Dr. Mrinalini Balki

Lab Description

Dr. Balki’s laboratory at Mount Sinai hospital was established in 2007 and aims to bridge clinical practice with basic science by investigating the effects of anesthetic drugs used in obstetric practice. Her lab is equipped with an organ bath assembly with individual transducers and a computerized data acquisition system to measure and record contractility in human myometrial tissue samples. This system allows them to investigate and quantify the effects of various drugs on myometrial contraction patterns. By leveraging this innovative system, Dr. Balki’s team delves into pharmacological basis of postpartum hemorrhage to reduce its incidence. Dr. Balki regularly collaborates with basic science researchers as well as clinicians, with the overall goal of mitigating uterine atony and postpartum hemorrhage. The research is supported by funding from various funding agencies including CIHR.

Research Focus

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. Oxytocin-induced desensitization occurs after prolonged administration of oxytocin during labor induction and impairs the contractility of the uterus after delivery resulting in excessive postpartum bleeding. Dr. Balki & her group have developed and validated a “desensitization model” to study the effect of various medications on human myometrial contractility. Their effort is to find effective pharmacological therapies for improving myometrial contractility in the desensitized muscle and to explore the strategies to minimize the desensitization phenomenon. They have also expanded their research to investigate myometrial contractility patterns in high-risk conditions such as morbid obesity, and preeclampsia. They hope their studies will form a basis for future modifications in oxytocin augmentation regimens and pharmacotherapy for control of uterine atony and postpartum hemorrhage in at-risk patient populations.

Selected Publications 

Publications: https://www.ncbi.nlm.nih.gov/myncbi/mrinalini.balki.1/bibliography/public/

1. van den Bosch OFC, Chaudhry R, Wicker J, Mubashir T, Limb D, Jogendran R, Munshi L, Balki M. Predictors and Hospital Outcomes in Pregnant Patients Undergoing Extracorporeal Membrane Oxygenation: A Nationwide Study. Anesth Analg. 2022 Dec 1;135(6):1172-1179. doi: 10.1213/ANE.0000000000006210.  
2. McDonagh F, Carvalho JCA, Abdulla S, Cordovani D, Downey K, Ye XY, Farine D, Morais M, Balki M. Carbetocin vs. oxytocin at elective caesarean delivery: a double-blind, randomised, controlled, non-inferiority trial of low- and high-dose regimens. Anaesthesia. 2022 Aug;77(8):892-900. doi: 10.1111/anae.15714.  
3. Balki M, Downey K, Walker A, Seaward G, Carvalho JCA. Prophylactic Administration of Uterotonics to Prevent Postpartum Hemorrhage in Women Undergoing Cesarean Delivery for Arrest of Labor: A Randomized Controlled Trial. Obstet Gynecol. 2021 Mar 1;137(3):505-513. doi: 10.1097/AOG.0000000000004288.  
4. Jayasooriya GS, Carvalho JCA, Luca A, Balki M. The Effects of Nitroglycerin on the Oxytocin Dose-Response Profile in Oxytocin-Desensitized and Naïve Human Myometrium: An In Vitro Study. Anesth Analg. 2021 Jan;132(1):231-239. doi: 10.1213/ANE.0000000000005055.   
5. Drew T, Balki M. What does basic science tell us about the use of uterotonics?. Best Pract Res Clin Obstet Gynaecol. 2019 Nov;61:3-14. doi: 10.1016/j.bpobgyn.2019.05.017.