Placental Pathophysiology
Research type
Research Study
Full title
Understanding the placental structure, function and pathophysiology underlying the development of adverse pregnancy outcomes.
IRAS ID
234385
Contact name
Nick Orsi
Contact email
Sponsor organisation
University of Leeds
Duration of Study in the UK
5 years, 8 months, 18 days
Research summary
Whilst many women enjoy a healthy pregnancy adverse outcomes can unexpectedly complicate 1 in 5 pregnancies (preterm birth, pre-eclampsia, growth restriction and gestational diabetes) and cause a spectrum of maternal and fetal morbidity and mortality. Predicting which mothers are at risk of these obstetric disorders and implementing preventative strategies is an unmet clinical need.
The aetiology of some of these complications can be traced to placental dysfunction. Conventional assessment techniques have largely focused upon a two-dimensional subjective description of the placental architecture to characterise potential villi abnormalities and vascular changes, rather than objective, quantitative parameters. This study will aim to develop the latter and endeavour to better understand the processes whereby adverse pregnancy outcomes arise.
The study population will be pregnant women attending the LGI or SJUH maternity services regardless of whether their pregnancies are considered low or high risk. If suitable for recruitment, informed consent will be acquired and samples obtained after delivery.Placenta samples will undergo novel staining and imaging (iDisco and lightsheet microscopy) to identify the aberrant placental architecture in pregnancy complications. We will aim to determine whether any of the possible changes (vasculature, villous tree and cell morphology) are linked with differences in gene expression, protein synthesis, or metabolic mediators. To correlate placental changes evident in the maternal circulation, blood and urine samples from an existing biobank will be used. Moreover will we investigate whether these changes can be reflected in altered structure or function in vitro using placenta tissue for primary cultures.
Case-control studies will then determine whether it is possible to correlate quantifiable placental disease (such as vessel number, villus architecture, gene expression, biomarker levels) by comparing complicated and healthy pregnancies (normotensive, appropriate birth centile, intact membranes, term delivery).
Together, these data will further our understanding and assessment of placental structure and function in adverse pregnancy outcomes.
REC name
London - Riverside Research Ethics Committee
REC reference
18/LO/0067
Date of REC Opinion
17 Jan 2018
REC opinion
Further Information Favourable Opinion