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Experts Corner

Perinatal Pathology

Carolyn M. Salafia, M.D.
Perinatal Pathologist

Carolyn Salafia, MDCarolyn M. Salafia, M.D. is board certified in Anatomic and Clinical Pathology and in Pediatric Pathology. For fifteen years, her clinical practice and scientific inquiries have been directed exclusively to the area of reproductive and developmental pathology. In her words, "The developmental pathologist must use the tools of tissue study to assist the clinical caregivers in determining the causes of pregnancy compromise." She continues, "It's important to clinicians and patients to be able to sort out what appears to be simply part of the 'built-in' fragility of human reproduction, and what requires our surveillance and treatment. Prior to the development of sensitive HCG tests and obstetric ultrasound, the pathologist played a necessary role in confirming the fact of pregnancy in a woman who presented with abdominal pain or bleeding of unknown cause. Pathology training has not kept pace with obstetric advances. To confirm the fact of pregnancy with the diagnosis of 'placenta' or 'products of conception' does not contribute to understanding of the cause of loss, which is now what clinicians and patients want and need to know."

Dr. Salafia is one of a small handful of pathologists nationally who specialize in reproductive pathology. She has recently been awarded a POR (Patient Oriented Research) Scholarship to the Joseph L. Mailman School of Public Health at Columbia University. As a full-time graduate student, her studies have allowed her to focus her daily clinical diagnoses more squarely on those questions that she feels may be most in need of answer. First how do we know who will recur with a next pregnancy complication or loss? The current limited methods of obstetric risk assessment "...complicate our ability to honestly assess the effects of treatment, and may cause many women to be exposed to unnecessary treatment . . . and worry," Dr. Salafia says. "There are more and more tests that can be done to evaluate pregnancy loss, and more and more ways to follow pregnancy by ultrasound, and to treat. We need better understanding of recurrence risk to be able to treat only those women who need treatment. We also need better ways to detect the causes of loss, so our treatments can be directed to the specific tissue-damaging process. Our goals are to use this new training in research methodology to tackle these problems head on." Together with her clinical colleagues, she is also developing surveillance and treatment trials for vascular causes of early and late pregnancy complications.

Dr. Salafia maintains a clinical diagnostic consultation and research program with a wide range of obstetric, reproductive endocrine, genetic and pathology collaborators. She has been supported by federal and private funding agencies, and her current training is NIH-sponsored. She sits on numerous editorial boards of medical journals, and is a member of, among others, the Society for Gynecologic Investigation, the Teratology Society, the Society for Pediatric Pathology, and the American Society of Reproductive Immunology. She has authored over 70 publications and 10 book chapters. She and her husband, Duncan, have six-year-old twins, Mark and Claire, adopted from Korea at age three months. Additional information about the doctor and a list of her publications in the field may be found in her Curriculum Vitae.

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