Research on complications of pregnancy is to New Heights, UK

Having placentas delivered from America and studying patients while climbing mountains is all part of the day job for Dr Andrew Murray, who is leading an unusual research project into pregnancy complications funded by West Sussex-based children's charity Action Medical Research.

Dr Murray, from the University of Cambridge, is working with researchers from the University of Colorado Denver, who are sending him samples of healthy placenta tissue from women who are taking part in the project after giving birth in Leadville, Colorado - a town which sits at 3,100 metres high (over a third the height of Everest).

He is comparing the tissue samples from the women from high altitudes, where oxygen levels are lower, with those of women who gave birth at sea level who either did or didn't have pregnancy complications.

He says: "There is already quite well established research in pregnancy which shows babies from high altitude mothers are more susceptible to conditions such as pre-eclampsia and fetal growth restriction.

"However, some of these mothers do successfully adapt and we want to learn not only what effect low oxygen has, but also how a normal altitude placenta might adapt to low oxygen as well."

The nature of the work meant Dr Murray had to develop an innovative new method of pre-treating placenta tissue samples so they can be frozen ready for delivery from the USA, without being damaged or altered.

He said: "This advance means that if a sample is being collected at 3am in Colorado it can be quickly and easily preserved by one of the nursing staff on site and shipped to our lab in Cambridge for analysis."

The researchers working with Dr Murray aim to increase our understanding of what causes some of the most devastating complications in pregnancy - such as miscarriage, stillbirth, pre-eclampsia and, in particular, fetal growth restriction - that are linked to problems with the placenta.

An unborn baby needs a constant supply of nutrients and oxygen and relies on the placenta to deliver everything from their mothers' blood. If the placenta isn't working properly, there can be serious consequences, including miscarriage, pre-eclampsia, stillbirth and fetal growth restriction.

Fetal growth restriction, for example, is a major problem, affecting up to eight per cent of pregnancies.1Babies can grow so dangerously slowly in the womb that they are at risk of death and disability. Estimates suggest over half of unexplained stillbirths are linked to fetal growth restriction.2

Even those babies who are born alive can be so small that they are still at risk of dying. Some develop lifelong disabilities, such as cerebral palsy and learning difficulties. They also have an increased chance of developing heart disease, strokes and diabetes during adulthood.

Around 60,000 babies suffer from fetal growth restriction each year in the UK.3 Around 1,000 die as a result of their condition.3 Currently, there is no way to boost the babies' growth while they are still in the womb, meaning parents can face a stark choice between risking continuing with the pregnancy and having the baby delivered prematurely.

Dr Murray says: "My background is studying the heart and muscles at high altitude. Some people can climb mountains easily without an oxygen mask. Others suffer major altitude sickness and just can't do it and feel exhausted at altitude.

"I have conducted studies at the base camp of Everest to see how mitochondria, tiny structures which produce energy for the cell, adapt at altitude in the people who do climb successfully. It is thought the mechanisms that can alter mitochondria function in some people on Everest may be similar to what can happen in the placenta.

"Lack of oxygen or hypoxia is a feature for many serious conditions - critical illness, heart failure, anaemia, lung failure and cystic fibrosis are all associated with having low oxygen levels. It is a well documented issue in the heart and muscles but not in the placenta.

"At the moment, the theory is that it's a problem with the cells in the placenta itself so perhaps we could use therapies to target these cells. This is a very under-studied area of research."

Dr Alexandra Dedman, Senior Research Evaluation Manager, said: "The researchers hope their work will eventually lead to new ways to screen for fetal growth restriction and prevent the lasting harm it can cause to babies. They plan to work towards new blood tests, which could allow doctors to identify babies who are struggling in the womb earlier.

They also believe their findings could guide the development of the first-ever treatments for the condition. An effective treatment could save babies' lives and spare them from long-term disabilities."

References

1. Resnik R. Intrauterine Growth Restriction. Obstetrics and Gynecology 2002; 99:490-496.

2. Froen JF, Gardosi JO, Thurmann A, Francis A, Stray-Pedersen B. Restricted fetal growth in sudden intrauterine unexplained death. Acta Obstet Gynecol Scand. 2004; 83(9):801-7.

3. McKenna D, Dornan J. Who's looking for the high-risk fetus in the low-risk mother? The Obstetrician and Gynaecologist 2005;7:50-51.

Source:
Action Medical Research

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NYC OKs Bill use pregnancy Center disclosure

Advice centres, including PCs, anti-abortion groups trying to dissuade, women from termination of pregnancy, pregnancy is forced to tell whether they offer abortions, emergency prevention and prenatal care under a bill passed Wednesday by the City Council and Mayor approved.

The Bill would force centers for disclosure in their advertisements and on signs in their inputs and waiting rooms. In addition to the centres inform orally when asked about these services by phone or personally.

Mayor Michael Bloomberg is expected to be the Bill into law, his spokeswoman said to sign Evelyn Erskine.

A similar regulation in Baltimore a federal judge was told by unconstitutional in January, although this city plans to appeal. And Austin, Texas, has adopted a similar measure.

The New York City measure for any pregnancy Center, which looks like a medical facility or offers ultrasonic, Sonograms or apply a prenatal care would - supervised but where services are not directly by licensed medical provider.

Abortion rights advocates say that the centers try women cheat by opening offer in nearby offices, the abortions and implies that she references given at the end of pregnancy women will give. Although Center dress staff in medical uniforms take clients for testing room and carry out and evaluate ultrasound, it often not licensed medical provider, advocates say.

"There are people out there presented himself as doctor's offices, deceive women, that misinformation," City Council said Speaker Christine Quinn, which the Bill a measure to protect of the consumer called.

A court challenge the legislation, which also guarantees that women who visit the centers their information be kept private, should spark by opponents.

"This legislation will prevent that pro-life advocates speaking freely, only because their speech some powerful interest groups is unwelcome, to promote abortion," said New York Archbishop Timothy Dolan and Brooklyn Bishop Nicholas DiMarzio, in a statement. "Finally, this legislation will avoid some women valuable services and information before it, whether or not an abortion make their decision."

The President of EMC frontline pregnancy centers, Chris Slattery, said that the Bill contains "a grotesque violation of our first amendment rights."

"We are women from this industry abortion to protect," he said.

Slattery said that his group has monitored 12 centers in New York of the some of the doctors are, and that women, who are looking for help there are not deceiving.

The Group Gets New York that "abortion capital of America." In 2009, ended up 41 per cent of pregnancies in the city (excluding miscarriages) abortion, says the City Department of health. At the national level, issues ended with 22 percent of abortion, according to the Guttmacher Institute, the resources related to sexual and reproductive health produced.

Quinn argues the New York City measure will withstand any challenge Court and differs significantly from the Baltimore regulation. In New York, the rules apply to centers regardless of whether they offer abortions or she said clients on doctors who perform abortions.

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Why $ 10 drugs pregnancy can cost gold

The cost of drugs, to prevent premature birth in high dams will increase from around $ 10 per dose to gold, since the FDA approved the branded version of the treatment.? New medicines is a form of progesterone, which have already been defined for decades and now is made for this purpose by the specific demand known as pharmacies capitalisation.

Now pharmaceutical company, KV new drug named Makena, has warned the capitalisation pharmacies have to bear the FDA action if they still sell nonbranded version drugs, technically known as 17-hydroxyprogesterone caproate. KV for the new drug can cost price means the mother to 30,000 on pregnancy — but some doctors and pharmacists say may be a way to avoid an increase in the prices of mass. (More on time.com: prolonged pregnancy: a new drug to help prevent premature birth)

However, for the first time, why the drug, which has been used for decades suddenly became so expensive? Premature birth affects 1 in 8 pregnancies — some 543,000 deaths annually — resulting in: semi-intensive care and often throughout the life of the disabled child. Is responsible for 26 billion USD per year in medical costs — figure KV refers to justify new prices of Makena.

To help offset the costs of injection weekly, KV only announced the program of the patient assistance for families in financial need. "We established that a comprehensive programme of patient aid as part of our commitment to ensure access to approved FDA Makena all eligible women," KV by CEO Greg Divis said in a statement.

March of Dimes — hundreds of thousands of dollars in donations from KV subsidiary-RX, which will market Makena, which received — supports the introduction of a new drug. "Approved by the FDA the product is good," says Dr. Alan Fleischman, Medical Director of March for Dimes. "Drugs are expensive, but it is very important drugs to very important. The company promised that each woman is eligible whose Doctor recommend it [will be able to obtain it], and the ability to payment shall not preclude the possibility of that. "(More on time.com: expected? The text of the "BABY" for tips for a healthy pregnancy)

However, many other doctors expressed outrage route prices. "This is ridiculous. This medicine has been used for 40 or 50 years, "says Dr. Sam Kim, Director of the Division of reproductive endocrinology and fertility in a hospital at the University of Kansas.

"It's going to be prohibitively expensive for a lot of patients," says Dr. Robin Kalish, Director of maternal fetal medicine clinical at New York Presbyterian/Weill Cornell Hospital in Manhattan.? Adds much research on drugs — including a major study of 2003 showing that drug cuts premature birth by one-third of pregnancies in women carrying one, who previously had premature babies — were financed by the Government.

Because low-income women are at high risk for premature birth, the burden of costs for Makena is falls to Medicaid, which already face massive budget cuts in many countries. Matt Salo, Executive Director of the National Association of Directors of Medicaid told the AP: "there is no question they are inadmissible."

Corresponds to the March of Dimes Fleischman: "programs, Medicaid and insurance companies may only began their discussions with the company". (More on time.com: save lives of mothers with Magic marker)

Already many of the patients and doctors may be wondering whether you can use other types of progesterone to reduce the risk of premature birth, without paying for Makena. In fact, several types are already on the market. Almost all women who have been through in vitro fertilization (IVF) have some form of hormone, or as a Suppository vaginal or intramuscular injections, which are one of the most difficult part of the procedure. These drugs will continue to be available at their current prices, but must be used on a daily basis, rather than once a week as Makena.

"It is possible to use a daily gels, creams, suppositories [or injections]," says John Preckshot, Director of marketing, Professional Compounding centers of America, the leading trade organization representing the specialty pharmacies.? Many of these demand makes version weekly hydroxyprogesterone to prevent premature birth.

A study of Brazilian small stated that daily progesterone vaginal work to reduce the risk of premature birth, notes Kalish, but this was only one small study. (More on time.com: stress does not Hurt the chances of success with IVF)

Preckshot adds that capitalisation pharmacies may still have the option of a different version of hydroxyprogesterone, which would not patent on Makena. "There is the possibility of applying different vehicles, other than used in Makena," says Preckshot, who is also the capitalisation of the pharmacist himself.

"Capitalisation pharmacies have already been at for the patient," says Dr. Kim. "The Problem is, depending on the Pharmacy and depending on who makes it, it changes the — there is always the same level of [hormone in product]. That is the reason, the company took over, but I don't have any problems if the capitalisation of pharmacies, you can continue to do so. "

Still, issues of responsibility may prevent doctors from using the other option, now that the product is branded Federally approved. In addition, have not been tested alternatives. "In theory, you can use any of progesterone. The Problem is, there are no studies [most of these alternatives]. And it is impractical to daily intramuscular fat shots for so many months, "says Dr. Zev Rosenwaks, Director of the Centre Cohen/Perelman Reproductive Medicine at New York Presbyterian/Weill Cornell.

Now it seems with the interests of the KV, insurance companies, the capitalisation of pharmacies, government policies and doctors will determine the impact of Makena prematurity rate and high-risk women access to the substance, which can mean the difference between a normal life and one severe disability of thousands of children.

Links:

Kid Crazy: Why we are rozmazanego the joys of parenthood

HCG diet Myth: why would hormone pregnancy Make You Skinny?

Uterus may be more important than the quality of the eggs for healthy infants

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