The Placental Assessment Predicting Pregnancy Outcome (PAPPO) study
-
Authors list
Professor Alexander Heazell, Dr Melissa Whitworth, Dr Clare Davenport, Professor Lelia Duley, Professor Jim Thornton, Professor Alan Montgomery, Professor Tracey Roberts
-
Research centre
Many stillbirths happen because the placenta isn’t working properly. When this happens, the baby can’t get all of the oxygen and nutrients it needs to survive and grow in the womb. If we had a way of telling when the placenta stops working normally, we could stop stillbirths from happening by delivering the baby early.
The PAPPO study has been reviewing past research to see if measuring 'markers' that give clues about how well the placenta is working can help predict, and stop, stillbirth. Because very few large studies have been done, there wasn’t enough evidence to tell if measuring these markers can improve a baby’s chances.
However, we haven’t given up, and are still looking for tests that can accurately predict stillbirth. Looking at data from 65 studies, we are trying to find out which tests work best to predict when a baby will be stillborn. So far, most tests weren’t very accurate, and couldn’t always tell when the placenta wasn’t working.
We will carry on researching these tests in a group of 660 women in late pregnancy whose babies are not moving as much as normal: the FEMINA3 study. We hope that this research will help us understand how to tell when the placenta isn’t working properly. Then, we can find babies at risk of stillbirth as early as possible, and take action to give them a better chance of survival.
Get our research updates
Tommy's funds research across the UK investigating the reasons for pregnancy complications and loss. We can keep you updated on our research news. If you're interested in being kept updated about our research and news from Tommy's, click here.
This study takes place in a Tommy's centre and is funded by Tommy's and the National Institute for Health Research
Read more on this topic
-
Research into stillbirth
When 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. -
Preventing stillbirth: the role of the immune system in rejecting the placenta
Tommy’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
Pre-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
Researchers supported by Tommy’s are looking at whether a package of care and resources for pregnant women can help stop stillbirths. -
Stillbirth and fetal free haemoglobin
Researchers 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. -
Diabetes, fetal growth and stillbirth
Women 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. -
ReMIT-2 – a feasibility study for spotting the early signs of complications
We 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. -
Can low levels of taurine make stillbirth more likely?
Tommy’s researchers are looking at how the lack of an important nutrient might harm the placenta during pregnancy, putting women at a higher risk of stillbirth. -
Homing peptides: targeting drugs to the placenta
Drugs 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. -
Can steroid injections improve blood flow to babies at risk of stillbirth?
Finding out whether steroids can improve the blood flow through the placenta -
Older mothers and the ageing placenta
Consistent with ageing, the placenta in older mothers does not work as effectively. Researchers supported by Tommy’s are investigating why this happens. -
Viagra: is it an effective treatment for stillbirth (STRIDER)
Viagra works by increasing blood flow. Fetal growth restriction is often caused by poor flow of blood through the placenta. This trial is looking at whether Viagra is effective in increasing blood flow to the baby.