Tommy's has state of the art clinics in all four of our research centres: London, Manchester, Edinburgh, and our National Centre for Miscarriage Research
The Tommy’s Preterm Surveillance Clinic
Run by Professor Andrew Shennan, the Tommy’s Preterm Surveillance Clinic at Guy’s and St. Thomas’ has been providing specialist care to women at risk of preterm birth for over 10 years. Experts state that rolling out this clinic’s model nationally could prevent almost 9,000 premature births each year in the UK. In 2017, the total number of referrals from women at high risk of giving birth too early doubled compared to 2016. We are now seeing an average of 200 referrals each month.
Read more about the Preterm Surveillance Clinic
This unique Preterm Surveillance Clinic – funded by Tommy's as part of our research in St Thomas' Hospital, London – has won an NHS Innovation Challenge Prize for its success in reducing the number of premature births in South East London. Over 10 years, the clinic has reduced premature birth locally and regionally by 10%.
The clinic’s work on the QUIPP application – a tool that can help clinicians assess pregnant women at risk of premature birth – won a further two prizes in 2016:
- 1st prize – Health Tech Innovation Award King’s College London Lion's Den Challenge
- 1st prize – Health Service Journal Award for the use of IT to drive value in clinical services
Each woman who is referred to the clinic will have a thorough risk assessment and receive a personal plan of how to manage her pregnancy.
The impact of the clinic
- Over 90% of high-risk women seen at the clinic have had a healthy baby at full-term, compared to a national average of 50-70% of women.
- Despite increasing referrals of high risk women, there has been a 21% reduction in preterm births at St Thomas’ Hospital in the last year.
- Now the largest preterm clinic in the world, it has influenced development of similar specialist clinics in the UK (London, Birmingham, Liverpool, Manchester and Belfast) and abroad (USA, China and India).
- The clinic has pioneered a test that more accurately predicts preterm birth in women at risk. The test, developed by Hologic, measures the exact level of a protein known as fetal fibronectin (fFN) that reliably indicates whether a woman will give birth prematurely, and as such has led to significant cost-savings: for each patient admitted from the pre-term clinic, the test saved an average of £1,800 per patient because many women didn’t receive unnecessary treatment and could be discharged home. Given the expense of the 60,000 premature births per year in the UK, the national uptake of this new test could lead to national NHS savings of over £100 million a year.
The hypertension in pregnancy clinic
Based in St. Thomas’ Hospital and led by Professor Lucy Chappell, the hypertension in pregnancy (HiP) clinic gives specialist care to pregnant women with high blood pressure (hypertension).Since it opened in May 2015, the clinic has seen over 150 women, who directly benefit from the research taking place in Tommy’s centres.
Read more about our research into hypertension.
The diabetes clinic
In recent years, more and more women of childbearing age suffer from gestational or pre-existing diabetes. The Tommy’s Diabetes Clinic at Guy’s and St. Thomas’ Foundation Trust works to help women with diabetes, and as well those suffering from endocrine disease and other disorders like cholestasis. These increase the risks of stillbirth, pre-eclampsia, and premature labour.
The vital research carried out in the clinic has been a driving force for the adoption of universal screening for gestational diabetes. Early diagnosis is crucial – the sooner diabetes is discovered, the sooner doctors can help women get the care they need.
The Placenta Clinic
In 2009, we opened the UK’s first placenta clinic run by Dr Alex Heazell, which works with pregnant women whose babies have growth restriction. We monitor and care for them through their pregnancy, and study the placenta to find the links between the baby’s life-support machine, growth restriction, and stillbirth.
Read more about the Placenta Clinic
The placenta gives babies all the food and oxygen they need to grow. Problems with the placenta can affect a baby’s growth, causing “fetal growth restriction.” This happens in around 5% of all pregnancies, and can lead to miscarriage or stillbirth – but we believe it can be discovered early on, giving the baby the best possible chance.
The clinic keeps on growing, and we now see more than 1,000 women a year. As well as conducting its own research, it also helps recruit women for other, national trials. In the STRIDER study on sildenafil, a drug that could be used to treat fetal growth restriction, the Tommy’s Placenta Clinic recruited 41 of the 126 women involved. Findings from our research can be put into practice straight away, so women can benefit from medical advances as fast as possible.
The Rainbow Clinic
The Tommy’s Rainbow Clinic, established in 2013 at St. Mary’s, provides specialist care and support for parents who have suffered a stillbirth or neonatal death. Run by Alex Heazell, the clinic has been so successful that we have now opened a second Rainbow Clinic in South Manchester, allowing us to give even more women the care they need.
Read more about the Rainbow Clinic
Becoming pregnant after a stillbirth is an incredibly daunting prospect. Around half of all stillbirths are unexplained, leaving parents feeling powerless to stop it happening again.
The standard of care given to women who have suffered a stillbirth varies a lot. Women can be left having to explain over and over again what they have gone through.
Tommy’s decided that this could not continue. That’s why, in 2013, we set up the Rainbow Clinic at St. Mary’s Hospital in Manchester. Here, we give women who have had stillbirths the best possible care, to help them have safe, healthy pregnancies.
Our Rainbow Clinic has now seen over 500 families, and cares for 150 women every year. We are delighted that a recent report has shown that for every £1 invested in the Rainbow Clinic, we create £1.82 worth of value. The clinic has also been very successful in lowering the number of premature births.
In March 2017, we held a study day for medical professionals from over 25 units in the UK. Six of these units now have the resources to open Rainbow Clinics where they are. This will allow the service to reach other areas and help many more families around the UK.
This fulfils our aim of a network of clinics across the UK, so all women who have suffered a stillbirth have access to the care they need.
The Lupus in Pregnancy (LIPs) Clinic
As part of the Manchester suite of clinics, Tommy’s is supporting this specialist clinic run by Dr Clare Towers. The clinic helps women with the autoimmune disorder Systemic Lupus Erythematous and related diseases. These increase the risk of problems such as pre-eclampsia, premature birth and growth restriction. Tommy’s supports the clinic through access to our research midwives.
The Manchester Antenatal Vascular Service (MAViS)
Run by Jenny Myers at St. Mary’s hospital in Manchester, this clinic gives extra monitoring and pregnancy care to women with a history of high blood pressure, and those at risk of related complications. MAViS is currently home to exciting research funded by the National Institute for Health Research. Tommy’s supports the clinic through access to our research midwives.
Tommy's Metabolic Antenatal Clinic
In 2008, Tommy’s funded a specialist clinic to help women with severe obesity to have safe and healthy pregnancies. The metabolic antenatal clinic is home to specialists in pregnancy care and diabetes, as well as midwives and a specialist dietician. It is constantly growing, and now provides care to 25-30 women every week. Last year women attending the Tommy’s clinic were an astounding 8 times less likely to have a stillbirth than women attending clinics not specialised in helping obese women.
The care provided in the clinic includes frequent check-ups of mothers and babies, as well as personalised advice about healthy eating. We also educate women attending about the risks involved in obese pregnancy.
Read more about the Metabolic Antenatal Clinic
Obese women have a higher risk of complications during pregnancy including gestational diabetes and high blood pressure. Currently in England around half of all women of childbearing age are either overweight or obese. The role of clinics like this is crucial in helping women who face these risks, to give their babies the best chance at health in both the short and long term.
As well as lowering the rate of stillbirth, women attending the clinic were also less likely to have a baby with a low birth weight, and more likely to have their blood sugar tested. Blood sugar testing is important to check whether expecting mothers have diabetes – the earlier we know, the more we can do to make sure mother and baby stay healthy.
The clinic is an example of clinical excellence both nationally and internationally: this year, it has been visited by doctors from as far as India and Australia who want to learn how the clinic is helping lower the risks of obese pregnancy. By spreading the clinic’s findings across borders, Tommy’s support is helping save babies’ lives through early intervention and care around the world.
Over 2017, the clinic has been looking at the risks of obese women developing type 2 diabetes after giving birth. From studying a database of 858 women with a BMI of 40 or more, we found that having gestational diabetes results in a sevenfold increase in the rate that type 2 diabetes develops.Hide details
Tommy's Lothian Preterm Birth Clinic
The success of our metabolic antenatal clinic prompted us to open our new ‘preterm birth clinic’ in October 2016; the first of its kind in Scotland.
The aim of the clinic is to continue Tommy’s work in reducing preterm birth rates and late miscarriage rates, to improve the quality of care for women and to develop our expertise in managing complex cases.
Read more about the Lothian Preterm Birth Clinic
We know that continuity of care is so important. Women in Lothian are now able to attend a clinic where they can have investigations, treatment and ongoing support within in the same setting.
At the moment we see women at the highest risk of preterm birth. We offer assessment and individualised treatment, and well as ongoing support and counselling. Women at the highest risk of preterm birth or late miscarriage (a miscarriage that happens after 14 weeks of pregnancy) can have treatment to prevent pregnancy loss and preterm birth, personalised to their preferences.
In our first year, we have had in excess of 100 referrals and 49 deliveries. We’re pleased to report that 45 women have participated in our research studies.
Tommy’s National Centre for Miscarriage Research has recurrent miscarriage clinics in three different sites in the UK. All of these offer close monitoring and care during the early stages of pregnancy to women who have previously suffered miscarriages. They are also able to take part in Tommy’s clinical trials, which hope to provide women with reasons for their loss. The clinics are based in:
- Birmingham Women’s Hospital
- University Hospital Coventry
- St. Mary’s Hospital London