A Picture of Yinka
words by Maryann Brinley / photographs by Kolawole Oyelese
t’s definitely dark on the beach in Ocean Grove, New Jersey, a little after 4 am in the morning. But, to Kolawole Oyelese, MD, this is the perfect time to be awake and doing just one of the many things he loves in life: photographing. Most obstetrician-gynecologists who specialize in high risk pregnancies and fetal health — a field of medicine notoriously well-known to rob dedicated physicians of their good night’s rest — would stay in bed at that bewitching hour, if they could. Not Oyelese. This doctor, better known by his nickname, “Yinka,” is an assistant professor of OB-GYN at UMDNJ-Robert Wood Johnson Medical School (RWJMS) and among the world’s leading experts on a deadly disorder known as vasa previa, which can kill perfectly developed newborns upon delivery.
“I look after women with such conditions as heart disease, diabetes, cancer,” he says. Oyelese also deals with fetuses with congenital malformations, with repeated pregnancy loss, with multiple pregnancies — “twins, triplets, quadruplets and more!” — and essentially any other serious complication of pregnancy. “It’s an exciting, challenging job and I consider it my calling in life. Dealing with a fetus as a patient actually builds your reverence for life, for what goes on before a person is born.” An expert in prenatal diagnosis, placental and cord disorders, intrapartum obstetrics, preterm labor, pre-eclampsia and sonography, he has even managed cases of delayed interval delivery, when one twin is delivered prematurely but the pregnancy is sustained so the other fetus can be born closer to full-term. In the past, the mortality for these second children was high because it was believed they had to be taken from the womb immediately. The longest interval in Oyelese’s personal experience was from week 18, when the first fetus was born, to 38 weeks, when the second arrived safely. These situations are precarious for everyone, among his most memorable, and certainly anxiety-ridden.
No wonder Yinka finds the calm and surreal point where night meets day, so very late and very early at the same time, just right for capturing other, less stressful aspects of nature. With his Canon Digital Rebel camera, at 4 am, “I am able to see the beauty no one else can see because most people are asleep,” he says, laughing about how little free time his profession really does permit. “You use the spare time you do have carefully.”
Oyelese, who fell in love with photography just three years ago, often drives the 40 miles from his home in Highland Park to set his camera up on a tripod in the sand and wait for the sun to make its magic on the Atlantic Ocean at dawn. All outdoor shots, he recommends, should be taken within two hours of sunrise and sunset “when the most pleasant light is obtained,” he says. “I love landscapes and color but I’ve recently taken up portraits, too. I’m an addict.” To create his dramatic early morning landscapes, in fact, Oyelese keeps the lens of his camera open for several minutes instead of seconds. Doing this actually brings the emerging daylight on the shore in the camera’s eye before the sun comes up over the horizon. He’s been lucky to “catch the most amazing colors in the sky with lovely reflections in the water and wet sand. There is no more exhilarating feeling than being in such a majestic location.”
A graduate of the University of Ibadan in Nigeria, Oyelese originally planned to become a neurosurgeon or to specialize in cardiac surgery. “I actually fell into obstetrics-gynecology by accident,” he explains. The director of a Nigerian hospital where he was training in the emergency room became the president of the Nigerian Medical Association and asked him to take care of her OB-GYN patients while she was away for several months. “She was powerful and well-known and when she returned,” Oyelese says, “she told me that I had done such a good job that I couldn’t leave.” He jokes about being blackmailed into choosing his specialty because, in truth, he loves his work. Later, in England where he spent seven years learning high-risk pregnancy medicine, he was mentored by Dr. Stuart Campbell, the father of ultrasound technology in obstetrics and gynecology. After another residency at Georgetown University Hospital in Washington, DC, Oyelese completed a fellowship at RWJMS.
He hasn’t been back to Nigeria in 17 years “but I’m ready for a visit soon. I love Nigeria but the country has gone through so many political changes and there is still a lot of unrest in Africa.” For now, New Jersey, with its proximity to seashore, mountains and city life, “is a lovely place to be.” Oyelese also met his wife, Patrice Jegou, a Canadian from Alberta and a classical musician completing her doctorate at Rutgers University, here. Musically motivated himself, Oyelese and his brothers used to perform as a singing group back in Nigeria.
“Actually the most memorable place I’ve ever been is in Canada at Banff National Park,” he recalls. Married just last summer, this couple has a long travel wish list which includes Italy, Spain, Greece, Argentina, the Falkland islands, more of Canada, Asia, Africa and the rest of the United States. All four of Oyelese’s siblings have found their futures in America. One brother is even the neurosurgeon Yinka didn’t become — a job this older brother wouldn’t want for anything in the world now. “I love what I do. This is my calling,” he insists. One sister is an internist at Johns Hopkins, while the other is an engineer and another brother is an architect. Their mother was a school principal and their father, now deceased, was a professor of statistics and mathematics.
Oyelese offers regular editorial input to Obstetrics and Gynecology, the most prestigious journal in this field where he has been ranked among its top reviewers. His own publications have been cited by every major obstetrical text as well as numerous journal articles. His research presentations have won prizes at the New Jersey Maternal Fetal-Medicine Society in 2003, 2004 and 2006, as well as the New York Perinatal Society in 2005.
A teacher and mentor, Oyelese publishes often but is particularly proud of a paper that has changed the way maternal-fetal medicine is practiced, and as a result, has saved thousands of lives. Four years ago, his RWJMS team completed the world’s largest study on the subject of vasa previa. The results of this work done with John Smulian, MD, MPH, RWJMS, professor and director of maternal-fetal medicine, first appeared in Obstetrics and Gynecology in April 2006. “I get calls from doctors all over the world now” about vasa previa.
“I believe this has been my biggest contribution to medicine,” Oyelese says. One in 2,000 pregnancies is affected by this rare condition in which the umbilical cord inserts into the fetal membranes rather than directly into the placenta. Vasa previa is more likely to occur when the placenta has attached low in the uterus or over the cervix, rather than in its usual location, in the upper part of the uterus. Once outside the protection of the cord itself, these misplaced vessels are fragile and supported only by the amniotic sac during what can appear to be a very normal pregnancy. However, when the stress of labor begins and the fluid-filled fetal membrane bursts, these blood vessels can rupture easily. “If this occurs, about 60 to 70 percent of the babies will die,” Oyelese says. His first experience with a vasa previa disaster was more than a decade ago in London when a television celebrity lost her baby while he was on duty in obstetrics at the hospital. “I saw this patient and started asking how we could have prevented her baby’s death,” he recalls.
In his cover story for Contemporary ObGyn in November 2003, Oyelese and co-authors wrote, “The sudden unanticipated death of a healthy fetus at term is certainly one of the most heartbreaking tragedies a woman — and her obstetrician — will ever face.” Yet, what could have averted the catastrophe was a simple routine transvaginal ultrasound, or TVS, and color Doppler screening done between weeks 20 and 30 of gestation. A colorized Doppler will show if there is abnormal blood flow over the cervix, indicating abnormally placed fetal vessels. And by using TVS as opposed to the more widely used transabdominal sonography, the doctor can position the probe in the vagina and closer to the cervix which offers a better picture of any potential problem.
When vasa previa is identified, a Cesarean section should be scheduled by week 35 or long before normal labor might begin. Though it is not currently standard practice in the U.S. to test for vasa previa, Oyelese says that this simple check takes no extra time or demands on personnel or equipment. “It can be done as part of any routine ultrasound scan.” Since Oyelese and his colleagues published their work, screening for vasa previa has become more widespread in the U.S. though it is by no means universal yet. “In the four and a half years that I’ve been here, we have diagnosed at least 20 cases of vasa previa and have delivered these babies by Cesarean section, saving their lives. It is noteworthy that in the same period, we haven’t missed any cases so no babies have died from vasa previa.
“We’ve made such an impact and saved so many babies’ lives,” he says in his deep, musically intonated voice, calmly leading an interviewer to believe that this is a man without a care in the world. Perhaps he’s even been up since 4 am today. To see the impact Oyelese is also having on the world of photography, visit photo.net/photos/YinkaMD.
On April 9th, Yinka Oyelese underwent routine, arthroscopic shoulder surgery for a rotator cuff injury. Six days later, severe chest pains, when breathing in, sent him straight to the emergency room at Robert Wood Johnson University Hospital with his wife Patrice. It was 4:30 am, April 15th, and Oyelese would soon know intimately what it was like to be a patient with a life-threatening condition. Treated by a team of physicians led by RWJMS assistant professor Kinshasa Morton, MD, and pulmonologist Lawrence Davanzo, MD, Oyelese had developed a pulmonary embolism in his right lung. Even standard anti-coagulant therapy with heparin wouldn’t stabilize his condition. “I continued to develop multiple new clots in my lung with death of new lung tissue each time,” he explains. “It became apparent that without further intervention, the condition was likely to become more serious, possibly taking my life.” On April 21st, John L. Nosher, MD, RWJMS professor and chair, Radiology, inserted a small umbrella-shaped filter into Oyelese’s superior vena cava to prevent further clots from traveling to his lungs. A week later, he was finally discharged and says, “This story is remarkable because it shows how a UMDNJ physician’s life was saved by another UMDNJ physician using pioneering technologies.”