Global Network for Perinatal and Reproductive Health

Global Network for Perinatal and Reproductive Health

Mail code: L466
3181 SW Sam Jackson Park Road,
Portland, OR 97239

Global Network Investigators

Tsungai Chipato, M.B., Ch.B., M.R.C.O.G.
University of Zimbabwe, Harare, Zimbabwe

Tsungai Chipato, M.B., Ch.B., M.R.C.O.G.Harare Maternity Hospital is the largest hospital in Zimbabwe with full services in all areas of obstetrics and gynecology. It has a long track record of excellence in clinical research, including efforts in maternal mortality, sexually transmitted diseases, infections of the reproductive tract, contraception utilization, adolescent pregnancy, HIV infection, cervical cancer, male sexuality, and male fertility. This center has participated in large international trials including one recently conducted to test the effect of magnesium sulfate in eclampsia, recently published in Lancet and which is being used to define clinical management around the world. The department has secured significant international funding and is a WHO collaborating center for research in human reproduction. There is a fully developed clinical epidemiology unit with a graduate diploma in clinical epidemiology and formal teaching in epidemiology, biostatistics, health economics and health social sciences. The principal investigator, Dr. Tsungai Chipato is also Chairman of the Department of Obstetrics and Gynecology.

Rodrigo Cifuentes, M.D., Ph.D.
Hospital Universitario del Valle, Cali, Colombia

This center is well recognized in the country and Latin America for excellence in care and progressive research in reproductive and public health. It is a tertiary care, teaching center which serves as the center of reference for all other hospitals in the city of Cali. The Department of Obstetrics and Gynecology has twenty four faculty members. A total of 8,500 deliveries are cared for at the center in a year. Pre-eclampsia and preterm birth are the most common pathologies seen, in addition to complications of induced abortion. A research center, CEMIYA, is part of the Department. Ongoing research includes genetic polymorfisms in preeclampsia, therapy of HELLP syndrome with corticosteroids and use of Misoprostol in pregnancy. The P.I. at this center has extensive experience in research in reproductive health and is a Professor in the Department.

José de Codes, M.D., Dr. PH
Federal University of Bahia School of Medicine, Salvador, Brazil

The Maternity Hospital Climerio de Oliveira belongs to the Federal University of Bahia, Brazil. It is the hospital where medical students, interns, and residents of the medical school receive obstetrical training. They rotate and provide service under teaching supervision in all the existing clinical services of the hospital. The hospital has 60 obstetrical and 12 high-risk beds. A prenatal clinic provides around 1,000 prenatal consultations per month. A family planning clinic started its operation in July 1998. It has attended 1,200 clients from the community. The clinic is expanding now to serve high reproductive risk patients identified during the prenatal period. There is an ultrasonography service, a laboratory of clinical pathology that performs blood and urine tests. A laboratory of cytogenetics is now starting operation. The principal investigator is an Associate Professor in the Department of Obstetrics, Gynecology and Human Reproduction.

Vineeta Das, M.B.B.S., M.D.
Shally Awasthi, M.B.B.S., M.D., DNB, MS
King George Medical College, Lucknow, India

King George Medical College was established more than 100 years ago. It is affiliated to Lucknow University. It has a 2250 bed hospital. It provides health care to a vast population from central India. There are 36 Departments, 300 faculty, 600 postgraduate students and 800 undergraduates. The institution is involved in major research projects. It has an Institute of Clinical Epidemiology. The Departments of Pediatrics and Obstetrics and Gynecology have been associated with important and policy relevant research work. Extramural funding from USAID, University of Oxford, INCLEN, WHO, ICMR, DBT and DST. Dr. Awasthi and Dr. Das are Professors in the Departments of Pediatrics and Obstetrics and Gynecology respectively and are faculty members of the Clinical Epidemiology unit. They have completed many projects related to child survival and safe motherhood. In addition both have worked in the field of reproductive tract infections in males as well as females.

Sean Daly, M.D.
Coombe Women's Hospital, Dublin, Ireland

Sean Daly, M.D.The Coombe Women's Hospital is the largest healthcare provider for women in the Republic of Ireland. In the year 2000, there were just under 7,500 deliveries in the hospital. The hospital provides care both as a primary care centre for the women of West Dublin and as a tertiary care institution for Ireland. There is a level three nursery in the hospital. In addition, the hospital has the largest gynaecological workload in Ireland. Projections based on the growing birth rate, the urbanization of the population and the re-organization of the provision of healthcare within Dublin will result in approximately 8,000 deliveries annually in the hospital. The Master, or CEO of the hospital, who is the principal investigator, will take primary responsibility for the proposed projects with the assistance of the Director of Pathology. This offers commitment at the highest level within the institution.

Mario R. Festin, M.D.
University of the Philippines, Manila, The Philippines

Mario R. Festin, M.D.The Philippines General Hospital and its Department of Obstetrics and Gynecology are the main University Tertiary Center in the country. Services in all areas of Obstetrics and Gynecology are available; there are animal laboratory facilities and a well developed and established clinical epidemiology unit. The Department of Obstetrics and Gynecology, offers a four year residency program and postgraduate training programs in Gynecologic Oncology, Infectious Diseases, Trophoblastic disease and Reproductive endocrinology. Dr. Festin is the Vice Chancellor for Research in the University and Executive Director of the National Institutes of Health in the Philippines. A clinical epidemiologst, was formerly the Assistant Chairman for the Department of Obstetrics and Gynecology where currently multiple ongoing projects funded by international and local agencies in the areas of fetal growth, management of preeclampsia, patient satisfaction, sexually transmitted diseases, and vaginal infections, are conducted.

Hernando Gaitán, M.D.
Juan Carlos Sabogal, M.D.
Universidad Nacional de Colombia, Instituto Materno Infantil, Santa Fé de Bogotá, Colombia

Hernando Gaitán, M.D. This institute is the main center providing reproductive health care to a vast segment of the population in Bogotá, the capital city of Colombia. It has a long track record of excellence in clinical research. Its results have been applied in different settings in the world in neonatal and perinatal care. It has a particular strength in the diagnosis and treatment of septic complications of pregnancy including complications of abortion. Counts with all the services in obstetrics and gynecology and provides postgraduate education to residents and fellows in all areas of the field. It has close ties with government supported research institutes conducting research in reproductive health, as well as to the main teaching hospital of the National University. The principal investigator for the project is the Director of Clinical Epidemiology. The focus of current research activities are the areas of antibiotic use in pelvic inflammatory disease, vaginal infections, evaluation of laparoscopy, contraception, perinatal infections, and preeclampsia.

Ricardo Gómez, M.D.
Hospital Sotero del Río, Universidad Católica de Chile, Chile

Sotero del Río Hospital is one of the largest maternities of the country, with 9,000 deliveries per year. It provides tertiary care to a vast population of the south-east region of Santiago. Clinical research is conducted with the approval of two review boards and emphasizes the development of new strategies to understand and prevent common obstetrical complications. Academic activities are carried out in affiliation with Catholic University of Chile and includes under and post-graduate medical education. Staff of the high risk pregnancy unit has been recently appointed to lead a national effort aimed to generate guidelines for the practice of obstetrics in the country.

Xu Liangzhi, M.D., M.Sc.
West China University of Medical Sciences, Chengdu, P.R. of China

Xu Liangzhi, M.D., M.Sc.The principal investigator has conducted important work in the areas of maternal mortality and postmenopausal care. The study of infections of the reproductive tract in China has not progressed as rapidly as in other areas of the world, being one of the reasons why the principal investigator and her group are very keen in developing such an effort. Laboratories in the areas of microbiology, reproductive endocrinology, pathology, genetics and reproductive immunology are fully operational. Technologies available include PCR immunoassays, and standard testing. The department counts with other technologies available including antepartum health surveillance. There is a Perinatal Health Network in the city of Chengdu where ongoing statistics are obtained and care for patients is provided. The hospital is a women's and children's hospital. A Clinical Epidemiology Unit is well developed and established.

Sompop Limpongsanurak, M.D., M.P.H.
Surasith Chaithongwongwatthana, M.D.
Chulalongkorn University, Bangkok, Thailand

Sompop Limpongsanurak, M.D., M.P.H.Surasith Chaithongwongwatthana, M.D.This center is one of the leading academic institutions in Thailand. It is the national streptococcus reference center in Thailand. Since 1981, it has an established Clinical Epidemiology Research and Training Center, part of INCLEN. The principal investigator has been very active in developing clinical research within his department and as a result of such activity has been involved also in the development of research at this university. He has had administrative roles with the Royal Thai College of Obstetricians and Gynecologists and his research interests have focused on gestational trophoblastic disease, infections in pregnancy, and HIV-infection in reproductive health. He has conducted work in evaluation of adolescent pregnancy as well as vaginal infections. This center has fully capable laboratory facilities with retroviral research technology available and a very close relationship with the Thai Red Cross and other laboratories and facilities. The department is involved in clinical research in the areas of menopause, assisted reproductive technology, maternal-fetal medicine, oncology and infections of the reproductive tract. The department is also a WHO collaborating center for research in human reproduction and a JHPIEGO (Johns Hopkins Programs on International Education of Obstetrics and Gynecology) collaborative center.

Pisake Lumbiganon, M.D., M.S.,
      Coordinator, Global Network for Perinatal & Reproductive Health
Jadsada Thinkhamrop, M.D., M.Sc.
Khon Kaen University, Khon Kaen, Thailand

Pisake Lumbiganon, M.D., M.S.Jadsada Thinkhamrop, M.D., M.Sc.This center is a well established research institution in this region of the world. A Clinical Epidemiology Unit has been functioning very effectively for many years now and the principal investigator has developed collaborative research initiatives with colleagues worldwide. This center is one of the centers taking part in WHO sponsored clinical trials of misoprostol to reduce maternal mortality and evaluation of antenatal care. Dr. Lumbiganon serves as coordinator for the GNPRH with Dr. Tolosa and is also a member of multiple advisory committees for WHO, is the Chairman of the Department of Obstetrics and Gynecology and is a member of the Editorial Board of the British Medical Journal. He has extensive international and national publications, most recently two large RCT's on evaluation of antenatal care and use of misoprostol to reduce post-partum hemorrhage. Dr. Thinkhamrop the co-principal investigator has significant experience in the study of vaginal infections as well as conduction of clinical trials.

V.K. Paul, M.D., Ph.D.,
Suneeta Mittal, M.D.
All India Institute of Medical Sciences, New Delhi, India

V.K. Paul, M.D., Ph.D.Suneeta Mittal, M.D.The All India Institute of Medical Sciences (AIIMS), is the foremost medical school in the country. Created as an autonomous institution through an Act of Parliament in 1956, AIIMS leads the Nation in medical education, health sciences research and patient care. The perinatal-neonatal services provided by the Departments of Obstetrics and Gynecology and Pediatrics (Division of Neonatology) are well recognized for setting standards in the country. The Principal Investigator has conducted studies on maternal genital tract infections due to genital mycoplasmas and Chlamydia trachomatis and their association with prematurity/LBW and conducted a trial of antenatal erythromycin to reduce these adverse perinatal outcomes. The Department of Obstetrics and Gynecology had been involved in WHO funded studies on reproduction. The present studies by the Co-principal Investigator include the WHO sponsored studies on mifepristone for emergency contraception and its comparison with Levonorgesterol, and a medical method for termination of pregnancy using mifepristone. The Division of Neonatology is currently the WHO Collaborating Centre for Training and Research in Newborn Care for the South-East Asia region.

Abraham Peedicayil, M.B.B.S., D.G.O., M.D., M.P.H., M.R.C.O.G.
Christian Medical College and Hospital, Vellore, India

Abraham Peedicayil, M.B.B.S., D.G.O., M.D., M.P.H., M.R.C.O.G. This center is one of the largest in India with a fine reputation for pioneering innovation in medicine including being the first hospital being able to perform neurosurgery, open heart surgery, and kidney and bone marrow transplants. It has a fully approved residency program in obstetrics and gynecology and all services related to the practice of obstetrics and gynecology. The Department of Obstetrics and Gynecology has participated in large multicenter trials including a clinical trial with the Medical Research Council to study eclampsia, which is now the study that has established the standard of care around the world. Other research projects include: the ethnic variation and duration of pregnancy and studies on methotrexate, its utilization in hydatidiform moles, and infections of pregnancy. One of the ongoing interests is the study of the best method for induction of labor. There is a fully staffed laboratory for microbiology, pathology, cytology, and pharmacology. There is a fully operational animal research facility and a Clinical epidemiology Unit is well established. The principal investigator, the president of Vellore Obstetrical and Gynecological Society, holds multiple postgraduate degrees and has published extensively nationally and internationally.

Manorama Purwar, M.D., D.G.O., M.S.
Government Medical College, Nagpur, India

Manorama Purwar, M.D., D.G.O., M.S. This center is the largest health care provider for women in Central India. The hospital provides primary care for the women of Nagpur and secondary and tertiary care for Vidharbha region. It is the hospital where medical students, interns and residents of the medical school receive obstetrical training. The hospital has 210 obstetrical and Gynecological beds. Prenatal care is provided six days a week with 70-250 consultations per day and approximately 10,000 deliveries a year. There is a fully staffed laboratory for microbiology, pathology, and cytology. Dr. Manorama Purwar is an Associate Professor and Unit In charge III in the Department of Obstetrics and Gynaecology Society and a past President of Nagpur Obstetrics and Gynaecology Society and has extensive National and International publications. There is a fully developed Clinical Epidemiology Unit since 1992 where Dr. Purwar is a faculty member. Currently multiple ongoing projects funded by international and local agencies in the areas of abortion, family violence and pre-eclampsia are conducted. The Obstetrics and Gynaecology department is a WHO collaborating center for research in human reproduction and the ICRW (International Council for Research in Women) collaborative center. This center is one of the centers participating in a WHO sponsored Clinical Trial of Calcium Supplementation for prevention of pre-eclampsia in low calcium intake women. Main research interests are: pregnancy induced hypertension, infection and pre-maturity, reproductive tract infections and adolescent health care.

Motiur Rahman M.D., Ph.D.
International Centre for Diarrhoeal Disease Research, Bangladesh
(ICDDR,B) Mohakhali, Dhaka 1212, Bangladesh

ICDDR,B: Centre for Health and Population Research (the centre) is a large, non-profit international health organization with headquarters in Dhaka, Bangladesh. It conducts research and provides service and training in a variety of the most important health problems, which developing countries face. The Laboratory Sciences Division (LSD) conducts laboratory-based research in diarrhoeal diseases, acute respiratory infections, reproductive tract infections, HIV, other infectious diseases, environmental health, and nutrition. It has seven state-of-the-art laboratories for bacteriology, Virology, Immunology, nutritional biochemistry, parasitology, environmental microbiology, and pathology research. The principle investigator has been working in the field of RTI/STI. He has completed several studies regarding prevalence of RTI/STI among different population groups including pregnant women, antimicrobial susceptibility of N. gonorrhoeae in Bangladesh and in-vitro susceptibility and treatment outcome in gonorrhea. Currently he is involved in monitoring the antimicrobial susceptibility of N. gonorrhoeae in Bangladesh and Nepal. He is also involved in a project that aims to reduce low birth weight by treatment of bacterial vaginosis in early pregnancy.

Andres Sarmiento, M.D.,
Libia Patricia Gómez, M.D.
Hospital Simón Bolívar & Hospital Fundación Santa Fé de Bogotá, Universidad El Bosque, Asociación Bogotana de Perinatología, Santa Fé de Bogotá, Colombia

Hospital Simón Bolívar is a tertiary care center where referrals for high risk pregnancies are made for the public health care system in the city of Santa Fé de Bogotá, with 8 million inhabitants. Had 6,400 deliveries in 2000. Hospital Fundación Santa Fé de Bogotá is a tertiary care center with 1,200 deliveries. Both hospitals serve as training centers for undergraduate and graduate students for Universidad El Bosque and both count will all medical specialties. The P.I. Andres Sarmiento is Chairman of the Department of Obstetrics and Gynecology at Hospital Fundación Santa Fé de Bogotá and academic coordinator for perinatal medicine at Hospital Simón Bolívar. The P.I. and co-P.I. serve on the Board of the Asociación Bogotana de Perinatología a professional association which gathers more than 150 leaders in the perinatal field and are involved in policy making for obstetric and reproductive health care in the country.

Sheela Shenoy, M.B.B.S., D.G.O., M.D.
Medical College, Trivandrum, India

Sheela Shenoy, M.B.B.S., D.G.O., M.D.The hospital attached to the Medical College of Trivandrum is a major teaching center affiliated to the University of Kerala. It has full obstetrics and gynecology services and a research unit under the Indian Council of Medical Research and the Center Council for Research in Ayurveda and Siddha. This is an institution with a long track record of excellence in research and clinical practice. It provides care to a vast population. Innovative research in the utilization of indigenous drugs, and other areas has been explored and developed. The department has an interest in safe motherhood, child survival related to fertility transition, adolescent health care and clinical trials in perinatal care. International collaboration is being conducted in different areas, including studies on the long-term effects of smoking on health. The United Nations Population Fund as well as the University of Uppsala and the Karolinska Institute in Sweden are participating in different initiatives. A Clinical Epidemiology Unit is well established where the P.I. is a member.

Moses Sinkala, M.D., M.P.H.
Lusaka District Health Clinics, University Teaching Hospital, Lusaka, Zambia

Lusaka, the capital city of approximately 2 million persons, has an organized network of satellite health clinics and a referral teaching hospital. The clinics, of which there are 23, provide predominately outpatient and preventative services. Nine have active labor wards. In 1999, there were over 32,000 deliveries conducted in the Lusaka Urban District Clinics. Patients with acute and/or complicated cases, including those needing surgical intervention, are referred to the University of Zambia Teaching Hospital (UTH), also located in Lusaka. In 1999, the Teaching Hospital delivered an additional 15,000 babies, bringing the total number of obstetric cases managed by the entire system to 47,000 per year. The Director of the Lusaka District Clinics is Dr. Moses Sinkala and the Director of the UTH is Dr. Elwyn Chomba. There are a number of collaborative research initiatives in Lusaka, each of which is jointly managed by U.S. and Zambian scientists. In addition, through a Fogarty International Center-funded collaboration between the Zambian Ministry of Health and the University of Alabama at Birmingham (UAB), a number of Zambian physicians have been formally trained in public health training at UAB, in the form of the MPH degree in Epidemiology, International Health and/or Health Behavior. A major goal of this training program is to establish a core of individuals who are interested in improving pregnancy outcomes, and who are equipped with the appropriate research and management skills to have an important population-wide impact in Zambia. A number of ongoing research projects are currently on-going, including the Bill and Melinda Gates Foundation Award to Establish an Electronic Perinatal Medical Record System in Lusaka, Zambia. This four year award will fund the establishment of a unified electronic perinatal record for the Lusaka Urban District Clinics and the University Teaching Hospital, and is designed to improve individual patient care, provide critical surveillance data, and support perinatal research efforts in Lusaka.

Kyi Kyi Thinn, M.B.B.S.
D. Bact., Ph.D (London), Ph.D (Hon.) (Yangon), FACTM(Australia)
The Institute of Medicine, Yangon, Myanmar

Kyi Kyi Thinn, M.B.B.S. The Institute of Medicine, Yangon, Myanmar is the largest and oldest medical school in Myanmar. The Department of Microbiology and the Department of Obstetrics and Gynaecology of the Institute of Medicine have a long history of research and academic collaboration. The teaching hospital of the Department of Obstetrics and Gynaecology is the Central Women's Hospital, an 800 bedded hospital with 600-1000 deliveries per month, which functions as an undergraduate and postgraduate teaching hospital and is very active in reproductive health research. The principal investigator, Professor Kyi Kyi Thinn is Head of the Department of Microbiology as well as a member of the Academic Board of Studies and member of the Research and Ethical Committee of the Institute of Medicine.

Jorge E. Tolosa, M.D., M.S.
Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Coordinator, Global Network for Perinatal & Reproductive Health

Jorge E. Tolosa, M.D., M.S.The Division of Research in Reproductive Health (DRH) within the Department of Obstetrics and Gynecology, was established in 2001 and has experience in international and national scientific collaboration for academic and research purposes. The Global Network for Perinatal and Reproductive Health is coordinated from this center. There is a fellowship program in reproductive health research available in the Division to members of the centers of the GNPRH, for purposes of advancing the goal of research capability development and transference of skills. Ratana Komwilaisak, M.D., from Khon Kaen University in Thailand and Juan Carlos Sabogal, M.D., from Universidad Nacional de Colombia, both completed their program in 2001. The DRH has one Ph.D. level investigator, clinician-investigators and their staff, two M.P.H. research associates, for a total of twelve members. The research agenda of the DRH includes the study of the association between social stressors and their impact on the health of pregnant women, specifically on premature birth and low birhtweight, and research in reproductive health as carried by the GNPRH.

The Department of Obstetrics and Gynecology has 2,000 deliveries every year at Thomas Jefferson University Hospital. The Division of Maternal-Fetal Medicine (DMFM) is involved with approximately 50% of those deliveries, corresponding to the population defined to be at high risk for maternal or fetal complications; 95% of the total population receives antenatal care at our center. There is a total available faculty of 6 Maternal-Fetal Medicine specialists. The DMFM has extensive experience and expertise in antenatal testing and intrapartum diagnoses and has one of the largest antenatal testing and ultrasound units in the United States. Additional resources include infectious diseases, clinical epidemiology, perinatal pathology, genetics, a fetal cardiology and physiology unit, and a reproductive immunology laboratory. This Division works in concert with one of the largest neonatal divisions in the country which cares for over 2300 neonates per year. Importantly, the DMFM has an active community outreach network with over 40,000 deliveries under its direction covering satellite units and centers in three States: Pennsylvania, New Jersey and Delaware. The DMFM is part of the largest network conducting perinatal research in the United States, the Maternal-Fetal Medicine Units network of the National Institute of Child Health and Human Development (NICHD), of the National Institutes of Health (NIH). In the academic area, the DMFM has a fully approved fellowship in Maternal-Fetal Medicine. The Department of Obstetrics and Gynecology has a fully approved residency program in Obstetrics and Gynecology, with thirty two postgraduate students.

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