Tommy's work on stillbirth in Manchester has reduced stillbirth by 22% in the region over the last four years.
The centre’s focus is the baby’s life support machine, the placenta. Our scientists have recently made some important breakthroughs in understanding what can go wrong in that area and which chemical substances may tell us early on that there’s a problem, so that treatment can be targeted before it’s too late.
The centre also runs specialist clinics that allows to combine research with treatment and care. Fetal growth restriction is one of the main causes of stillbirth, and the centre opened the Manchester Placenta Clinic to combine specialised antenatal care for pregnancies affected by fetal growth restriction with frontline research into why the condition occurs and how it might be treated. The Rainbow Clinic was opened to care for women pregnant after a previous stillbirth.
It is estimated that over 3,500 women experience a stillbirth every year in the UK. In 2011, the Manchester centre launched a new Stillbirth Research Programme which focuses on:
- Understanding the causes of stillbirth and developing new diagnostic tools
- Preventing stillbirths by identifying babies at risk
- Developing new national guidelines for health professionals.
Working in collaboration with the Tommy’s teams in London and Edinburgh as well as many overseas researchers, the Manchester centre is a vital part of the Tommy’s research network which is now a major force in the drive to improve pregnancy outcomes worldwide.
The Stillbirth Research Programme
One in 200 women giving birth in the UK has a stillborn child, which equates to over 4,000 births per year. This rate of stillbirth is higher than that in comparable countries in northwest Europe. Despite its frequency, there is little public awareness of the frequency of stillbirth. There has also historically been a lack of funding for research into stillbirth. Our Stillbirth Research Programme, which launched in 2011, focuses on the following three areas:
Understanding the causes of stillbirth - Why did my baby die?
The most frequently asked question by parents is ‘Why did my baby die?’ Understanding the reasons for stillbirth helps parents with the grieving process.
It's also key to preventing women from losing another baby. Women who have a stillbirth are between two and ten times more likely than normal to have a stillbirth in their next pregnancy.
Preventing stillbirths by identifying babies at risk - How can I stop it happening?
Prevention of stillbirth represents a significant challenge as 85% of stillbirths occur in babies with no structural abnormalities, which explains why some of the advances in obstetric scanning have not led to a significant reduction in the stillbirth rate. One sign which identifies that a baby is at increased risk of stillbirth is a reduction in fetal movements, with pregnancies being 1.5 times more likely to have a stillbirth and 2.5 times more likely to have severe fetal growth restriction.
Our recent FEMINA2 study recruited 300 women presenting with reduced fetal movements. 56 had a bad outcome, including stillbirth, failure to grow, signs of stress before birth and admission to the neonatal intensive care unit. For each case we collected 181 different pieces of information. We were then able to see which of these predicted poor pregnancy outcome. We have made a combination of seven ultrasound features and blood tests that has the potential to detect 30% more babies with poor outcome than our current standard tests.
Stillbirth is very closely related to problems in the placenta; how these problems arise and what effects they have are not fully understood. One abnormality seen in stillbirths is inflammation in the placenta (known as villitis). Other investigations have not found a cause for this inflammation such as a bacterium or virus. We are interested in this inflammation and how it relates to problems in the placenta; to investigate this we will look closely at how inflammation changes the structure of the placenta and whether it changes how effectively the placenta works.
An outstanding achievement...I would like to congratulate Professor Colin Sibley and Dr Alex Heazell for their leadership of a flagship research enterprise that serves the nation and global community well. Their team has chosen to focus on the placenta and the clinical consequences of imperfect placentation, building on decades of research strength in the field. The translational nature of the research, the track record in research training, and productivity are remarkable and commendable.
The Tommy's Rainbow Clinic is part of the Tommy's Stillbirth Research Centre at St Mary's Hospital in Manchester. It provides specialist antenatal care for women who have suffered a previous stillbirth or neonatal death.
The Placenta Clinic, run as part of the Tommy's Stillbirth Research Centre at St Mary's Hospital in Manchester, is the largest placenta-focused research group in the world.
When a baby dies after 24 weeks of gestation it is called a stillbirth. Incredibly, over 3,500 babies are stillborn every year in the UK and many of these deaths remain unexplained. Tommy’s research is dedicated to improving these shocking statistics.