Problems with the placenta account for many stillbirths and studying the functioning of the placenta should allow us to understand the causes of stillbirth better. The four main causes of stillbirth are fetal abnormality, pre-eclampsia, premature birth and fetal growth restriction (FGR). The aim of the Tommy's Placenta Clinic, the first of its kind in the UK, is to combine antenatal care for women at risk of fetal growth restriction with frontline research into why the condition occurs and how it might be treated. By creating such a close link between researchers and patients, we hope research will advance faster.
In the five years since the Manchester Placenta Clinic was set up by Dr Ed Johnstone, the portfolio of clinical research clinics held in Tommy’s Manchester centre has grown. While the Manchester Placenta Clinic remains the core clinical component of our strategy, we have expanded our research clinics to include:
- The Rainbow Clinic, for parents who have experienced a stillbirth, run by Dr Alex Heazell
- The Manchester Antenatal Vascular Service (MaVIS), a clinic for women at high risk of hypertension in pregnancy, run by Dr Jenny Myers
- Lupus in Pregnancy Study (LIPS) Clinic, run by Dr Clare Tower.
The Placenta Clinic sits at the heart of the stillbirth research programme
These active research clinics are having a huge effect on care for patients in St Mary’s Hospital.
Each of these specialist clinics focuses on disease processes that affect the placenta, and the information obtained in one group of high-risk patients helps us continue to develop new ways to identify the pregnancies that are at greatest risk of complications.
Women who are at high risk of their babies having fetal growth restriction (failure to grow properly in the womb) are offered a variety of tests to check whether their placenta is working as it should. This then enables us to determine which patients are at highest risk of a growth-restricted baby and give them increased attention during the rest of their pregnancy.
Our research clinics collect a lot of information on the placenta and baby while still in the womb. By following women through to birth we can then study the placentas in the laboratory and make connections with what we found before birth, and understand how this relates to placental function and pregnancy outcome.
Consequently, our research clinics, particularly the Manchester Placenta Clinic, sit at the heart of our placental research programme. They also provide an important way for us to translate our research into better care, such as introducing measurement of placental growth factor (PlGF) to better diagnose pre-eclampsia, and using the findings of the IMPS study to structure Rainbow Clinic.