Stillbirth and growth restriction - could state-of-the-art MRI scans identify babies at risk?

Published on 22 November 2011

Around 4,000 babies are stillborn each year in the UK.¹ Many other babies who stop growing properly within the womb have to be born prematurely, in an attempt to save their lives. Such devastating pregnancy complications often result from problems with the placenta. Dr Fiona Denison and her team at the University of Edinburgh are researching whether MRI scans could help detect these problems and identify unborn babies who are at risk.

What is the problem and who does it affect?

Cosseted within its mother’s womb, unable to eat or breathe by itself, an unborn baby depends on the placenta to survive. The placenta brings a constant, and vital, supply of oxygen and nutrients. Without it, the baby would die.

If the placenta stops working well, babies start to struggle in the womb, as Dr Fiona Denison explains: “If starved of oxygen and nutrients, babies can stop growing properly – a condition known as intrauterine, or fetal, growth restriction. Other babies sadly lose their lives and are stillborn, a devastating outcome.”

Poor functioning of the placenta, which is in fact a common feature of several different pregnancy complications, can be notoriously difficult to detect and there is often no way to tell how badly mother and baby might be affected.

If babies are thought to be at risk, doctors and parents face a difficult decision, explains Dr Denison: “We have to decide whether it is best to let the pregnancy continue, and risk stillbirth, or to deliver the baby prematurely, which brings its own risks of disability and even death. Without a good diagnostic test, we often cannot tell what’s best.”

What is the project trying to achieve?

“We are researching whether new imaging techniques can help us tell which babies are struggling during pregnancy. We are using state-of-the-art MRI scans, which we think will be able to detect fetal hypoxia – low oxygen levels in babies within the womb,” says Dr Denison. The scans will measure oxygen levels in the babies’ brains and within the placenta.

Around 50 pregnant women are volunteering to take part in the study; half have babies thought to be at risk. The MRI scans, which take around 45 minutes, are safe for both mother and baby.

“Our long-term goal,” explains Dr Denison, “is to find out whether these new MRI scans have the potential to tell us how well a baby is doing within the womb, so we are better placed to decide whether to let the pregnancy continue or to deliver the baby early.” Improving this decision making could prove life-saving.

What are the researchers’ credentials?

The project team, based in Edinburgh, is leading the field in developing novel ways to assess babies’ health within the womb using the imaging technique of MRI – magnetic resonance imaging.

The multidisciplinary team, led by Dr Fiona Denison, includes medical imaging experts, radiologists and clinicians specialising in pregnancy and childbirth.

References

1. Confidential enquiry into maternal and child health (CEMACH). Perinatal mortality 2007. Published June 2009. http://cemach.interface-test.com/getattachment/1d2c0ebc-d2aa-4131-98ed-5... (website accessed October 2011).