Current Research
My main research interests are: the pathophysiology of the hypertensive diseases of pregnancy; the renin-angiotensin system in pregnancy; the use of transabdominal fetal heart rate monitoring in the last three months of pregnancy, and the effect of smoking on it.
The hypertensive diseases of pregnancy: I have been working in this area since coming to Nottingham, and have just been presented with the Chesley Award of the International Society for the Study of Hypertension in Pregnancy (ISSHP), at the 2012 international meeting of the Society in Geneva. ("The Chesley Award is given to a member of the Society in recognition of her/his sustained and substantial contribution to research in preeclampsia, not only for her/his work but also for encouraging the work of others.")
Hypertension in pregnancy can be gestational hypertension, pre-eclampsia (PE) or essential hypertension +/- superimposed PE. Pre-eclampsia is associated with maternal multi-organ dysfunction, affects 2-7% of all pregnancies and is one of the leading causes of maternal and perinatal morbidity and mortality, both in the UK and world-wide. As well as investigating the underlying causes of PE, from a basic and applied science perspective, my group have also been, for some years, following-up women and their babies who have been exposed to the disease. It is increasingly recognized that women who suffered from gestational hypertension or PE are at considerably greater risk of the early development of cardiovascular, renal, metabolic, cerebrovascular and ischaemic heart disease in later life. We are acknowledged to have one of the most comprehensive early follow-up datasets of women who had hypertension in pregnancy, and a uniquely-detailed 2-year follow-up of the babies of such women. I was the Chief Investigator of the BHF-funded Genetics of Pre-Eclampsia (GOPEC) study, and am also a member of the InterPregGen consortium (EU funding of €5.96 million), which is managed from Nottingham (Dr Linda Morgan).
The group: (Nottingham) Professor Fiona Broughton Pipkin, Dr Pamela Loughna, Dr Amanda Green, Dr Anna Roberts (from October 2012), Dr Lesia Kurlak, Dr Alastair Ferraro (Collaborators) Dr Hiten Mistry, Dr Kate Bramham (KCL), Dr Jason Waugh (Newcastle), Professor Markus Mohaupt (Berne, Switzerland)
The renin-angiotensin system (RAS) in pregnancy: We are studying the potential rôle of the RAS in very early placentation, together with assessment of its systemic impact. It is now known that the redox balance markedly influences the capacity of renin to generate angiotensin I from angiotensinogen, and angiotensin II (AngII) exerts much of its vasoconstrictor effect by the generation of reactive oxygen species. Placentation occurs at very low oxygen tensions, and we have increasing evidence of potential involvement of the RAS and possible pathways involved. We have also applied for grant funding to study the renal RAS in pregnancy (Australian collaboration; see below); this links in with our work on hypertension in pregnancy. Our interest in antioxidant capacity in pregnancy links to the rôle of selenium deficiency, and a developing collaboration with the University of East Anglia in relation to selenium soil enrichment in Malawi.
The group: (Nottingham) Professor Fiona Broughton Pipkin, Dr Lesia Kurlak, Professor Dave Barrett. (Collaborators) Dr Hiten Mistry, Dr Kate Bramham (KCL), Professor Robin Carrell's group, CIMR, Cambridge; Professor Graham Burton's group (Centre for Trophoblast Research, Cambridge), Professor Eugenie Lumber's group (University of Newcastle, New South Wales, Australia), Dr Helena Strevens (University of Lund, Sweden).
Transabdominal fetal heart rate (FHR) monitoring: Using the AN24 transabdominal FHR monitor, we are able to study factors affecting the FHR and its variability while the mother is at home under normal conditions. To do this, we work directly with Professor Barrie Hayes-Gill, Professor of Electronic Systems and Medical Devices, founder of Monica plc, a University of Nottingham spin-out company. We have been able to show deleterious, dose-dependent effects of smoking on FHR variability very clearly, and are now following this up. We hope to be able to study the fetal e.c.g. transabdominally as well, but this is technically a considerable challenge.
The group: Professor Fiona Broughton Pipkin, Dr Pamela Loughna, Professor Barrie Hayes-Gill, Dr Habiba Kapaya.
(Updated: July 2012)