Premature births breakthrough 

18/09/2017 00:00 
Researchers have found a potential way of preventing premature births by healing unwanted ruptures in the delicate membrane that surrounds a fetus in the womb.

The team, which included UCLH fetal medicine consultant Professor Anna David, presented their discovery at the British Science Festival in Brighton this week.

Forty per cent of preterm births are caused by a break in the fetal membrane. Unlike other mammals, humans have no healing mechanism for the fetal membrane. Once broken as a result of mechanical stress, weakness, bleeding or prenatal surgery, it will either fail and cause premature birth, or allow amniotic fluid to leak out of the womb with potentially fatal results.

The researchers, from UCL and Queen Mary University of London, have discovered the biological reasons for this poor healing response. One cause is a membrane protein called connexin 43, which stops healing cells that would otherwise produce collagen to repair the break from entering the wound.

The healing treatment may involve inhibiting the activity of connexin 43 in the area of the membrane break, while stimulating collagen-producing cells.

The treatment could be particularly useful and straightforward in cases where surgery is carried out on the fetus — for example to correct a defect identified through prenatal ultrasound scans. The medical team could then make sure that the hole left by the operation will heal. At present, 40 per cent of fetal surgeries are followed by leakage of amniotic fluid and premature labour. The team anticipate that it will take at least 3-5 years before a treatment for fetal membrane defects would be ready for testing in patients.

About one in nine pregnancies ends in premature birth before 37 weeks. In the UK, 50,000 babies a year are premature, 10,000 of whom die in infancy.

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