PhD Projects on offer
Prediction of adverse pregnancy outcome using routine serial ultrasonic fetal biometry and utero-placental Doppler
Supervisor: Gordon CS Smith (Department of Obstetrics & Gynaecology).
A significant proportion of adverse pregnancy outcome is determined by abnormal placentation. The placenta can be assessed directly through physical measurements and Doppler flow velocimetry of the utero-placental circulation. Its function can also be assessed indirectly through serial measurements of fetal structures (head, abdomen and femur). However, there is a lack of well designed studies of the ability of direct and indirect assessment of placentation as a method of screening for women at high risk of adverse pregnancy outcome. We are conducting a prospective cohort study of unselected nulliparous women. We are performing utero-placental Doppler and serial biometry, but care of the women is blinded to the results of these scans. Analysis of this cohort will allow accurate and effective quantification of the ability of ultrasound to predict adverse pregnancy outcome. We have recruited >4000 women by the end of 2010 and have a target of 4500 (recruitment continues until July 2012 with completion of the outcome data by Spring 2013). The project will involve statistical analysis of the data from this cohort study using a variety of multivariable regression methods.
Key references.
1. Smith GCS. First trimester determination of complications of late pregnancy. JAMA 2010;303:561-562.
2. Smith GCS, Fretts R. Seminar: Stillbirth. Lancet 2007;370: 1715-25.
3. Smith GCS, Crossley JA, Aitken DA, Pell JP, Cameron AD, Connor JM, Dobbie R. First trimester placentation and the risk of antepartum stillbirth. JAMA 2004; 292:2249-2254.
4. Smith GCS, Wood AM, Pell JP, White IR, Crossley JA, Dobbie, R. Second trimester maternal serum levels of alpha-fetoprotein and the subsequent risk of sudden infant death syndrome. N Eng J Med 2004;351:978-86.
5. Smith GCS, Stenhouse EJ, Crossley JA, Aitken DA, Cameron AD, Connor JM. Early pregnancy origins of low birth weight. Nature 2002;417:916.
6. Smith GCS, Smith MFS, McNay MB, Fleming JEE. First trimester growth and the risk of low birth weight. N Eng J Med 1998:339:1817-1822.
