Impact of Tommy's research centres

Tommy's research centres produce high quality, relevant research to provide improved evidence needed for new understanding, new treatments and new and updated guidelines. This research will lead to the number of babies who die during pregnancy or birth decreasing.

Jump to: Tommy's National Centre for Miscarriage Research | Tommy's Manchester Research Centre | Tommy's London Research Centre | Tommy's Edinburgh Research Centre

Why we invest in research

Tommy's research centres produce relevant, high quality research improving the lack of evidence in the field.

'To improve pregnancy care we need to better understand what goes wrong and where to direct treatment. We can only improve care by investing in scientific research to give us answers.'Jane Brewin, CEO Tommy's

Every paper published increases understanding and can lead to new treatments and updated guidelines which have the potential to reduce the number of babies who die during pregnancy or birth.

Tommy's National Centre for Miscarriage Research

'Miscarriage is the most common complication of pregnancy: 1 in 4 women experience at least 1 miscarriage during their reproductive lifetime. The work of Tommy’s National Centre for Miscarriage Research is therefore important and personally relevant to millions of families across the United Kingdom and beyond. We are proud of our efforts to answer the questions of couples experiencing miscarriage, and to improve their lives.'Professor Arri Coomarasamy, Director of Tommy’s National Centre for Miscarriage Research

Highlights of research 2016-2017

  • Understanding that metabolic profile predicts miscarriage.
  • Understanding the role of uterine natural killer cells in miscarriage (to clear senescent stromal cells).
  • Novel imaging of the fetal brain and heart in early pregnancy.
  • Developing preimplantation screening tool to identify embryos with the greatest potential to develop into a healthy baby.

Translating research into clinical care 2016-2017

  • Contributing to recurrent pregnancy loss national guidelines, and National Bereavement Care Pathway.
  • Improving local support services such as having a dedicated telephone line and miscarriage support group.

Read more about the achievements of Tommy's National Centre for Miscarriage Research

Significant Discoveries

  • Understanding that metabolic profile predicts miscarriage. 

    More microbial diversity is associated with adverse early pregnancy outcomes however is amenable to pre-conception modification.

  • Understanding the role of uterine natural killer cells to clear senescent stromal cells in miscarriage. 

    The inflammatory response essential for implantation within the uterus is generated by senescent stromal cells, that are subsequently targeted and cleared by uterine natural killer cells. Imbalance between the induction and clearance of these senescent stromal cells can affect pregnancy outcomes.

  • Novel imaging of the fetal brain and heart in early pregnancy.  

    The entire fetal ventricular system has been visualised in a completely new way, far beyond the possibilities of standard ultrasound imaging techniques.

  • Preimplantation screening tool.

    A patent has been published by Tommy's researchers and collaborators defining a novel method to evaluate the viability of an early pregnancy after in vitro fertilisation, and to assist embryo selection for implantation in the womb. This invention claims a more reliable method to identify those embryos with the greatest potential to develop into a healthy baby.

National Guidelines

  • Recurrent Pregnancy Loss guidelines.

    Our team has contributed significantly to the development of national and European recommendations for the management of recurrent pregnancy loss. Now available in draft, the recommendations advocate clinical diagnosis after the loss of 2 or more pregnancies (reduced from 3 previously). The guidelines are built upon careful consideration of all the scientific evidence available to date in recurrent miscarriage research, by a multi-disciplinary group of clinicians over several years. They aim to help doctors, nurses and midwives in everyday clinical care decisions. Furthermore they are expected to gain endorsement from RCOG and other national authorities around Europe (certainly the Netherlands and Denmark) imminently

  • Bereavement Care. 

    Many women who experience miscarriage or ectopic pregnancy suffer psychological morbidity throughout the weeks and months afterwards. Bereavement services available to parents vary hugely between different regions and different stages of pregnancy. Therefore Tommy's miscarriage researchers are working with other contributors to the All Party Parliamentary Group on Baby Loss to produce a National Bereavement Care Pathway. This will reduce the variation in the quality of bereavement care provided by the NHS, and raise awareness of what more can be done by the government, Parliament or other agencies to help those affected.

Support Services

  • Additional dedicated staff. 

    2 part-time research nurses with a focus on early pregnancy loss to support dedicated research midwife in Birmingham. A telephone line for those who attend the recurrent miscarriage clinic is maintained so that they can call during office hours to receive specialist advice or just a friendly ear to renew self confidence and trust that life will get better again. 

  • Miscarriage support group.

    In London, a new miscarriage support group at Queen Charlotte's and Chelsea Hospital has been established for couples who have experienced pregnancy loss. It draws around 20 women and their partners to share their experiences informally once a month.

"Attending the support group was a turning point for me. I had been suffering in silence for a long time. Meeting other people and talking about our experiences helped me to see that I was not alone. The facilitators Flora and Halima were wonderfully supportive during the session and helped me to release the pain and anger I had been feeling. I was also able to meet the staff from the early pregnancy unit who were able to offer me reassurance that they would be there for me in a future pregnancy."London miscarriage support group user 2017

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Tommy's Manchester Research Centre

Highlights of research 2016-2017

  • Testing drug delivery packaging technique to treat fetal growth restriction.
  • Identifying that the placenta functionality may play key role in increasing risk of stillbirth for older women.
  • Gaining Human Tissue Act approval for 2 pregnancy tissue Biobanks stored for use in research.

Translating research into clinical care 2016-2017

  • Leading the evaluation of the Government-backed NHS initiative to reduce stillbirth.
  • Steering group member of perinatal mortality review tool.
  • Steering committee of confidential enquiry into intrapartum stillbirth.
  • Contributing to intrapartum care of high risk women NICE guideline.

Read more about the achievements of the Tommy's Manchester Research Centre

Significant Discoveries

  • Selectively delivering packaged drugs to placental arteries. 

    In mice with fetal growth restriction (FGR), packaging drugs so that they are selectively delivered to the placental arteries, improves blood vessel structure and increases fetal growth. Use of this packaging technique for drug delivery to the placenta in women could successfully treat FGR with reduced risk of side-effects.

  • Placenta functionality in older women. 

    Women of advanced age are susceptible to FGR and stillbirth. Researchers have shown that the placentas of older women have poorer function than those of younger women and this may be the cause of the susceptibility to stillbirth. This information provides the foundation for developing new diagnostic tools and treatments which can be translated into patient care in the Rainbow Clinic.  

  • Biobanks of pregnancy tissue. 

    2 Human Tissue Act approved biobanks of pregnancy tissue have been stored for use in research. They are a major research resource for not just this group but also others in the field.

National Guidelines

  • NHS England Saving Babies' Lives Care Bundle. 

    Tommy's researchers leading national evaluation of the NHS England Saving Babies' Lives Care Bundle. 

  • National Confidential Enquiry into Intrapartum Stillbirth. 

    Tommy's researcher a member of the steering committee for national confidential enquiry into intrapartum stillbirth. 

  • Intrapartum Care of High Risk Women NICE Guideline

    Tommy's researcher part of Intrapartum Care of High Risk Women NICE Guideline group

  • Perinatal Mortality Review Tool 

    Tommy's researcher on National Steering Group of the Perinatal Mortality Review Tool.

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Tommy's London Research Centre

Highlights of research 2016-2017

  • Showing continuous glucose monitoring during pregnancy in type 1 diabetics is associated with improved neonatal health outcomes.

  • Demonstrating how low dose aspirin significantly reduces early onset pre-eclampsia.
  • Universal screening tool for preterm birth, the QUIPP app completed and new study, EQUIPTT (Evaluation of QUiPP app for Triage and Transfer), is underway.

Translating research into clinical care 2016-2017

  • Contributing to NHS England Stillbirth Care Bundle.
  • Reviewing NICE Quality Standard for Diabetes in Pregnancy.
  • Developing preconception care templates for population of 4.4 million.

Read more about the achievements of Tommy's London Research Centre

Significant Discoveries

  • Continuous glucose monitoring during pregnancy

    The largest randomised controlled trial in type 1 diabetes in pregnancy showed for the first time that the use of continuous glucose monitoring during pregnancy is associated with improved neonatal health outcomes. 

  • Low dose aspirin significantly reduces early onset pre-eclampsia

    Professor Andrew Shennan is clinical director for South London Clinical Research network responsible for all research delivery across this network (>1000 trials). Trials published this year include ASPRE, demonstrating how low dose aspirin significantly reduces early onset pre-eclampsia. 

National Clinical Guidelines

  • National Maternal and Perinatal Audit (NMPA)

    Professor Debra Bick is a member of the WHO Guideline Development Group for prioritising recommendations in maternal and perinatal health and the Independent Expert Panal for the National Maternal and Perinatal Audit (NMPA). Dr Dharmintra Pasupathy is the Senior Obstetric Lead for the NMPA which aims to improve pregnancy and nenoatal outcomes through better understanding of national variation in clinical practice.

  • NICE Quality Standard for Diabetes in Pregnancy

    Professor Catherine Williamson is a member of the British Maternal and Fetal Medicine Society executive (representative for Maternal Medicine). This involves reviewing national guidelines such as the NICE Quality Standard for Diabetes in Pregnancy. 

  • NHS England Stillbirth Care Bundle

    Professor Williams has also reviewed and contributed to the NHS England Stillbirth Care Bundle. 

  • Chief Medical Officer's Physical Activity and Pregnancy Advisory Group

    Professor Lucilla Poston has contributed to the Chief Medical Officer's Physical Activity and Pregnancy Advisory Group, a Department of Health initiative to increase awareness of the benefits of physical activity in pregnancy including development of a widely disseminated infographic (LINK!?). 

  • Eastern Academic Health Science Network Pregnancy Diabetes Programme

    Professor Murphy led the Eastern Academic Health Science Network Pregnancy Diabetes Programme, developing and evaluating preconception primary care templates for a population of 4.4 million and providing evidence based preconception advice to 3,869 women with diabetes, leading to substantial improvements in pregnancy preparation in women with type 2 diabetes. 

 

Tools for Research/Products and Interventions

  • MHRA approval of medical device for preterm prediction app

    6 new algorithms have been created for improved prediction and functionality of the QUIPP app based on 5,000 patient visits.

  • CRADLE device

    Andrew Shennan's CRADLE device has been adopted by the Red Cross and Medecins Sans Frontieres. 6700 devices are in use worldwide, disseminated in 2017. 

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Tommy's Edinburgh Research Centre

Highlights of research 2016-2017

  • Showing attendance at the metabolic clinic was associated with reduced rates of stillbirth and low birth weight and improved detection of gestational diabetes.
  • Analysing largest ever placebo controlled trial of metformin in pregnancy.
  • Using innovative trial design to enable data of 450,000 women to be used in determining the effectiveness of stillbirth reduction measures.

Translating research into clinical care 2016-2017

  • Reviewing screening policy for gestational diabetes in Lothian.
  • Reviewing protocol for post-partum follow-up of women with gestational diabetes.

Read more about the achievements of the Tommy's Edinburgh Research Centre

Significant Discoveries

  • Metabolic Clinic Attendance

    Fiona Denison and Rebecca Reynolds published the clinical outcomes from the metabolic clinic. This showed that attendance at the metabolic clinic was associated with reduced rates of stillbirth and low birth weight and improved detection of gestational diabetes. (Denison et al., BMJ Open 2017 Jun 21;7(5):e015218.)

  • Metformin in Pregnancy

    The largest ever placebo controlled trial of metformin in pregnancy shows that it is safe, but there is no value in treating women who do not have gestational diabetes.

National and Local Guidelines

  • Gestational Diabetes

    Rebecca Reynolds and Fiona Denison are key members of a working party revising the screening policy for gestational diabetes in Lothian. Rebecca Reynolds is also part of the working party reviewing  the protocol for post-partum follow-up of women with gestational diabetes.

Tools for Research/Products and Interventions

  • Birth Mirror

    Fiona Denison won the Medicity DEVELOP prize for customer discovery, the Medicity DEVELOP Engage Invest Exploit Prize, the Medicity DEVELOP runner-up Prize and the Converge Challenge KickStart Digital Entrepreneur Award for her pioneering “birth mirror”.

  • Innovative Trial Design

    The AFFIRM study  uses a stepped wedge cluster trial design to determine whether a novel intervention of increased fetal movement awareness and “better” management of women presenting with decreased fetal movement reduces still birth.  The stepped wedge cluster design allows us to use routine data to determine outcome in a very large population of 450,000 women.  Such a sample size would be prohibitively expensive using any other trial design, but allows us to look at changes in “real” outcomes such as stillbirth.  The use of the stepped wedge design is fairly innovative in obstetric research, but we hope that AFFIRM will inspire others to learn from our practice.

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Read more about our recent research achievements.

Our research centres are independently reviewed every two years by leading professors from around the world. 

In addition, each centre must report its annual progress on key performance measures.

Our impact reports 

Read more about the impact of our work

  • Tommy's information services impact logo

    Impact of Tommy's information services

    Tommy's evidence-based, high quality, comprehensive pregnancy information informs and empowers pregnant women to make healthy behaviour and lifestyle choices, ultimately leading to a reduction in the number of babies who die during pregnancy or birth.

  • Tommy's clinic impact logo

    Impact of Tommy's clinics

    Our NHS supported specialist clinics deliver a high quality care environment, enabling improved recruitment to clinical trials and faster implementation of research findings.

  • A chalk drawing of a graph showing a decline in numbers

    Baby loss rates in the UK

    All of Tommy's work has the same goal. To reduce the number of babies who die during pregnancy or birth. These are the rates of stillbirth, miscarriage and preterm births in the UK.

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