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Focus on George Macones, MD, MSCE

George Macones, MD, MSCE is the Mitchell and Elaine Yanow Professor and Head of obstetrics and gynecology. His areas of specialty include maternal fetal medicine, obstetrics and gynecology.
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Dr. Macones sees patients at:

• The Women’s Health Center in the Center for Advanced Medicine, 4621 Parkview Place, 5th floor, Suite A, St. Louis, MO 63110.

• The Center for Women’s Wellness and Fetal Health, Missouri Baptist Medical Center, 3023 N. Ballas Rd., Building D, 4th floor, Suite 450, St. Louis, MO 63131.

• Progress West HealthCare Center, 2 Progress Point Parkway, Suite 101G, O’Fallon, MO 63368.

FOR AN APPOINTMENT, PLEASE CALL: 314 747-1336 (Center for Advanced Medicine), 314 996-6000 (Missouri Baptist) or 314 362-7135 (Progress West)

What happened in the course of schooling to make you choose maternal fetal medicine as your specialty?

I was destined for medicine. My mother was a nurse. She was always so enthusiastic about medicine and I inherited that from her. During medical school, the last thing in the world I thought I was going to specialize in was obstetrics/gynecology. I had done some ENT (ears, nose and throat) research and was sure that was what I was going to do. But I hit the labor and delivery floor during my last rotation as a third-year medical student and absolutely fell in love with the specialty. It was a good fit for my personality, so it was a very easy decision.

I went to Pennsylvania Hospital in Philadelphia for my residency and initially wanted to specialize in GYN oncology because I liked being in the operating room. After my intern year, I decided maternal fetal medicine was right for me. I loved pregnancy -- it’s fascinating from a physiological perspective. I also enjoy helping my patients through the ups and downs that happen in this specialty. We experience great highs and very low lows with our patients -- that really fit with who I am. It’s been the best choice I could have possibly made.

What influenced your decision to come to Washington University?

When I was in Philadelphia, I worked my way up the ranks at the University of Pennsylvania -- ultimately running the maternal fetal medicine division and obstetric service for the Penn health system. But Washington University is one of the great medical schools in the country and I was ready for the next step to take over the academic leadership of this outstanding department.

It was an incredibly easy decision for me to come here. I thought it was a place that I could really make a difference in helping the department and the school. It’s been everything I could have possibly hoped for.
Dr. George Macones and sons


What do you find is most interesting about your practice?

I’m really interested in moms who have serious medical problems -- women who either want to get pregnant, or who are pregnant and need someone to help them optimize their chances for a good pregnancy outcome. A vast majority of high-risk patients come to us because Washington University has so many incredible medical specialists. We have a real potpourri of medical problems to take care of and that makes it intellectually challenging.

I also see many women who have had difficult pregnancies in the past. They might have lost a pregnancy, or had a baby that was born early. I really enjoy helping those women, as well.

What new developments in your field are you most excited about?

We continue to make great progress looking at babies in utero with ultrasound and identifying problems that might come up after birth. Technology that looks for birth defects is getting better and better – we’re able to see more and more of what’s happening with the fetus during pregnancy.

Our radiology department also has the ability to do an MRI of the fetus through the mom. This gives us a great window into what’s happening with the baby in terms of anything we need to be worried about after delivery. That’s very exciting.

Another area of great importance is new information about ways to prevent preterm deliveries --especially in women who have had one before. There is a great deal of research looking at different progesterone agents to help those women achieve a good pregnancy outcome. If a woman has had a prior early delivery, giving her progesterone can sometimes help to make sure she has a full term delivery the next time.

The Center for Fetal Care is a joint program with pediatrics, pediatric surgery and pediatric cardiology. We look for birth defects and help those moms with a multidisciplinary approach to have a good plan for their pregnancy and help prepare them for what’s likely to come after delivery. We’re working hard to be the Midwest referral center for kids with birth defects.

What are some of the in utero procedures?

One of the in utero interventions we know that work includes laser ablation for twin-twin transfusion syndrome, which is a sharing of blood vessels between twins. One baby can get too much, one baby can get too little -- it can be a very serious complication for a pregnancy. Anthony Odibo, MD, is an excellent specialist here, who performs a laser treatment for that condition using a fetalscope. That’s really one of the areas where doing a fetal procedure can help to improve outcomes, and I’m proud to say it is something we have to offer our patients.

Where are you from?

I was born and raised in Philadelphia – staying there for medical school, my residency and fellowship. I was at Penn for about 11 years before coming to St. Louis.

Compared to the East coast, the Midwest is a little slower, but nicer in a lot of ways --it’s an easier life here. This medical school is one of the finest in the country. For me, it couldn’t get any better than this.

Is there a particular award or achievement that is most gratifying?

My favorite achievement has been as one of the leaders of our national group of high-risk pregnancies. I’ve had the opportunity to run our large annual scientific meeting in maternal fetal medicine – with about 3000 people in attendance. I’m very proud of that achievement.

I’ve also been able to write practice guidelines for obstetricians around the country on some very important topics. The most recent being how we monitor fetuses during labor. Because it touches so many people and so many women – I think it’s made a big difference.

What is the best advice you’ve ever received?

Advice that I’ve gotten from other doctors, who have also become department chairs when they were relatively young, was “be true to the vision you have when it comes to what is important to your department”. That has served me pretty well here.

If you weren’t a doctor, what would you like to be doing?

I’d love to be the CEO of a huge company -- absolutely, no question about it.

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Copyright 2014 Washington University School of Medicine