Authors often compare publishing a book to birthing a baby – a metaphor that is even more apt when the book in question is THE medical textbook on high-risk pregnancy, delivery, and fetal health.

At 1,494 pages, the 9^th edition of Creasy & Resnick’s Maternal-Fetal Medicine: Principles and Practice weighs in at 9.79 pounds – a good two pounds heftier than the average newborn baby. Clad in a glossy purple cover, it is a book that demands attention on any shelf.

“I should have warned you guys to bring a wheelbarrow for your books,” joked Dr. Judette Louis, professor and chair of Obstetrics and Gynecology (OB/GYN) at the USF Health Morsani College of Medicine and one of seven co-editors of the newest edition.

The department celebrated the publication of the new edition with a book-signing breakfast Wednesday for its trainees: 24 OB/GYN residents and four fellows in Maternal-Fetal Medicine (MFM). Both Dr. Louis and Dr. Charles J. Lockwood, dean of the Morsani College of Medicine and executive vice president of USF Health, were on hand to sign each copy. The publisher describes the book as “the definitive reference in the field for more than 35 years.”

“I am incredibly honored that Drs. Creasy and Resnik honored me as the new chief editor,” said Dr. Lockwood. He noted that the book would be 400 or so pages longer if it included all the references, which are only listed online.

“It’s definitely a great weight-bearing exercise,” joked Dr. Lockwood about the textbook’s heft.

Jokes aside, the residents said the book signing was a nice recognition that the physicians they are learning from are among the nation’s top experts.

“Knowing that we have some of the best mentors in the field as we go on to our careers – I think it’s inspiring,” said resident Dr. Rachelle Price, who will start her MFM fellowship next year.

“It’s amazing,” said Dr. Danielle Hardman. “I went to medical school here, so Dr. Lockwood’s been here during all my time here. It’s an honor” to have her textbook signed by him.

Resident Dr. Brittany Manobianco said one of her friends, who is going into MFM, was especially excited to get her copy.

“This is her Taylor Swift tour,” she proclaimed.

Perhaps fortunately, Ticketmaster did not work on the books – but the editors definitely did. Each editor was assigned a different section of the book, which includes chapters by a variety of authors who are experts on a variety of maternal and fetal high-risk conditions, such as premature labor and pregnancy-related hypertension. Editors conducted multiple levels of review and fact checks to ensure that each chapter reflects the latest science, evidence and best practices.

And then they proofed it all over again.

“I read every word in this book,” Dr. Lockwood said. “Every. Single. Word.”

Just how familiar is Dr. Lockwood with Creasy & Resnick?

Back when he was an MFM fellow himself, Dr. Lockwood studied the textbook’s first edition.

Photos by Allison Long, USF Health Communications.

Inside the mother’s womb, a fetus exchanges oxygen through the umbilical cord. Once the fetus is delivered, the umbilical cord is clamped, giving the baby the ability to breathe oxygen independently. In rare cases, the fetus has a severe congenital abnormality that obstructs the airway and makes independent breathing after delivery difficult or impossible. Instead of a traditional birth, an innovative surgical procedure, the Ex Utero Intrapartum Treatment (EXIT), is performed to deliver the baby. During this procedure, the baby’s head and shoulders are delivered by an elective Cesarean section, leaving the umbilical cord and placenta intact while pediatricians establish an independent, free airway. After the airway is well established by the pediatricians, the umbilical cord is clamped, and the baby is delivered completely. The procedure may take up to five to ten minutes and requires full coordination between obstetrics, anesthesia, and pediatric teams. USF Health and Tampa General Hospital’s multidisciplinary team performed its first EXIT procedure in 2009 and second in 2016. January 2019 marked the third time in order to deliver a baby with a growth from the tongue that was compressing the airway.

The January 2019 EXIT delivery team featured Sarah Obican, MD, high-risk obstetrician, maternal-fetal medicine subspecialist, who performed the surgery and delivery of the baby in order for the airway to be established. (Photo courtesy of the USF Health Fetal Care Center of Tampa Bay)

“When you do cases of such complexity, you can’t do it alone. You need to have an institution that offers all these subspecialists in one setting and that’s what USF offers,” said Prasad Burjonrappa, MD, MBA, division chief of Pediatric Surgery. Dr. Burjonrappa’s role during the 2019 EXIT procedure was to work alongside Jaime Flores-Torres, MD, neonatologist, to evaluate the infant’s airway and determine if he was a candidate for endotracheal intubation, the placement of a tube into the trachea through the mouth or nose, or if the baby needed a tracheostomy, a surgical procedure to create an opening through the neck into the trachea.

(Left) The baby was born with a growth from the tongue that was compressing his airway. (Right) After the removal of the mass, the baby went home a few days later with no complications. (Photos courtesy of the USF Health Fetal Care Center of Tampa Bay)

An EXIT procedure involves two patients – mother and baby – who each need specialized care to avoid complications. This is why the procedure requires a multidisciplinary team of up to 20 physicians and other health practitioners. With such a large team working together, the procedure needs to be highly coordinated because it’s critical that everyone knows their role, when to act, and how long they have to finish. The USF-TGH team establishes protocols and contingency plans and practices mock surgeries to prepare for every outcome. To ensure the procedure runs smoothly, Anthony Odibo, MD, MSCE, FRCOG, FACOG, director of the USF Health Fetal Care Center of Tampa Bay, oversees and directs the various teams that come together to make the high-risk delivery a success.

“The most challenging part of this is the unknown,” said Sara Zientara, fetal care coordinator for the Fetal Care Center. “You don’t know exactly how that baby is going to come out. You don’t know exactly how that surgery is going to go and you just have to take it as it comes and be able to multitask and problem solve, so preparing everyone for what their role is and could be is important.”

Thanks to the well-established USF Health Fetal Care Center at Tampa General Hospital and the prepared and coordinated team, the January 2019 delivery was yet another success. Once the baby was born and was transferred to an ICU, the baby stayed intubated until the procedure to remove the mass was complete, and then the mother and baby went home a couple of days later without any major complications.

A small part of the EXIT procedure team at the USF Health Fetal Care Center of Tampa Bay located at Tampa General Hospital. (From left to right) Amy Amato, clinician of operations for the TGH women’s operating room, Jaime Flores-Torres, MD, neonatologist, Prasad Burjonrappa, MD, MBA, division chief of Pediatric Surgery, Sarah Obican, MD, high-risk obstetrician, maternal-fetal medicine subspecialist, Sara Zientara, coordinator for the Fetal Care Center, Chinedu Nwabuobi, MD, MS, 3rd-year maternal-fetal medicine fellow. (Photo by Allison Long)

Learn more about the USF Health Fetal Care Center’s multidisciplinary team involved in this EXIT procedure.

Story by Torie Doll. Videos by Torie Doll and Allison Long.

The University of South Florida-led study created a rigorous mathematical model to simulate maternal and newborn outcomes, comparing elective induction to expectant management

TAMPA, Fla. (April 25, 2018) – It’s better to induce labor than to watch and wait.  That’s the main result of a new study published in PLOS ONE.

Researchers at the University of South Florida Morsani College of Medicine found that first-time healthy mothers electively induced at 39 weeks of pregnancy are at lower risk of cesarean delivery and other serious complications compared to those expectantly managed and induced at 41 weeks if undelivered by then.

Photo by Sandra C. Roa | University of South Florida Communications and Marketing

Obstetricians generally recommend inducing (artificially stimulating) labor and delivery after 41 weeks since continued pregnancy after this point is associated with higher chances of stillbirth and risks to the mother. However, uncertainty exists about best timing of deliveries when the fetus is between 39 and 41 weeks. The USF-led study presents compelling evidence that electively inducing labor at 39 weeks results in less risk, not more, to mothers and their newborn infants than expectant management, or watchful waiting, in the same population.

Elective induction was associated with reduced rates of cesarean deliveries and maternal complications including preeclampsia, fewer stillbirths and newborn deaths, and lower rates of newborn complications such as birth injuries, respiratory distress and shoulder dystocia (infant’s shoulder becomes lodged behind the mother’s pubic bone).

“Safely preventing primary cesarean deliveries, stillbirths and reducing other perinatal complications are of the greatest concern,” said the study’s principal investigator Charles J. Lockwood, MD, senior vice president for USF Health and dean of the Morsani College of Medicine. “Sometimes clinicians do something because that is the way it’s always been done. These findings demonstrate the importance of strong evidence-based research in informing and shaping standards of care.”

“When I was in residency training, it was drilled into us that elective induction of labor increased C-section deliveries.  But, actually we found the opposite” said lead author Rachel Sinkey, MD.  Dr. Sinkey conducted the research when she was a maternal-fetal medicine fellow at USF Health and is now an assistant professor of obstetrics and gynecology in the Division of Maternal-Fetal Medicine, University of Alabama at Birmingham.

The USF researchers created a rigorous mathematical model, using data from the NIH’s Safe Labor Consortium supplemented by review of the latest medical literature. A theoretical cohort of 100,000 patients was used to simulate key pregnancy outcomes for two groups: first-time mothers with low-risk pregnancies who elected to have labor induced at 39 weeks and those choosing expectant management with induction of labor only if medically indicated or if their pregnancies extended beyond 41 weeks.

Compared to elective induction of labor at 39 weeks, waiting to induce labor at 41 weeks resulted in increased:

• C-section rates (35.9 vs. 13.9 percent). Even when the cervix was unfavorable in position or dilation, C-sections were more frequent with expectant management.
• Maternal complications (21.2 vs. 16.5 percent)
• Stillbirths (0.13 vs. 0 percent)
• Newborn deaths (0.25 vs. 0.12 percent)
• Severe neonatal complications (12.1 vs. 9.4 percent)

The USF findings were recently corroborated by results of the National Institutes of Health-supported ARRIVE trial of induction versus expectant management.  That large-scale, randomized controlled trial also found that induction of labor at 39 weeks in low-risk pregnant women resulted in a lower frequency of cesarean deliveries and preeclampsia.

The USF findings are supported by biologically plausible explanations. Both inadequate delivery of essential nutrients and oxygen to the fetus, known as placental insufficiency, and increasing fetal growth are associated with advanced pregnancies and may explain why elective induction of labor at 39 weeks reduces the risk of adverse pregnancy outcomes, Dr. Sinkey said.

More study is needed to address health care system logistics and costs associated with routine elective induction of labor at 39 weeks. Spontaneous labor without medical intervention remains critically important to many women, Dr. Sinkey said, however, induction of labor should be presented to patients as an acceptable option.

“We acknowledge that not all women nor their providers desire elective inductions and we recommend that the patient should be final arbiter of the timing and mode of delivery after adequate counseling and informed consent,” the study authors conclude.

USF Health perinatologist Valerie Whiteman-White, MD, who built a distinguished academic career in maternal-fetal medicine and was known for her strong work ethic, indomitable spirit and devotion to family and faith, died April 2 after a long, courageous battle with cancer.  She was 55.

Dr. Whiteman had recently been promoted to professor in the USF Health Morsani College of Medicine Department of Obstetrics and Gynecology – an accomplishment she worked tirelessly to achieve, even using the time she spent undergoing chemotherapy to write journal articles.  The latest of her papers, finding evidence that intrauterine tobacco exposure impacts fetal brain programming, was just published this January in the Journal of Perinatal Medicine.

Valerie Whiteman, MD

“Dr. Whiteman had a passion for and excelled at helping women with high-risk pregnancies bring healthy babies to the world.  We are deeply saddened by the loss of our colleague whose career was cut short, but whose exemplary life will not be forgotten,” said Charles J. Lockwood, MD, senior vice president for USF Health and dean of the Morsani College of Medicine.

Catherine Lynch, MD, professor of obstetrics and gynecology and associate vice president for Faculty Development and Women’s Health at USF Health, spent a lot of time with Dr. Whiteman while her colleague and friend was in hospice care.  Knowing that Dr. Whiteman’s 17-year-old daughter Talia will graduate from Tampa Preparatory School in May, Dr. Lynch arranged for teachers and classmates to bring a pre-commencement celebration for Talia to Dr. Whiteman’s bedside.

“Val truly loved what she did and thrived on difficult cases, especially complex obstetric cases,” Dr. Lynch said.  “But at the end of the day, what was most important to her was her daughter Talia.  Val was a true ‘volleyball mom,’ spending weekends at tournaments cheering Talia on.”

Dr. Whiteman received her MD degree from the State University of New York (SUNY) in Buffalo, NY.  She completed a residency in obstetrics and gynecology at SUNY Health Science Center of Brooklyn, NY, and a fellowship in maternal-fetal medicine at the University of Illinois College of Medicine in Chicago.

She joined USF’s medical school in 2008 from Temple University School of Medicine, where she was an assistant professor of obstetrics and attending perinatologist at Temple University Hospital.

At USF, Dr. Whiteman stepped up to become interim director of the Division of Maternal Fetal Medicine when the previous director left, and served as full division director from 2013 until a recurrence of cancer.  She was a member of the university’s Medical Student Selection Committee.

Jerome Yankowitz, MD, chair of the Department of Obstetrics and Gynecology, said that Dr. Whiteman was a driving force behind restarting the USF Maternal Fetal Medicine fellowship program, which flourished under her direction and received board approval on its first attempt.

“Dr. Whiteman truly kept the Maternal Fetal Medicine Division going while we were recruiting,” Dr. Yankowitz said. “And, she managed to beautifully balance being an incredibly hard working faculty member with always being there for her daughter. She was a loving, attentive and supportive mother.”

Dr. Whiteman in an earlier photo with a baby she cared for prenatally

Specializing in high-risk pregnancies, Dr. Whiteman worked out of Tampa General Hospital, where she was a key member of multidisciplinary teams involved in some of the hospital’s most complicated deliveries.  In 2009, Dr. Whiteman was lead obstetrician for TGH’s first ex utero intrapartum treatment, known as EXIT, which she had performed twice previously before coming to Tampa. In 2012, she enlisted the help of urogynecologist Dr. Lennox Hoyte to perform TGH’s first-robot assisted abdominal cervical cerlage surgery, an unusual procedure that allowed a mother to deliver another daughter.

“Dr. Whiteman embraced tough clinical and surgical cases. A number of women have credited her with helping them have their first successful pregnancy outcome.  One patient even gave her daughter the name ‘Valerie’ out of gratitude,” said Judette Louis, MD, assistant professor of obstetrics and gynecology.

“She was dedicated to academic medicine and education, and as a leader she was selfless and always fair. We miss her dearly.”

While she maintained a professional demeanor, colleagues also remember Dr. Whiteman as someone with a wry sense of humor, a stylish dresser (she operated for hours wearing high heels), and a dog lover.  She traveled whenever time permitted to countries such as Grenada, the United Kingdom, Brazil and Australia.

Anna Parsons, MD, professor emeritus in the Department of Obstetrics and Gynecology, said Dr. Whiteman came from a family of “very strong, very smart” women.  “I’ve never seen anyone with such resilience,” Dr. Parsons said.  “Even her cancer doctor told her ‘I’ve seen you bounce back so many times.’”

That is why her death, even after a long battle with cancer, still seems sudden, Dr. Parsons said.

“Dr. Whiteman had such a strong will to live, and I think her faith helped her through a lot of adversity… She was fundamentally a private person, and some people did not even realize what she was going through.  She kept up her spirits and everyone else’s to the end.”

Dr. Whiteman, center, was the lead obstetrician for a multidisciplinary team that performed the first EXIT procedure at Tampa General Hospital. A specialist in high-risk pregnancies, she thrived on complex obstetric cases and had many grateful patients.

Dr. Whiteman is predeceased by her parents; and husband, William “Skip” White.  She is survived by daughter, Talia White; fiancé, Simplice Essou; brothers, Leopold “Lee” Whiteman, Jr., and Esmond Modeste; and many other close relatives, friends and co-workers.

A memorial service will be held 11 a.m. on Saturday, April 8, at Ray Williams Funeral Home, 301 N. Howard Ave., Tampa, FL 33606.  Contributions in Dr. Whiteman’s honor can be made to the March of Dimes.

University of South Florida study indicates these syndromes, when combined with poor pregnancy outcomes, can confer additional cardiovascular disease risk sooner

Tampa, FL (July 22, 2016) — The short-term risk of  developing cardiovascular disease following a first pregnancy is higher for women experiencing placental syndromes and a preterm birth or an infant born smaller than the usual size, a University of South Florida study reports. The USF researchers also found a five-fold increase in health care costs for women with placental syndromes who developed cardiovascular disease as soon as three to five years following delivery, compared to those who did not.

Their results were recently published online, in advance of print, in the American Journal of Obstetrics and Gynecology. The study, done in collaboration with Baylor College of Medicine, was supported by the Agency for Healthcare Research and Quality.

Dr. Mary Ashley Cain, an assistant professor in the USF Morsani College of Medicine’s Department of Obstetrics and Gynecology, specializes in maternal-fetal medicine.

“Pregnancy does not occur in isolation; it’s part of a woman’s overall health history,” said lead author Mary Ashley Cain, MD, assistant professor in the Department of Obstetrics and Gynecology, USF Health Morsani College of Medicine. “Our study further supports the need for improved interconception care to identify and manage maternal high blood pressure, unhealthy weight and other cardiovascular risk factors before the next pregnancy.”

“Early lifestyle modifications, treatment with appropriate medications and routine follow-up may improve the cardiovascular profile of these patients and help prevent or reduce future poor pregnancy outcomes.”

Other epidemiological studies have shown associations between cardiovascular disease and placental syndromes, including preeclampsia, a condition characterized by high blood pressure in pregnancy; placental infarction, an interruption in blood flow between the placenta and baby; and placental abruption, separation of the placenta from the uterine wall before delivery. However, most previous studies followed women with placental syndrome for long-term risk of adverse cardiovascular outcomes — up to 15 years after giving birth.

The USF study focused on the short-term risk of developing cardiovascular disease — within 5 years of a first pregnancy. Disease arising in this time period would be more likely to affect any future pregnancies. Also, for the first time, researchers evaluated health care utilization and hospital costs to quantify the burden of placental syndrome-associated cardiovascular disease.

The population-based retrospective study followed 302,686 Florida women and girls, ages 15 to 49, with no history of cardiovascular disease before their first documented delivery. Maternal placental syndromes were defined as gestational hypertension, preeclampsia, eclampsia, and placental abruption or infarction. Cardiovascular disease was defined as a diagnosis of coronary heart disease, cerebrovascular disease, peripheral artery disease or congestive heart failure, or a cardiac or peripheral artery revascularization at least 90 days after the delivery discharge date.

Among the USF researchers’ findings:

• After adjusting for sociodemographic, clinical and behavioral factors, women with any placental syndrome had a 19-percent higher risk of developing cardiovascular disease within five years of their first pregnancy than women without PS.
• When placental syndrome was combined with poor fetal outcomes – either preterm birth or small for gestational age, or both – the risk of cardiovascular disease upon short-term follow-up increased to 45 percent.
• Women with placental syndromes who subsequently developed cardiovascular disease incurred a five-fold increase in health care-related costs during short-term follow-up, compared to those who did not develop cardiovascular disease.
• The researchers concluded that preventing placental syndromes in the 36,713 women with one or more placental syndromes in their study population would have “saved more than $63 million in direct costs of inpatient and emergency care during the average 5-year follow-up period.”

Dr. Cain led the population-based retrospective study on maternal placental syndromes and short-term cardiovascular outcomes.

Just how hypertensive disorders of pregnancy and related placental abnormalities may increase premature cardiovascular disease risk in women with no apparent medical history of heart disease requires more research.

“It’s a chicken-or-the-egg situation,” Dr. Cain says. “We don’t know whether existing (asymptomatic) baseline cardiovascular disease is unmasked by placental syndromes in some pregnant woman, or if something about the placental syndromes triggers damage to mothers’ blood vessels that can lead to cardiovascular disease.”

Dr. Cain, who specializes in maternal-fetal medicine, is working with Aarti Patel, MD, assistant professor of cardiology at USF Health, to create a postpartum follow-up clinic for women with increased risk of cardiovascular disease. Patients will be seen at both the USF Health South Tampa Center for Advanced Healthcare and Tampa General Hospital’s Genesis Center and include those who have experienced placental syndromes and/or adverse pregnancy outcomes.

Article citation:
Mary Ashley Cain, MD; Jason L. Salemi, PhD; Jean Paul Tanner, MPH; Russell S. Kirby, PhD; Hamisu M. Salihu, MD, PhD; and Judette M. Louis, MD, MPH; “Pregnancy as a window to future health: maternal placental syndromes and short-term cardiovascular outcomes,” American Journal of Obstetrics & Gynecology, 2016 Jun 2. pii: S0002-9378(16)30267-8. doi: 10.1016/j.ajog.2016.05.047. [Epub ahead of print].

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Media contact:
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abaier@health.usf.edu or (813) 974-3303

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One of the first maternal-fetal medicine subspecialists, he excelled at academic medicine and advanced women’s health with a focus on the patient

USF Health’s William N. Spellacy, a nationally renowned academic physician who was instrumental in advancing women’s health and shaping the initial subspecialties in obstetrics and gynecology, died Oct. 8, 2015.  He was 81.

Dr. William N. Spellacy

Dr. Spellacy, a board-certified obstetrician-gynecologist and one of the discipline’s first maternal-fetal medicine subspecialists, joined the University of South Florida College of Medicine in 1988 to become chair of the Department of Obstetrics and Gynecology – a leadership role he held for the next 14 years. He arrived at USF in 1988 bringing nine people from the University of Illinois in Chicago, where he had developed and led an Ob-Gyn department that achieved national prominence.

In addition to chairing three academic OB/GYN departments during his lifetime, Dr. Spellacy was one of the principal architects of the three original subspecialties in Ob-Gyn: maternal-fetal medicine, reproductive endocrinology and gynecologic oncology. The new subspecialty board certifications allowed physicians to gain additional training to advance patient care and research.

Building a competitive residency program

Soon after his arrival at USF, Dr. Spellacy mobilized efforts to build an ambulatory program at Tampa General Hospital, expanding opportunities for outpatient training and care.  The highly competitive residency program he built at USF routinely attracted hundreds of applicants, and many chosen ranked first or second in their medical school classes.

Among those for whom Dr. Spellacy served as a mentor and colleague was Catherine Lynch, MD, professor of obstetrics and gynecology and associate vice president of Faculty Development and Women’s Health at USF Health Morsani College of Medicine.

“Dr. Spellacy is the reason I stayed at USF,” said Dr. Lynch, who was a top third-year medical student when Dr. Spellacy was recruited as chair.

When interviewing for Ob-Gyn residency slots across the country at institutions like Duke, Yale and Brown University, Dr. Lynch said, all the faculty and chairs she spoke with were impressed by her letter of recommendation from Dr. Spellacy, but also often followed up with a question. “They inevitably asked, ‘Why do you want to leave Tampa, when you have one of the best OB programs in the country with Dr. Spellacy?'”

Dr. Lynch stayed at USF, and was recruited by Dr. Spellacy as a faculty member in general OB-Gyn.  He delivered both her daughters.

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“I’ve never worked a day in my life”

In 2012, Dr. Spellacy was honored with the USF Health Morsani College of Medicine Dean’s Award. As he addressed the audience at the ceremony, he recalled when he graduated from medical school that he received advice from his father stating that if he went into a field he loved he would never work a day in his life.

“I remember Dr. Spellacy closing by saying he never worked a day in his life,” Dr. Lynch said. “That exemplified his true love for medical education, patient care and anything related to women’s health.”

Anna Parsons, MD, and Michael Parsons, MD, USF emeritus faculty now retired from the Department of Obstetrics and Gynecology, were among those who trained under Dr. Spellacy and followed him to USF from the University of Illinois College of Medicine.

At a time when the term “patient-centric” was not yet part of the health care lexicon, Dr. Spellacy demonstrated to trainees and students what it meant to put patients at the center of their practice.

“He was very busy, yet he was the only physician I saw who turned off his pager whenever he went into a session with a patient,” Dr. Anna Parsons said. “He taught me that a patient should leave feeling better when you walked into the room, even if their problems are serious, because you’ve focused only on her, explained (a diagnosis) clearly, come up with a care plan and offered hope.”

Promoting access to quality care for all women

Dr. Spellacy spent much of his academic career working to ensure that all women gained access to the best medical care possible.  Among his achievements in the Tampa Bay region:

• With support from a $1-million legislative appropriation and TGH administration, he was instrumental in creating the Genesis clinic in a renovated county building – a TGH center where USF physicians continue to provide comprehensive women’s health care for medically underserved patients today, including prenatal and infant care.

• He helped develop a plan, still in place, that provides continuity of prenatal, postpartum and gynecological care for incarcerated pregnant women in Hillsborough County, including hospitalizations at TGH for all deliveries and gynecological surgeries. Dr. Spellacy himself visited jail for nearly two decades to help care for the female inmates.

• He directed a Perinatal Outreach Program, which brought a specialized USF team, including a maternal-fetal medicine physician, perinatal nurse practitioner and genetic counselor, to rural clinics in Hillsborough, Pasco and Polk counties to provide specialized prenatal care for women with high-risk pregnancies.

Dr. Aronoff and Dr. Spellacy

A voracious reader and contributor to research literature

Dr. Spellacy, who had a passion for acquiring and sharing knowledge, was elected in 1992 to the prestigious Institute of Medicine, now the Academy of Medicine – one of medicine’s highest honors.

To remain current in his field, Dr. Spellacy read a prodigious number of medical journals – so many, Dr. Anna Parsons said, that “he once joked that he read his height in journals every week, and he was 6 feet 1 inch tall.”

Dr. Spellacy’s own contributions to the research literature were impressive. He authored more than 500 peer-reviewed articles, 80 book chapters and 10 books, including topics covering diabetes in pregnancy, contraception, biochemical and biophysical fetal monitoring, prevention of preterm delivery complications, and evaluating teaching effectiveness for medical students and residents, to name a few.

James Mayer, MD, now an associate professor of Ob-Gyn, joined USF as a new resident, completed the department’s first fellowship in reproductive endocrinology and infertility, and was invited to remain as a faculty member during Dr. Spellacy’s tenure.

Dr. Mayer recalls the library card catalog where Dr. Spellacy would file away cards, each with a few sentences concisely summarizing findings from articles he had read.  During board rounds, if a diagnosis, treatment or another topic emerged that a resident seemed unsure about, Dr. Spellacy would refer the young physician to his cataloged citations.

“He’d say ‘you can probably learn something about that in the second paragraph, third article of this particular journal.’” Dr. Mayer said. “He kept you on your toes, but you always felt like he was on your side. He taught and mentored in a way that built people up, so you aspired to be like him.”

“Dr. Spellacy was an unusually unassuming person who focused on others’ needs, and treated everyone with the same degree of dignity and respect. He was always thinking about ways to improve the experiences of his faculty, residents, students and patients” Dr. Parsons said. “He got the best from people by focusing on their successes and strengths.”

A career of leadership and service

A native of St. Paul, MN, Dr. Spellacy earned his undergraduate and MD degrees at the University of Minnesota, where he also completed a residency in obstetrics and gynecology and began his profession in academic medicine as a faculty member in 1963. He moved to the University of Miami in 1967 and quickly advanced to the academic rank of professor.

While still in his 30s, Dr. Spellacy was recruited to chair the Department of Ob-Gyn at the University of Florida, where he remained until 1979.  He moved to Chicago to head the Department of Obstetrics and Gynecology at the University of Illinois. Under his leadership, the department achieved national prominence in research, education and patient care.

Throughout his career, Dr. Spellacy held committee memberships and leadership positions with many prominent professional organizations. He was elected president of Association of Professors of Obstetrics and Gynecology (APGO), the Society for Gynecologic Investigation, the Society of Perinatal Obstetricians, and the Perinatal Research Society.  He directed the American Board of Obstetrics and Gynecology and served as an oral examiner for the certifying board.

His numerous honors and awards included the American College of Obstetrics and Gynecology’s Perdue-Frederick Research Award, the APGO Excellence in Teaching Award (twice), the Council on Resident Education in Obstetrics and Gynecology National Faculty Award for Excellence in Residency Education, USF Outstanding Resident Teaching Award, and USF Distinguished Research Professor.  He was named several times to the Good Housekeeping “Best Doctors for Women” list and the “Best Doctors in America” list.

Even after stepping down as chair in 2002, Dr. Spellacy continued on as a professor focusing on USF medical student and resident education. He continued to serve as Ob-Gyn residency program director, a role he filled his entire time as chair, until 2012.

A triple-threat academic physician

As a role model who excelled in all three areas of academic medicine – education, research clinical care – Dr. Spellacy influenced generations of students, residents and faculty, some of whom advanced to positions as department chairs, heads of boards, or other leadership roles.

Dr. Spellacy completed his first marathon in Chicago at age 50, running alongside some of his University of Illinois residents. He turned that experience into a teachable moment when shortly thereafter he delivered an address at the Society for Gynecologic Investigation annual meeting, Dr. Parsons recalled.

“He based his talk on teaching people to run for endurance and running as team,” she said. “And, he spoke about the joy of eventually having those you’ve taught run on ahead of you.”

Dr. Spellacy’s legacy will live on in the hundreds of residents he personally trained, countless he influenced and thousands of babies he delivered and women he cared for.

Known for his punctuality, Dr. Spellacy passed away at 9 a.m. sharp on Oct. 8 from complications from a fall he experienced after leaving the office in summer 2014.  He is survived by his wife of 32 years, Lynn M. Larsen; and his children, Kathleen Spellacy, William N. Spellacy Jr., and Kimberly Schroeder (Timothy); and grandchildren, Zackary and Andrew Abraham, William N. Spellacy II, Garrett Spellacy, and Avery and Eleanor Schroeder.

A memorial service will be held 2 p.m., Saturday, Oct. 24, at St. Boniface Episcopal Church, 5615 Midnight Pass Rd. (Siesta Key), Sarasota, FL 34242. Blount & Curry MacDill, 813-876-2421.

Contributions in Dr. Spellacy’s honor can be made to The William Spellacy Memorial Fund #250283 on both the USF Unstoppable online giving site and the USF Faculty & Staff Giving site. The link for donations to the William Spellacy Memorial Fund is bit.ly/spellacy.
 

A chapter about Dr. Spellacy, written by Dr. Michael Parsons, and included in the book “Evolution of an Academic Department: Obstetrics and Gynecology at the University of South Florida” was used as a source for this article.

Story by Anne Delotto Baier, USF Health Office of Communications.

Bridging laboratory and clinical sciences, the study aims to improve the health outcomes  of pregnancies complicated by poor fetal growth

Tampa, FL (Sept. 28, 2015) – The USF Health Morsani College of Medicine has received a $4-million National Institutes of Health grant that will employ new imaging technologies and test biomarkers in the blood to determine whether abnormalities in the smallest blood vessels of the placenta and negative environmental influences, particularly smoking, cause fetal growth restriction (FGR).

The ultimate goal of the four-year study is to design a reliable way to predict poor growth of the fetus earlier in pregnancy so that physicians can intervene sooner to help prevent stillbirth, Cesarean delivery, decreased oxygen levels and other adverse outcomes.

The USF research award (1U01HD087213-01) was announced today as one of 19 projects funded by the Human Placenta Project — an initiative launched by the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Development to better understand the role of the placenta in health and disease.

Anthony Odibo, MD (left) and Umit Kayisli, PhD, of the USF Health Department of Obstetrics and Gynecology, are co-principal investigators of a $4-million Human Placenta Project — one of 19 new projects awarded in the U.S. and Canada by the NIH.

“I am so proud of our team,” said Charles J. Lockwood, MD,  dean of the USF Health Morsani College of Medicine and senior vice president for USF Health. “This is an important NIH initiative which addresses the common source of most major adverse pregnancy events – abnormal placentation.”

“In the past, it has been challenging to identify which women may benefit (from early therapeutic intervention), because they are at high risk for fetal growth restriction,” said co-principal investigator Anthony Odibo, MD, professor in the USF Department of Obstetrics and Gynecology.  “But powerful new imaging technology gives us the opportunity to really visualize all the blood vessels in the placenta, study the underlying problem of growth restriction, and create a highly predictive model for identifying small babies at risk of FGR.”

The USF grant, bridging laboratory and clinical sciences, will be led by Dr. Odibo and co-principal investigator Umit Kayisli, PhD, associate professor of obstetrics and gynecology.  Dr. Odibo, specializing in maternal-fetal medicine, is an expert in fetal therapy and directs the USF Fetal Care Center at Tampa General Hospital.  Dr. Kayisli specializes in molecular and cellular biology in reproduction and its clinical implications.

They will work on the NIH project with USF Ob/Gyn co-investigators Charles J. Lockwood, MD, Frederick Schatz, PhD, and Ozlem Guzeloglu-Kayisli, PhD, and with Rajendra Kedar, MD, from the USF Department of Radiology.  USF colleagues at Necker Hospital in Paris and at Oakland University William Beaumont School of Medicine in Rochester, MI, will also collaborate.

Fetal growth restriction (FGR), affecting up to 10 percent of all pregnancies, is commonly defined as fetal weight below the 10^th percentile for gestational age as determined by ultrasound. The condition remains a leading contributor worldwide to the death and illness of babies before and after birth.

Placental function – the ability of the critical organ to shuttle blood, oxygen and nutrients from mother to fetus through an intricate network of blood vessels – is inadequate in pregnancies complicated by FGR.  But predicting FGR has been difficult, because until recently imaging technologies have not been sensitive nor specific enough to clearly detect the smallest blood vessels in the placenta and monitor the flow of blood through this branching microvasculature.

Dr. Odibo points to an ultrasound image of the placenta, a critical organ that shuttles blood, oxygen and nutrients from mother to fetus through an intricate network of blood vessels.

For the USF study, researchers will use two of the latest technologies – superb microvascular imaging, or SMI ultrasound, and blood oxygen level-dependent magnetic resonance imaging, or BOLD MRI.

The investigators will compare biopsies of placenta from normal and FGR-complicated pregnancies in the laboratory and correlate them with the imaging assessments of the placental microvasculature.  They will also study how smoking affects the microvasculature and the potential link with FGR.

“The results obtained from SMI ultrasound and BOLD MRI combined with changes in expression levels of several biomarkers and epigenetic modifications in response to smoking will be instrumental in developing a predictive model for pregnancies at high risk for fetal growth restriction and improving the sensitivity and specificity of a potential early diagnosis and treatment of FGR,” Dr. Kayisli said.

For a list of all new grants awarded as part of the NIH Human Placenta Project, go to http://www.nichd.nih.gov/news/releases/Pages/092815-NIH-awards-HPP.aspx.

-USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Physical Therapy and Rehabilitation Sciences, and the USF Physician’s Group. The University of South Florida is a Top 50 research university in total research expenditures among both public and private institutions nationwide, according to the National Science Foundation.  For more information, visit www.health.usf.edu

Media contact:
Anne DeLotto Baier, USF Health Communications
(813) 974-3303 or abaier@health.usf.edu

Photos by Eric Younghans, USF Health Communications and Marketing

Treatment at the USF Health Center builds on leading translational research by Dr. Lockwood’s laboratory team

By Saundra Amrhein

The photographs arrive year after year: cherubic-faced babies, teetering toddlers, precocious kindergartners.

They are reminders to two USF Health doctors of the ultimate outcomes of years of research and struggles that often play out in their offices, the joyful results balanced against quiet frustration and painful loss.

Now, USF Health is announcing a major new initiative through which those doctors and a team of researchers hope to make a dent in the years of futile and heartbreaking attempts of expectant mothers to carry their pregnancy to full term – a hope to ensure that more efforts by area couples end in healthy childbirth.

Last month, USF Health launched The Pregnancy Loss Prevention Center — a clinic lodged at the USF Health South Tampa Center for Advanced Healthcare on the campus of Tampa General Hospital on Davis Islands.

Dr. Charles Lockwood and Dr. Stephanie Romero practice at the new Pregancy Loss Prevention Center, which is housed at the USF Health South Tampa Center for Advanced Healthcare.

At the helm is Dr. Charles Lockwood – the new dean of the USF Morsani School of Medicine and senior vice president for USF Health. His internationally renowned and award-winning research has long focused on preventing premature births, stillbirth, miscarriage and maternal thrombosis. While dean of Ohio State University’s College of Medicine, his institution was one of three Ohio universities and affiliated hospitals to receive a total of $10 million from the March of Dimes to fund the study and prevention of prematurity – which is the leading cause of infant death, blindness, mental disabilities and lung disorders in children.

At USF, he will run the new clinic with Dr. Stephanie Romero, a USF Health obstetrician and gynecologist and an assistant professor of obstetrics and gynecology and maternal fetal medicine. Dr. Romero, also an award-winning researcher, likewise has spent years studying factors – including genetic causes – that lead to pregnancy loss and premature birth.

The multi-disciplinary clinic – which will work with other USF departments and divisions, including genetics, and reproductive endocrinology – will first and foremost seek to give patients a clear and early understanding of what is happening to them so they can better chart a path through treatment or other options, like seeking an egg donor, that are realistic with their circumstances. In doing so, the doctors hope to offer extra office time and individualized care to cut through the uncertainty, anxiety and trauma that so many mothers, couples and families face, sometimes enduring multiple miscarriages and not knowing why or what to do.

“Time is a great resource we can provide, which a busy doctor in daily practice with thirty or forty patients a day can’t do,” says Dr. Lockwood, whose research team – among other accomplishments – has been credited with the development of “fetal fibronectin,” the first biochemical predictor of prematurity.

“That’s the most important ingredient we bring to the table,” he adds. “And also it brings a lot of psychological support, so they know what’s going on. That can have a magical effect on their ability to continue to pursue pregnancy.”

THE CENTER

Dr. Romero walked through the hushed and peaceful hallways of the maternal-fetal division on the fourth floor of the USF South Tampa Center, past examination and ultrasound rooms, stopping to greet and hug a staff member.

It is here where the Pregnancy Loss Prevention Center is based, initially starting out on two Monday mornings a month with plans to eventually expand to once a week as the center’s patient base grows, Dr. Romero said.

Likely to be referred here by physicians, gynecologists, infertility specialists or other medical personnel, patients will have experienced multiple miscarriages, stillbirths or premature births or the risk factors leading to them – from preeclampsia, diabetes and lupus to inflammation and infection.

While studies have shown that 50 percent of all fertile women trying to conceive suffer a miscarriage, about 10 percent of women suffer repeat miscarriages, a rate that increases with age, Dr. Romero said.

The clinic will run examinations on patients – and their partners, if necessary – and conduct laboratory tests to help determine problems or pre-dispositions for troubled pregnancies, she said.

Echoing Dr. Lockwood’s sentiments, Dr. Romero stressed one of the most important factors of the new clinic: quick communication. Patients will not only receive in-depth care, but they will have access to her personal email.

“You really want to get back to them as fast as possible,” she said, adding that the patient’s anxieties as well as physical symptoms need to be addressed right away. “Timeliness is such a big deal, especially at the beginning of pregnancy.”

High levels of anxiety dominate the conversations, she added, and run the risk of further impacting the mother and fetus’ health, as well as determining the patients’ willingness to even attempt another pregnancy.

“You are helping someone through a grieving process,” she said. “I’ve definitely had patients, more than one, say that if it happens again, I can’t go through this again.”

TREATMENT AND SUPPORT

The patients’ trauma from previous losses matched with years of searching in the dark with big unknowns and uncertain outcomes make it essential for the doctors to spend a lot of time with the expectant mothers.

“Some folks don’t even realize it’s a disease entity,” Dr. Romero said. Other times, patients endure multiple miscarriages not knowing they were due to uterine abnormalities, something the center could diagnose and get fixed right away.

“That’s something so easy to correct with surgery. Otherwise you would have no clue,” she said.

Depending on the patients’ conditions and causes for past losses, Dr. Lockwood added, approaches aside from surgery could include everything from heparin and aspirin therapy, to treatment of the immune system, hormone treatments, weight loss and bed rest. A team of researchers working with Dr. Lockwood in laboratories on the USF Tampa campus will be on hand for further investigation of maternal as well as fetal tissue following a miscarriage.

“What we’d like to be able to do is offer detailed genetic analysis, if that’s the explanation,” Dr. Lockwood said. “Or an evaluation for immunology abnormalities, if that’s the explanation.”

For instance, before the 10-week gestation point, most pregnancy losses are due to genetic factors, Dr. Lockwood says. That could include extra copies or deletions of chromosomes passed on to the embryo. The most common feature of such cases is advanced maternal reproductive age. Often such loses are a harbinger of the premature start of menopause – which is, in turn, most influenced by when her mother started menopause. The older her mother was before starting menopause, the longer the patient could likely go before showing higher rates of abnormal chromosomes and miscarriage. On average, if her mother started menopause at the age of 52, the patient could start showing higher chromosome abnormalities by age 35, and by age 40 a miscarriage rate of 50 percent, according to Dr. Lockwood. “However, if her mother was menopausal at 42, increased miscarriage rates may occur at age 30.”

“So it does vary significantly from a biological standpoint,” he added.

Another cause of genetic abnormality is when both parents carry a gene that is lethal to the developing embryo, Dr. Lockwood said.

Between 10 weeks and 20 weeks of gestation, genetic abnormalities are less frequently the cause for miscarriages, and other issues become more prevalent, such as Antiphospholipid antibody syndrome, lupus or other auto-antibody diseases and immunological disorders, he said.

After 20 weeks and before 32 weeks, inherited abnormalities in the cardiac conduction system can result in stillbirths. However, in this timeframe, the most common cause for stillbirths and premature delivery is inflammation and infection, something that can be diagnosed and addressed, Dr. Lockwood said. Other factors include hemorrhaging and stress on the fetus – including when there are twins and triplets.

With a clear diagnosis, he said, the patients can gain a sense of control and make an informed plan about the next step – whether that is with a positive prognosis for another pregnancy attempt or the practical necessity to try something else, such as IVF or an egg donor.

“They get closure,” Dr. Lockwood said. “It may not be good news, but it does provide closure and then helps them make some decisions.”

THE RESEARCH

Last spring when Dr. Lockwood left Ohio State University, where he was dean of the College of Medicine, to take over as dean of USF’s Morsani School of Medicine, he did not come alone. Joining him were three other researchers from his lab, including Dr. Frederick Schatz, who has worked with Dr. Lockwood for 35 years – from New York University to Yale University and then Ohio.

The new Pregnancy Loss Prevention Center at USF is modeled on similar practices Dr. Lockwood has run with his associates at NYU, and Yale and will build on his team’s laboratory research, much of which has been funded by grants from the National Institutes of Health and the March of Dimes Foundation.

A federally-funded Ob-Gyn translational research team working with Dr. Lockwood in laboratories on the USF Tampa campus complements the treatment provided to patients who have experienced multiple miscarriages, stillbirths or premature births or the risk factors leading to them. L to R: Ozlem Guzeloglu-Kayisli, PhD, assistant professor; Frederick Schatz, PhD, professor; Nihan Semerci, biological scientist; and Umit A. Kayisli, PhD, associate professor.

Dr. Schatz and his fellow researchers – Umit Kayisli and Ozlem Guzeloglu-Kayisli – called what they do “translational science” – the goal of taking their discoveries in the laboratory to the clinical level to treat patients.

Ultimately, Dr. Schatz said, their successes in preventing stillbirth and premature births will have a ripple effect that extends out from the immediate families to the entire medical industry and society.

“Statistically it’s a very serious problem,” Dr. Schatz said of prematurity and the disorders and millions of dollars in care it leads to over the course of a lifetime. “It creates a tremendous burden on the health care industry and society.”

In addition to being credited with discovering fetal fibronectin, Dr. Lockwood and his research team have more recently focused on such crucial conditions as preeclampsia – a disease marked by high blood pressure and abnormal protein levels in the urine. Preeclampsia affects between 6 percent and 8 percent of pregnancies in the United States. It is also a major indicator for premature birth, a leading cause of prenatal death and is responsible for 8 percent of maternal deaths, according to a research article by Dr. Lockwood and fellow researchers published in the American Journal of Pathology in September 2013.

Dr. Shatz holds a slide with sections of human placenta immunostained for the presence of the progesterone receptor, which may be related to preterm birth.

A major finding recorded in the research article identifies and describes a specific factor called IP-10 that was found at elevated levels in fluids of first-trimester women. The article calls it a new and “robust” early predictor of preeclampsia – a crucial discovery to help doctors confront a disease that becomes very dangerous in later stages of pregnancy or if left untreated.

Another important area of study for the researchers funded by the March of Dimes has centered on the mechanisms by which progesterone receptor levels suddenly drop during pregnancy, inducing a premature birth.  The research has zeroed in on the correlation or role in these cases of spiking levels of thrombin – the enzyme that facilitates the clotting of blood – and interleukin-1beta, a hormone involved in inflammation.

And most recently, in promising research for which the team has applied to NIH for funding, the group is working with an Ohio State University researcher who has isolated a probiotic in laboratory cultures. The probiotic, incubated with maternal cells, leaves healthy bacteria alone while inhibiting bad bacterial growth. The hope is that the probiotic might one day be able to block in pregnant women the onset of infection and inflammation – the leading causes of premature deliveries between the second and third trimesters.

The probiotic is being used or taken in Europe, but it has not yet been tested on pregnant women, Umit Kayisli said.

While Dr. Lockwood is immersed in all these examples of cutting edge laboratory research, he said he also has drawers full of photographs, cards and letters from happy families that remind him of what is at stake.

“When you do have a healthy baby,” Dr. Lockwood said, “there’s nothing better than that.”

For more information on the Pregnancy Loss Prevention Center or to schedule an appointment, please call (813) 259-8500.

Photos by Eric Younghans, USF Health Communications

The robot-assisted cervical stitch surgery, performed through the abdomen, was a first for Tampa General Hospital

Tampa, FL (Oct. 26, 2012) — A long-delayed dream came true  this week at Tampa General Hospital when Cynthia Coniglio finally delivered a healthy baby girl at 38 weeks. Over the years, Coniglio, 38, struggled through lost pregnancies because her cervix was too short to close tight enough throughout pregnancy to keep the baby in place.

For years, surgeons have treated insufficiencies of the cervix in pregnant women with what’s called cerclage – a single stitch to hold the cervix in place and help prevent a miscarriage or preterm birth. Also known as “cervical stitch surgery,” the procedure is traditionally done through the vagina, but when this is technically difficult or impossible the cerclage can be done through the abdomen.

Cynthia Coniglio snuggles with her baby daughter Raven, just a few days old.

 Coniglio had already experienced a failed transvaginal cervical stitch surgery and lost part of her cervix to other previous complications when she sought out USF Health’s Maternal Fetal Medicine team at Tampa General.  Her 18-month-old daughter Clover was born several months prematurely, and requires special medical care.

“I just couldn’t to go through another emotional rollercoaster of a miscarriage or spending months in the neonatal intensive care unit,” said Coniglio, who lives in Brooksville, FL.  “I believed if anyone could save my pregnancy it would be physicians at a teaching hospital, because they try new things.”

Coniglio’s complex case lended itself to innovative thinking about how to best reduce risk to mother and baby. 

Valerie Whiteman, MD, interim director of Maternal-Fetal Medicine at USF Health, enlisted the help of  Urogynecology Director Lennox Hoyte, MD, an expert in laparoscopic gynecological surgery using the da Vinci robot.  In June, once Coniglio reached 12-1/2  weeks of pregnancy, Dr. Hoyte and Whiteman used the daVinci robot to create the cerclage through the abdomen, and seal the cervix long enough for Coniglio’s healthy delivery.

It was the first robot-assisted transabdominal cervical cerclage at Tampa General Hospital. 

USF Health’s Dr. Lennox Hoyte, left, and Dr. Valerie Whiteman, right, with patient Cynthia Coniglio and her new baby girl, at Tampa General Hospital.

“Cynthia’s cervix was so short that it was like keeping the baby in a house with no foundation,” Dr. Whiteman said. “Most cervical cerclages are still done transvaginally, but that wasn’t feasible here, so we decided to go in from above (with several small stitches through the abdomen).”

“When you’re negotiating the tight spaces of a pelvis, with a pregnant uterus and big blood vessels, there’s no room for error,” she said. “The beauty of the robot is that it can articulate in places that the surgeon’s hands can’t, thereby reducing potential risks.”

Laparoscopic, or minimally invasive surgery, involves the doctor making several small incisions used to slip in tiny cameras and specially designed surgical instruments to perform the procedure.  Surgeons manipulate these instruments inside the body remotely with devices similar joysticks, while visualizing what’s happening from video monitors near the operating table. 

Dr. Hoyte describes the process like “operating with chopsticks.” The integration of robotics into this process allows surgeons to precisely direct challenging procedures as if they were using their own hands and fingers. The dexterity and superior visualization of the robotic system helps complex surgical procedures, such as an advanced cervical cerclage, go more smoothly, he said.

But, Dr. Hoyte emphasized, the real story is not the technological advances but the happy outcome for all.

Coniglio’s cervix remained stable for the rest of her pregnancy. She delivered a full-term, 6-pound, 14-ounce, 20-inch baby girl, Raven, by C-section on Tuesday, Oct. 23.

“It’s amazing; I cried when she was born. She looked so big and healthy,” Coniglio said. “She wouldn’t be here without Dr. Whiteman and Dr. Hoyte.” 

-USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a global research university ranked 50^th in the nation by the National Science Foundation for both federal and total research expenditures among all U.S. universities.

–          Tampa General Hospital –

 Tampa General Hospital is a 1,018 bed acute care hospital and is the only Level 1 trauma center on the west coast of Florida. It is the primary teaching hospital for the University of South Florida College of Medicine. It also serves as the region’s only burn center, adult solid organ transplant center and provides specialized rehabilitation services. Tampa General has established centers of excellence in the following clinical areas: cardiac, neurosciences, digestive disorders, orthopedics, infectious disease, high risk and normal obstetrics, and pediatrics. 

Photos by Eric Younghans/USF Health Communications

Media contacts:
Anne DeLotto Baier, USF Health Communications, (813) 974-3303 or abaier@health.usf.edu
Ellen Fiss, Tampa General Hospital, (813) 844-6397 or efiss@tgh.org