A Double Blind Randomised Placebo Controlled Trial Of Melatonin As An Adjuvant Agent In Induction Of Labour
Funder
National Health and Medical Research Council
Funding Amount
$384,566.00
Summary
Induction of labour, a common obstetric intervention fails in almost 40% of first time mothers. There is evidence to suggest that the endogenous hormone melatonin has important roles in the progress of labour. We will undertake a double-blind randomised placebo controlled trial of melatonin supplementation to improve the success of induction of labour in first time mothers. We will also assess the economic impact of melatonin supplementation at induction of labour.
Characterisation Of Immune Regulators In The Human Myometrium.
Funder
National Health and Medical Research Council
Funding Amount
$85,285.00
Summary
Premature birth is a major cause of perinatal death and morbidity. It further predisposes the individual to increased morbidity throughout life. Although the mechanism of birth has been heavily researched with an objective of preventing preterm babies, it is still not fully understood. A major problem has been the lack of suitable and accessible animal models. A key organ coordinating the birth event is the uterine smooth muscle, myometrium. For effective birth and delivery, the myometrium needs ....Premature birth is a major cause of perinatal death and morbidity. It further predisposes the individual to increased morbidity throughout life. Although the mechanism of birth has been heavily researched with an objective of preventing preterm babies, it is still not fully understood. A major problem has been the lack of suitable and accessible animal models. A key organ coordinating the birth event is the uterine smooth muscle, myometrium. For effective birth and delivery, the myometrium needs to be contracting synchronously in a coordinated manner to dilate the cervix while pushing the fetus into position for eventual delivery through the birth canal. This project aims to characterise the molecular events occurring at the myometrium which precedes and precipitates labour. These local changes will be linked with the systemic hormonal changes in order to approach a model for human parturition.Read moreRead less
A Randomised Controlled Trial Of Outpatient Cervical Priming For Induction Of Labour
Funder
National Health and Medical Research Council
Funding Amount
$611,611.00
Summary
This study aims to compare two approaches that prepare pregnant women before they are induced to give birth. Eligible women who agree to be in the study will be allocated to receive (a) the usual, standard care already used in SA hospitals or, (b) a new method. In the new approach, women will have their labour primed by a midwife and will be discharged and further monitored by the midwife from hospital. This approach might give women a more satisfying experience with less medical intervention.
The Influence Of Acupuncture Stimulation On The Induction Of Labour : A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$123,874.00
Summary
Acupuncture, the insertion of fine needles, into specific areas of the body is increasingly being used to treat a number of conditions. During pregnancy and childbirth, women are looking to the complimentary therapies. There is interest in safe and more natural methods to induce labour in women with prolonged pregnancy. Small studies have been undertaken and these show that acupuncture may have a role with inducing labour. However, these studies were small and there is a need for a larger well d ....Acupuncture, the insertion of fine needles, into specific areas of the body is increasingly being used to treat a number of conditions. During pregnancy and childbirth, women are looking to the complimentary therapies. There is interest in safe and more natural methods to induce labour in women with prolonged pregnancy. Small studies have been undertaken and these show that acupuncture may have a role with inducing labour. However, these studies were small and there is a need for a larger well designed study to see whether acupuncture really does help with inducing labour. This study assesses whether women who have prolonged pregnancy can be successfully induced using acupuncture treatment. Women booked for a medical induction will be offered the opportunity to take part in the trial. Women interested in taking part in the trial will be randomly entered into one of two groups. One group will receive acupuncture and the other group will be given placebo- sham acupuncture. This second group involves the insertion of the needles into areas away from classical acupuncture points. Participation in the trial will take place over a two day period prior to the date of their planned induction. Each treatment will take one hour. Prior to term, focus groups will be held with women examining thier views on the use of acupuncture during pregnancy. All women will be asked to complete a questionnaire after the birth of their baby, this will ask for their views on acupuncture, their expectation and satisfaction from their birthing experience. There is no information to suggest there are any risks or side effects associated with the treatment. In 2001 we expect to report on the effectiveness of this treatment on the induction of labour and maintenance of labour and assessment of whether this treatment meets women's expectations and satisfaction. If the results are positive, it is hoped this will become an option for women requiring an induction of labour.Read moreRead less
Mimetics Of Natural Triggers Of Innate Immunity As Vaccines
Funder
National Health and Medical Research Council
Funding Amount
$241,650.00
Summary
Knowledge of what properties of an antigen allow it to induce an immune response is central to our understanding of how we fight disease and how we can vaccinate effectively against disease. The fact that an antigen is foreign to the host is not in itself sufficient for it to initiate the series of events that must take place in order to activate B and T lymphocytes, the cells involved in immunity. For vaccine purposes, antigens must be delivered with substances called adjuvants to be effective. ....Knowledge of what properties of an antigen allow it to induce an immune response is central to our understanding of how we fight disease and how we can vaccinate effectively against disease. The fact that an antigen is foreign to the host is not in itself sufficient for it to initiate the series of events that must take place in order to activate B and T lymphocytes, the cells involved in immunity. For vaccine purposes, antigens must be delivered with substances called adjuvants to be effective. There is very little known about how adjuvants actually work but many of the highly effective experimental adjuvants contain an immunostimulant which is usually either whole dead bacteria or components of the cell walls of bacteria or other organisms. From evidence emerging in the literature and our own experimental observations, we have begun to understand the requirements for and the chain of events leading to immune response induction. The interaction of certain lipid-containing groups, present on antigens from pathogenic organisms, with a specialised type of cell, the dendritic cell, is a key event in this process. We have designed synthetic mimics of lipid-containing moieties from bacteria and coupled them to unrelated parts of viral proteins. We showed that these lipopeptides can elicit potent anti-viral immune responses and long lived memory responses. The experiments outlined in this proposal will examine the interaction of these and other second generation lipopeptides with dendritic cells. We will determine whether these can bind to particular molecules on the dendritic cell surface to initiate a specific series of signals leading to immune induction and if so we will seek to use different lipid groups to trigger the immune response in different and predictable ways. The outcomes of this work may have a major impact on the design of new vaccines as well as increase our understanding of how the immune system is triggered to respond to invading organisms.Read moreRead less
Linking Of Physiological Models Of Iv Anaesthetic Disposition With Models Of The Cardio- And Cerebro-vascular Systems
Funder
National Health and Medical Research Council
Funding Amount
$227,036.00
Summary
On average, nearly 1 in 10 Australians are anaesthetised each year. Most cases include an injection of either thiopentone or propofol directly into a vein. These drugs quickly produce the desired loss of consciousness, but can also produce significant undesirable effects on the circulatory system. To date, anaesthetists have relied on their accumulated experience to choose doses of these drugs that achieve an appropriate balance between their desirable and undesirable effects. However, the scien ....On average, nearly 1 in 10 Australians are anaesthetised each year. Most cases include an injection of either thiopentone or propofol directly into a vein. These drugs quickly produce the desired loss of consciousness, but can also produce significant undesirable effects on the circulatory system. To date, anaesthetists have relied on their accumulated experience to choose doses of these drugs that achieve an appropriate balance between their desirable and undesirable effects. However, the scientific basis of this process was poorly understood. Consequently, we conducted experiments in sheep in which we showed that the level of unconsciousness produced by these drugs depended on their concentration in the brain. Each sheep was unharmed and could be studied repeatedly. We established the important factors that influenced this brain concentration, and developed a unique computer model of the processes governing the desirable effects of thiopentone and propofol. However, understanding of what influences the undesirable effects of these drugs is less well developed. In this project, we propose a series of experiments in which we inject the thiopentone and propofol in special sites within the sheep so that we achieve low concentrations in some parts of the body, but high concentrations in others, while also measuring their undesirable effects. This will show which sites in the body high concentrations of drug should be avoided to minimise these undesirable effects. Another series of studies will be used to extend our computer model so that it can predict these undesirable effects. This extended model will allow anaesthetists to visualise and understand the fundamental factors influencing both the desirable and undesirable effects of thiopentone and propofol. This in turn will lead to dose strategies that help the anaesthetist maximise the desirable effects, while minimising the undesirable, in individual patients.Read moreRead less
Molecular Mechanisms Regulating Spontaneous Onset Of Human Labour
Funder
National Health and Medical Research Council
Funding Amount
$481,156.00
Summary
The single most important complication contributing to poor pregnancy and neonatal outcome is premature birth. If we are to provide the best possible start to life, improve perinatal health and reduce the risk of developing adult disease . A better understanding of labour is requisite to improving health care delivery during pregnancy and outcomes for both mother and baby. This reserach project will investigate the how labour-associated events are reguluated by nuclear proteins.
The Mechanisms That Regulate The Onset Of Human Labour And Delivery
Funder
National Health and Medical Research Council
Funding Amount
$528,170.00
Summary
Reproductive biologists still cannot explain the molecular mechanisms that govern human birth. This lack of knowledge prevents the development of better moitoring and treament of complications of labour and delivery. If we are to provide the best possible start to life and improve newborn health care delivery then we must: (1) better understand what triggers labour; (2) determine whether there are biomarkers that we can use to identify women at risk of early birth; and (3) identify new ways to d ....Reproductive biologists still cannot explain the molecular mechanisms that govern human birth. This lack of knowledge prevents the development of better moitoring and treament of complications of labour and delivery. If we are to provide the best possible start to life and improve newborn health care delivery then we must: (1) better understand what triggers labour; (2) determine whether there are biomarkers that we can use to identify women at risk of early birth; and (3) identify new ways to delay birth. This is the overall objective of this research project. In particular, this project focuses on how the multiple events needed to achieve a successful outcome to pregnancy are coordinated at the time of birth.Read moreRead less