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The Placenta and What it Tells Us – Harvey Kliman, MD, PhD

February 1, 2018


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Our podcast guest is Dr. Harvey Kliman, MD, PhD.  Listen as Chris Duffy visits with him about his research of the placenta and pregnancy outcomes.

Harvey Kliman, MD, PhD, is a Research Scientist in the Department of Obstetrics, Gynecology & Reproductive Sciences and the Director of the Reproductive and Placental Research Unit at Yale. His clinical interests include infertility, implantation, recurrent pregnancy loss, endometrial receptivity testing, and placental pathology. He both does testing for impaired implantation and pregnancy loss, and sees patients.

Dr. Harvey Kliman received his undergraduate training at Syracuse University where he graduated summa cum laude. He received both his MD and PhD degrees from the University of Chicago in the funded MD, PhD Research Scientist Program. He completed his residency in Anatomic Pathology and Laboratory Medicine from the University of Pennsylvania, Philadelphia, PA. He then completed an NIH funded postdoctoral research fellowship in the Department of Obstetrics and Gynecology, University of Pennsylvania. He was on the faculty of the University of Pennsylvania and then was recruited to Yale in 1991 where he is a faculty member in the section of Reproductive Endocrinology and Infertility in the Department of Obstetrics, Gynecology & Reproductive Sciences.

Dr. Kliman is a board certified specialist in Anatomic Pathology and Laboratory Medicine. His clinical research centers on implantation, endometrial receptivity testing, recurrent pregnancy loss, evaluation of pregnancy loss tissues, intrauterine growth restriction, and placental markers of autism. His basic science research centers on the biology of trophoblasts, trophoblast invasion, markers of preeclampsia, and the control of normal and abnormal placental growth. He has been funded by over 15 NIH and industry grants and directs Reproductive Pathology Services at Yale. Dr. Kliman has published more than 80 articles in leading medical journals and is the inventor of 7 patents and 3 pending patents. His work has been profiled in many media publications, including the New York Times, Glamour, Cosmopolitan, and Self. He also has appeared many times on TV and radio programs as an expert medical guest, including the Home Show, Montel Williams, ABC, NBC and CBS news programs.

Dr. Kliman was a featured lecturer at the 2011 Stillbirth Summit.

The placenta can be compared to the rings on a tree.  It can tell us so much about the course of the pregnancy.

Placenta Research

With regard to placental research, Dr. Kliman’s department work developed a mathematical solution to accurately estimate intrauterine placental volume. Care givers of pregnant women currently only track the growth of the fetus without any insight into the growth of the placenta, despite its importance in prenatal development. The placenta is the critical organ responsible for both respiratory and nutritional support of the fetus. In situations where the placenta is significantly small or large for gestational age, a care giver may not have any warning that the fetus is compromised or near death until it is too late. Fetal complications due to placental abnormalities occur in as many as 20% of pregnancies. Clinical intervention is possible with early detection. This invention allows for assessment of in utero placental volume using three basic measurements: width, height and thickness of the placenta. There are no alternative Currently there are no simple, reliable or convenient methods to determine the volume and/or weight of a placenta prior to delivery available today. We propose to use this method to generate normative data on a large population of pregnant women which can be used to automatically flag abnormal placental size. Such normative data will form the basis for the generation of tables which can be incorporated into future ultrasound devices. This will empower future caregivers to identify and intervene in cases where an IUFD would have been the first indication of any problems. This method will create a “placenta tank” gauge where none has existed.This compromises a health care provider’s ability to assess the state of a pregnancy since the placenta is the critical organ responsible for both respiratory and nutritional support of the fetus. Currently care givers of pregnant women only track the growth of the fetus without any insight into the growth the placenta. In situations where the placenta is significantly small or large for gestational age a care giver may not have any warning that the fetus is compromised or near death until it is too late. This invention teaches the use of mathematical equations to estimate the in utero placental volume using three basic measurements: width, height and thickness of the placenta.

 

The profession of obstetrics can be described simply in 3 words – In or Out.  The duty of the obstetrician is to monitor the condition of the mother and the baby and determine at each point in time, whether the pregnancy outcome will be better with baby in the uterus or out.  The management of all elements and risks and determination of optimal delivery timing is the ultimate objective.

Contact Dr. Kliman

Phone:  203.785.3854 or email harvey.kliman@yale.edu

Kliman Labs Website: klimanlabs.yale.edu

·        Specific information regarding areas of interest to loss patients and patients currently pregnant with concerns about their pregnancies:

        Pregnancy Loss

        Estimated Placental Volume

        Research

 


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