Background
Suboptimal adaptation of the maternal vascular system to the invading trophoblast in early pregnancy results in suboptimal placental function and can result in pre-eclampsia (PE) and intrauterine growth restriction (IUGR). Despite recommendations from international bodies for universal assessment for PE risk in the first trimester, there are no recommendations for
screening in Ireland. Internationally, there is no agreed optimal screening protocol. Screening usually consists of some or all of the following components:
1) Assessment of maternal clinical risk factors, blood pressure (BP) and body mass index (BMI)
2) Ultrasound assessment
3) Assessment of angiogenic markers in maternal blood
The role of maternal physiological assessment in the first trimester, beyond BP assessment, for the prediction of later placental dysfunction has not been well explored.
Aims
This project aims to investigate maternal physiological parameters in submaximal exercise testing in the first trimester of pregnancy and correlate these with PE risk assessed through
a combination of maternal clinical risk factors, ultrasound assessment and measurement of serum angiogenic markers, and assess women’s experiences of exercise testing in pregnancy.
Hypothesis
(1) Maternal physiological function correlates with maternal PE risk. (2) Maternal physiological parameters measured in the first trimester of pregnancy can be used for PE
risk assessment and can be used to develop novel algorithms for PE screening. (3) Exercise testing in the first trimester is acceptable to pregnant women.
Objectives
I will develop research skills alongside the experience of exposure to a clinical research environment and important concepts around human physiology and health. I will describe
the correlation between novel maternal first-trimester physiology parameters and pre-eclampsia risk, the first report of its kind in Ireland. Outcomes from the project will inform
future research, practice and information dissemination to clinicians and patients around potential approaches to PE screening in Ireland.
