Action on Pre-eclampsia Research Collaborations

“As researchers we are committed to bringing about better health and healthcare. To do that effectively, and equitably, it is vital that we are able to include the voices of the people who have real-world experiences. APEC is world class in supporting engagement and involvement in pre-eclampsia research.”

Dr Lisa Hinton, THIS Institute

PARROT-2 Follow on study assesses impact of PlGF tests

Researchers at Kings College London are in the process of conducting a follow on study to PARROT, PARROT-2. PlGF-based testing has been demonstrated to be useful in ruling out a diagnosis of pre-eclampsia.

Chief Investigators: Prof Lucy Chappell and Dr Kate Duhig

The Cradle Trial

The goal of the Cradle Trial is to improve global women’s health through innovative research.

Project aims:
Create a device capable of accurately detecting abnormalities in women’s vital signs during pregnancy.
Develop this device so that it is specifically suitable for use in under- resourced environments, based on all team members` practical professional experience in such locations.
Assess the introduction of this device into routine care of women in communities and hospitals in low and middle-income countries and by mobile health carers, e.g. midwives.
Determine whether introduction of the device improves the healthcare that women receive and therefore reduces rates of maternal death and severe illness.
Evaluate the role of the CRADLE device in other patient populations within low income settings, e.g. refugee settlements, developing / training their own basic treatment facilities.

Chief Investigator: Prof Andy Shennan OBE

The WILL Trial

The WILL trial aims to investigate the clinical effectiveness and cost-consequences of planned early term delivery at 38+0 to 38+3 weeks’ gestation, compared with expectant care at term until at least 40+0 weeks’ gestation, in pregnant women with chronic or gestational hypertension that develops by 37+6 weeks’ gestation.

Chief Investigator: Prof Laura Magee, Kings College London

The HAPPEE Project

Humanities and Arts in Preventing Pre-eclampsia complications through community Engagement and Education.

The HAPPEE Partnership Project is an interdisciplinary collaboration aiming to improve education around pre-eclampsia and hypertension in pregnancy. The project is divided into three main phases.

Phase 1 involved qualitative work in Zimbabwe and Haiti to understand the knowledge, experience and help-seeking patterns of women and the wider community in relation to maternal care and particularly hypertension in pregnancy.The aim was not only to scope levels of knowledge with respect to symptoms and danger signs in pregnancy but also to explore potential socio-cultural barriers to women accessing care.

Phase 2 of the project involved the development of culturally sensitive and context specific materials to address educational barriers.

Chief Investigator: Prof Andrew Shennan

PICk-UP

An investigation into whether administration of enalapril given postnatally Improves Cardiovascular fUnction following preterm Pre-eclampsia’ (PICk-UP)

Hypertensive disease in pregnancy is associated with future cardiovascular disease and, therefore, provides an opportunity to identify women who could benefit from targeted interventions aimed at reducing cardiovascular morbidity. This study focused on the highest-risk group, women with preterm pre-eclampsia, who have an 8-fold risk of death from future cardiovascular disease.

Chief Investigator: Prof Jenny Myers, St Mary’s Hospital, Manchester

World Pre-Eclampsia Day 2020

Giant PANDA

The aim of this study is to find out which blood pressure medication is best for pregnant women with high blood pressure. Why is this important? Around 10% of pregnant women in the UK are diagnosed with high blood pressure before or during pregnancy. Without treatment, high blood pressure can cause damage to the heart and kidneys, and rarely, complications such as a stroke.

Chief Investigator: Prof Lucy Chappell, Kings College London

iPlacenta

The overall objective is to develop state-of-the-art models to mimic the placenta in vitro.

The placenta rapidly develops structurally and functionally throughout gestation and is a unique organ, having blood supply from two organisms. The placenta is made up of maternal and fetal vessels, with numerous highly branched villi lined with trophoblasts (syncytio) facilitating gaseous, nutrient and waste exchange. ​

Organ-on-a-chip technology offers functionality not possible with conventional 2D or 3D culture; it is a rapidly advancing technology with the ability to better replicate physiological complexity.

Chief Investigators: Kevin O’Reilly, Aston Medical School and Colin Murdoch, University of Dundee

James Lind Alliance

Aim: To identify research priorities for hypertensive disorders of pregnancy from both individuals with lived experience and healthcare professionals.

The James Lind Alliance (JLA) is a non-profit making initiative established in 2004. It brings patients, carers and clinicians together in Priority Setting Partnerships (PSPs) to identify and prioritise the Top 10 unanswered questions or evidence uncertainties that they agree are the most important.

Chief Investigator for hypertensive disorders of pregnancy: Dr Louise Webster

The BuMP Trials – Blood Pressure Monitoring in Pregnancy

Aim – to ascertain whether monitoring blood pressure at home during pregnancy can help the early detection of hypertension and pre-eclampsia.

Around one in ten women will have high blood pressure in pregnancy. For some women this may be a sign of pre-eclampsia, which is usually detected in routine appointments through blood pressure and urine checks. Does home blood pressure monitoring help early identification of hypertension and pre-eclampsia?

Chief Investigator: Prof Richard McManus and Dr Katherine Tucker, Oxford University

Co- Investigator- APEC

Bereavement Support following pre-eclampsia

Aim: To ascertain the specific support needs of parents following the death of a baby due to pre-eclampisa.

Through questionnaire analysis identify how to best support parents bereaved due to pre-eclampsia and asociated conditions and explore how this support can be implemented.

Chief Investigators: Prof Alex Heazell, University of Manchester, with APEC

SNAP HT2 BHF

Hypertension affects 1 in 10 pregnancies, often persisting postpartum, when antihypertensive requirements may vary substantially. This unmasked, randomized controlled trial evaluated the feasibility and effects on blood pressure (BP) of self-management of postpartum hypertension. Women with gestational hypertension or pre-eclampsia, requiring postnatal antihypertensive treatment, were randomized to self-management or usual care. Self-management entailed daily home BP monitoring and automated medication reduction via telemonitoring. Women attended 5 follow-up visits during 6 months.

Chief Investigator: Prof Richard McManus, University of Oxford

PARROT

Aim – Evaluate the effectiveness of placental growth factor testing to assess women with suspected pre-eclampsia through a multicentre, pragmatic, stepped-wedge cluster-randomised controlled trial.

Chief Investigator: Prof Lucy Chappell and Dr Kate Duhig, Kings College London

Co- Investigator- APEC

Low-Dose Aspirin For High-Risk Pregnancy

The CaPE Trial

Aim: to investigate the clinical and cost-effectiveness of calcium supplementation plus usual care compared with usual care alone in women at high risk of pre-eclampsia. Background: epidemiological studies and RCTs suggest calcium may reduce risk of pre-eclampsia. However, most studies have been conducted in populations with low dietary calcium intake, so findings have not been viewed as applicable to a population with adequate calcium intake, such as in the UK. Moreover, little research has focused on impact of calcium on women at high risk of pre-eclampsia.

Chief Investigator: Dr Shireen Meher, Birmingham Women’s and Children’s NHS Foundation Trust

PHOENIX trial

The PHOENIX trial is a non-masked, randomised controlled trial, comparing planned early delivery with usual care in women with pre-eclampsia between 34+0 and 36+6 weeks’ gestation.

Based at KCL, Chief Investigator is Professor Lucy Chappell.

The Coronet Study

The study aims: Co-produce guidance for remote antenatal care, working with key stakeholders, including pregnant women and their families. Understand stakeholders’ views on what works well and why in remote antenatal care. Develop guidance to help healthcare staff put this into practice. Capture good practice for remote antenatal care that can be used in the future.

Based at THIS Institute, Chief Investigator: Dr Lisa Hinton

Action on Pre-Eclampsia Facebook Research Group.

Patient and public involvement (PPI) groups give lay members and patients the opportunity to become involved in all aspects of medical research. Social media is a well established forum for education and support about medical conditions. Facebook has 1.23 billion active users worldwide with 24 million people in the UK logging in every day. Dr KIm Turner has created the APEC Facebook Research group.

PLGF based tests in suspected pre-eclampsia

PlGF – What we know

Placental growth factor (PlGF) is a protein involved in placental angiogenesis (the development of new blood vessels). In pre-eclampsia, levels of PlGF can be abnormally low.

Walker Redman Award

A scholarship programme with the aim of adding some financial support to a student’s research projects, not that it should fund every part of their plans. The awarding committee will be looking at the realistic nature of the proposals, the deliverability, what support they have and the possibility of putting something new and original into the jigsaw of how we solve pre-eclampsia.