The department of gynecology and obstetrics has grown and changed over the last five years, and we are very proud to provide
unmatched expertise in women’s health management as well as premier training for our students, residents, and fellows.

Our longstanding partnership with Riverside University Health System (RUHS), which ended in 1998, was renewed in 2017 when we once again took over all OB-GYN services. During negotiations in 2016, we recruited Ronald B. Johnson ’84 back from his service at White Memorial Medical Center to run our RUHS program. He was joined by Bryan T. Oshiro ’85 in maternal -fetal medicine (MFM) and several existing faculty to begin a core group, with cross coverage by main campus faculty. The next three years added faculty including Bryan J. Hill ’10 in urogynecology and Ivan Rybkin ’15 and Canty Wang ’15 in general OB-GYN. Our return to RUHS supplies valuable training experience for our growing residency and fellowship programs.

The last five years have also seen the retirement of several longstanding department leaders. Robert J. Wagner ’69 retired in December 2021, marking 50 years of service to Loma Linda University School of Medicine (LLUSM), including 27 years directing the residency program, 37 years leading the gynecologic oncology (GYN/ONC) division, and one year as interim chair in 2017. Elmar P. Sakala ’73-B also stepped back from clinical practice following a remarkable career in MFM. His dedication and enthusiasm while directing the OB-GYN student clerkship made him well-known to many. He joins other longstanding faculty William C. Patton ’69 and John D. Jacobson ’70 in providing portions of our resident and student didactic training during clinical retirement. 

Kevin C. Balli ’98 was named department chair in December 2017, after 15 years with the department. His tenure thus far has been marked with further growth and changes, including our response to the COVID-19 pandemic and our move to the new hospital tower in August 2021. The upheaval in health care brought by the pandemic was vividly felt by the gynecology and obstetrics department. Our initial uncertainty gave way to rapid preparation, aided by tireless work from department members, including leadership by Courtney Martin, DO, our director of maternity services and Children’s Hospital quality. As we progressed through waves of illness, we rebuilt department scheduling to cover critical access for our patients in labor and delivery and emergency services. As the tertiary referral hospital for much of San Bernardino and Riverside counties, we cared for many extremely ill pregnant patients, even performing some emergency cesarean deliveries in the intensive care unit. Despite multiple challenging cases, we thank God that we never lost any pregnant mothers from COVID-19. Caring for pregnant patients with COVID-19 led to original research by Ruofan Yao, MD, and Dr. Martin, aided by other faculty, including Ciprian P. Gheorghe ’08 and medical student Melissa Nishino ’22. This project resulted in a July 2021 publication showing our development of the Loma Linda Obstetric Warning Score for predicting the risk of progression to severe disease in pregnant patients testing positive for SARS-CoV-2. This score has been used around the world to assist in rapid management of pregnant women with COVID-19.

Proving that a crisis resists scheduling, our move-in day to the new Troesh Medical Campus began with the rapid deterioration of an intubated pregnant patient and a heart-pounding rush across the connecting bridge, resulting in both the first surgery and the first delivery in the brand-new operating rooms. The rest of the day was spent moving patients into the large state-of-the-art San Manuel Maternity Pavilion, named for the generous $25 million donation from the San Manuel Band of Mission Indians. Stretching out into this new space coincides with a 34% increase in deliveries over the last six years—hitting 3,713 in 2021—with continued rise in 2022. As a condition of the donation, we were recognized for our ongoing excellence in obstetric quality, surpassing other hospitals in our region despite caring for the most critically ill patients. Our research into acute management of severe hypertension in pregnancy by Dr. Martin, Heather R. Figueroa ’08, and others was highlighted as an “Editor’s Pick” in the prestigious Green Journal, Obstetrics & Gynecology in February 2021. This and other quality metrics have brought our department state and national recognition in the California Honor Roll and the U.S. News and World Report (USN&WR).

Beyond obstetrics, our gynecologic services have also been recognized as one of the top 30 departments nationally by USN&WR. Sam Siddighi, MD, and Jeffrey S. Hardesty ’80-B continue to provide specialized pelvic floor surgery and are active in ongoing research studying optimal treatment of pelvic prolapse. The GYN/ONC division has teamed up with the MFM division to study optimal management of placenta accreta spectrum, which has been on the rise. Their team-based approach yielded a recent publication showing marked reduction in blood transfusion when managing these complex cases. In July, their team welcomed our first GYN/ONC fellow, Nora Badiner, MD, capping off a multi-year effort to establish our department’s first ACGME-accredited fellowship. Growth in deliveries has been mirrored in infertility procedures in our Center for Fertility. Led by Gihan Bareh, MD, the center performs over 250 IVF cycles per year. With best-in-class success rates, her wait list continues to grow.

Our services have benefited tremendously from the energy and drive of our residents and students. Our residency program, overseen by Danielle M. Mason ’05, recently received full accreditation for nine yearly positions, up from six. Our medical student clerkship director, Elaine A. Hart ’00, was a recent LLUSM Teacher of the Year, the third member of our faculty to receive this award. Her leadership consistently places the OB-GYN clerkship in the top ranks of LLUSM students each year.

Dr. Balli has chaired the department of gynecology and obstetrics for five years. In his spare time he can be found playing the piano for LLU Church campmeeting and playing board games with his children and their friends.

DEPARTMENT AT A GLANCE

DELIVERIES: In 2021, our department was responsible for over 3,700 deliveries, with continued growth in 2022.

PROVIDERS: The department is currently supported by a total of 52 faculty (including four retired faculty emeriti), 35 residents, and one fellow.

LOCATIONS: Our department covers eight clinical rotation sites throughout the Inland Empire.

RECENT RESEARCH:

• Insulin resistance and other risk factors of cardiovascular disease amongst women with abnormal uterine bleeding
• Initial clinical characteristics of gravid severe acute respiratory syndrome coronavirus 2-positive patients and the risk of progression to severe coronavirus disease 2019
• Semiautonomous treatment algorithm for the management of severe hypertension in pregnancy
• When the balloon goes up, blood transfusion goes down: a pilot study of REBOA in placenta accreta spectrum disorders
• Detection of bone metastases in uterine cancer: how common are they and should PET/CT be the standard for diagnosis?

ALUMNI FACULTY MEMBERS (As of summer 2022): Kevin C. Balli ’98, Ashley B. Beem ’14, Emerald K. Caruso ’99, Stephanie Fegale ’15, Heather R. Figueroa ’08, Ciprian P. Gheorghe ’08, Jeffery S. Hardesty ’80-B, Elaine A. Hart ’00, Bryan J. Hill ’10, John D. Jacobson ’70 (Emeritus), Ronald B. Johnson ’84, Melissa Y. Kidder ’94, Kathleen M. Lau ’82, Danielle M. Mason ’05, Bryan T. Oshiro ’85, William C. Patton ’69 (Emeritus), Ivan Rybkin ’15, Elmar P. Sakala ’73-B (Emeritus), Robert J. Wagner ’69 (Emeritus), Canty Wang ’15, Ai-Mae C. Watkins ’93, and Jessica White ’17.