D. Ware Branch, MD
Professor of Obstetrics and Gynecology
30 North 1900 East RM B200
CAMPUS
(801) 581-5490
Email: w.branch@m.cc.utah.edu
The Department of Obstetrics and Gynecology at the University of Utah is widely recognized for its research contributions in the field of women's health. My research focuses on Maternal-Fetal Medicine (high-risk pregnancy care) and centers on immunology of pregnancy, especially the areas of antiphospholipid syndrome and recurrent miscarriage and fetal death. My research projects supported by the Benning endowment include: 1) Fetal Origins of Childhood and Adult Diseases; 2) Endometrial Analysis in Women with Recurrent Miscarriage; 3) Screening for Mutations in Women with Uterine Anomalies; and 4) A Tissue Bank for Unexplained Fetal Loss Between 10 and 20 Weeks’ Gestation.
Fetal Origins of Childhood and Adult Diseases: According to the hypothesis underlying this research, perturbations of maternal health or nutrition during pregnancy affect the fetus in ways that may promote the development of disease states in childhood of adulthood. Utah researchers hypothesized that the fetal origins of adult diseases are mediated via a process known as epigenetics in which the gene expression is altered without alteration in the gene coding sequences themselves. Epigenetic changes include modifications of the overall gene structure such as DNA methylation and both histone acetylation and methylation. This work also will explore how diet supplementation might beneficially alter this pattern of adult disease.
Endometrial Analysis in Women with Recurrent Miscarriage: Recurrent miscarriage (RM) is a common reproductive problem (about 1 in 100 couples) that results in considerable emotional duress and family turmoil. In most cases, a definitive cause can not be established, leaving affected couples frustrated and subject to a variety of unproven managements. Some RM may be due to failure of the embryo to properly implant in the endometrium (the lining of the uterus) because it is either immunologically hostile or "non-receptive" in other ways. Our research is particularly interested in immunological features, such as natural killer cells and their elaborated biochemicals, that might adversely impact or limit implantation. The goal of this research is to define the molecular endometrial immune response in women with a history of recurrent miscarriage and compare this to a group of control women.
Screening for Mutations in Women with Uterine Anomalies: Congenital defects of uterine structure, known as congenital uterine anomalies, are a major cause of miscarriage, fetal death, and infertility. Although the true incidence of congenital uterine anomalies is unknown, it has been estimated that about 1 in every 500 women is affected, and that some 10% to 20% of recurrent miscarriage or early fetal loss results from uterine anomalies, as well as some cause of infertility. Relatively little genetic information is available in humans regarding the "cause" of uterine anomalies. If a relationship between gene mutations and human uterine anomalies is found, numerous studies will be initiated, particularly in the areas of endometrial cell histology and function. Inforamtion providing a possible diagnosis for the participants will be invaluable in determining the potential for passing the uterine defect to children of the participants.
A Tissue Bank for Unexplained Fetal Loss Between 10 and 20 Weeks' Gestation: Fetal loss, the death of the fetus after 10 weeks' gestation, is a devastating complication of pregnancy affecting from some 1% to 3% of all pregnancies in the U.S. Of these, the majority occur between 10 and 20 weeks' gestation. Though a variety of factors have been implicated in fetal death, including genetic syndromes, anatomic malformations, maternal disease, infectious factors, immunologic factors, and thrombophilic disorders, the cause of fetal death is not identified in at least 50% of cases. In order to better understand fetal losses between 10 and 20 weeks, we have established a tissue bank comprised of bio-specimen from a population of pregnant women who have a fetal death documented to have occurred between 10 and 20 weeks' gestation, inclusive, and who also have undergone a standard evaluation for the relatively few known causes. This tissue bank will contain DNA from tissue and blood collected from both the parents and the fetus. These carefully collected specimens will be used to advance the understandings of otherwise unexplained fetal losses that occurs between 10 and 20 weeks' gestation.