W. Tony Parks, MD
Dr. Parks is Director of Perinatal Pathology at Magee-Womens Hospital of UPMC.
Associate Professor of Pathology
Magee-Womens Hospital of UPMC
Department of Pathology
300 Halket Street
Pittsburgh, PA 15213
Office Telephone: 412-641-3708
Division Telephone: 412-641-4641
- BS - University of Michigan, 1983
- MD - Washington University School of Medicine, 1988
Clinical ExpertiseDr. Parks' clinical interest is in perinatal pathology, including fetal autopsy and placental pathology. Dr. Parks is the Director of Perinatal Pathology at Magee-Womens Hospital, where he currently examines the majority of the perinatal cases, approximately 4500 placentas and 100 autopsies per year.
Early Placental Changes in Preeclampsia
This is a collaborative project with Dr. Sandra Founds. She has performed microarrays to compare the gene expression patterns in 11-12 week placentas (obtained at chorionic villous sampling) from women who subsequently develop preeclampsia with those who do not. My role on this project has been to identify the specific placental localization (through in situ hybridization and immunohistochemistry) of these gene products. We have published two papers on one particularly exciting prospect, LAIR2, that shows highly specific localization to leading edge and perivascular trophoblast and may play a role in determining the depth of trophoblast invasion into the decidua and myometrium. The project has now turned toward evaluating other gene expression products from the same initial study (for which we have received NIH funding). I am also continuing to work on LAIR2 to determine its potential utility as a marker for trophoblastic tumors.
Maternal Obesity, Weight Gain and Racial Disparities in Stillbirth
This NIH-funded project, headed by Dr. Lisa Bodnar from Epidemiology and Dr. Hy Simhan from Maternal-Fetal Medicine, is a retrospective study of all stillbirths at Magee-Women's Hospital over the period from 2003-2011. For each case, two Maternal-Fetal Medicine clinicians fill out a detailed form tabulating multiple possible factors related to the stillbirth. Also for each case, I review the placental pathology and fill out a detailed placental pathology form. Each case is then juried to determine the probable and possible etiologies of the stillbirth. The data will then be aggregated and analyzed, with particular focus on maternal weight and racial disparities.
MicroRNA Expression in Placentas
This is an ongoing project in Dr. Yoel Sadovsk's laboratory. He has found changes in microRNA expression with hypoxia in trophoblast culture, and he is now attempting to extend these findings to intact placentas. The ultimate goal is to find serum markers in pregnant women that will detect and possibly quantitate hypoxia in a conception. For this project I evaluate the placental pathology.
Neutral Lipid Trafficking in Normal and Hypoxic Placentas
This is an ongoing project in Dr. Yoel Sadovsky’s laboratory. Previous studies from his lab have shown that hypoxia induces the accumulation of lipids within placental trophoblast. His group is now characterizing the mechanisms underlying lipid transport in the placenta. For this project I evaluate the placental pathology and assist with intracellular localization studies.
Synctial knot counts in placental hypoxia
This project is a collaboration with Dr. Janet Catov, an epidemiologist in the Department of Obstetrics and with members of the POUCH study group from Michigan State University. Increased numbers of syncytial knots have long been recognized as a marker for placental hypoxia. Only recently, however, has a study attempted to quantitate the number of syncytial knots in a normal placenta for a given gestational age. The initial aim of this study is to determine the accuracy and utility of syncytial knot counts, using placental slides and clinical data from the POUCH study. For this study the POUCH placental pathologist, Pat Senagore, and I count syncytial knots in a standardized fashion on the same placental slides. Janet Catov will then analyze these syncytial knot counts in the context of the clinical data from the POUCH study to determine the relation of the syncytial knot counts to clinical evidence of placental hypoxia. Ultimately, this project will expand to identifying the best markers for placental hypoxia for research studies (using immunohistochemical markers) and to identifying the most expeditious means of detecting placental hypoxia in a clinical setting.
Accessibility of Placental Pathology Data to the MOMI Database
The MOMI database collects large amounts of clinical data on nearly all deliveries at Magee. Yoel Sadovsky recently appointed Janet Catov to head the MOMI database and to facilitate connections and data accessibility of other relevant databases to MOMI. I've been working with Janet Catov to accomplish this project with respect to placental pathology. This has required developing text capture mechanisms to extract data from the narrative reports from the past and to develop a placental synoptic to generate placental pathology data in a form more appropriate for MOMI going forward.
Sleep Disordered Breathing, Obesity, and Pregnancy
The central hypothesis of this NIH-funded study (PI: Francesca Facco) is that sleep disordered breathing is an effect modifier that increases maternal cardiovascular risk and placental hypoxic injury in obese pregnant women. The study will examine multiple outcomes in obese pregnant women with sleep disordered breathing who will be randomized into CPAP treatment and sham CPAP treatment arms. One major outcome will be the degree of placental hypoxic injury in the placentas from these women.
Selected PublicationsView Dr. Parks' publications on PubMed
- Xie L, Mouillet JF, Chu T, Parks WT, Sadovsky E, Knofler M, Sadovsky Y. C19MC microRNAs regulate the migration of human trophoblasts. Endocrinology. 2014 Dec;155(12):4975-85.
- Marinescu PS, Saller DN, Parks WT, Yatsenko SA, Rajkovic A. Prenatal Diagnosis of Trisomy 6q25.3-qter and Monosomy 10q26.12-qter by Array-CGH in a Fetus with an Apparently Normal Karyotype. Clinical Case Reports. 2015 Feb;3(2):92-5.
- Catov JM, Peng Y, Scifres CM, Parks WT. Placental pathology measures: Can they be rapidly and reliably integrated into large-scale perinatal studies? Placenta. 2015 Jun;36(6):687-92.
- Parks WT. Placental hypoxia: the lesions of maternal malperfusion. Semin Perinatol. 2015 Feb;39(1):9-19.