3 Miscarriages Followed ByTwins

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3 Miscarriages Followed ByTwins
1 in 4 pregnancies in the UK end in miscarriage, premature birth or still birth.

Margate mum, Lisa Hooper, went through the agony of three late miscarriages before being referred to the Tommy's research clinic in London and subsequently gave birth to twin girls, Holly and Ella, in November 2009. Lisa and her husband Max are keen to share her story to give hope to other mums-to-be experiencing pregnancy complications.

Following three late miscarriages (after 17 weeks) and no explanation as to why they were occurring, Lisa was referred to Professor Andy Shennan, Professor of Obstetrics at the Tommy's-funded Maternal and Fetal Research Unit at St Thomas' Hospital. He recommended Lisa went into the MAVRIC trial, which trials different types of stitches.

Lisa was allocated the abdominal stitch which is the most drastic stitch offered because it goes in through the abdomen, before the patient falls pregnant. At 28 weeks Lisa took the Rapid fFNTest (the fetal fibronectin test) which is also being trialled at the clinic and is an effective way of predicting women who may be at risk of miscarrying or going into preterm labour. The non-invasive test (similar to a cervical smear) indicates to the clinician whether they are able to reassure women who have a negative test result that their baby is unlikely to be born within the next two weeks, or can provide the necessary assistance and supervision especially focused on those who need it most because they have received a positive test result and may be at highest risk. Having had the stitch inserted in November 2008, Lisa's test result came out very low risk and she gave birth to her twins the following November 09.

Over the past year Tommy's has recruited thousands of women onto pregnancy trials such as MAVRIC and the Rapid fFN Test which have helped people like Lisa Hooper. These women consequently have a statistically better chance of pregnancy outcomes, given 1 in 4 women experience complications in the UK.

Lisa says: "Taking part in this trial has changed our lives. The work that this clinic does is amazing and I'm really, really grateful for it. I feel blessed that I was able to be involved."

Tommy's Professor Andy Shennan says: "Fetal fibronectin is the most accurate test we have to predict preterm delivery, and we have found it incredibly useful in both reassuring women, and directing our efforts to those who need it. We are currently looking at the best ways to deal with this new knowledge, but I am in no doubt it benefits many of the women we see, and helps achieve a successful outcome, as with Lisa and her twins."

About Tommy's
Tommy's is a registered charity and we believe it is unacceptable that one in four women loses a baby every year. We want to give every baby the best chance of being born healthy, so we work to fund medical research into the causes of premature birth, stillbirth and miscarriage, and provide a free information service that educates all parents-to-be about health in pregnancy. Our information service is informed by our medical research and includes a telephone midwife service, a comprehensive website and free books and leaflets promoting health in pregnancy. By 2030 Tommy's wants to halve the number of babies who die during pregnancy or birth.

About the Rapid fFN™ Fetal Fibronectin Test
The Rapid fFN™ Fetal Fibronectin Test is the single, strongest independent predictor of pre-term birth risk at less than 32 weeks gestation. It is a non-invasive test approved for use in women from 22 to 35 weeks of pregnancy. The test is simple and carried out similar to a cervical smear test. It measures the amount of fetal fibronectin in a woman's vagina. Fetal fibronectin is like a "glue" that a woman's body produces during pregnancy to help secure the membranes around the fetus to the uterus. Normally, from 22 to 35 weeks gestation only a very tiny amount of this "glue" is found in the vagina. Around 35 weeks the amount starts to increase as the body is preparing to give birth. If fetal fibronectin is detected, this indicates a higher risk of imminent birth.

99.5% of women with signs and symptoms of preterm birth that have a normal (negative) fetal fibronectin result will not have their baby within the next 7 days. Moreover, in studies of women with risk factors but no symptoms and a normal test result when measured at 22-24 weeks had a less than 1% chance of delivering within the next 4 weeks. An elevated (positive) fetal fibronectin result does not always mean the baby will be born preterm. However, women who test positive are at significantly higher risk for preterm birth. Knowing a fetal fibronectin is elevated can help the pregnant woman and her doctor manage her pregnancy and keep the baby in the uterus as long as possible. The doctor has options and may prescribe treatments like bed rest, tocolytic drugs, or corticosteroids. Every extra day in the uterus helps a baby's organs develop. Further information can be found at: www.ffntest.com

About the MAVRIC trial
The MAVRIC trial is a controlled trial designed to compare the outcome of pregnancy amongst women who have cervical stitches inserted via the abdominal route versus the vaginal route. The insertion of a 'stitch' is used for women who have recurring, late miscarriages a possible cause being an 'incompetent cervix'.

March 2010

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