Room to breathe

Researchers at Mercy Hospital for Women make a world-first discovery in the fight against stillbirth  

Seven babies are stillborn in Australia every day � a number that has not changed in over 10 years. For the most part these babies die seemingly without rhyme or reason and the devastation of their passing without even a breath of life shakes families to the core. At Mercy Hospital for Women, the Translational Obstetrics Group has recently published results of a world-first study that may one day save these precious lives. The group�s newly discovered blood test could identify babies with dangerously low oxygen levels who are at imminent risk of stillbirth.

In the womb, a baby relies on the placenta as its life-support system. The placenta gives nutrients and oxygen that help a baby to develop and grow in-utero. In some pregnancies the placenta doesn�t function as it should which means nutrients don�t reach the baby and it becomes growth restricted. These babies are at risk of dangerously low oxygen levels and stillbirth. Growth restricted fetuses are at four times the risk of stillbirth than non-growth restricted fetuses.


Room to breathe 
Translational Obstetrics Group (L-R) Dr Louie Ye, Dr Tu�uhevaha Kaitu�u-Lino, Dr Clare Whitehead, Ms Laura Tuohey, Professor Stephen Tong. The focus of this group is on scientific discoveries that can directly impact the care of pregnant women. 

The challenge for clinicians in these cases is to determine whether the baby will have more chance of survival inside its mother�s womb where it may not be receiving adequate nutrients and oxygen, or if it should be delivered early into the nursery risking the complications of prematurity.  

To date the only way to tell when a baby is growth restricted is by ultrasound, or by feeling a mother�s abdomen to determine the size of the baby. Such �tests� produce approximate results as opposed to accurate readings of a baby�s condition inside the womb.     

Dr Clare Whitehead, a researcher in the Translational Obstetrics Group has been working on developing a new blood test that can accurately monitor changes in the mother�s blood, which will inform clinicians how the baby is coping in the womb. Published in the prestigious medical journal BMC Medicine, Claire�s discovery could allow caregivers to deliver at risk babies before stillbirth strikes.  

�Up until now there hasn�t been a good test to predict or diagnose changes in the mother�s blood or the level of oxygen in the baby,� said Clare. �So we started looking at tiny parts of the placenta that break off into the mother�s blood. These tiny parts contain genes that provide information about what�s happening in the placenta at that particular time. This technique is working very well and it�s one that hasn�t previously been used to monitor growth restricted babies.�  

The new test measures fragments called RNA that leak out of the placenta. The team found when the baby and placenta are suffering from dangerously low oxygen levels, these RNA fragments are produced. They leak into the mother�s blood where they can be measured.

Incredibly, the team showed the amount of these RNA fragments circulating in the mum�s blood appears to accurately reflect how low oxygen levels are within the baby. In cases where oxygen levels were critically low, they found a huge amount of RNA fragments in mum�s blood.  

Clare�s research was supervised by Professor Stephen Tong who heads the Translational Obstetrics Group and Professor Susan Walker, Sheila Handbury Chair of Maternal Fetal Medicine and Director Perinatal Medicine, Mercy Hospital for Women. Professor Tong, who originally came up with the concept for the test, explained the team have now set out to confirm these exciting findings. They have implemented a large international clinical trial involving seven major hospitals throughout Australia and New Zealand.

If developed, such a test could save many of the estimated three million babies lost to stillbirth globally every year.  

Major grants support research into women's and babies' health  
 

Five Mercy Health researchers were awarded more than $2.5 million from the National Health and Medical Research Council (NHMRC) grants program for 2014.

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Professor Stephen Tong for his work developing diagnostics and therapeutics for preeclampsia

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Dr Tu'uhevaha Kaitu'u-Lino, Postdoctoral Fellow for her work targeting the anti-angiogenic factors of preeclampsia

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Dr Natalie Hannan, Postdoctoral Fellow for her research into the role of cardiac enzyme corin in a pregnancy�s success

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Associate Professor Martha Lappas, NHMRC Career Development Fellow for her focus on the role of sirtuin proteins in the mechanisms that regulate infection induced preterm birth

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Professor Sue Walker, Sheila Handbury Chair of Maternal Fetal Medicine, Director Perinatal Medicine, for her work to improve the prediction and detection of contributors to stillbirth

Congratulations to each recipient and their research teams. Their work contributes significantly to advances in women�s and babies� health nationally and internationally.

 

Date Published:  17 December 2013

First Published in Our Voice, Summer 2013 

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