Specialist Registrar in Obstetrics and Gynaecology, North West London Deanery
Honorary Clinical Research Fellow, Imperial College London
I run the CONCEIVE Study, which is based at Queen Charlotte's & Chelsea Hospital, West London.
CONCEIVE is a unique longitudinal study investigating whether and how cardiovascular and metabolic changes from pre-conception and through pregnancy are associated with adverse pregnancy outcomes, specifically, the development of preeclampsia and/or small for gestational age babies.
Our aim is to investigate whether differences in maternal cardiovascular adaptation very early in pregnancy predispose to pre-eclampsia or small for gestational age babies.
We are recruiting healthy women prior to pregnancy and following them all the way through into the postnatal period with simple non-invasive cardiovascular assessment and blood and urine tests. Data obtained will be invaluable in determining the mechanisms of cardiovascular adaptation in early pregnancy, and may elucidate subtle cardiovascular parameters which associate with the development of poor pregnancy outcomes, specifically pre-eclampsia.
Pre-eclampsia is one of the leading causes of maternal and neonatal mortality and morbidity worldwide. Currently, the pathogenesis of pre-eclampsia remains elusive. The most common hypothesis is that impaired trophoblastic invasion leads to release of placental factors into maternal circulation, from which subsequently arise endothelial dysfunction. However, up to 40% of unaffected pregnancies show poor trophoblastic invasion. There is now emerging evidence that maternal cardiovascular health may be associated with the development of pre-eclampsia, and conversely, the occurence of pre-eclampsia is associated with a higher risk of cardiovascular disease in later life in affected women.
The CONCEIVE Study is funded by Action Medical Research, Tommy's Charity, National Institute for Health Research Imperial College BRC and Imperial Healthcare Charity, and receives support from Samsung UK and SPD Development Company Ltd.
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