RESEARCH

PROJECTS

The three major areas of research which is supported by PEARLS are set out below:

Placental function studies

This basic laboratory work has been designed to show how mothers blood vessel walls respond to the cells of the placenta. A healthy interaction equals a healthy placenta. We have now been able to show that some of the suspected 'toxins" in "Toxaemia" (the old name for preeclampsia) attack the placetal cells. This follows on from work we have done to describe the effect of blood pressure medications on the formation and function of the placenta. Some types of medications are better than others, at least in terms of how they stimulate the placental cells. A new collaboration with Kerry-Anne Rye at the HRI and Prof Ralph Nanan at Nepean has allowed us to examine why some women and some couples are more prone to preeclampsia than others. This will include looking at how high cholesterol can be detrimental to the development of a normal placenta and how some parents (interaction between mother and fathers immune systems) can promote a healthy placenta and others lead to a the type of shallow placenta we see in preeclampsia.

Outcomes for mothers and babies

Our group has been instrumental in defining improved outcomes for mothers after preeclampsia. Work done with hospitals here in NSW and overseas, has determined that there are aspects of clinical care (e.g how much fluid a mother is given in labour) that determine whether they develop heart failure or not. Heart failure is one of the very dangerous consequences of preeclampsia. Our ongoing work will examine not only the immediate impact of preeclampsia on the heart, but whether this effect is still present 20 years later. We will address the question about whether pregnancy events in and of themselves are risk factors for heart disease in the same way that we know longer term high blood pressure is a risk factor. We will also examine whether future weight, diabetes and cholesterol levels have been influenced by events in pregnancy.

Control of Blood Pressure - Developing tests for Preeclampsia

We and others have identified some blood and urine tests which can identify patients with preeclampsia. This is a very new area of research and the usefulness of these tests is currently being considered. The current rounds of tests has arisen from work we have done to show that a placenta with reduced blood flow is a toxic placenta and thus these tests are very specific to the placental insult. This is very different from prior tests which do not actually examine the mechanism of disease but are non-specific tests of mothers wellness or otherwise. We will continue to determine how these tests predict high blood pressure, whether controlling the blood pressure, controls the blood results and whether we can reverse the toxic response at the same time as reversing the high blood pressure. We have the capacity in some of our laboratory work to very directly examine blood flow to the placenta for the first time.

COLLABORATIONS

In carrying out medical research it is important to consider what other work is being done by the international scientific community. Members of the team have collaborations in place with a number of organizations internationally as follows:

    University of Western Sydney
    We are looking at the effect of preeclampsia on the circulation to the eye (As a reflection of circulation to the brain) with members of the University of Western Sydney specializing in this area.

    Harvard University
    With members of Harvard in the USA we are considering possible new treatments for preeclampsia.

    University of Florida
    We are looking at the effects of pregnancy hormones on the kidney and blood pressure with experts at the University of Florida in the USA.

    University of Melbourne
    We are working with scientists at the University of Melbourne considering the effects of Preeclampsia on the heart.

PHD Students

We are proud to have been able to support a number of PHD students involved in preeclampsia research.

CURRENT STUDENTS
    • Charlene Thornton - Outcomes for mothers and babies
    • Neroli Sunderland - Blood pressure and angiogenic controls of placental function in primate pregnancy
    • Francesca Charlton - cholesterol and the risk of placental failure in preeclampsia
    • Aiden O'Loughlin - Coronary artery motion and prediction of coronary events; Is pregnancy a risk factor?
    • Samantha Lupton - Retinal vascular changes in pregnancy and preeclampsia; the role of genetics
    • Gabrielle Bobek - Control of placental blood flow in pregnancy and correlation with placental structural changes
    • Annette Robertson - Sleep dysfunction in preeclampsia
    • Jane Tooher - Long term cardiac and metabolic consequences of preeclampsia

PAST STUDENTS
    • Stephan Orange (2005) - Immune control of blood pressure in pregnancy - now working in the pharmaceutical industry
    • Angela Makris (2006) - Predictive testing in Preeclampsia - obstetric physician and deputy Director of our Group at the Heart Research Institute
    • Charlene Thornton (Masters 2005) - Rates of Preeclampsia in Sydney