PUFFIN-2: Using MRI scans to monitor pregnant women with diabetes

We want to know which women and babies are most at risk of complications associated with type 1 or 2 diabetes. To do this, we are using MRI scans to detect problems with the placenta.

  • Authors list

    Professor Lucy Chappell, Dr Alison Ho, Dr Louise Webster, Dr Sara White, Dr Caroline Ovadia

    Start date: 2019
    End date: 2022

This project took place at our London centre which operated between 1995 and 2021.

Why do we need this research?

Pregnant women with type 1 or 2 diabetes are at higher risk of complications, and many have large babies. However, while carrying out a study to work out the best treatment for women with high blood pressure in pregnancy, Tommy’s researchers noticed that around 50% of women who had both high blood pressure and diabetes actually gave birth to babies who were​​​​​​​ underweight. These women were also at high risk of developing pre-eclampsia and of giving birth prematurely.

We want to find out more so that we can work out which pregnant women with diabetes will have underweight babies and which will have overweight babies. This will ensure that these women receive the most appropriate care to improve outcomes for themselves and their babies.

What’s happening in this project?

Tommy’s researchers have developed a safe way of taking pictures of the baby and placenta using Magnetic Resonance Imaging (MRI) scans. In the​​​​​​​ previous PUFFIN study, they monitored pregnant women with high blood pressure in this way and noticed that it was possible to detect changes in the placenta before a woman developed complications such as pre-eclampsia.

Our researchers are now carrying out the PUFFIN-2 study in pregnant women with type 1 or 2 diabetes. So far 11 women have agreed to take part. The team are monitoring the placentas of these women by performing MRI scans twice during their pregnancies and are also taking blood samples to look for substances that show how well the placenta is functioning and how stable their diabetes is. The women are also having their blood sugar levels monitored throughout the study.

What difference will this project make?

The findings of this study will help us to understand more about which pregnant women with diabetes are at greatest risk of complications and will highlight ways in which doctors can identify these women before problems arise. This will help to make sure that these women get the best possible care, reducing the chances of health problems for them and their babies.