Humans of health research

Professor Christoph Lees is Professor of Obstetrics at Imperial College London and Head of Fetal Medicine at Imperial College Healthcare NHS Trust.

His research work focuses on Fetal Growth Restriction (FGR) - a condition where a baby grows smaller than expected during pregnancy - and pre-eclampsia - a condition in which high blood pressure and excess protein are present in the urine during pregnancy. Professor Lees leads the The Trial of Randomised Umbilical and Fetal Flow in Europe 2 (TRUFFLE 2) study which aims to clarify the optimal timing of delivering babies with FGR in late preterm pregnancy (32-36 weeks). The study is funded by the National Institute of Health Research (NIHR) Imperial Biomedical Research Centre

“I have been very interested in fetal growth restriction and pre-eclampsia for many years.  These conditions are associated with stillbirth, which affects 1 in every 200 births in the UK. 

“I wanted to see how we can predict stillbirth and get to the causes of the condition, starting with fetal growth restriction, which we also call FGR.

“This is caused mainly by problems with blood flow through the placenta, which supplies oxygen and blood to the baby, causing the fetus’s growth to slow or stop and leading to health complications. FGR can cause anxiety for women and their loved ones, as they have to be closely monitored throughout their pregnancy and deliver their babies earlier than expected.

“The TRUFFLE 2 study is a follow up from the TRUFFLE 1 study which looked at the best time to deliver babies with FGR between 26-32 weeks.  It showed that babies delivered on the basis of a technique that monitors blood flow in a small vessel below their heart - late ductus venosus changes - had better neurodevelopmental outcomes than babies delivered on the basis of two other techniques.

“I would say that this study was a career milestone for me and the team, as it led to change in practice. The success of it allowed us to move on to the TRUFFLE 2 study and secure a £2.5 million grant from the National Institute of Health Research (NIHR).”

Bonnie Mylrea-Foley is an Obstetrician at Imperial College Healthcare NHS Trust and Clinical Research Fellow at Imperial College London.  Bonnie works on the TRUFFLE 2 study alongside Professor Christopher Lees.

“One of the reasons I became involved in research is that during my clinical work I started to question why we do things a certain way and I wanted to better understand the science behind how we look after women and their babies. 

“The TRUFFLE 2 study looks at babies that are not growing very well during the later stages of pregnancy which is something we see really regularly in obstetrics, however we still don’t know the best way to look after them. I joined the study because I know that this could affect everyday practice.

“As a research fellow my role in the TRUFFLE 2 study varies. I have meetings with our centre for trials research and our research midwives to launch new study sites, we have meetings with our statisticians on how the data collection is going or I can be with Professor Lees talking to a patient who might be eligible for the study and seeing if they want to take part. I also scan patients to check how their baby is growing.

“What I would say to anyone interested in research is that there is no one way to do it. You can be involved in research throughout your training in many different ways. For example, I first got involved in Professor Lees’ research work at the start of my training and I told him about my interest in pregnancy research. If you show initiative and seek people out you’ll find that there are always opportunities.

“What I enjoy most about being a research fellow is the people I have met through research. I have connected with other researchers across Europe because of the TRUFFLE 2 study and have had the opportunity to visit many of the centres. You begin to see how research and clinical care works in other countries and it broadens your horizons.”

Kathlyn Axibal took part in the TRUFFLE 2 study. She gave birth to her daughter Luna at 34 weeks, in October 2020.

“I took part in the TRUFFLE 2 study when the doctors informed me that my baby had FGR and wanted to make sure my daughter was delivered safely.

"As part of the trial, I had scans twice a week, the baby’s blood flow and weight was monitored and I had regular consultations with the team. I found the team to be very accommodating. They answered my all my questions and as a result I fully trusted them.

 "The decision was made to deliver Luna at 34 weeks and five days.  She weighed just 1.6kg and she needed a lot of support. I delivered her during the height of the COVID-19 pandemic so I couldn’t have any visitors in the hospital. However, I received such great support from the team, which was so important as I was on my own.

“I think it is important to participate in research as you can help yourself and others. I now have a healthy 15 month old daughter and I can’t imagine what the outcome might have been had I not participated. I am so grateful for the team and I hope they can continue help as many women as possible.”