Research Updates Summer 2019: Entry Level Research Scholarships
Identifying risk factors of amniotic fluid embolism and improving treatments
Amniotic fluid embolism (AFE) is a life-threatening pregnancy complication. Up to 40% of women affected will die or have permanent neurological injury. At the University of Oxford, Dr Kate Fitzpatrick’s study identified a number of factors that increased the risk of AFE and looked at which treatments were most successful. It found that older maternal age, multiple pregnancy, having too much amniotic-fluid (polyhydramnios), a low-lying placenta, placental abruption (where placenta separates too early from the womb) and induction of labour are associated with an increased risk of AFE. The study suggested that rapidly treating blood clotting problems, including early use of enough tranexamic acid – a drug which has recently been identified as beneficial for treating heavy bleeding shortly after birth – may help save women’s lives.
Investigating the impact of birth tears on future pregnancies
Third and fourth degree tears (severe perineal tears) are becoming more common. Dr Andrea Woolner at the University of Aberdeen led the first study of its kind using Scottish national data to provide more information for women and healthcare professionals before making choices about future pregnancy and delivery after a severe childbirth tear. Women who opted for a vaginal birth in the second pregnancy were six times more likely to have a repeat third or fourth degree tear than women who did not have a severe tear at their first birth. Currently, healthcare professionals do not know the best way to manage future pregnancies for women who suffer these tears in their first pregnancy. The study found that third and fourth degree tears can affect the subsequent pregnancy and delivery, therefore improving the prevention of these tears needs to be prioritised.
Understanding womb lining to better treat womb conditions
Dr Alison Maclean at the University of Liverpool is looking at different cell types in the inner lining of the womb in order to identify differences in endometrial cell types. Cells from different areas of the endometrium have different levels of hormone metabolising enzymes, which can be used to identify the different cell types. The team are working on isolating these different cell types to look at them in detail and to explore if they are causing certain diseases, such as endometriosis or endometrial cancer. This will allow them to find ways to target the cells directly and to produce new treatments for these diseases.
Updates from our Research Project Grants
Novel tests to identify better treatment for gynaecological cancers
Patients are often diagnosed with gynaecological cancers when it is too late to remove the tumour surgically or their tumours can become resistant to chemotherapy. Finding new effective treatments that slow or halt the disease improves the quality of women’s lives. Dr Felicity May’s project at Newcastle University investigated the effects of oestrogen on different gynaecological cancers in order to develop a blood test to see which gynaecological cancer patients will respond to hormone therapy, which blocks oestrogen. Successfully used to treat oestrogen-fed breast cancer tumours, hormone therapy could offer a less toxic treatment to women with gynaecological cancers that are oestrogen dependent.
Preventing unplanned pregnancy using contraception after childbirth
A significant number of women have an unintended pregnancy within a year after childbirth. Some of these will end in termination or may lead to short spaces between pregnancies, which can place the baby at higher risk of being born prematurely. One of the most effective methods of contraception is intrauterine contraception (IUC) but requires a healthcare provider to insert a device in the womb. Dr Sharon Cameron and her team at the University of Edinburgh and the Royal Infirmary Edinburgh worked with obstetricians and midwives to successfully trial a new contraceptive service, which provides intrauterine conception immediately after birth. Most women taking part in the study who chose this method of contraception were highly satisfied and continued using it. The use of this contraceptive service after childbirth was found to increase women’s access to contraception and could prevent unintended pregnancies and help spacing between births with improved outcomes for women and babies.
Investigating the link between endometriosis and auto-immune diseases
Endometriosis is a chronic inflammatory disease where womb-like tissues grows outside the uterus, causing pelvic pain and reduced fertility in millions of women globally. Professor Krina Zondervan’s project is carrying out the most comprehensive study to date on the links between endometriosis and auto-immune diseases in women in the UK. Using worldwide databases, the project will increase our understanding of the fundamental causes of the disease and enable us to develop urgently needed patient-tailored treatments with fewer side effects, including the potential to repurpose treatments used in auto-immune diseases to treat endometriosis. The results have been finalised and tell a remarkably consistent story: that there is a significant association between endometriosis and risk of subsequent diagnosis with a range of immunological disorders, including classical auto-immune diseases, auto-inflammatory disease, and mixed pattern disease.