A Comprehensive Look at Women’s Health
Ob/Gyns Offer More than Routine Care

While it is a fact that women are more likely to see a doctor than men, many women routinely see just one doctor – their obstetrician/gynecologist. Knowing that these are often the only doctors in patients’ lives, the department of obstetrics, gynecology and reproductive sciences at The University of Texas Medical School at Houston has taken a comprehensive approach to women’s health care.

“Women’s health care has often been neglected in medicine,” said Larry C. Gilstrap III, M.D., department chairman. “Women’s health does not solely fall under the purview of our department, but since we deal primarily with women we can serve as leaders, developing a better plan for women’s health.”

Gilstrap, the Emma Sue Hightower Professor, has a more personal reason to make sure the department is a leader in its field.

“I have three daughters and five granddaughters,” he said with a smile, pointing to a table overflowing with family photographs. “And I hope to train some of their Ob/Gyns.”

Components of this comprehensive plan for women’s health include building the clinical practice, receiving significant research funding, and enhancing and developing health care policy and curriculum.

Over the last 5 years, the department has received significant research funding to further research into women’s health needs. Last year, the National Institute of Child Health and Human Development funded two collaborative clinical research programs in the school for more than $1 million each over five years. The collaborative multicenter Neonatal Research Program, headed up by Jon Tyson, M.D., and the Maternal Fetal Medicine Program, with principal investigator Susan Ramin, M.D., and co-principal investigator Gilstrap, support multi-institutional clinical trials and establish national registries to aid patients and physicians.

The department also received one of the first grants from the National Institutes of Health designed to train young physicians in women’s health care by creating Women’s Reproductive Health Research Scholars.

“Research is important. Most changes in clinical practice come from innovative ideas from research – both clinical based and basic science. We are proud to be participating at a national level in several clinical trials and providing great training opportunities for our researchers,” Gilstrap said.

In addition to collaborating on the national level, Gilstrap and his department team up in-house with other medical school faculty.

“By collaborating with our colleagues from other departments, we are working to meld basic science and clinical research,” he said, adding that the department is working with Rodney Kellems, Ph.D., chairman of the department of biochemistry and molecular biology, to try to better understand the origin of pre-eclampsia – convulsions and coma associated with hypertension or edema following child birth.

The department also has a close relationship with the department of pediatrics, which goes beyond sharing expertise and patients to sharing personnel.

“Dr. John Sparks and I also work closely, bringing UT-Houston to the community. We have several perinatal units where we provide consultation, ultrasound, prenatal diagnosis, and have a protocol for the transport of very sick pregnant women to Memorial Hermann Hospital,” Gilstrap explained.

Technology improvements on both the pediatric and obstetric/gynecological sides have changed the practice of delivering babies and at the same time have improved the health outcomes of the mother and child. From ultrasound to diagnose and treat problems before the baby is born to delivering babies earlier, many mothers depend on these medical advances.

Gilstrap chaired the National Institutes of Health Consensus Conferences in 1994 and 2000, which recommended women in premature labor or threatening to go into premature labor be given a course of corticosteroids.

“These guidelines made a huge impact – we went from 20 percent of the women eligible for this treatment actually receiving it to 85 percent receiving treatment,” he said.

Fetal screenings for disease have grown in number over the last few years and are likely to increase.

“In the very near future we will know the genetic mutation for all human disease because of the Human Genome Project. That will really impact our practice in terms of prenatal and prepregnancy diagnoses,” Gilstrap said.

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©2006 Texas Medical Center

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