UK Directory of Research Themes

Aberdeen Maternity Hospital, University of Aberdeen

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Queen's University Belfast

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• Pre-eclampsia
• Medical Education

Birmingham Women's Hospital, University of Birmingham

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University of Bristol (St Michael's Hospital)

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• Non-invasive prenatal diagnosis
• Placental dysfunction

• Preterm labour
• Cell signalling

• Materno-fetal immunology
• Cervical cancer screening

Edinburgh

University College London, University College London Hospital

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University of Manchester/St Mary's Hospital

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• Feto/maternal health
• Pre-eclampsia
• Premature labour
• Teenage pregnancy

• Human papillomavirus/cervical screening/neoplasia
• HPV in diagnostics
• HPV vaccines
• Clinical trials

Medical School, University of Newcastle upon Tyne

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• Mechanisms of trophoblast invasion and clinical consequences of defective placentation
• Mechanisms of myometrial quiescence
• Genetic regulation of human embryonic heart development
• Screening for fetal abnormality

School of Human Development, Faculty of Medicine and Health Sciences, University of Nottingham

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Clinical Trials

A variety of major national trials in obstetrics and gynaecology are run from the City Hospital Nottingham Trials Unit. These include:

• studies of intervention in pregnancy, such as:
• Growth Restriction Intervention Trial and follow-up (GRIT)
• Amniocentesis Results Investigation of Anxiety (ARIA)
• Control of Hypertension in Pregnancy (CHIPS)
• Smoking Nicotine and Pregnancy (SNAP)

In addition, there are gynaecological trials investigating:

• Aspirin and heparin for recurrent miscarriage (SPIN)
• Laparoscopic Uterosacral Nerve Ablation (LUNA)

The techniques of internet based trial randomisation and data management and cluster randomised trials are used.

Early Human Development

The early human development group is interested in the epigenetic regulation of oogenesis and preimplantation embryo development and how embryo technologies, such as IVF and somatic cell nuclear transfer can induce epigenetic defects with long-term developmental and health consequences. Strong programmes are being developed on the influence of diet on epigenetic programming in early mammalian and human development. A number of new model systems have been developed to investigate the effects of assisted reproduction technologies and perturbations to maternal methionine/folate metabolism during oocyte and early embryo development on heritable epigenetic changes in DNA methylation leading to altered fetal development and predisposing late onset diseases such as hypertension and metabolic disease. Collaborations have been established with Dr. Kevin Sinclair (School of Biosciences, University of Nottingham) and Dr. Bill Rees (Rowett Research Institute, Aberdeen) to use rat and sheep in vivo models and we are using human embryonic stem cells as a direct test of the effects of nutrients on programming the human genome. Other projects focus on:

• culture
• derivation and characterisation of human embryonic stem cells
• epigenetic, characterisation and modification of human embryonic stem cells

haematopoietic and cardiomyocyte differentiation of stem cells and factors that influence epigenetic modification in the preimplantation embryo.

Fetal and Neonatal Biology

The Fetal Biology Group is involved in assessing under-nutrition during early gestation and the effects on organ development on early life. Novel applied research investigates basic fetal and perinatal science, encompassing molecular biology at the gene level through to organ function. Endocrine and metabolic studies of the physiology of pregnancy and parturition in sheep have been used to identify candidate mediators for fetal programming and mechanisms of adipose tissue development, neonatal adaptation and hypertension in later life. Studies of fetal cardiovascular physiology.

Fetal and Maternal Health

For many years members of the Division of Obstetrics and Gynaecology have worked in the field of maternal and fetal health, in particular hypertensive disorders of pregnancy, fetal growth and assessment of fetal health in labour.

Studies have included:

• examination of placental function
• the placental blood supply in normal and compromised pregnancies
• assessment and evaluation of fetal growth and health in utero and after birth
• the role of the renin (not rennin)-angiotensin system in normal and pathological pregnancy
• lead Centre for the Genetics of Pre-Eclampsia (GOPEC) study
• follow-up of mothers who developed hypertension in pregnancy

Medical Education

Current projects include:

• studies of the role of personality, references and personal statements in relation to performance over the 5 years of a medical degree
• investigation and assessment of the selection process for entry to medicine
• the contextual learning model

Medical Physics

Research projects include:

• studies of targeted radionuclide therapy, including use of antibodies
• development of new radiopharmaceuticals for clinical diagnosis
• assessment of tablet swallowing and gastrointestinal transit in adult and paediatric patients

There are links to the Imaging Group in establishing basic phantom studies using 3D ultrasound

Obstetric and Gynaecological Imaging

For many years this group has been the leading international group involved in magnetic resonance imaging (MRI) in obstetrics, in particular studying fetal growth and utero-placental blood flow. More recently, MRI techniques have been used in conjunction with 3D power Doppler ultrasound to investigate blood flow within the pelvis in gynaecological conditions. The combination of these techniques has been used for validation in the exploration of vascular changes in a variety of gynaecological conditions, including:

• menstrual disorders
• endometriosis
• subfertility
• gynaecological cancers

Reproductive Medicine

The Reproductive Medicine Group encompasses work in general gynaecology and in NURTURE and has links to the Imaging Group . There are major interests in:

• polycystic ovarian syndrome (PCOS), including a study of the function genomics and proteomics of PCOS
• cardiovascular risks in siblings of women with PCOS,
• changes in blood flow in the pelvis in relation to subfertility and endometriosis

Polycystic Ovary Syndrome

This group in collaboration with Dr Shahid Mian (Nottingham Trent University), Dr Robert Layfield (Biomedical sciences, University of Nottingham), Dr Paddy Tighe (Department of Immunology, University of Nottingham) and Dr Peter Marsters (School of Human Development, University of Nottingham) are currently involved in unravelling the complexity of PCOS. Projects currently undertaken include the functional genomics (microarray) and proteomics (2D and SELDI mass spectrometry) of PCOS. This work has recently been supported by a MEDICI fellowship awarded to Mr. William Atiomo to explore ways of commercializing the research output. Mr Atiomo is also involved in other work exploring the familial risks of cardiovascular disease in PCOS, the role of insulin sensitizers in fertility treatment and the role of the HELICA in fertility treatment in PCOS. Other relevant website. www.pcos.i8.com

Uterine Signalling

Based largely in Derby, this group concentrates on ion channel expression and function in human uterine physiology and pathophysiology, in particular studying myometrial and endometrial function. The emphasis is primarily on cellular mechanisms underlying implantation, pregnancy maintenance and labour. The techniques used include:

• patch-clamp electrophysiology
• isometric tension recordings of smooth muscle function.

Oxford University, The Womens Centre, John Radcliffe Hospital

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University of Southampton, School of Medicine

Research in Southampton is co-ordinated through Divisions (www.som.soton.ac.uk/research). Most studies in obstetrics and gynaecology link with the Developmental Origins of Health and Disease (DOHaD) Division (Director : Prof M Hanson). Other main collaborations have been with the Divisions of Cancer Sciences or Infection, Inflammation and Repair (IIR). There are also excellent facilities for clinical research, encompassing urogynaecology (Mr G Reinhart, Mr A Monga, Mr N Saunders), laparoscopic surgery and endometriosis (Mr A Moors), and fetomaternal medicine (Dr K Brackley, Mr M Coleman, Mr D Howe), including the Wellcome Trust Clinical Research Facility. For further details please contact Prof I. Cameron ( itc@soton.ac.uk ) or Ying Cheong (Y.Cheong@soton.ac.uk).