Victorian medical researchers have developed a blood test that could reduce the risk of stillbirth.
Seven babies are stillborn daily Australia, affecting one in every 135 pregnancies. Globally, three million babies die annually at birth.
The breakthrough follows three years of research by Dr Clare Whitehead, published in BMC Medicine last week.
The new test measures fragments called RNA, which leak out of the placenta during pregnancy. Professor Stephen Tong from the University of Melbourne’s Translational Obstetrics Group hypothesised that RNA in a mother’s bloodstream was correlated to oxygen levels in an unborn baby.
Clinicians at Monash Health spent three years studying the hypothesis, eventually demonstrating that a large amount of RNA fragments appeared in mother’s blood in cases where oxygen levels were critically low.
The RNA can be collected from a simple blood test, and precisely measured, allowing caregivers to deliver at-risk babies before stillbirth strikes.
“RNA really tells you what the placenta’s thinking and whether it’s under any stress at the time,” Professor Tong said.
Dr Whitehead said the breakthrough of the new test is precision.
“Currently, doctors rely on repeated ultrasounds to monitor foetal wellbeing. However, these tests… are far from perfect, and only give very blunt estimations of foetal oxygen levels,” she said.
Prof. Tong explained that clinicians currently use ultrasound to check for hypoxia (low oxygen levels) by looking for known behaviours a baby might adopt in a mother’s womb.
It’s a balancing act, especially for babies with “growth restriction” because “if we deliver too late, stillbirth might happen, but delivery too early means a risk of prematurity,” he said.
The aim is to “leave baby safely to gain more time in mum’s tummy.”
Prof. Tong said the test would be critical in the birth suite because “we know each contraction makes a baby increasingly hypoxic” and that RNA rises dramatically in the mother’s blood during labour. This is the critical danger period for stillbirth.
By measuring RNA clinicians will be able to tell precisely whether a baby needs an emergency birth.
In the next stage of the study, the group has received a $400,000 grant to conduct a validation study involving 180 expectant others in seven teaching hospitals across Australia and New Zealand.
The study is targeting babies under 33 weeks suffering growth restriction from chronic hypoxia.
“We think this is where this sort of test may have its most importance,” Prof. Tong said.
The group hopes to have the study complete by the end of 2014 and produce and easy-to-use clinical chart to estimate oxygen levels in a baby from the blood tests.
If successful, the test will have major commercial appeal.
Prof. Tong believes it will take three-to-five years to become a regular part of clinical practice.
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