Recite me link

Research within Maidstone and Tunbridge Wells NHS Trust is ever growing, and maternity is no exception. Our vision is to establish a team of research midwives to help support and deliver cutting edge research for women and families accessing our services. Research enables us to gain new knowledge to improve patient care and develop new treatments. A more detailed explanation of research can be found on the main website.

Research is delivered in combination with research staff, such as research midwives, and clinical staff, including obstetricians, midwives, maternity support workers and sonographers. Together we aim to support you to make an informed decision about taking part in research, should you so wish.

The types of studies we support include large-scale studies that are taking place in several hospitals across the UK, and smaller local studies that are just taking part in our maternity services. We are a growing team within maternity research and, as such, we are always looking for new research opportunities that are suitable for the services we offer.

How to get involved in maternity research

If you think you may be suitable to participate in one of our studies, and you would like more information, please do not hesitate to contact the Maternity Research Team (contact details at the bottom of this page). Enquiring about a study does not mean you have to take part; all contribution to research is voluntary. If you decide against taking part in research, your ongoing care will not be affected in any way.

The Maternity Research Team

Louise Swaminathan MRes; BSc (Hons) – Senior Research Midwife

Lydia Ufton BSc (Hons) – Clinical Research Midwife

Lily French BSc (Hons) – Clinical Research Midwife

Kate Munson BSc (Hons) – Clinical Research Midwife

Our team currently consists of 4 research midwives. Together we support research across all maternity sites within MTW and aim to cover Monday-Friday. If you would like to discuss any of our studies, please contact us on:

Mobile: 07706 000477

Landline: 01622 220284

Email: mtw-tr.maternity-research@nhs.net

Current Research

GBS3

GBS3 is looking at whether testing pregnant women to see if they carry group B Streptococcus (GBS) reduces the risk of infection in newborn babies compared to the current strategy in place in the UK. The current strategy in the UK is to offer antibiotics during labour to women who are considered at risk of their baby developing GBS infection.

Group B Streptococcus is also known as GBS, Strep B or group B Strep. It is a common type of bacteria that normally causes no harm. In the UK, 1 in 4 pregnant women carry GBS in their vagina and rectum (back passage). You’re unlikely to know you carry it.

If you carry GBS, your baby will be exposed to it around labour and birth. While most babies won’t be affected, there is a very small chance of your baby becoming seriously ill or even dying. In extremely rare cases GBS infection can also cause miscarriage, early labour or stillbirth.

Maidstone and Tunbridge Wells NHS Trust are taking part in the GBS3 study and will be offering GBS testing during labour from 37 weeks pregnant using a bedside test, if attending Maidstone Birth Centre or Tunbridge Wells Hospital. If you are booked to birth at Crowborough Birth Centre or at home, you will be offered the same test but between 35-37 weeks pregnant. This should be organised following your birth place assessment.

The test requires a swab to be taken from both your vagina and rectum (back passage) by a midwife which will be put into a machine and the results will be available on the same day*. The procedure will not hurt but it may be slightly uncomfortable. If the result is positive for GBS, you will be offered intravenous antibiotics as soon as possible once your labour has started. If your waters have gone prior to going into labour and you test positive for GBS, you will be offered an induction of labour as well as intravenous antibiotics.

Antibiotics are available at Tunbridge Wells Hospital, Maidstone Birth Centre and Crowborough Birth Centre, but not at home.

*It may take longer than a day to process and report the GBS test result if taken antenatally.

If you have any questions regarding GBS3, please contact the Maternity Research Team

Useful links about GBS3 and GBS:

Twitter: @GBS3Trial

 

iGBS3

iGBS3 is a research study of women’s natural immunity against GBS. We want to find out how much antibody a woman needs to pass to her baby to protect the baby from getting GBS disease. This will help in developing a maternal vaccine that will help protect your baby from becoming unwell with GBS disease in the first 3 months of life.

To do this, we need to take a small sample of cord blood from a large number of women. Because this needs to be done just after delivering the baby, we will be using a verbal consent approach. If you do not want to give a cord blood sample, you can decline at any time and no samples will be taken. Cord blood samples will be stored locally (at Maidstone and Tunbridge Wells NHS Trust) for 3-4 months. If your baby develops GBS disease in the first 3 months of life, you will be asked for written consent for us to retrieve the stored cord sample as well as an additional sample of blood from the baby in order to measure antibodies in it. These antibodies will be compared with the antibodies from GBS colonised women delivering infants who remained healthy.

Further information can be found here.

Twitter: @iGBS3_Study

 

The Big Baby Clinical Trial

The purpose of this trial is to find out if starting labour earlier than usual (inducing), at 38 weeks, makes it less likely that shoulder dystocia (when the head is born, but there is a delay in delivering the shoulders) will happen in women whose babies appear to be bigger than expected (over the 90th centile on the growth chart).

You may be able to take part in the study if:

  • The weight of your baby is predicted to be over the 90th centile
  • Your baby is head down
  • You have not had a previous caesarean section

Further information can be found here.

Twitter: @BigBabyTrial

 

The Cleft Collective Cohort Studies

This study aims to explore the role that the environment and genetics play in the development of cleft lip and/or palate; which treatments work best, when and for whom; and about how you and your child adapt to the cleft and its treatment.

You may be able to take part in this study if:

  • Your baby has been diagnosed with a cleft lip and/or palate either antenatally (on scan) or postnatally (after birth).

Further information can be found here.

 

CRAFT-OBS: a study of risk and management in women with a history of caesarean section in labour

This is an observational study that aims to explore the incidence of late miscarriage and preterm birth in women with a previous caesarean section in labour (4cm dilated or more). You may be approached to take part in this study if you:

  • Have had a previous caesarean section in labour (4cm dilated or more)
  • Are not at a high risk of preterm birth and being managed accordingly
  • Are having one baby (i.e. not twins)

As this study is purely observational, all that will be asked of you is to provide permission for anonymous data to be collected about your previous pregnancies and births and your current pregnancy and birth.

Further information can be found at: https://www.kcl.ac.uk/research/craft

Previous research we have been involved in

The POOL Study

This study plans to look at the use of water for labour and birth to determine

  • how many women are using birth pools
  • how many women give birth in water
  • the outcomes for mothers and their babies as a result of water birth

The outcome of this study is die to be published in spring 2023.

Further information can be found at: https://www.cardiff.ac.uk/centre-for-trials-research/research/studies-and-trials/view/pool

Twitter: @pool_study

 

RETHINK

This study followed participants through pregnancy, labour and birth, and into the postnatal period to see if we could identify those women who might benefit from additional support in early labour to reduce their chance of a difficult labour and unnecessary intervention.

The outcome of this study is pending.

ObsQoR

This National surveillance study, which ran for 3 consecutive days at MTW, recruited participants that had received anaesthetic care either during their labour, birth or immediate postnatal period. This study is looking at the quality of recovery in women following anaesthetic interventions to try and identify if a screening survey is able to highlight those who are likely to have problems, aiding us to improve aspects of their care.

The outcome of this study is pending.

Twitter: @ObsQor

PANCOVID

This study collected information about COVID-19 and SARS-CoV-2 in pregnancy and babies from around the world into a register which will be used to share information with healthcare professionals around the world, allowing them to improve the care they give. The study wanted to find out more about the effect of COVID-19 on early pregnancy, the growth of babies, early delivery and possible infection of babies.

More information can be found at https://pan-covid.org

Twitter: @PANCOVIDreg

Acupuncture for treatment of slow labour

The purpose of this study was to explore if acupuncture could be used to treat an established labour that had slowed down, instead of using a hormone drip.

The findings of this study are currently being analysed.

GBS2

This study aimed to see if a rapid test system is better in identifying women who need antibiotics because they are colonised with Group B streptococcus (GBS) compared with the current system  based on risk factors alone.

We are currently awaiting the findings of this study to be published.

Further information can be found here.

Intradermal sterile water injections for relief of low back pain in labour: is a two-injection technique as effective as a four-injection technique? A pilot study.

The aim of this study was to find out if a two-sterile water injection (SWI) technique was as effective at relieving lower back pain in labour compared with a four-SWI technique (standard practice).

Findings

The findings of this study suggest that a two-SWI technique may reduce lower back pain as adequately as the current four-SWI technique. The two-SWI technique, if given in the upper part of the lower back, may also reduce the pain of injection administration. However, as this study was small, a larger study is advised to confirm the findings.

Kangaroo care in preterm or low birth weight babies in a postnatal ward

The aim of this study was to explore if Kangaroo care (skin-to-skin contact with the mother) affected the length of stay and feeding outcome compared with standard care (baby next to the mother in a cot) for preterm and low birthweight babies, and babies of diabetic mothers.

Findings

The outcome of this study suggests that the use of Kangaroo care reduces the length of hospital stay by one day, and significantly increases the rate of exclusive breastfeeding at the time of discharge from hospital. There was no significant difference in the rate of exclusive breastfeeding at 6 weeks post birth or admissions to the neonatal unit. Overall, parents rated Kangaroo care highly.

Please see the published article for further information

Skin-to-skin contact after elective caesarean section: investigating the effect of breastfeeding rates

The purpose of this study was to determine whether Kangaroo care (skin-to-skin contact with the mother) in the operating theatre following a planned caesarean section affected breastfeeding outcomes.

Findings

There was no significant difference between the rate of breastfeeding at 48 hours, 10 days and 6 weeks post birth. However there was a significant correlation between the duration of skin-to-skin contact and the breastfeeding rate at 48 hours and 6 weeks; the greater the duration of skin-to-skin contact, the greater the rate of breastfeeding.

Acupressure for inducing labour for nulliparous women with post-dates pregnancy

This study compared the use of acupressure against a sham treatment for the induction of labour in first time mothers who were 41 weeks gestation or greater.

Findings

The findings of this study suggest that acupressure is not beneficial to induce labour; there was no significant difference in the time of labour onset between those receiving acupressure and those receiving the sham treatment. Those receiving acupressure were more likely to require induction of labour or augmentation of labour using the hormone drip. There was no difference in the mode of delivery or the condition of the baby at birth.