One Minute Insight
Women’s Health theme lead Professor Gordon Smith, talks about the POPs study, and how their findings will hopefully try and prevent complications during pregnancy.
One Minute Insight
Paediatrics theme lead, Professor David Rowitch discusses how genomic medicine techniques are helping children.
A baby is ‘breech’ when they have not turned to a ‘head down’ position for birth. When breech babies are spotted in the final stages of pregnancy, clinicians will attempt to turn the baby safely ready for a vaginal birth. Babies remaining in the breech position are usually delivered by caesarean to avoid the risks of breech delivery. However, not all breech babies are discovered before delivery under standard care.
Researchers wanted to investigate whether providing an extra scan late in pregnancy will help identify babies who are in a breech position earlier and reduce the risk of complications before labour or the number of emergency caesareans. Nearly 4,000 pregnant women were invited to have an extra ultrasound at 36 weeks. Almost 5 per cent of babies were found to be breech and in about half of these cases the baby had been thought to be in a head first position. Identifying these previously undiagnosed cases enabled clinicians to intervene or plan for a caesarean section. On day of delivery, there were no undiagnosed breech deliveries by women participating in the study. Women whose scans showed their baby was breech had their baby turned or delivered by planned caesarean.
Researchers used the Cambridge data to estimate what might happen if such a scan was introduced nationally. They showed that it could prevent ~4000 emergency caesareans each year in the UK and prevent 5-10 baby deaths. The findings led to questions in Parliament and the research team is working with the NHS makers policy to construct the case that late pregnancy ultrasound is part of normal care for pregnant women.
Researchers studied more than 4,000 first-time mothers by analysing blood samples and the placenta. They found that the placental genes controlled a small molecule called spermine – a metabolite which is a substance involved in the metabolism. This molecule is important in all cells and essential for the growth of some bacteria.
They observed female placentas had a high level of the enzyme that makes spermine, and women who were pregnant with girls had a higher level of spermine in their blood compared to women who were pregnant with boys. So these findings might explain why women expecting a girl are more at risk of complications such as pre-eclampsia and women expecting a boy are more at risk of the baby not growing at a normal rate inside the womb.
This research could help doctors predict women who are at higher risk of pregnancy complications.
Using ultrasound scans, a study was conducted to look at growth restriction in babies before they were born and whether the scans could be an indicator of any problems before birth.
The women who participated were offered extra scans in the later stages of their pregnancy so researchers could investigate the growth of their baby in the womb. Then after they had given birth, the babies were measured, and tissue samples from the placenta and umbilical cord were collected.
After scanning more than 4,500 women, researchers were able to demonstrate that extra scans from 24 weeks could be a predictor of adverse pregnancy outcome. However, they are working now on whether biomarkers might improve such prediction when combined with the scan results.
It is hoped that women could potentially be identified as a ‘high risk’ using these new screening tests before they experience complications. Doctors would then be able to act to prevent complications to themselves or the unborn baby.