Bristol Twin (BRIT) Study

  • Research type

    Research Study

  • Full title

    The Bristol Twin (BRIT) Study

  • IRAS ID

    181260

  • Contact name

    Sarah Newell

  • Contact email

    sdnewell@doctors.org.uk

  • Sponsor organisation

    University of Bristol

  • Duration of Study in the UK

    3 years, 0 months, 3 days

  • Research summary

    Twin pregnancies are high-risk pregnancies with complications including prematurity, growth restriction and pre-eclampsia. Monochorionic pregnancies (MC) occur when identical twins share one placenta; this places the pregnancy at higher risk than when twins have two separate placentas.
    We plan to recruit every mother with MC twins at St Michael’s Hospital over a two year period. We plan to closely monitor them, using new imaging techniques both antenatally and postnatally, to improve prediction and treatment of complications associated with MC twin pregnancies. There are three arms to the study: (i) Cardiac imaging (ii) MRI imaging to assess brain development (iii) 3D power Doppler to assess placental development.

    i. Cardiac imaging

    Twin-to-twin transfusion syndrome (TTTS) complicates ~15% of MC twin pregnancies. We plan to explore novel imaging techniques to identify impending cardiac compromise, both as a tool to predict the development of TTTS, and to monitor the recovery from TTTS following laser surgery.

    ii. MRI

    Monochorionic twins are at increased risk of brain injury and development of the neonatal brain is poorly understood. We aim to use different MRI techniques to assess the functional development of both twins’ brains before and after birth. We aim to investigate whether brain size and development correlates with discordance in the blood flow to each twin.

    iii. 3D power Doppler

    This will involve the 3D reconstruction of early placental development. It is hoped that this will improve our understanding of how the shared placenta develops. Importantly it may lead to treatment strategies to reduce complications associated with MC pregnancies.

    iv. Angiogenic Factors

    Angiogenic factors are crucial for changes occurring in blood vessels during placental development, but nothing is known about these factors in twin pregnancies with placental abnormalities. We plan to measure these factors in maternal blood to look at the serial trend throughout the pregnancy.

  • REC name

    South West - Central Bristol Research Ethics Committee

  • REC reference

    15/SW/0230

  • Date of REC Opinion

    8 Sep 2015

  • REC opinion

    Favourable Opinion