Fetal welfare assessment

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Ambulatory Fetal Activity Monitoring

Prof Shaun Brennecke, Prof Christine East, Prof Paul Colditz, Prof Colin Sullivan, Prof Stuart Crozier, A/Prof Stephen Wilson

It would be very helpful to be able to accurately monitor babies’ movements in the womb so that we could help the few babies who need it, and so prevent poor outcomes. Mothers feel their babies moving, but it is often difficult for them to detect all the movements that do occur. The best way of measuring babies’ movements is during an ultrasound. This is, however, expensive and means that the pregnant mother needs to lie still for about half an hour to have this testing done.

We are developing a way of recording babies’ movements, which lets the pregnant woman continue with her normal activities. We will do this using an AMBULATORY FETAL ACTIVITY MONITOR, which is an accelerometer, like an advanced pedometer. The ambulatory fetal activity monitor will measure the activity of the unborn baby during pregnancy, looking at the number of times s/he moves and how simple or complex the movements are. We expect that the unborn baby who is not getting enough nutrition during the pregnancy will have fewer movements than other unborn babies.

This project involves monitoring 750 pregnant women at three hospitals, including the Royal Women’s Hospital, with healthy and possibly unhealthy babies, to help identify the babies who need help. Once we have this information, we will be able to use it in the future to possibly prevent poor outcomes in those babies who do need help.

Fetal lactate measurement in labour

Prof Christine East, Prof Shaun Brennecke, Dr Mary-Ann Davey, Dr Omar Kamlin

There is currently an epidemic of caesarean sections performed in Australia and overseas. Although many caesarean sections are performed for concerns about fetal welfare, the majority of babies are shown to be well at birth, meaning that the operation, with its inherent short- and long-term risks, could have been avoided, without compromising the baby’s health. This project is a world-first randomised trial of fetal scalp blood sampling for lactate estimation during labour, with a view to reducing the caesarean section rate for apparently non-reassuring fetal status.

This may become a test that is easier to use and predicts outcomes as well or better than current monitoring methods.

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