Can steroid injections improve blood flow to babies at risk of stillbirth?
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Authors list
Dr Emma Ingram, Dr Ed Johnstone, Dr Jenny Myers, Dr Penny Cristinacce
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Research centre
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?'
More research projects
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Research into stillbirth
Research into stillbirthWhen a baby dies after 24 weeks of gestation, it is called a stillbirth. Nearly 3000 families a year get the devastating news that their baby is not alive. Our research is helping to change this. -
Diabetes, fetal growth and stillbirth
Diabetes, fetal growth and stillbirthWomen suffering from type 1 or type 2 diabetes are more likely to suffer from stillbirths. We want to help people with diabetes to have healthy pregnancies. -
Preventing stillbirth: the role of the immune system in rejecting the placenta
Preventing stillbirth: the role of the immune system in rejecting the placentaTommy’s are studying chronic histiocytic intervillositis, which causes the immune system to reject the placenta, leading to stillbirth or miscarriage. -
Understanding how the womb lining matures during pre-eclampsia
Understanding how the womb lining matures during pre-eclampsiaPre-eclampsia can lead to health problems and sometimes stillbirth, but we don’t know enough about what causes it. Our researchers are studying how the lining of the womb develops during early pregnancy. This could reveal new ways to prevent pre-eclampsia and reduce the risk of stillbirth. -
The AFFIRM trial for prevention of stillbirth
The AFFIRM trial for prevention of stillbirthResearchers supported by Tommy’s are looking at whether a package of care and resources for pregnant women can help stop stillbirths. -
Homing peptides: targeting drugs to the placenta
Homing peptides: targeting drugs to the placentaDrugs which could help prevent pregnancy complications can’t reach the placenta effectively. Tommy’s researchers are making use of ‘homing peptides’ to deliver drugs directly to the placenta. This work could help to prevent pregnancy complications and stillbirth. -
Stillbirth and fetal free haemoglobin
Stillbirth and fetal free haemoglobinResearchers supported by Tommy’s have found that the substance that usually carries oxygen around our blood may have harmful effects on the baby when it escapes from red blood cells. -
ReMIT-2 – a feasibility study for spotting the early signs of complications
ReMIT-2 – a feasibility study for spotting the early signs of complicationsWe need better ways to spot the early signs of pregnancy complications. The ReMIT-2 study laid the foundations for a large clinical trial of a blood test which could predict which women need urgent care to prevent stillbirth.