardinal Glennon we offer fetal MRI, which is often helpful in evaluating specific types of birth defects such
as those involving the Central Nervous System. We also have the expertise of two gifted pediatric cardiologists, Dr.
Renuka Peterson and Dr. Angela Sharkey, who provide detailed assessments of baby’s hearts before birth, and can
help families understand any abnormalities that are found and what is expected for their child after delivery.”
As the most comprehensive fetal care center in middle-America, the St. Louis Fetal Care Institute has provided
innovative, compassionate care to mothers whose babies have congenital, structural and genetic anomalies since
2009. The FCI is led by a nationally recognized, expert team of physicians who are experienced in leading-edge
treatments and technologies, ensuring the best possible results for patients. The new clinical suite at SSM Cardinal
Glennon offers patient-centered care with two nesting rooms, an ultrasound examination and treatment room, and a
large conference/consultation room to allow the family to meet with a larger care team.
Available Fetal Interventions
for appropriate fetal diagnoses
Fetoscopic procedures:
• Laser photocoagulation for Twin-Twin Transfusion
Syndrome
• Fetal cystoscopy and posterior urethral valve
ablation for bladder outlet obstruction
• Resection of constricting Amniotic bands
Open fetal procedures:
• Open repair of open neural tube defects
• Resection of sacrococcygeal teratomas
• Resection of giant lung lesions
• EXIT procedure – Ex utero intrapartum treatment
for airway obstruction and unstable congenital
heart defects
Other therapeutic fetal procedures:
• Fetal transfusions
• Thoracic or vesicoamniotic shunt placement
To contact the St. Louis Fetal Care Institute at SSM Cardinal Glennon Children’s Medical Center,
please call 314-268-4037 or 877-776-3385 or e-mail fetalcare@ssmhc.com. To learn more about
the St. Louis Fetal Care Institute, go to www.stlouisfetalcare.com.
11

Q&A
Kim Martin, MD
Interventional Geneticist and OB/GYN, SSM Maternity Care
Adjunct Associate Professor of Obstetrics and
Gynecology, Saint Louis University School of Medicine
Q: Why did you choose to specialize in genetics What is it about
Saint Louis University and SSM Maternity Care that made you want to practice here
A: When I was a resident, ultrasound was becoming a much more important tool in obstetrics and gynecology, and
I really enjoyed doing it. I realized that the ability to identify healthy babies and babies with birth defects/genetic
disorders was going to increase, and I wanted to be a part of this emerging technology. Similarly, an explosion in genetic
information was taking place at that time. I decided to specialize in genetics because this knowledge seemed to blend
perfectly with ultrasound. Saint Louis University and SSM Maternity Care is a natural fit for me because there is a
large ultrasound practice. The Division of Maternal-Fetal Medicine is very strong, but it did not have a board-certified
medical geneticist. My skill set complements the other members of my division well. I truly love my job here.
Q: What do you like best about your job
A: Like most doctors, my job is different every day. I never know what we will find with our ultrasound machine, and
every family I meet is unique. This daily variety keeps me interested and enthusiastic. I am happy to get up and go to
work every day, and this is good for me and my patients. Despite almost 20 years in practice, I am still amazed by how
much there is to learn. Saint Louis University and SSM provides a very stimulating atmosphere.
Q: How does the genetics team stay up-to-date on the latest research, diagnostic testing and technology available
A: Like all areas in medicine, knowledge continues to increase exponentially. Genetics is no different, and with
completion of the Human Genome Project, the number of genetic disorders for which specific testing is available,
is rapidly growing. Just last week we sent blood from a couple which will be used to sequence all known functional
regions of their genomes! We attend national conferences and routinely read publications, but we also work closely with
other geneticists here at SLU and SSM, and around the world. Laboratories often specialize in one or two disorders,
so almost every week we interact with other institutions. Right now we are corresponding with a lab in Taiwan and
may be shipping some samples there. Fortunately, there are several online databases that we can utilize to research the
particular disorder and find the best laboratory to do the testing. We often consult with several labs before making a
decision about where a particular test will be performed.
Q: Do you have a particular patient care philosophy that has guided you throughout your career
12
A: There are two basic principles that I think exemplify what I strive to achieve in my practice. The first is that the right
thing to do in any situation is what is best for the patient; and that takes precedence over my schedule, and usually
my private life. When I enter a patient’s room, I am 100 percent in the room, and do my very best to meet whatever
needs they have and ensure that their questions are answered, even if the answer is “I don’t know, but I will try to find
the answer for you.” The second principle is that it is essential that families understand their genetic and obstetrical
risk factors so that they can make informed choices about the options that are available to diagnose and/or treat them.
Something that distinguishes a geneticist from other medical specialists is that our counseling of patients is, above
all, non-directive. Our responsibility is to educate families so that they are empowered to make choices that are best
for themselves within the context of their personal, professional, moral, and religious community and to support and
affirm those choices.
To reach Dr. Martin or to make an appointment at an
SSM Maternal & Fetal Care Center, please call 1-888-636-7642.

FOCUS ON
FACULTY
Genetic Specialists
Kimberly Martin, MD
Adjunct Associate Professor of Obstetrics and Gynecology,
Saint Louis University School of Medicine
MD: McGill University, Montreal, Quebec
Internship: University of Western Ontario
Residency in Obstetrics and Gynecology:
University of Western Ontario
Fellowship in Medical Genetics: University of British Columbia
Rachael Bradshaw, MS, CGC
BA, Biology: Earlham College
MS, Medical Genetics: University of Cincinnati
Meg Hefner, MS, CGC
BS, Zoology and Psychology: University of Toronto
MS, Human Genetics: University of Michigan
Darbey Raible, MS, CGC
BS, Biological Sciences: University of Notre Dame
MS, Medical Genetics: University of Cincinnati
Maternal-Fetal
Medicine Specialists
Raul Artal, MD
Chairman, Department of Obstetrics, Gynecology and Women’s
Health at Saint Louis University School of Medicine
Professor of Obstetrics and Gynecology,
Saint Louis University School of Medicine
MD: Sackler School of Medicine, University of Tel-Aviv, Israel
Rotating Internship: Beilinson Hospital, Israel
Residency in Obstetrics and Gynecology: Beilinson Hospital,
Israel; Case Western Reserve University/Metro General Hospital
Fellowship in Maternal-Fetal Medicine:
Harbor-UCLA Medical Center
Gilad Gross, MD
Division Director, Maternal-Fetal Medicine at
SSM St. Mary’s Health Center
Medical Director, Labor and Delivery, Antepartum and
Postpartum at SSM St. Mary’s Health Center
Professor of Obstetrics and Gynecology,
Saint Louis University School of Medicine
MD: Saint Louis University School of Medicine
Residency in Obstetrics and Gynecology:
University of Missouri-Kansas City
Fellowship in Maternal-Fetal Medicine, OB/GYN:
Washington University School of Medicine
Erol Amon, MD
Director, Maternal-Fetal Medicine Fellowship at
Saint Louis University School of Medicine
Professor of Obstetrics and Gynecology,
Saint Louis University School of Medicine
MD: Northwestern University Medical School
Internship and Residency in Obstetrics and Gynecology:
Saint Joseph Hospital, Northwestern University Medical School
Fellowship in Maternal-Fetal Medicine:
University of Tennessee Center for Health Sciences
William Holcomb, MD
Maternal-Fetal Medicine Specialist, SSM Maternity Care
MD: Indiana University
Residency in Obstetrics and Gynecology:
Washington University School of Medicine
Fellowship in Maternal-Fetal Medicine:
Washington University School of Medicine
Dorothea Mostello, MD
Director, Diabetes in Pregnancy Program at
Saint Louis University School of Medicine
Associate Professor of Obstetrics and Gynecology,
Saint Louis University School of Medicine
MD: The Johns Hopkins School of Medicine
Residency in Obstetrics and Gynecology:
University of Colorado Health Sciences Center and
Affiliated Hospitals
Fellowship in Maternal-Fetal Medicine:
University of Cincinnati
Thomas Myles, MD
Director, Maternal-Fetal Medicine Outreach Program at
SSM St. Mary’s Health Center
Professor of Obstetrics and Gynecology,
Saint Louis University School of Medicine
MD: Saint Louis University School of Medicine
Residency in Obstetrics and Gynecology:
Illinois Masonic Medical Center
Fellowship in Maternal-Fetal Medicine: Rush-Presbyterian,
St. Luke’s Medical Center
Jaye Shyken, MD
Associate Professor of Obstetrics and Gynecology,
Saint Louis University School of Medicine
MD: University of Missouri School of Medicine
Residency in Obstetrics and Gynecology:
University of Missouri and Clinics
Fellowship in Maternal-Fetal Medicine:
Washington University School of Medicine
Mike Vlastos, MD
Co-Director, St. Louis Fetal Care Institute
Assistant Professor of Obstetrics and Gynecology,
Saint Louis University School of Medicine
MD: Creighton University
Residency in Family Practice: University of Wyoming
Residency in Obstetrics and Gynecology: Regions Hospital
Fellowship in Maternal-Fetal Medicine:
Washington University School of Medicine
13

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