PUFFIN: using MRI scans to detect complications of pregnancy hypertension

Prof Lucy Chappell, Dr Kate Duhig, Dr Alison Ho, Dr Carolyn Gill, Mr Paul Seed

We want to identify which women and babies are at risk of complications associated with hypertension. To do this, we are using MRI scans to detect abnormalities.

Why do we need this research?

About 5% of women during pregnancy have hypertension, or high blood pressure, which can lead to problems for both mother and baby.  Mothers are at risk of stroke and damage to their kidneys, while their babies may be born early or underweight. In some cases, this can lead to stillbirth. 

If we can identify which women are at high risk of complications linked to hypertension, this would help us to ensure they receive the right level of care. On the other hand, if we can find out which babies will remain well, we will be able to normalise their care as much as possible, with the aim of avoiding early delivery. 

What’s happening in this project?

Researchers supported by Tommy’s have developed a safe way of taking pictures of the baby and placenta using Magnetic Resonance Imaging (MRI) scans. By studying the placenta in this way, they hope to improve our ability to detect problems linked to high blood pressure. MRI scans also enable us to look at blood flow and see how well the baby’s brain is developing. This could help us to work out which babies are struggling the most. 

Alongside the MRI investigations, the team also want to look at substances in the mother’s blood. They are particularly interested in molecules that are involved in placental blood vessel development, and those which are linked to placental stress.

Our researchers have set up the PUFFIN study to collect data from women throughout and after their pregnancy. The team have recruited 40 women with high blood pressure, and 15 with pre-eclampsia. The women have had MRI scans at different points during pregnancy, and have donated blood samples for the researchers to study. Women who had a caesarean section to deliver their baby also donated samples of the placenta.

Now that all the women have given birth, our scientists are analysing all these MRI scans and samples, to look for signs that could predict if a mother is going to suffer complications later during their pregnancy. They hope to announce the results of their work soon.

The team have also now begun a follow-up study, PUFFIN-2, involving 20 women with both hypertension and diabetes. As well as receiving MRI scans and blood tests, the women will have their blood sugar levels monitored continuously using a special device which sits just under the skin.

What difference will this project make?

The findings from these studies could help doctors decide whether or not a mother with health conditions such as high blood pressure or diabetes is likely to suffer complications during pregnancy. This will help to ensure that mothers get the care they need to reduce the chances of health problems for both themselves and their baby.

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