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.
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.
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.
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.