Research and Education
Qualifications:
BSc (Hons) Clinical Genetics for Birth Defects, St George’s Hospital Medical School, 2001
MBBS, Guy’s, King’s and St Thomas’ Medical School, 2004
MRCOG, Royal College of Obstetricians and Gynaecologists, 2010
MD (Res), University College London, 2016
RCOG Subspecialty training in Maternal and Fetal Medicine, 2016
CCT in Obstetrics and Gynaecolgy, 2016
Books:
Self-Assessment: Spyridon Bakalis, Fred Ushakov and Pran Pandya, Fetal Medicine: Basic Sciences and Clinical Practice, Third Edition, 2019, Elsevier
Panos Stamoulos and Spyridon Bakalis: The Renal and Urinary System and Electrolyte Balance (One Stop Doc Series). Arnold 2005.
Chapter 4: Diagnosis of Fetal Abnormalities at the 11-14 Week Scan – Abnormal Ultrasound Findings Souka A and Bakalis S, from ‘The 11-14 Week Scan’ Nicolaides KH, Sebire NJ and Snijders RJM, Parthenon 1999
Current Research:
Principal Investigator for PReCePT
During pregnancy, a woman’s body adapts with changes in blood pressure, heart function and protein production. Abnormal cardiovascular and/or metabolic adaptation to pregnancy may be linked to the development of pregnancy complications such as preeclampsia and/or growth restricted babies.
Once diagnosed with preeclampsia and/or growth restriction in baby, there usually comes a point of clinical decompensation in mum and or baby, prompting urgent delivery of the baby.
For the PRECEPT study, we aim to recruit approximately 160 women, 100 of whom will have healthy ongoing pregnancies. The remaining 60 will be categorized based on preeclampsia (PE), fetal growth restriction (FGR) or both and further subdivided into 4 gestation bands.
In the PE and/or FGR groups, we will carry out cardiovascular and metabolic tests at diagnosis, throughout, and after pregnancy. In the healthy ongoing pregnancy group, we will see them to perform the same tests at around 28/32/36 weeks and after pregnancy.
The study is observational with no intervention. All cardiovascular tests are noninvasive, and women will be required to provide a urine and blood sample for metabolite analysis. Where possible, blood tests will be timed with clinically indicated blood sampling as part of their routine management.
Data from this study will establish a profile of values at different gestation and changes through pregnancy for cardiovascular and metabolite processes. If changes in cardiovascular function are seen prior to or in conjunction with clinical deterioration, it raises the prospect of prompt intervention and potential therapies.
The PRECEPT study will be conducted at Queen Charlotte’s & Chelsea Hospital, Imperial Healthcare NHS Trust in close collaboration with the University of Cambridge (who has collaborated on the design of the protocol and loaned ‘Innocor’ – one of the machines used for cardiovascular testing)
Principal Investigator for DESIGN
In the UK the number of babies stillborn has not fallen in the past 20 years. Most babies that die before birth are normal, but many weigh less than expected. A small baby in the womb may reflect suboptimal placental (afterbirth) function . However, some babies are small and are normally grown reflecting the constitution of the parents. The Growth Assessment Programme (GAP) aims to improve the identification of small babies by considering maternal characteristics such as size and ethnicity when assessing growth. Evidence from only observational studies suggest that GAP is better at identifying babies at risk. However, a key concern is that adjustment for maternal ethnicity, some very small or very large babies might be missed or wrongly identified. Correct identification of small babies is fundamental as appropriate management and follow up reduces their risk of a stillbirth. Therefore, a well-designed clinical trial is needed to assess if GAP is better in identifying small babies.
This is a cluster randomized trial. Hospitals are randomised, rather than individual women who will receive the care allocated to their hospital avoiding contamination of the intervention. All maternity units in the trial will introduce the GAP programme eventually, but one group will use GAP immediately, while the other group will delay implementation of GAP. The time before the introduction of GAP in the delayed arm means we can compare maternity units using GAP with those continuing with usual care.
In the end of the trial we will be able to inform the best way to identify small babies. We will also look at stillbirth and other important outcomes. We will also ask women about their experiences of care. Finally, we will estimate the impact of GAP on clinical service provision and health economics.
Publications:
Outcomes of Urinary Tract Abnormalities Diagnosed by the Routine Third Trimester Scan
Spyros Bakalis, Kevin Cao , Radha Graham , Peter Cuckow , Nav Johal , Paul Winyard , Pranav Pandya , Divyesh Desai
Eur J Obstet Gynecol Reprod Biol 2020 May
The value of the routine third trimester ultrasound scan in antenatal care: Problems with guidance and outdated data in a highly technological field.
Bakalis S, Cao K, Johal N, Cuckow P, Pandya P
Eur J Obstet Gynecol Reprod Biol.2020 Feb
Transplacental metoprolol for fetal supraventricular tachycardia.
Vigneswaran TV, Rosenthal E, Bakalis S, Nelson-Piercy C, Chappell L, Simpson JM.
Ultrasound Obstet Gynecol. 2019 Nov 19.
Successful outcome after spontaneous first trimester intra-amniotic haematoma and early preterm premature rupture of membranes.
Bakalis S, David AL.
BMJ Case Rep. 2018 Nov
Spina bifida in pregnancy: A review of the evidence for preconception, antenatal, intrapartum and postpartum care.
Kenga Sivarajah, Sophie Relph, Radha Sabaratnam, Spyros Bakalis
Obstetric Medicine May 2018
A retrospective multicenter study of the natural history of fetal ovarian cysts.
Tyraskis A, Bakalis S, Scala C, Syngelaki A, Giuliani S, Davenport M, David AL, Nicolaides K, Eaton S, De Coppi P.
J Pediatr Surg. 2018 Feb 12.
A systematic review and meta-analysis on fetal ovarian cysts: impact of size, appearance and prenatal aspiration.
Tyraskis A, Bakalis S, David AL, Eaton S, De Coppi P.
Prenat Diagn. 2017 Oct;37(10):951-958. Review.
Prediction of small-for-gestational-age neonates: screening by maternal biochemical markers at 30-34 weeks.
Bakalis S, Gallo DM, Mendez O, Poon LC, Nicolaides KH.
Ultrasound Obstet Gynecol. 2015 Aug;46(2):208-15.
Prediction of small-for-gestational-age neonates: screening by uterine artery Doppler and mean arterial pressure at 30-34 weeks.
Bakalis S, Stoilov B, Akolekar R, Poon LC, Nicolaides KH.
Ultrasound Obstet Gynecol. 2015 Jun;45(6):707-14.
Prediction of small-for-gestational-age neonates: screening by fetal biometry at 30-34 weeks.
Bakalis S, Silva M, Akolekar R, Poon LC, Nicolaides KH.
Ultrasound Obstet Gynecol. 2015 May;45(5):551-8.
Umbilical and fetal middle cerebral artery Doppler at 30-34 weeks’ gestation in the prediction of adverse perinatal outcome.
Bakalis S, Akolekar R, Gallo DM, Poon LC, Nicolaides KH.
Ultrasound Obstet Gynecol. 2015 Apr;45(4):409-20.
Prediction of small-for-gestational-age neonates: screening by biophysical and biochemical markers at 30-34 weeks.
Bakalis S, Peeva G, Gonzalez R, Poon LC, Nicolaides KH.
Ultrasound Obstet Gynecol. 2015 Mar 31.
Uterine artery Doppler at 30-33 weeks’ gestation in the prediction of preeclampsia.
Lai J, Poon LC, Pinas A, Bakalis S, Nicolaides KH.
Fetal Diagn Ther. 2013;33(3):156-63.
Systolic, diastolic and mean arterial pressure at 30-33 weeks in the prediction of preeclampsia.
Lai J, Poon LC, Bakalis S, Chiriac R, Nicolaides KH.
Fetal Diagn Ther. 2013;33(3):173-81
C-reactive protein at 11-13 weeks’ gestation in spontaneous early preterm delivery.
Bakalis SP, Poon LC, Vayna AM, Pafilis I, Nicolaides KH.
J Matern Fetal Neonatal Med. 2012 Dec;25(12):2475-8.
Maternal serum ferritin at 11- to 13-week gestation in spontaneous early preterm delivery.
Beta J, Poon LC, Bakalis S, Mosimann B, Nicolaides KH. J Matern Fetal Neonatal Med. 2012 Oct;25(10):1852-5
Outcome of prenatally diagnosed agenesis of the corpus callosum.
Fratelli N, Papageorghiou AT, Prefumo F, Bakalis S, Homfray T, Thilaganathan B.
Prenat Diagn. 2007 Jun;27(6):512-7.
Outcome of antenatally diagnosed talipes equinovarus in an unselected obstetric population.
Bakalis S, Sairam S, Homfray T, Harrington K, Nicolaides K, Thilaganathan B.
Ultrasound Obstet Gynecol. 2002 Sep;20(3):226-9.
Outcome of pregnancy in chromosomally normal fetuses with increased nuchal translucency in the first trimester.
Souka AP, Krampl E, Bakalis S, Heath V, Nicolaides KH.
Ultrasound Obstet Gynecol. 2001 Jul;18(1):9-17. Review.