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Carolyn M. Salafia, MD Carolyn M. Salafia, M.D. is board certified in Anatomic and Clinical Pathology and in Pediatric Pathology. For nearly thirty years, her clinical practice and scientific inquiries have been directed to the area of reproductive and developmental pathology, including the perinatal origins of neurodevelopmental disorders such as autism. 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 and the assessment of potential risks for the child.” 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. Before 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 ways to detect the causes of loss, so our treatments can be directed to the specific tissue-damaging process. Also, we now know that life before birth influences life-long health. With our team of mathematicians, computer scientists, physicists and physicians, we are using every tool of modern science to better understand cause, to potentially enable treatment.” |
