Labour difficulties – reducing the risks for babies
This research was completed on 31 October 2008
Published on 7 October 2005
Some babies' health is put at risk by the very process of being born. These babies can go on to develop cerebral palsy, or even die, while their mothers are in labour. Researchers are studying how women's contractions affect their babies' well being, in the hope of making childbirth safer.
What's the problem and who does it affect?
The hazards of birth
Childbirth can be a risky time for babies. While their mothers are in labour, some babies suffer from a condition called fetal distress. Their oxygen levels drop dangerously low and their heartbeat becomes abnormal. This poses an immediate threat to a baby's health. A worrying 398 babies died during childbirth in England, Wales and Northern Ireland during 1999. That's a risk of dying of over 1 in 2000. The risk is much higher in developing countries. Sadly, other babies that survive may go onto develop cerebral palsy or permanent disabilities. Doctors rely on emergency surgery Unfortunately, doctors have no way of helping babies with fetal distress while they're still in the womb. And they know little about what causes the condition. So babies who are in distress must be born urgently, and doctors normally intervene by performing an emergency caesarean section. This is a major operation for the mothers. Around one in five caesarean sections in the UK are performed because of fetal distress.
What is the project trying to achieve?
Can dysfunctional labour protect babies from distress?
Doctors know all too well that some women have dysfunctional labours - their contractions aren't frequent enough or strong enough, and their labour fails to progress. The researchers leading this project suspect that dysfunctional labour might be the body's way of protecting a baby from fetal distress. They already know that each contraction can temporarily block the supply of oxygen to both the womb and the baby. They think that low oxygen levels might cause dysfunctional labour, possibly by changing acidity levels in womb muscle. To test their idea, researchers will take samples of muscle tissue and blood from the wombs of women who are undergoing caesarean sections. They will measure oxygen and acidity levels, and study the biochemical nature of contractions, looking for any differences between women who have dysfunctional labours and women with normal labours whose babies are in distress.
What are the researchers' credentials?
|Project Leader||Professor S C Wray PhD|
|Location||Department of Obstetrics and Gynaecology, The University of Liverpool, Liverpool Women's Hospital, Liverpool|
|Grant awarded||7 July 2005|
|Start date||1 November 2005|
|End date||31 October 2008|
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The project leader, Professor Susan Wray, manages the most highly rated physiology department in the country (5*) and is an acknowledged world expert on the womb and its contractions. Her collaborator, Dr Siobhan Quenby, works in the largest women's hospital in Europe and has an excellent track record of translating basic research into the clinic. The researchers have preliminary data to support their hypothesis and are exceptionally well placed to succeed. They have over ten years' experience of handling biopsy samples from the wombs of women in labour and, with 8000 births each year, the hospital treats more than enough women to ensure the study is completed quickly. The expertise and track record of the project team, along with the top-class resources available to them, put them in an enviable position to make a real impact on fetal distress and difficult births.
Who stands to benefit from this research and how?
Towards treatments that prevent fetal distress
Researchers hope their work will shed light on what causes fetal distress and why some women have dysfunctional labours. They hope this improved understanding will lead to better ways to treat both babies and their mothers during childbirth. Childbirth is a terrifying experience for those women who go through labour knowing their unborn child has fetal distress and is at imminent risk of dying or developing a permanent health problem like cerebral palsy. Doctors' only real means of helping is performing an emergency caesarean. By the time many women are rushed to theatre, they are almost relieved to be undergoing what is a major operation in the hope of seeing their baby born safely. Sadly, fetal distress still causes babies to die or develop permanent disabilities. So improvements in understanding and managing labour are urgently needed. This project could well represent a major step forward, by revealing important information about how contractions affect an unborn baby's well being, information that could lead to new treatments.