Professor Dan Rurak – Biological Reasons for Stillbirths

Late last year (August 2012), the Ritchie Centre was delighted to have Professor Dan Rurak, all the way from the University of British Columbia in Vancouver, present some very interesting work about possible biological mechanisms for stillbirths, particularly those that occur late in gestation.

Professor Rurak presented data on the oxygen supply and demand of the fetus in the womb. His findings highlighted that the oxygen delivery to the fetus decreases with advancing gestational age due a reduction in its supply. For example, there is a decrease in blood flow/kg of fetal weight from 35 weeks of gestation until term and the increase in uterine blood flow does not keep up with the rapid increases in fetal growth rate. What needs to happen, therefore, is that the fetus must somehow decrease its fetal oxygenation consumption to balance out the reduction in supply. During a normal pregnancy this is achieved by the fetus reducing body movements, such as fetal breathing movements, and the rate of growth of the femur declines with increasing gestation.

The implication of these findings may influence conditions such as pre-emclampsia (hypertension during pregnancy) or post-term pregnancy (where the baby has not been born after 42 weeks which is the normal duration of pregnancy). In these conditions, where there is either a compromise in oxygen or a compromise in the demands of the fetus, there may be a mismatch in the supply and demand of the oxygen and these may play a role in the occurrence of stillbirths.
The Ritchie Centre has certainly been very impressed by Professor Rurak’s work that has been a fascinating look into the highly complicated and regulated process of pregnancy.

The Ritchie Centre Seminar Series: Ethics and Moral Distress in the PICU - Dr Sarah te Pas

The Ritchie Centre Seminar Committee was pleased to host Dr Sarah te Pas, a paediatric intensivist from the Sophia Children’s hospital at Erasmus Medical Centre, Rotterdam, in the Netherlands, speaking about ethics and moral distress in the Paediatric Intensive Care Unit (PICU).  By her own admission, Sarah is not an ethicist but has an interest in the ethics of care related to her work and has completed a master’s degree in the “Ethics of Care”.  Sarah provided the audience with some theoretical background on ethics, ethics in science and ethics in medical care referring to the four cardinal virtues of ethics included prudence, justice, temperance and courage and the pillars of the Hippocratic Oath including autonomy, beneficence, non-maleficence and justice.  When the concept of justice is involved in the ethics of care it becomes complicated as equal distribution of health care services and the costs involved become issues. 

Sarah also discussed moral distress, which occurs when a person knows what the right thing to do is but is unable to do it due to some constraint.  This is in contrast to ethical dilemma’s, where a person is grappling with what is right and what is wrong.  The most common cause of moral distress in the PICU is when parents and doctors disagree on treatment.  For example, the treating physicians may believe that treatment will result in an unacceptable residual morbidity and impairment of quality of life and therefore that treatment should be withdrawn and the patient palliated.  However, as it is the decision of the parents, if the parents want treatment to be continued regardless of the potential long-term outcomes, then it must be continued.

Sarah presented a case to the audience of a 12 week old, term born infant who was diagnosed with a rare genetic condition which resulted in ventilator dependent hypoventilation with a high likelihood that the infant would remain ventilator dependent for the rest of her life.  In addition, the condition was associated with a range of other problems including cardiac arrhythmias, gastrointestinal problems, urogenital problems etcetera.  However, as the condition was so rare, little is known about the likely prognosis making it difficult to properly inform the parents of her likely long-term outcome.  Through discussion with the audience Sarah described the Utretcht model of decision making which involves exploring, defining, analysing and weighing up options before a moral decision can be made. 

We thank Sarah for a very interesting discussion. 

Advancing Women's Research Success Grant awarded to Centre scientist

We are thrilled to announce that Ritchie Centre scientist Dr Hayley Dickinson has been awarded one of the University's prestigious 2013 Advancing Women's Research Success grants.

This is a great achievement and well deserved. Hayley leads dynamic and innovative programs of research in making birth safer and in understanding the roles of the placenta in fetal growth.

Science is a hard career for anyone. It can be especially hard for women with young children.

This award recognises the importance of women in science and the need to continue to advance women in science.

At The Ritchie Centre we are enormously proud of all of our scientists but, perhaps, just a wee bit extra proud of our women who are caring for young families while still pushing back the frontiers.

Well done Hayley. We are very proud.

Euan Wallace
Director

Ritchie centre students at it again - Cerebral Palsy Alliance Best Abstract Awards

Two Ritchie Centre PhD students - Samantha Barton and James Aridas were awarded the Cerebral Palsy Alliance Best Abstract Awards at the Perinatal Society of Australia and New Zealand (PSANZ) conference dinner tonight. Pictured below with Professor Nadia Badawi (middle right) and Associate Professor Iona Novak (left) from the Cerebral Palsy Alliance.
Congratulations to Samantha and James.

Dr Nadine Brew awarded the David Henderson-Smart scholarship at PSANZ

In honour of the late David Henderson-Smart, a pioneer in perinatology, PSANZ president, Vicki Flenady today awarded the David Henderson-Smart scholarship to Dr Nadine Brew from the Ritchie Centre. This scholarship is focused on assisting early career researchers develop a research career in perinatal medicine - http://www.psanz.com.au/scholarships-awards/dhs
Nadine will present her research project entitled "Use of activated protein C to reduce brain injury in hypoxic-ischaemic encephalopathy" tomorrow afternoon.
Congratulations to Nadine on the award of this prestigious scholarship.

More Ritchie Centre Student Success - PSANZ 2013

5 Ritchie Centre students/post-docs have been awarded PSANZ Early career researcher travel awards:

James Aridas - PhD candidate

Samantha Barton - PhD candidate

Miranda Davies - Post-doc

Melinda Dolan - PhD candidate

Jacqueline Melville - PhD candidate

Congratulations to these students/post-doc on their success.

Watch this space for more updates from PSANZ 2013 in Adelaide

Ritchie Centre student success at Fetal and Neonatal Workshop in Barossa Valley

Students of the Ritchie Centre have shown their brilliance at the recent Fetal and Neonatal Workshop of Australia and New Zealand, winning 4 of the 8 prizes awarded at the meeting.

Stacey Ellery took out the best student presentation prize with her talk "Maternal Creatine Supplementation Protects the Neonatal Spiny Mouse Following Birth Asphyxia, but what are the Effects on the Mother?"

Domenic LaRosa took out the runner up best student presentation prize with his talk "Maternal dietary creatine supplementation prevents changes in diaphragm muscle function 1 month after asphyxia at birth?"

Melinda Dolan was the runner up for the most outstanding short oral and her presentation "Determining the role of glucocorticoids in inflammation-induced fetal lung maturation using glucocorticoid receptor knockout mice", was noted for having the most complicated experimental design!

Justin Lang won the best response to a question prize.

Congratulations to these students and all of the Ritchie Centre students who showcased the excellent research being conducted at the centre.