Can steroid injections improve blood flow to babies at risk of stillbirth?

Finding out whether steroids can improve the blood flow through the placenta
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    Dr Emma Ingram, Dr Ed Johnstone, Dr Jenny Myers, Dr Penny Cristinacce

Start: September 2012

End: August 2020

The placenta is very important in pregnancy as it supplies babies with the oxygen and nutrients they need to grow and survive. In a healthy pregnancy, oxygen is transferred from the placenta to the baby continuously through the umbilical cord. However, in some pregnancies, there are gaps in the flow of blood between the baby and the placenta, meaning that babies are not able to grow properly and are at risk of being stillborn.

At the moment, there are no treatments that can improve the flow of blood between the placenta and the baby – the only option in these pregnancies is to deliver the baby early. When this happens, the mother is given steroids to help the baby’s lungs mature so that it can breathe better after birth.

Steroid injections have been shown to improve blood flow in placenta

Interestingly, these steroid injections have actually been shown to temporarily improve blood flow between the placenta and the baby, although we don’t know whether this benefits the baby.

We have recently pioneered the development of an exciting new way of looking at the placenta while the baby is still growing using Magnetic Resonance Imaging  (MRI).

Using our technique, we can look much more closely at the blood flow between the placenta and the baby, and find out how much oxygen is present. We will now use this method to monitor babies that have been struggling because of gaps in the flow of blood to and from the placenta, to see if there is an increase in the amount of oxygen in both the placenta and the baby after a steroid injection.

We want to find out if steroid injections could be used as a treatment when babies are not growing properly. In the future, we also hope to use our MRI technique to assess how well other novel therapies are working.

The devastating effect of stillbirth

Stillbirth is devastating for families. We have been gathering testimony about the terrible effect of stillbirth on parents and wider family to raise awareness and make the case that more must be done to bring down the statistics.

'We sat on the bed laughing and joking, pushing the worry away. The midwife seemed to be away for ages. When she returned we were taken to a scan room to be scanned. As we walked in the room I knew something wasn’t right as there were three people in the room already. I nervously lay on the bed and after a few minutes the doctor turned to me and said, ‘I’m sorry but there’s no heartbeat.’

'Those words still make me feel sick to my stomach. I just remember screaming and screaming. I looked to David who sat with his head in his hands. I eventually managed to stop screaming and sat and cried uncontrollably. How could this have happened?'

Shelley, whose baby Joseph was stillborn at 37 weeks