Dr. Mrinalini Balki

Balki LabBack row left to right: Dr. Stephen Lye, Dr. John Kingdom, Dr. Jose Carvalho
Front row left to right: Alice Luca, Dr. Mrinalini Balki

Lab Description

Dr. Balki’s state-of-the art laboratory at Mount Sinai hospital was established in 2007 and is equipped with an organ bath assembly (Radnoti eight unit tissue-organ bath system) 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 the effect of various drugs on human myometrium contraction patterns, in order to gain a better understanding of the mechanism behind postpartum hemorrhage and ways to reduce its incidence. The lab is supported by research funding from the Canadian Anesthesiologists’ Society, University of Toronto, and Society for Obstetric Anesthesia and Perinatology.

Research Focus

The main 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 in relation to the clinical problem. 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 & 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 advanced maternal age, 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 

  1. Balki M, Erik-Soussi M, Ramchandran N, Kingdom J, Carvalho JCA. Contractile effects of oxytocin, ergonovine and carboprost and their combinations: An in vitro study on human myometrial strips. Anesthesia Analgesia 2015;120:1074-1084. 
  2. Balki M, Erik-Soussi M, Kingdom J, Carvalho JCA. Comparative efficacy of uterotonic agents: In-vitro contractions in isolated myometrial strips of laboring and non-laboring women. Canadian Journal of Anaesthesia 2014;61:808-818.
  3. Balki M, Erik-Soussi M, Kingdom J, Carvalho JCA. Oxytocin pretreatment attenuates oxytocin-induced contractions in human myometrium in vitro. Anesthesiology. 2013; 119:552-61.
  4. Balki M, Kanwal N, Erik-Soussi M, Kingdom J, Carvalho JCA. Contractile efficacy of various prostaglandins in pregnant rat myometrium pretreated with oxytocin. Reproductive Sciences 2012; 19: 968-975.
  5. Balki M, Cristian A, Kingdom J, Carvalho JCA. Oxytocin pretreatment of pregnant rat myometrium reduces the efficacy of oxytocin but not of ergonovine maleate or prostaglandin F2 alpha. Reproductive Sciences 2010; 17: 269-277.
  6. Magalhaes J, Carvalho JCA, Parkes R, Kingdom J, Li Y, Balki M. Oxytocin pre-treatment decreases oxytocin-induced myometrial contractions in pregnant rats in a concentration but not time-dependent manner. Reproductive Sciences 2009; 16: 501-508. 
Mrinalini Balki, PhD

Mrinalini Balki, MD

E: mrinalini.balki@uhn.ca​
P: (416) 586-5270
F: (416) 586-8664


Laboratory Members

Dr. Mrinalini Balki, MD: Principal Investigator
Alice M Luca, MSc: Research Assistant
Dr. Desire Onwochei, MD: Anesthesia Fellow
Dr. Jose Carvalho, MD, PhD: Co-investigator
Dr. John Kingdom, MD:  Co-investigator
Dr. Stephen Lye, PhD: Collaborator