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
Predicting Intrapartum Fetal Compromise At Term Using The Fetal Cerebro-umbilical Ratio And Placental Growth Factor Levels
Funder
National Health and Medical Research Council
Funding Amount
$86,733.00
Summary
A lack of oxygen to a baby after the onset of labour (i.e. fetal distress) in an otherwise healthy pregnancy is one of the top three causes of death in singleton pregnancies after 37 weeks. Our previous research has shown that a late pregnancy ultrasound scan combined with a blood test from the mother measuring the levels of a placental hormone can potentially identify pregnancies at risk. We aim to assess the value of this screening test at a major tertiary hospital.
The survival of a baby at birth is crtically dependent upon the ability of the lungs to successfully take over the role of exchanging oxygen and carbon dioxide between the air and blood. To perform this task, during fetal life the lung must have grown properly and near the end of gestation it must mature both structurally and biochemically. Thus, babies that are born early, before the expected time of birth, are born before the lungs have had the opportunity to mature. It is not surprising, ther ....The survival of a baby at birth is crtically dependent upon the ability of the lungs to successfully take over the role of exchanging oxygen and carbon dioxide between the air and blood. To perform this task, during fetal life the lung must have grown properly and near the end of gestation it must mature both structurally and biochemically. Thus, babies that are born early, before the expected time of birth, are born before the lungs have had the opportunity to mature. It is not surprising, therefore, that an inability to breathe is one of the primary problems faced by a prematurely born infant. During late gestation the lung changes dramatically in order to increase its ability to exchange gases. There is an increase in surface area and a reduction in the barrier thickness between the airspace and the blood stream. The molecular mechanisms involved in this remodelling are unknown, but it is known that the administration of corticosteroids to women at risk of preterm labour causes a large decrease in this barrier thickness and increases the distensibility of the lung. This project seeks to understand how the structure of the lung matures in late gestation and to determine whether corticosteroids regulate these changes by altering the structure of a specialised molecule, called versican. Versican resides in the tissue space outside of cells and has special properties that allow it to retain water and help organise the surrounding matrix. We propose that alterations in the structure of versican will reduce its ability to retain water, thereby reducing the tissue volume and contributing to a reduction in the air-blood tissue barrier within the lung.Read moreRead less
Improving And Evaluating The Health Of Mothers And Babies
Funder
National Health and Medical Research Council
Funding Amount
$320,848.00
Summary
This research program considers new ways to monitor an unborn baby’s health and to provide better care for childbearing women. Several projects will test the unborn baby’s well being. A new study will consider two forms of cooling treatments to help relieve pain following childbirth. Further research involves studies of the genetics of increased blood pressure in pregnant women and a structured way of looking at existing evidence to consider how well it delivers.
Fetal Lactate Measurement To Reduce Caesarean Sections During Labour: A Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$386,600.00
Summary
Caesarean section rates in Australia are well above the World Health Organization’s recommended level. Many babies appear unhealthy in labour, so they are born by caesarean. They are usually healthy at birth, meaning that the operation could have been avoided. In this study, half the babies who seem distressed will have a blood test for lactate and the other half will not. We will then determine whether having a lactate test makes a difference in the number women having caesarean births.
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
Cell Therapy For Prevention Of Perinatal Inflammation
Funder
National Health and Medical Research Council
Funding Amount
$539,337.00
Summary
Exposure of babies to infection or inflammation before birth is common and is associated with preterm delivery and illness in newborns. The biggest problem for these babies is lung disease due to inflammation of the lungs before birth and/or in response to lung injury after birth. There is no treatment for the underlying inflammation and no way to prevent or treat the lung disease that it causes. This project will investigate a new stem-cell based treatment for lung inflammation that may prevent ....Exposure of babies to infection or inflammation before birth is common and is associated with preterm delivery and illness in newborns. The biggest problem for these babies is lung disease due to inflammation of the lungs before birth and/or in response to lung injury after birth. There is no treatment for the underlying inflammation and no way to prevent or treat the lung disease that it causes. This project will investigate a new stem-cell based treatment for lung inflammation that may prevent life-threatening lung disease in preterm babies.Read moreRead less
STan Intrapartum Fetal Monitoring (cardiotocographic Plus Electrocardiographic) Compared With Cardiotocographic (CTG) Monitoring Alone: An Australian Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$791,369.00
Summary
Women in high risk labour have their babies monitored by electronic fetal monitoring. This detects unborn babies not coping during labour, but may lead to unnecessary caesarean sections by incorrectly indicating that the baby is at risk. We will compare CTG to STan monitoring, which may give fewer false readings. We will show if STan reduces emergency caesarean section, and will investigate the impact on the baby, assess psychological aspects such as mental health and wellbeing, and costs.
Sleep-disordered Breathing In Pregnancy-induced Hypertension And Preeclampsia: Maternal And Fetal Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$129,559.00
Summary
Our study aims to compare signs of sleep-disordered breathing (such as snoring and breathing pauses) in pregnant women affected by hypertension or preeclampsia to those with a healthy pregnancy, and to see if they respond differently to the breathing problems. To do this we will examine whether snoring and breathing pauses during sleep have an impact on the pregnant woman’s blood pressure and the unborn baby’s heart rate overnight, and scans will monitor whether the baby’s growth is affected.
Fetal Responses To Intra-uterine Inflammation And The Postnatal Pulmonary Consequences
Funder
National Health and Medical Research Council
Funding Amount
$347,036.00
Summary
There is increasing evidence that exposure of the unborn baby to infection and inflammation may be the cause of several important and disabling illnesses in later life, including long-term lung injury and brain damage. Hospital-based studies have shown that infants who go on to develop these diseases have signs of inflammation before, and soon after, birth. These studies in humans, however, have only shown associations between inflammation and later disease. Carefully controlled scientific exper ....There is increasing evidence that exposure of the unborn baby to infection and inflammation may be the cause of several important and disabling illnesses in later life, including long-term lung injury and brain damage. Hospital-based studies have shown that infants who go on to develop these diseases have signs of inflammation before, and soon after, birth. These studies in humans, however, have only shown associations between inflammation and later disease. Carefully controlled scientific experiments are required to show that inflammation actually causes damage and to allow us to find ways to prevent or cure the diseases that result from such injury. In 1998, using sheep, our research group discovered a way to produce inflammation in the fetus without endangering its wellbeing or causing early labour. The inflammation is caused by injecting a sterile bacterial cell wall preparation (endotoxin) into the amniotic fluid surrounding the fetus. Using this model, we have found that an episode of inflammation before birth profoundly increases lung maturity, thus increasing the chances of survival if premature birth occurs. Based on our information from humans, we expect that if these lambs are allowed to survive past the first few days after birth, they will go on to develop chronic lung disease, and perhaps brain damage. This study will answer vital questions about the events that occur in the uterus and the fetus during periods of inflammation, and will then determine the long-term consequences in the weeks following birth. We expect that these lambs will have changes which at first will increase their chances of survival after birth, to be followed by chronic disability due to lung and brain damage. If confirmed, this finding will allow us to find treatments which can be applied before birth to ensure that children are less likely to be born with these disabling illnesses.Read moreRead less