Current Projects & Future Plans
The Save The Baby Unit in the Department of Obstetrics &
Gynaecology at St Mary’s Hospital has now been finished and
looks fantastic – but obviously a huge number of people and
an enormous amount of work has gone into making it happen.
For Professor Lesley Regan and her team it has been very
exciting to watch it come together, but it has also been
chaotic and at times very difficult. For ten months, while
the unit was being rebuilt, work had to go on, clinics had
to run, patients had to be seen, operations had to be
carried out, and nine of the team had to work out of one
room on the 1st floor of the hospital.
But at the end of May this year, Lesley and her dedicated
staff started moving into the newly refurbished unit. At
last everyone from the miscarriage team and the fertility
team to the Nurse Practitioners and laboratory staff could
work together under one roof in the new unit.
Lesley says “we are so excited to be in, but this is just
the beginning ... and the important research and development
work that we have been waiting to do, can now start again”.
These are just some of the vital research studies already
underway in the new Save The Baby Unit in the Department of
Obstetrics & Gynaecology at St Mary's Hospital, London :
Progesterone Hormone Study
The Recurrent Miscarriage Clinic team at STBU are about to
embark upon a randomised controlled trial to see whether
giving progesterone hormone to women with a history of
miscarriages , early in their next pregnancy can improve the
outcome. This is an extremely important study because,
although lots of people have tried to carry out similar
studies in the past, the number of patients recruited have
never been sufficient to determine a clearcut answer. The St
Mary's team have forged a collaboration with lots of
different centres around the UK and overseas in order to
ensure that sufficiently large numbers of patients are
recruited to achieve a meaningful answer.
The Medical Research Council are funding this study because
they are impressed with the study design and the fact that
having other centres from around the world involved means
that Lesley and her team can obtain the results they are
looking for in a much shorter timeframe.
Lesley says that the real importance of this study is that
Doctors have been using progesterone hormone for 50 years,
but without any hard evidence as to whether it is effective
or not. If the study shows that progesterone works, then it
will be particularly welcome news since this treatment is
simple, cheap and easy to administer. If the study concludes
that progesterone does not improve pregnancy outcome, this
is also very important, since it means that we should
abandon a useless treatment and instead spend our resources
and energies finding new and alternative treatments.
Tissue Bank
The newly refurbished Save The Baby Unit will soon become
the home of a unique Tissue Bank for pregnancy
complications. The Department of Obstetrics and Gynaecology
at St Mary's has been selected by Wellbeing of Women and the
Lord Mayor of London's Appeal fund to set up the biggest
ever collection of tissue samples from couples and their
babies who have suffered from recurrent miscarriage, pre-eclampsia,
intrauterine growth restriction and preterm labour. As a
result, clinicians and scientists will have the opportunity
to access unique samples from pregnancy complications, and
will be able to pose and answer questions about reproductive
health that will bring benefits to women locally, nationally
and internationally. This is absolutely vital work and will
be a real legacy that can be used in reproductive research
for years to come.
The Tissue Bank will hold samples from mothers, fathers,
babies, placentas and miscarriage tissues and will prove
invaluable in future research into identifying the genetic
codes and environmental factors that determine all of these
4 common pregnancy complications. The plan is that this
resource will then be made available to researchers in many
different hospitals in London and further afield. It is also
the first time that there will be an opportunity to look at
the genetic contribution that fathers make and whether this
influences the outcome of the pregnancy.
This is particularly exciting because the real value of the
Tissue Bank is that researchers will no longer have to spend
years collecting samples for a particular study, they will
just apply to the Tissue Bank for permission to use all the
samples they need. This will mean studies can be undertaken
and results obtained far quicker than ever before.
In order to maximise the success of this project, the STBU
needs to appoint research midwives and laboratory technical
staff, as well as vital equipment to obtain and store the
samples. Resources spent in this area are a real investment
for the future.
Complement Levels
Another study which is already underway, is to ascertain
whether a deficiency in complement levels, which are an
important part of the body's immune response to infections
and other injuries, may be linked with miscarriage. Lesley
and her team are collaborating with colleagues in the United
States who have had positive results when researching this
possibility in mice and are looking forward to working with
the STBU to see if they get the same results in humans.
Polycystic Ovaries
The St Mary’s Recurrent Miscarriage Group are well known for
the work they’ve done in blood clotting disorders and are
now exploring innovative new ways to use their knowledge and
apply it to other pregnancy complications. One of the key
areas they are looking at is whether there are disturbances
in the balance between clotting and thinning of the blood
amongst women with polycystic ovaries.
Researchers have known for over 20 years that there are a
huge number of women suffering from recurrent miscarriage
who also have polycystic ovaries. However, to date they have
never been able to pinpoint the underlying cause. It has
always been assumed that the link is due to a hormonal
disorder but more recent studies suggest that the polycystic
ovaries may be a marker for genetic differences in the way
that these women clot and thin their blood, which is a
vitally important step in the implantation of the tiny
embryo into the uterine lining. Here the Tissue Bank that we
are developing, will help to answer these questions.
How you can help...
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"For these patients
every month counts as their fertility declines with
time. That is why rebuilding these clinical and
research facilities is so important. It makes all
the difference between giving our patients the
promise of a live take home baby or condemning them
to childlessness forever. This project just cannot
wait."
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| Prof
Lesley Regan is head of the Department of Obstetrics
and Gynaecology at St Mary's Hospital, Director of
the St Mary's RMC and Visiting Professor to the
Harvard Centre of Excellence for Women's Health. |
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