Pregnancy, Fetal Wellbeing & Childbirth
This research stream focuses on the three inter-related areas of maternal health, fetal wellbeing and pregnancy outcomes at delivery, with the aim to improve the management of medical problems in pregnancy (antiphospholipid syndrome, pre-eclampsia, obstetric cholestasis, diabetes); fetal congenital abnormality, preterm labour, and dysfunctional labour.
The overarching goal is to implement a research strategy that will deliver new diagnostic tools, novel therapies and clinical management guidelines to improve overall outcomes for pregnant women and their children. Our strategy is centred on translating good basic science research related to parturition, inflammation, obesity and nutrition, reproductive ageing and preterm birth into novel and successful clinical outputs.
Our strengths include large multidisciplinary research team that has access to two of the largest and most socially and ethnically varied and complex populations of pregnant women in the UK that exhibits high rates of pregnancy-associated complications and social deprivation.
We have an excellent track record of developing first trimester screening tools, implementing clinical trials in pregnancy and proven experience in integrating science research goals with clinical need. Our research approach is further enhanced by cross-linking with the researchers with an interest in 'Women's Health Policy, Services and Public Health'. Collaboration will facilitate rapid evaluation of knowledge transfer, and effectiveness and safety of our research outputs in a monitored health care setting. The impact of mental health on pregnancy outcomes will also be a focused area for expansion in our research programmes.
In 1999, in a small study, we showed that antioxidants improved vascular function in women at risk of the disease, and the study showed early promise as fewer women developed pre-eclampsia. However a subsequent nationwide randomised controlled trial conducted by our unit showed no benefit of prophylactic treatment with vitamins C and E. In common with other cardiovascular diseases associated with oxidative stress it appears that antioxidants will not be able to provide an easy preventative strategy, but this does not mitigate against a role for oxidative stress, and we actively pursue research in that area. Having worked for some time in development of predictive tests for pre-eclampsia, and published patents in that area, we have recently joined the international study ‘SCOPE’ which aims to develop accurate predictive tests for pre-eclampsia, pre-term labour and fetal growth restriction. SCOPE draws upon scientific and clinical expertise from Universities across the world, and provides a unique opportunity for not only elaborating predictive tests but also through state-of-the art proteomics and bioinformatics, providing new insights into the aetiology of the three most common disorders affecting pregnant women.
Research in the unit run by Professor Andrew Shennan, is involved in a very practical problem, the accurate measurement of blood pressure in pregnant women. The last few years has seen the development of a wide range of automated instruments designed to measure blood pressure, and intended to provide replacements for the mercury sphygomanometer. Unfortunately, many have not been validated, especially for use in pregnancy. Professor Shennan’s team are accredited to validate new blood pressure measuring devices and have recently developed new devices for accurate measurement of blood pressure in the clinic, and a new, robust and inexpensive device for use in the developing world.
Clinical studies include:
- the predication, prevention and treatment of preterm labour
- improving induction and augmentation of labour
- development of new tocolytics for the treatment of preterm labour
