Live research projects

Twin pregnancies which share a placenta, termed monochorionic, are at an increased risk of fetal complications, such as selective intrauterine growth restriction (where one twin grows more than the other) and twin-twin transfusion syndrome (where blood passes unequally between twins that share a placenta).  

The placenta is connected to the developing babies by tubelike structures called umbilical cords, which provide oxygen and nutrients. Each baby shares a portion of the placenta, allowing each baby to grow. Whilst the function of the placenta is intended to be the same for each pregnancy, each placenta develops slightly differently.   

This study will look to answer an important question – whether differences in the placental anatomy, such as the umbilical cord location, play a role in how twin pregnancies develop. Understanding if certain placental features cause some pregnancies to be uncomplicated and others to develop complications, will help improve the way we care for women with twin pregnancies within the future.  

This could be by enhancing patient counselling for those who suffered complications during pregnancy; potentially providing clarity as to why certain pregnancy outcomes occurred. Additionally, if study results demonstrate significant associations then this could impact how we conduct future monochorionic antenatal surveillance, such as incorporating additional prenatal imaging.   

Diabetes before pregnancy and gestational diabetes mellitus (GDM) during pregnancy are significant risk factors for poor pregnancy outcomes for mother and baby. Risks can be reduced by optimising diabetes care before, during and after pregnancy.   

In Birmingham, Type 2 Diabetes and GDM are on the rise. However, only 11% of pregnant women with Type 2 diabetes have adequate preparation before pregnancy. Post-delivery monitoring of women with GDM is also inadequate; especially in women from global majority ethnicities and deprived communities in Birmingham.  

Patient focus groups have shared feedback on issues over access, awareness and fragmentation of care.  

This study aims to improve maternal diabetes care in Birmingham by developing a simulation model of the care pathway. Using this model, the team will perform scenario analysis to evaluate the impact of introducing different changes in the pathway and choose the best-fit model. Modelling and developing a locally relevant diabetes care pathway for Birmingham women will help reduce unwarranted variation in care, improve access, experience and outcomes in maternal diabetes care.