Tommy’s maternity care tools going global
Professor Andrew Shennan OBE runs Tommy's Premature Birth Clinic in London and developed the CRADLE device, which can easily detect pregnancy complications that may otherwise go unnoticed but can kill mothers and babies if not treated. As well as working to introduce this life-saving tool into the NHS, Prof Shennan is testing CRADLE in other countries to make pregnancy safer worldwide.
The journal Pregnancy Hypertension recently published a paper from Prof Shennan’s team about community health workers in Mozambique using Tommy’s CRADLE technology to help them identify and support pregnant women with pre-eclampsia, a potentially life-threatening blood pressure condition that can occur during pregnancy and is very difficult to diagnose.
Pregnancy-related deaths around the world
295,000 women per year die as a result of pregnancy and childbirth – a figure you may find shocking, since the risk is much higher in other countries than here in the UK. It’s a rare tragedy for 1 in 4800 mothers across Europe and Northern America, but a very real threat for those in sub-Saharan Africa where 1 in 37 die.
These numbers are estimated because places with the highest maternal mortality rates don’t have the healthcare registration systems needed to get a clear picture of the problem, so it’s hard to know where limited resources should be focused to save as many lives as possible. Another new study from Prof Shennan investigating pregnancy-related death across 8 countries found rates were 20 times higher in some than others, regardless of key maternity care resources and staffing levels.
Findings published in BJOG show Tommy’s CRADLE had some impact, but not every hospital and community care setting they studied made a significant improvement, which the researchers say highlights a need for more research and policy interventions to address persistent inequalities in global healthcare.
Learning from research in other countries
Several scientists from our London Research Centre are members of the PRECISE Network, an international group of pregnancy experts working to better understand what causes stillbirth, babies not growing properly in the womb (fetal growth restriction) and high blood pressure during pregnancy (hypertension).
Professor Lucilla Poston, our Chair of Maternal and Fetal Health in our London Research Centre, and other Tommy’s experts have recently shared various pieces of PRECISE research in the journal Reproductive Health, such as their work to set up a bank for biological samples from mothers and babies in sub-Saharan Africa and how they plan to study 10,000 pregnancies across those countries – including an approach called ‘deep phenotyping’, which sounds very technical but essentially means getting a really detailed view of the biological and socio-cultural factors that can raise the risk of pregnancy problems.
We know that hypertension and fetal growth restriction are caused by problems with the placenta, and in the UK we have discovered quite a lot about how they can develop which will help us find new ways of preventing and treating them to reduce stillbirth. Elsewhere in the world, there is less evidence on why these life-changing complications and losses can happen, so the Tommy’s team and wider PRECISE network will continue to shine a light on this neglected research area.
Contributing to global understanding of Covid-19 and pregnancy
Tommy’s researchers are working with the Stillbirth Centre of Research Excellence on a global research study to understand the challenges and concerns of new and expectant parents in the Covid-19 outbreak.
Newly launched, COCOON (COntinuing care in COVID-19 Outbreak: A global survey of New and expectant parent experiences) will see us gather as many diverse experiences of pregnancy and birth as possible. We also want to understand the experiences of parents who have lost their baby to miscarriage, stillbirth or neonatal death during the pandemic.
Alongside Tommy’s UK team, the global research study involves participants from Australia, Italy, Spain, Canada, the USA and many others. The hope is that this research will help to improve future care for all families around the world.
Premature birth is the biggest killer of newborn babies in the UK and much of Tommy's research is devoted to predicting and preventing this. One discovery has made a huge difference to our ability to treat women in time.
In more than half of stillbirths parents are not given a reason for their babies' death. Doctors simply do not know why it happens. This animation looks at how Tommy's researchers are finding out the causes of stillbirth and how this leads to treatments and saved lives.
Too many miscarriages are unexplained. Our research is entirely dedicated to finding out why miscarriages happen and how to prevent it in the future.
A recently published article, co-authored by Professor Catherine Williamson from Tommy’s Research Centre at King’s College London, suggests that certain pregnancy complications can indicate future health issues for women.
Tommy’s has received a grant from the UK Government’s Department for Health and Social Care to support the costs of its PregnancyHub information and support services throughout the summer, due to rising demand in the wake of coronavirus.
Although recruitment to some clinical trials had to be paused when coronavirus hit the UK, scientists at Tommy’s Research Centres across the UK are still hard at work, supporting women and families in our specialist clinics and sharing their latest studies with academic journals.
The day before Mother’s Day, and two days before the UK officially went into coronavirus lockdown, Zara Dawson found out she was having a miscarriage. Her third consecutive miscarriage in less than a year, and fourth consecutive loss, after losing her second son Jesse in 2018 to termination for medical reasons.