Mrinalini Balki

Appointments

Cross-Appointed to Department of Physiology, and Department of Obstetrics & Gynaecology

Primary: Department of Anesthesiology & Pain Medicine 

Professor, Faculty of Medicine, Department of Anesthesiology & Pain Medicine, and Department of Obstetrics & Gynaecology, and Department of Physiology 

Senior Clinician Scientist, Lunenfeld-Tanenbaum Research Institute, Sinai Health System 

Associate Member, Institute of Medical Science 

Staff Anesthesiologist, Mount Sinai Hospital, 

Consultant Staff, Kensington Eye Institute, Toronto 

Research Synopsis: 

Keywords: Postpartum hemorrhage, Uterine atony, Myometrial contractility, Vascular contractility, Oxytocin, Uterotonics, Anesthesia agents, Vasopressors 

Detailed Description: 

The focus of Dr. Balki’s lab has been to further the understanding of the pharmacotherapy of postpartum hemorrhage, and to establish the significance of the oxytocin-induced desensitization phenomenon that is clinically undesirable. Oxytocin-induced desensitization occurs after prolonged administration of oxytocin during labor and impairs the contractility of the uterus after delivery resulting in excessive postpartum bleeding. Dr. Balki’s group has developed and validated a “desensitization model” to study the effect of various medications on human myometrial contractility. Their innovative findings were highlighted in the American Society of Anesthesiologists’ and Mount Sinai Hospital’s press releases. Currently this is the only laboratory in North America studying physiological and pharmacological responses of human myometrial tissue to various drugs.  

Their effort is to find effective pharmacological therapies for improving myometrial contractility in the desensitized muscle and to explore various strategies to minimize the desensitization phenomenon. This has a potential to reduce the occurrence of postpartum hemorrhage in clinical settings. The findings of many of their translational studies have formed a basis of clinical trials in this area and changed the practice of administration of uterotonic drugs at cesarean deliveries.  

They have also expanded their research to investigate myometrial contractility patterns in response to uterotonics in high-risk parturients such as those with advanced age, morbid obesity, various comorbidities, and prior exposure to drugs affecting myometrial contractility.  

Their current research is exploring the effect of anesthetic agents on myometrial contractility to help determine the best drug to use during cesarean deliveries. Future work is planned to study the effects of various vasopressors on myometrial and vascular contractility; this will help find the most suitable drug for the treatment of hypotension in critical settings. 

Methods Used 

Procedures: In-vivo recording of myometrial contractility  

Equipment Used 

Organ bath assembly (Radnoti eight-unit tissue-organ bath system) with individual transducers and a computerized data acquisition system (Biopac MP160) to measure and record contractility in human myometrial and vascular tissue samples. 

Collaborations

Stephen Lye, Jaques Belik, Steffen-Sebastian Bolz, John Kingdom