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Building Evidence-based Research And Practice In South East Asia: Impact On Pregnancy And Childbirth Care And Outcomes.
Funder
National Health and Medical Research Council
Funding Amount
$1,354,337.00
Summary
Disorders related to pregnancy and childbirth are a major health issue in SE Asia. They represent one of the biggest health risk differences between the developed and developing world. By establishing a network of researchers and teachers of evidence-based health care across four SE Asian countries supported from Australia, this collaborative project aims to improve the clinical practice of treating pregnancy and childbirth related disorders and the health outcomes of mothers and infants in SE A ....Disorders related to pregnancy and childbirth are a major health issue in SE Asia. They represent one of the biggest health risk differences between the developed and developing world. By establishing a network of researchers and teachers of evidence-based health care across four SE Asian countries supported from Australia, this collaborative project aims to improve the clinical practice of treating pregnancy and childbirth related disorders and the health outcomes of mothers and infants in SE Asia.Read moreRead less
This project seeks to identify blood borne biomarkers that may be used, at the first antenatal visit, to identify women at risk of developing complications of pregnancy, If women at risk can be identified early opportunity is afforded to improve outcome for both mother and baby.
The Role And Regulation Of Phospholipase Isozymes In The Initiation Of Human Labour
Funder
National Health and Medical Research Council
Funding Amount
$462,589.00
Summary
Being born too early is the most significant problem facing contemporary clinical obstetrics in the developed world. Preterm birth is the major cause of ill-health and death in newborns, accounting for 85% of all early infant deaths, not secondary to genetic abnormality. In Australia in 1998, more than 17,000 babies were born too early, of these over 10,000 suffered respiratory complications and 1300 died during the first 21 days of life. Even though the likelihood of a premature baby surviving ....Being born too early is the most significant problem facing contemporary clinical obstetrics in the developed world. Preterm birth is the major cause of ill-health and death in newborns, accounting for 85% of all early infant deaths, not secondary to genetic abnormality. In Australia in 1998, more than 17,000 babies were born too early, of these over 10,000 suffered respiratory complications and 1300 died during the first 21 days of life. Even though the likelihood of a premature baby surviving doubles for every two weeks that birth is delayed (between 23 and 28 weeks of gestation), currently there is no treatment available that reliably delays or prevents premature birth. In order to develop clinically useful treatments and improve pregnancy outcome and the well-being of our newborn, it is essential to understand the mechanisms that start the process of labour and delivery. Thus, the overall aim of this project is to increase our understanding of how human labour is initiated and to identify processes that may be manipulated to delay premature birth. In particular, this project focuses on the role and regulation, of what we believe is, a central and common pathway involved in triggering the birth process. This pathway is a known regulator of inflammatory process in the body. Intriguingly, the process of birth displays many of the hallmarks of an inflammatory reaction. Our pilot studies suggest that this pathway is involved in activation many of the events that occur at the time of birth and that further investigation of its role will provide valuable insights in to what triggers human birth. The specific aims of this project are (i) to develop a better understanding of the mechanisms that initiate human labour and (ii) to identify more effectively ways of prevent preterm birth.Read moreRead less
Control Of Uterine Contraction: Role Of Interstitial Cells
Funder
National Health and Medical Research Council
Funding Amount
$587,206.00
Summary
Being born premature may increase risk of below average IQ, poor performance at school and behavioural difficulties in the child, and increased obesity and blood pressure as an adult, predisposing to life long socio-economic disadvantage. We have come up with a new approach to understanding the control of uterine contraction, namely, that cells other than muscle cells, recently identified in the uterine wall, are essential for inducing forceful and orderly muscle cell contraction during labour.
Multicentre Trial Of Calcium Channel Blocker Versus Calcium Channel Blocker Plus Cox2 Inhibitor In Preterm Labour
Funder
National Health and Medical Research Council
Funding Amount
$644,130.00
Summary
Preterm birth is a major problem in our society, and has enormous consequences for parents and children. It also has a major impact on scarce financial resources. When women present in preterm labor, current therapies have only limited success in stopping contractions and postponing birth. They have not been shown to reduce the rates of the serious neonatal problems associated with prematurity. This project will be coordinated in Newcastle, N.S.W., and will involve major perinatal centres throug ....Preterm birth is a major problem in our society, and has enormous consequences for parents and children. It also has a major impact on scarce financial resources. When women present in preterm labor, current therapies have only limited success in stopping contractions and postponing birth. They have not been shown to reduce the rates of the serious neonatal problems associated with prematurity. This project will be coordinated in Newcastle, N.S.W., and will involve major perinatal centres throughout Australia, along with overseas centres. It will test a new combination of drugs for their ability to postpone delivery in women presenting with preterm labour. It is postulated that the combination of drugs will be more effective than existing therapies. The drugs used in the trial are Nifedipine and Rofecoxib. Complications of prematurity include neonatal death, cerebral palsy, visual and hearing impairment, and chronic lung disease. These complications are most significant in extremely premature infants - in particular, those under 28 weeks gestation at the time of their delivery. For this reason, the study will focus only on women presenting in labour below 28 weeks. The ability to stop labour is important, but the main aim of any treatment for preterm labour is to reduce the rates of neonatal death and handicap. Babies born to women enrolled in this study will be followed for a period of one year after birth to assess their outcomes. It is our hypothesis that the combination of Rofecoxib and Nifedipine will result in lower rates of death and handicap in babies than Nifedipine alone. In addition, we will examine the rates of side effects in women receiving therapy. Currently used therapies, including intravenous ventolin, have high rates of maternal side effects. Nifedipine and Rofecoxib have both been shown to have low rates of maternal side effects.Read moreRead less
Regulation Of Prostaglandin Endoperoxide Synthase-2 In The Human Fetal Membranes At Birth
Funder
National Health and Medical Research Council
Funding Amount
$249,750.00
Summary
Preterm birth with the resulting immaturity of babies is the leading cause of death and disease among newborns. Early birth occurs in 6 to 11% of pregnancies, and its rate is slowly increasing in industrialized countries. We need a much better knowledge of the regulation of the parturition process to find ways to reverse this trend. Prostaglandins are hormonal substances that stimulate uterine contractions, cervical dilatation and membrane rupture. Intrauterine tissues produce prostaglandins, an ....Preterm birth with the resulting immaturity of babies is the leading cause of death and disease among newborns. Early birth occurs in 6 to 11% of pregnancies, and its rate is slowly increasing in industrialized countries. We need a much better knowledge of the regulation of the parturition process to find ways to reverse this trend. Prostaglandins are hormonal substances that stimulate uterine contractions, cervical dilatation and membrane rupture. Intrauterine tissues produce prostaglandins, and an increase of prostaglandin levels in the uterus is likely responsible for inducing labour both normally and preterm. We have previously identified an enzyme protein in the fetal membranes, called prostaglandin synthase-2, that has a key role in the synthesis of intrauterine prostaglandins during pregnancy. This enzyme is increasingly expressed before labour onset. In the present application, we propose studies to determine what causes the increased expression. We hypothesize that the gene encoding this enzyme is specifically activated in the fetal membranes in preparation for labour. We will define the mechanism of regulation by determining the activity of the gene in tissues from women who deliver either spontaneously or without labour at term and preterm. Further, we will determine the interaction of regulatory proteins with the prostaglandin synthase-2 gene in these pregnancies in order to understand the mechanisms of regulation at the molecular level. Finally, we will conduct cell culture studies to experimentally manipulate prostaglandin synthase-2 gene activity in fetal membrane cells. As an overall outcome of this work, new targets may be identified for drugs to disrupt prostaglandin synthase-2 gene activation specifically in the fetal membranes. The long term perspective is to block prostaglandin synthesis in the uterus in order to suppress preterm labour and prevent preterm birth.Read moreRead less