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
An In Vitro Study Of The Mechanisms Underlying Ineffective Labour In Women
Funder
National Health and Medical Research Council
Funding Amount
$326,820.00
Summary
Strong contractions of the uterus are necessary for successful vaginal delivery of the baby. Failure of the uterus to contract forcefully, ineffective labour, is a major cause of caesarean delivery. Drip infusion of oxytocin is routinely used in attempts to strengthen the weak contractions of ineffective labour, but this is not always successful in bringing about vaginal delivery. The normal preparation of the uterus for the process of birth is likely to involve a complex array of processes. The ....Strong contractions of the uterus are necessary for successful vaginal delivery of the baby. Failure of the uterus to contract forcefully, ineffective labour, is a major cause of caesarean delivery. Drip infusion of oxytocin is routinely used in attempts to strengthen the weak contractions of ineffective labour, but this is not always successful in bringing about vaginal delivery. The normal preparation of the uterus for the process of birth is likely to involve a complex array of processes. The failure to successfully resolve ineffective labour, other than by caesarean section, stems from a lack of understanding of these processes. In our studies of the human uterus over the past few years we found that the behaviour of samples obtained from women undergoing caesarean section during labour was quite variable. Some samples possessed a high degree of negative electricity which made contraction difficult. Some other samples were quite resistant to the contracting effects of oxytocin. In yet a third group, the uterus did not contract when given prostaglandin, one of the body's most important hormones during labour. When the obstetricians checked the medical records of these women, they found that ineffective labour had been diagnosed. The aim of this study is to work out the details of what is happening in these cases of ineffective labour. Since this problem is a major cause of caesarean delivery, a greater understanding of the underlying causes will facilitate the development of more effective treatments and hence bring about a resolution which is fundamental to healthy mothers and babies.Read moreRead less
Fetal Intrapartum Pulse Oximetry: A Multicentre Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$246,001.00
Summary
Current methods of monitoring the well-being of the unborn baby during labour often result in concern about the unborn baby's health. This leads to delivery by caesarean section, forceps, or vacuum. These babies are usually found to be healthy once born, meaning that the operation was unnecessary. In this study, when an unborn baby appears to be distressed, half of the study participants will be allocated to continue with the current monitoring of the baby's heartbeat. The other half will have a ....Current methods of monitoring the well-being of the unborn baby during labour often result in concern about the unborn baby's health. This leads to delivery by caesarean section, forceps, or vacuum. These babies are usually found to be healthy once born, meaning that the operation was unnecessary. In this study, when an unborn baby appears to be distressed, half of the study participants will be allocated to continue with the current monitoring of the baby's heartbeat. The other half will have a new form of monitoring in labour, fetal oxygen saturation monitoring, added. We will then determine whether the new form of monitoring makes a difference in the number of times women need to have a caesarean section, forceps, or vacuum delivery. It is important to do this research BEFORE the new form of monitoring becomes used routinely. This Australian research is leading the world in letting the health consumer (women) know whether the now monitoring method is effective in practice and ensuring that there are no unforeseen adverse events.Read moreRead less
The Early Origins Of Obsteric Diseases: Biological Investigations And Biomarker Discovery
Funder
National Health and Medical Research Council
Funding Amount
$282,290.00
Summary
Recent evidence has pointed to the beginning of pregnancy as the time when biological cascades begin that cause common diseases of pregnancy. This opens the door to developing bloods test in early pregnancy predicting who will develop problems, and to hunt for novel proteins in the bloodstream that are causing the illnesses. 'Proteomic technology' will be used, a new cutting edge tool that can scan the entire protein pool in mum's blood in a single experiment.
Fetal Intrapartum Pulse Oximetry: A Multicentre Randomised Controlled Trial (the FOREMOST Trial)
Funder
National Health and Medical Research Council
Funding Amount
$146,950.00
Summary
Current methods of monitoring the well-being of the unborn baby during labour often result in concern about the unborn baby's health. This leads to delivery by caesarean section, forceps , or vacuum. These babies are usually found to be healthy once born, meaning that the operation was unnecessry. In this study, when an unborn baby appears to be distressed, half of the study participants will be allocated to continue with the current monitororing of the baby's heartbeat. The other half will have ....Current methods of monitoring the well-being of the unborn baby during labour often result in concern about the unborn baby's health. This leads to delivery by caesarean section, forceps , or vacuum. These babies are usually found to be healthy once born, meaning that the operation was unnecessry. In this study, when an unborn baby appears to be distressed, half of the study participants will be allocated to continue with the current monitororing of the baby's heartbeat. The other half will have a new form of monitoring in labour, fetal oxgyen saturation monitoring, added. We will then determine whether the new form of monitoring makes a differnce in the number of times women need to have a caesarean section, forceps, or vacuum delivery. It is important to do this research BEFORE the new form of monitoring becomes used routinely. This Australian research is leading the world in letting the health consumer (women) know whether the new monitoring method is effective in practice and ensuring that there are no unforeseen adverse events.Read moreRead less