11 January 2011
Scientists in London are hoping the placenta holds the key to understanding the cause of pre-eclampsia – a condition which results in the deaths of several hundred babies in the UK[i] each year – as they embark on a new study funded by Action Medical Research, the leading UK-wide medical research charity dedicated to helping babies and children.
Up to five per cent of pregnant women in the UK develop pre-eclampsia.[ii],[iii] Women with the most severe disease can suffer high blood pressure, convulsions, strokes, liver and kidney failure, and life-threatening bleeds. In the UK, the most serious symptoms are rare, but worldwide the condition remains a major cause of death in mothers.[iv]
Treatment can help tackle some symptoms, lowering blood pressure and reducing the risk of convulsions. However, it does not slow the underlying progression of the disease. In fact, the only way to cure pre-eclampsia currently is to deliver the baby early.
An early birth can prove life saving, not just for mothers, but also for their babies, as pre-eclampsia can cause stillbirth.[v] However, as well as being premature, the babies also tend to be worryingly small, because they do not always grow very well in the womb.
Evidence suggests they might even be at increased risk of developing diabetes, high blood pressure and heart disease in later life. Despite the severity and frequency of pre-eclampsia, the biology behind it remains poorly understood. No-one knows exactly what causes the condition.
The researchers, from the Division of Biomedical Sciences, St George's University of London and Fetal Medicine Unit, St George's Hospital NHS Trust have many years’ experience in the study of pre-eclampsia.
Their highly productive work has provided a deeper understanding of how problems within the placenta can lead to complications during pregnancy. The team has a very high standing in this area of research. The project leader, Professor Guy Whitley, and his colleague Dr Judith Cartwright are highly skilled scientists. They have developed new laboratory techniques, which are designed to help them study the molecular processes that take place within the placenta during pregnancy.
The third team member, Professor Baskaran Thilaganathan, is a hospital consultant with many years’ experience of treating pregnant women who have developed pre-eclampsia. The researchers use state-of-the-art imaging techniques both at the bed side and in the laboratory.
They have refined a way of using sophisticated ultrasound scans during the first three months of pregnancy to assess a woman’s chances of developing pre-eclampsia and are among the leaders in this technique.
Professor Whitley, said: “We hope to provide an important insight into what causes pre-eclampsia. Longer term, we believe this could lead to improved diagnosis and treatment. We hope our work will lead to better ways to predict who is most likely to develop pre-eclampsia.
Pre-eclampsia is thought to result from problems with the placenta, which feeds and nourishes the baby throughout pregnancy. Early in pregnancy, the placenta embeds itself within the wall of the womb. Cells from the placenta invade the lining of the womb and alter the structure of the mother’s blood vessels, so that nutrients and oxygen can pass from the mother’s blood, through the placenta, to the baby. Evidence suggests that this process sometimes goes wrong, and that this might cause pre-eclampsia.
The researchers suspect two key factors might contribute to pre-eclampsia:
cells from the placenta, which are supposed to invade the lining of the womb, might be more likely to die, because they are more sensitive to signals that cause them to self-destruct
the lining of the womb might be more likely to secrete substances that prompt cells in the placenta to self-destruct.
The researchers are investigating their ideas in the laboratory, using samples donated by around 100 women.
1.NHS Choices. Your health, your choices. Pre-eclampsia. Introduction.http://www.nhs.uk/conditions/Pre-eclampsia/Pages/Introduction.aspx
2.Vatten LJ and Skjærven R. Is pre-eclampsia more than one disease? BJOG: An International Journal of Obstetrics & Gynaecology 2004;111:298-302.
3.Trogstad L, Magnus P, Moffett A and Stoltenberg C. The effect of recurrent miscarriage and infertility on the risk of pre-eclampsia. BJOG: An International Journal of Obstetrics & Gynaecology 2009;116:108-113.
4.Geographic variation in the incidence of hypertension in pregnancy. World Health Organization International Collaborative Study of Hypertensive Disorders of Pregnancy. Am J Obstet Gynecol 1988;158:80-83.
5.Confidential Enquiry into Maternal and Child Health (CEMACH), Perinatal Mortality, 2007, June 2009.http://www.cmace.org.uk/getattachment/1d2c0ebc-d2aa-4131-98ed-56bf8269e529/Perinatal-Mortality-2007.aspx
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Action Medical Research is the leading UK-wide medical research charity dedicated to helping babies and children. We know that medical research can save and change children’s lives. For nearly 60 years we have been instrumental in significant medical breakthroughs, including the development of the UK polio vaccine and ultrasound scanning in pregnancy. Today, we continue to find and fund the very best medical research to help stop the suffering of babies and children caused by disease and disability. We want to make a difference in:
- tackling premature birth and treating sick and vulnerable babies
- helping children affected by disability, disabling conditions and infections
- targeting rare diseases that together severely affect many forgotten children.