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Parturition

parturition

Parturition is the process of delivering a baby and is essential for procreation. We focus on important clinical problems associated with parturition such as preterm birth (being born too soon) and postpartum haemorrhage.

Our research takes place within the Division of Reproductive Health at Warwick Medical School. We have strong links with Warwick Systems Biology and University Hospitals Coventry and Warwickshire. Our research focuses on both basic and applied research.



Basic research:

This research focuses on the molecular mechanisms that govern contractility of the human uterus. This takes the form of theoretical mathematical analysis, quantitative assessment of the electrical activity of the uterus, and anatomical reconstruction of uterus.

We are part of a global effort to construct a computational model of the uterus to understand the fundamental processes that underpin its function. The aim is to apply this knowledge to new treatments that manipulate uterine function for therapeutic benefit.

Applied research:

This research focuses on applying our scientific knowledge in partnership with pharmaceutical companies to develop new treatments for preterm labour and postpartum haemorrhage.

In the past 10 years we have been involved with a number of companies on different projects developing novel therapies. Some of these projects have led to patents whilst other, more advanced projects, are currently in early phase 2a clinical trials.

What are the clinical problems and why are they important?

Preterm Birth

A baby born before 37 (and after 24) completed weeks gestation is defined as a premature baby. Premature birth is surprisingly common with approximately 8% of deliveries in the UK occurring prior to term.

There are many different causes of preterm labour such as infection within the uterus or multiple pregnancy (e.g. twins), but most occur for unknown reasons. This lack of understanding of the underlying causes of preterm birth has important consequences for the health and wealth of society.

Preterm birth is the underlying cause of 75% of all perinatal deaths. Babies that do survive suffer a high proportion of severe disability such as cerebral palsy, hearing and visual impairment, cognitive disability and poor educational outcomes. In addition to the immense emotional cost of premature birth to patients, the monetary costs to the UK are estimated to be £1 billion annually.

Postpartum Haemorrhage

Postpartum haemorrhage (PPH) is excessive bleeding from the uterus after delivery of the baby. Unlike preterm birth the incidence of PPH varies throughout the world with approximately 25% of deliveries in Africa compared to 12% in Europe. PPH is the leading cause of maternal death in childbirth accounting for approximately 30% of deaths.

There are a number of different causes of PPH but the most prevalent is a non-contractile uterus. The reasons why the uterus becomes non-responsive are not well understood.

In developed countries, PPH can be treated by invasive surgery, which, while lifesaving, can have long lasting consequences for the mother (e.g. inability to have more children). In resource poor settings, such surgery is not available.


Example papers:

  • Sheldon RE, Baghdadi M, McCloskey C, Blanks AM, Shmygol A, van den Berg HA.
    • Spatial heterogeneity enhances and modulates excitability in a mathematical model of the myometrium. J R Soc Interface. 2013 Jul 10;10(86):20130458
  • Bru-Mercier G, Gullam JE, Thornton S, Blanks AM, Shmygol A.
    • Characterization of the tissue-level Ca2+ signals in spontaneously contracting human myometrium. J Cell Mol Med. 2012 Dec;16(12):2990-3000.
  • Aslanidi O, Atia J, Benson AP, van den Berg HA, Blanks AM, Choi C, Gilbert SH, Goryanin I, Hayes-Gill BR, Holden AV, Li P, Norman JE, Shmygol A, Simpson NA, Taggart MJ, Tong WC, Zhang H.
    • Towards a computational reconstruction of the electrodynamics of premature and full term human labour. Prog Biophys Mol Biol. 2011 Oct;107(1):183-92.

Funding:

We receive funding from the following sources:
  • Medical Research Council
  • Biotechnology and Biological Sciences Research Council
  • Action Medical Research
  • GlaxoSmithKline
  • Ferring
  • Medical Research Council Technologies

Associated academic staff:

  • Jane Barlow
  • Ponnusamy Saravanan
  • Anatoly Shmygol
  • Siobhan Quenby