Scientists have received funding for a new project to investigate the dynamic interactions between the mother, placenta and fetus in pregnancy, with the aim of developing a monitoring tool that can be used in a range of settings, including at home to help detect complications earlier.
A team led by the University of Nottingham's School of Physics and Astronomy have received a Wellcome Discovery Award for a project that integrates cutting-edge biology, advanced imaging, and novel monitoring technologies to reveal new insights into healthy and high-risk pregnancies and allow early detection of problems.
During pregnancy, the fetus depends on an intimate physiological relationship with its mother, which from the second trimester, is increasingly mediated by the placenta. While long-term adaptations to changes in supply and demand are well described, short-term interactions are less examined.
There are no comprehensive investigations into how fetal-placental-maternal communication varies with circumstance, or whether it can reveal an inability to respond physiologically under stress. We think that impaired adaptive responses may contribute to unexplained stillbirths, particularly at late gestation.
The team which brings together experts from Makerere University in Uganda, Nottingham Trent University, the University of Manchester, and the Essential Baby Company, will characterise the dynamic interactions across different settings (including high and low-resourced contexts) in both apparently healthy and compromised pregnancies.
Physiological data will be gathered using the novel Pregnancy Activity Monitor (PAM- recording fetal heart rate, fetal movement, placental and uterine contractions and placental oxygenation), MRI and ultrasound.
The team will also develop a dynamic mathematical model of placental function, uncover the key drivers of placental dysfunction, identify new early-warning biomarkers and generate individualised estimates of placental efficiency.
Professor Penny Gowland continues: "Advances in MRI technologies is allowing us to push the boundaries of what is possible with imaging, we have already revealed new insights into placental contractions in pregnancy and by further characterising the function of the placenta and integrating new technologies and modelling we can build an even fuller picture that we can translate into new tools to effectively monitor pregnancy and identify problems sooner."
The findings will ultimately enable the creation of an at home version of PAM that provides real time monitoring to identify at risk pregnancies and improve prenatal care worldwide.
