According to the charity Action Medical Research the key to preventing unnecessary caesareans could be linked to cramp.
Most athletes know the searing pain caused by a build-up of lactic acid in their muscles during exercise. However, a dedicated young Liverpool doctor has found that the presence of lactic acid in the muscular tissue of the womb could also prompt up to a quarter of caesarean sections.
Whilst the so-called ‘too posh to push’ mums hit the headlines for choosing caesarean over natural birth, little thought is given to the many women who simply do not have the choice because their wombs are not contracting properly.
Approximately one in five births in the UK needs a caesarean delivery and a quarter of these are needed because labour is taking too long.
Currently, the only treatment to help these women is to administer a synthetic version of the hormone oxytocin in an attempt to improve the strength and frequency of contractions.
However a researcher, funded with a prestigious Action Medical Research Training Fellowship, has found a potential cause for these abnormal labours and has also discovered that oxytocin may be making matters worse for some women.
Dr Joanne Pierce undertook her research at the University of Liverpool and the Liverpool Women’s Hospital; working with Consultant Obstetrician Dr Siobhan Quenby of the Women’s hospital.
Analysis of blood samples, taken from the wombs of 72 women who had undergone a caesarean section, found that samples from wombs contracting inefficiently contained higher than normal levels of lactic acid.
Lactic acid is produced when muscles in the body are working hard without enough oxygen.
Dr Pierce has also shown that lactic acid reduces the strength and frequency of uterine contractions.
Since the womb is a muscle that needs to contract to allow the mother to give birth, having increased levels of lactic acid would slow down labour because it cannot contract strongly enough.
The doctor, who is now a Registrar in Obstetrics and Gynaecology in Liverpool, has already published three papers in this field and is working on a further two with a view to taking her valuable research forward to help those mothers that she sees every day.
Dr Pierce said, “I have been interested in this problem for a number of years, as those women who experience a dysfunctional labour have no choice but to have a caesarean; which is a major invasive procedure.
“Thanks to funding from Action Medical Research I have shown, both in the laboratory and clinically, that lactic acid could be behind some slow labours.
“If this is the case then giving oxytocin to these women could make matters worse. What we really need to concentrate on is finding ways to supply more energy to the uterus to allow it to function and reduce the amount of lactic acid.
“In the future this could mean that thousands of women who currently have a caesarean if they do not respond to oxytocin, could give birth naturally.”
Dr Pierce continued, “As with all research, a breakthrough in understanding means that we then need to consider how best to use this knowledge – so unfortunately there is no miracle treatment on the horizon within the next few months.
“However, it does mean that we have the first building block upon which further research can be built.
“Action Medical Research has recently launched its Touching Tiny Lives Campaign, which has highlighted the urgent need for more research like this to help to find answers to conditions that threaten babies and expectant mothers.
“It’s a very under-funded area of research, so the £3million that Touching Tiny Lives is looking to raise over the next three years is absolutely crucial for researchers, like myself, to help us to improve outcomes for mothers and their babies.”
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