The programmes, undertaken by our researchers and often in collaboration with others, are focused on benefiting patients by enhancing the overall care we provide across all clinical areas.
If you require any further information or are interested in joining one of our studies, please call 0151 702 4346 or email research@lwh.nhs.uk.
Randomised Evaluation of COVID-19 Therapy
There are currently no approved treatments for COVID-19.
Oxford University is running the RECOVERY Trial which will enable reliable assessment of the effects of multiple different treatments on major outcomes among people with COVID-19.
Some of the treatments will be drugs used for other conditions, other new drugs may become available during the trial.
All patients participating in the trial will receive usual standard of care.
Maternal and Perinatal Outcomes of Pandemic Influenza in Pregnancy
This NIHR supported study is a national study of women hospitalised with confirmed COVID-19 in pregnancy. The study will use the UK Obstetric Surveillance System (UKOSS) to collect information about all pregnant women admitted to hospital who are confirmed to have the virus infection. The information will be analysed on a continuous basis to inform ongoing guidance for women and maternity staff as we respond to the pandemic. Specifically, the study will describe incidence, management and outcomes of COVID-19 in pregnancy and identify factors associated with better outcomes for women and their babies.
Studying the Impact of COVID-19 on the NHS Workforce to Guide Trauma-Informed and Psychologically-Informed Support Provision
This study aims to investigate the immediate and longer-term impact of the COVID-19 crisis on the psychological and emotional wellbeing of NHS staff. This will allow for a better understanding on how to effectively support and maintain staff psychological well-being and mental health during this time.
A Phase II, Randomised, Single-Blind, Platform Trial To Assess Safety, Reactogenicity And Immunogenicity Of COVID-19 Vaccines In Pregnant Women In The United Kingdom
This study aims to recruit, vaccinate and follow-up pregnant women across the UK in order to look at the safety of, and immune responses to, COVID-19 vaccines in pregnant women and their babies.
Approximately 1 in 3 of all women who are pregnant, will visit the gynaecological emergency department in early pregnancy because of bleeding and/or abdominal pain. One woman in thirty with these symptoms will have, a pregnancy that grows outside of the womb (an ectopic pregnancy).
An ectopic pregnancy can be in the fallopian tube, ovaries or anywhere in the pelvis. Even with all modern technologies, it is still difficult to diagnose an ectopic pregnancy, with more than half not diagnosed when women first seek medical help. Because of this, we need to improve the way we diagnose an ectopic pregnancy by developing better tests in order to reduce the health risks and stress to women. We are looking for 625 women who are in the beginning of their pregnancy (less than 10 weeks from their last period) and visit the Liverpool Women’s Hospital emergency department because of bleeding and/or abdominal pain. We are trying to develop an easy and quick test that can accurately identify women with ectopic pregnancies
Chronic endometritis and recurrent miscarriage
The aim of this research trial is to find out if antibiotics can reduce miscarriage. In some women the lining of the womb (the endometrium) is inflamed. Researchers have found a link between this and miscarriage. A healthy endometrium is important for the embryo to be able to attach to the womb. It is thought that endometritis disrupts this process, and can lead to a miscarriage. Treating endometritis with antibiotics may reduce the inflammation and the likelihood of a miscarriage. This has not been tested.
This research trial will test this theory by comparing a 14-day course of an antibiotic (doxycycline) against a placebo (a ‘dummy treatment’ which will look exactly the same as the antibiotic but contains no active ingredients) to find out if taking antibiotics reduces miscarriages. The trial will be ‘double blind’. This means that the women and the trial researchers will not know who is taking the antibiotic capsules and who is taking the placebo.
Proper Understanding of Recurrent Stress Urinary Incontinence Treatment in Women: a randomised controlled trial of endoscopic and surgical treatment
This study is a trial of endoscopic versus surgical treatment for women with Primary Stress Urinary Incontinence (SUI) which affects 16-35% of women.
This study invites women who have already had an operation for SUI to investigate if endoscopic bulking injections or surgery are more effective for treating recurrent SUI. After receiving treatment, you will be asked to complete study questionnaires for 3 years.
A double-blind, randomised, placebo-controlled multicentre study to investigate safety and efficacy of elinzanetant for the treatment of vasomotor symptoms over 52 weeks in postmenopausal women
If you are a woman between 40 - 65, have not had a menstrual period for at least 6 months and experience Vasomotor Symptoms related to menopause (commonly referred to as hot flushes) you can take part in a study testing an investigational oral, non-hormonal medication to reduce hot flushes. The study aims to see how well the medication Elinzanetant works in participants with hot flushes, how it affects the body, and how the medication moves into, through, and out of the body.
Investigation of the Role of Sperm Quality in Fertility Diagnosis, Fertility Treatment and Miscarriage
The purpose of this study is to examine how the quality of your sperm affects your fertility diagnosis or fertility treatment success. Most research to date has focused on the woman and very little is known about the impact that sperm have on fertilisation, embryo quality, pregnancy or miscarriage.
Letrozole Or Clomifene for Ovulation Induction: Letrozole or Clomifene, with or without metformin, for ovulation induction in women with polycystic ovary syndrome: a 2x2 factorial design randomised trial (The LOCI Trial)
In order for you to conceive naturally, an egg will need to be released from your ovary. For women with PCOS, this does not always happen, and therefore we need to give medicines to help your body release an egg. There are two drugs we can give to help you release an egg; one called ‘clomifene’ and another called ‘letrozole’. There is another drug called ‘metformin’ that we can also give you at the same time as these other drugs, but we are not sure if this carries any additional benefit. Overall, we are not sure which drugs are best for ovulation induction and a successful pregnancy outcome. The purpose of this study is to test which drugs are best.
We know that lots of women have symptoms such as bloating and tummy discomfort. It is also very common to have cysts (balloon like swellings) on women’s ovaries picked up by ultrasound. In addition, some women have higher levels of a blood test called CA125; this blood test is abnormal in lots of conditions - women with periods, fibroids, appendicitis etc. A very small number of women with ovarian cysts or abnormal CA125 will go on to be diagnosed with ovarian cancer.
The purpose of this study is to identify better tests for women with ovarian cysts or abnormal blood tests so we can pick up ovarian cancer earlier. This will also reduce unnecessary tests, hospital visits and distress in women who don’t have cancer.
Preventing Ovarian Cancer Through Early Excision of Tubes and Late Ovarian Removal
PROTECTOR is an observational research study for women who are at an increased risk of developing ovarian cancer. Some women may carry a fault/alteration in their BRCA1 or BRCA2 gene making them high risk. Whilst, others may be at an increased risk due to a strong family history of cancer or a fault in another ovarian cancer causing gene like RAD51C, RAD51D or BRIP1. This study aims to assess the impact on women of a new two-step option to prevent ovarian cancer. This involves initially just having your tubes (fallopian tubes) removed to prevent ovarian cancer. This is followed by removing your ovaries in a separate operation at a later date of your choosing. The study assesses women’s views and the impact of this approach to prevent ovarian cancer on sexual function, hormone levels, quality of life and overall satisfaction. Outcomes from this new approach are compared to the traditional approach of removal of both tubes and ovaries at the same operation. We also compared this to the well-being of women who do not have an operation.
The Research Tissue Bank collects and stores tissue taken at surgery for research. By doing this the research tissue bank is able to build up a valuable collection that will be used by research groups investigating complications of the female reproductive system. It is hoped that the resulting knowledge will help other women in the future.
The aim of this study is to find out the best way to care for women with babies who appear to be bigger than expected for their dates. Identifying if labour should be started a little earlier for these women is an important unanswered question. The results of this study will provide evidence about the best way to care for women with bigger babies.
The aim of this study, by Liverpool University is looking at whether your relationship with your baby influences your engagement with health related behaviours during pregnancy. You must be in your third trimester (28-36 weeks) to participate in this study and before you decide whether to take part, it is important for you to understand what it will involve.
Important things you need to know:
For more information please contact Elizabeth Bickford-Smith: e.bickford-smith@liverpool.ac.uk or 0151 794 5102.
TTTS Registry - Multiple Pregnancy Registry
The purpose of this registry is to address the gaps in knowledge in order to inform us what is the best treatment to offer in multiple pregnancies that develop complications, and what is the best way to monitor for the development of these complications. This should ultimately improve the care we provide to these women and babies. Furthermore, the registry will help us to ensure that all units caring for women with multiple pregnancies in the UK are providing consistent, evidence-based care. The registry will also provide a platform to allow long-term follow-up of these children at a national level.
C-STICH2: Emergency Cervical Cerclage to Prevent Miscarriage and Preterm Birth: a Randomised Controlled Trial
A cervical cerclage is the placement of a stitch to keep the neck of the womb closed. A stitch can be placed in a planned way because of a risk of preterm birth based on a woman’s pregnancy history or because the neck of the womb is shorter than normal on an ultrasound scan but still closed. Sometimes the neck of the womb can start to open and expose the bag of water around the baby. If this happens between 16 and 28 weeks of pregnancy, an emergency stitch is sometimes inserted to try to delay delivery. Prolonging the pregnancy so that the baby can be born when they are bigger and stronger may give them a better chance of surviving and suffering from fewer complications of prematurity. However, doctors do not know if an emergency cerclage works. There is some evidence it may prolong pregnancy but it is possible that it will also speed up delivery by causing infection or damage to the neck of the mother’s womb
This study will ask women who have an open neck of the womb with the bag of waters around the baby coming through, to have either an emergency stitch or no emergency stitch. Which treatment they will receive will be decided by a process that randomly allocates a woman to one group or the other.
When to Induce Labour to Limit Risk in Pregnancy Hypertension - a Multicentre, Randomised Controlled Trial
The WILL study is looking to enrol pregnant women who have pre-existing or pregnancy-related high blood pressure (hypertension). High blood pressure can increase the risk of health problems to the mother and to her baby, and the WILL trial is being conducted to see at how many weeks of pregnancy it is best to deliver your baby, in order to minimise this risk as much as possible.
Excessive bleeding after childbirth (also known as postpartum haemorrhage or PPH) is a common problem which affects 1 in 20 women.
COPE is a research study to compare two drugs currently used to treat PPH, to decide which is better. The two drugs are carboprost and oxytocin.
The first PARROT study has shown that changes in blood levels of a substance produced by the placenta called Placental Growth Factor (PlGF) can help reduce the time it takes for doctors and midwives diagnose pre-eclampsia. This test can also reduce harm to pregnant women who are diagnosed with pre-eclampsia. We do not know when or how often this test should be repeated to help continue monitoring pregnant women who are thought to be at increased risk of pre-eclampsia.
The PARROT-2 study will help doctors and midwives understand when and how often to repeat the PlGF-based blood test between 22+0 and 35+6 weeks and we hope this will improve the care of all women at risk of pre-eclampsia.
Currently, doctors don’t have good information to help them decide about the best time to deliver a baby between 32 and 36 weeks of pregnancy. At the moment many different approaches are being used. This study aims to find answers about the safest time to deliver the baby.
Placental Growth Factor Led Management of the Small for Gestational Age Foetus: A Feasibility Study
The PLANES study is a randomised controlled trial investigating the feasibility of using biomarker led care for pregnant women who are carrying a small for gestational age (SGA) foetus. Women with a SGA foetus who wish to take part will have additional blood tests to track the health of a smaller foetus, and provide a care plan to safely keep the foetus inside the womb for longer, prolonging pregnancy and potentially improving the health of the baby.
Women with a SGA foetus and a normal biomarker ratio will have a repeat ultrasound and repeated blood test to retest the biomarker ratio every 2 weeks up until delivery. Your care pathway will be dictated by your blood test results and adjusted accordingly. This will be discussed with you by your medical team.
A Longitudinal Investigation of the psychoLogical predictors Associated with fear of Childbirth - the LILAC Study
We know that some women fear childbirth. This can be difficult and can cause a significant amount of worry and distress. We do not know enough about why these fears develop, or how they may develop during pregnancy. This study will explore in-depth what shapes feelings about childbirth. By understanding more about why these fears may develop, we can develop future ways of supporting women and reducing fear of childbirth in pregnancy. For further information please contact Siân Davies, S.M.Davies@2020.ljmu.ac.uk.
Neonatal encephalopathy is a condition related to a lack of oxygen and blood flow to a baby’s brain around the time of birth. We routinely offer cooling therapy to these babies in NHS hospitals. However, they may still have long term developmental problems, despite cooling therapy.
Recent evidence suggests that subtle genetic variations can influence how babies respond to this type of brain injury. Therefore, we need to understand the genetic variations so that in the future we can develop personalised medicines to treat babies more effectively.
Fluids Exclusively Enteral from Day 1
In this study we want to find out whether babies born 8-10 weeks early will do better if we feed them fully with milk from the first day. We want to know whether this will help babies go home sooner (reduce the number of days they need to stay in hospital). We will also check if this helps reduce infection risks, affects the risk of NEC, and helps mothers breast feed and be more involved in caring for their baby.
Cooling in Mild Neonatal Encephalopathy Trial
We know that babies with more severe encephalopathy benefit from being cooled for the first 3 days after birth. However, we do not know whether this is an effective treatment for babies with mild encephalopathy. Although babies with mild encephalopathy tend to rapidly recover on their own without a specific treatment, some babies may develop learning disabilities during childhood, including cerebral palsy, or problems in cognition, memory, or behaviour.
In the UK, some hospitals cool babies with mild encephalopathy, and others do not. The aim of this study is to examine whether cooling therapy is beneficial to babies with mild encephalopathy.
Neonatal Antimicrobial Resistance and Outcome
Infections are an important cause of deaths in babies during their first weeks of life. Infection is typically non-specific in presentation. This means clinicians must start antibiotics early and “guess” which antibiotics to use. We know from our surveillance network that in 10-20% of cases the antibiotics chosen will not be the correct ones. A small study showed that when this mismatch occurred the babies had a high mortality. We wish to collect information on neonatal infections, identify the pathogens associated with deaths and determine if gaps in optimal antibiotic treatment are related or lead to poor outcomes.
We are trying to find out more about the causes of breast, ovarian and prostate cancer in people with a family history of the disease. A small number of people have an increased risk of these cancers as a result of inheriting a mutation in specific genes, but we do not know what other genetic or lifestyle factors may be important. This study is trying to identify these other risk factors. This is a long-term study, which has and will continue to contribute to scientific papers.
Phenotyping Of Rare Genetic Overgrowth Disorders
We would like to increase our understanding of the clinical and genetic features of rare genetic overgrowth disorders. At present we do not fully understand the genetic causes of these conditions and the medical problems that are associated with each condition. Studying the clinical features (the ‘phenotype’) of individuals with overgrowth disorders will increase our knowledge of these conditions.
Improving our understanding of these disorders will enable health care professionals to provide more accurate information and the best possible care to individuals with overgrowth conditions. Identifying the genetic causes may also help with developing treatments in the future.
The Identification and Characterisation of Inherited Predispositions to Colorectal Tumours (CORGI) 2
Malignant bowel tumours, such as cancers, are rather common and benign bowel tumours, such as polyps are very common. Inherited factors (genes) may increase or decrease a person’s risk of bowel tumours. We are studying patients and families with a history of bowel tumours in order to identify genes that could affect the risk of developing this condition and find out why they have this effect. We are also studying patients and families who have developed tumours, such as cancers of the uterus (womb), that are potentially related to bowel cancer.
The purpose of this study is to identify and characterise new hereditary factors that may lead to the development of bowel tumours. In turn, this will increase our understanding of why bowel tumours develop
Flagship Study Exploring Needs, Technical Aspects and Quality Assurance of RNA Analysis as a Means to Interpret Sequence Variants of Unknown Significance
The aim of this study is to identify new gene faults and to understand which gene faults found during gene sequencing are disease causing. This will be done by looking to see if a gene fault affects splicing of the gene or of other genes. Finding which do will help make genetic testing possible for the disorder. This knowledge may eventually help in the management and treatment of these or other illnesses. Our research can also help understand how these genes normally work in the human body and brain.
EDEN - Prospective Study of Autism Emergence From Infancy in Neurofibromatosis Type 1
Many children with NF1 can have difficulties such as Autism Spectrum Disorder (ASD) and Attention deficit Hyperactive Disorder (ADHD). But we don’t understand how these conditions develop, what the early indicators of these difficulties might be or why some children with Nf1 are protected from these difficulties. We hope that this research study will help us develop new tests that may in the long-term, help us with earlier diagnosis and developing new treatments for children with NF1.
SCOTTY Study - Whole Genome Sequencing Study of Young Colon Cancer Patients and Their Parents
Our aim in this study is to conduct detailed genetic analysis of blood and tissue removed from tumours from individuals who have developed bowel cancer at a young age and also blood samples from each of their parents. These samples will be analysed using a technique called “NextGeneration Sequencing” (NGS). NGS is a scientific technique that gives us a “read-out” of all the genetic information that is stored in our DNA within each of our cells within the body. It is this information that makes every person unique. We aim to identify changes in patients DNA (mutations) that may not be present in parents. We aim to collect this information to help us identify mutations that are causing bowel cancer. This will in the long term help us to develop new treatments and predict who will be susceptible to cancer and so be able to prevent disease progression.
Genetics of endocrine tumours
This study aims to identify genes (part of our cells which carry inherited information) and proteins, which play a part in the development of endocrine tumours.
Over 900,000 new cases of prostate cancer are diagnosed worldwide every year. Studies have indicated that men who carry certain gene mutations are more susceptible to prostate cancer than men without a mutation. It has also been suggested that mutations may in some cases cause more aggressive prostate cancer.
The aim of this study is to follow up a group of men who have prostate cancer and who are known to have a mutation in a prostate cancer predisposition gene. The information we collect will be used to determine whether there are differences in the aggressiveness of the disease. Ultimately the aim of this research is to help improve our understanding and enable us to give better treatment advice to men receiving a diagnosis of prostate cancer.
Molecular Pathology of Human Genetic Disease is a well established study that aims to recruit participants with suspected or known genetic disorders to study genetic aetiology, natural history and predictors of outcome.
HumGenDis It is not restricted to any particular phenotype or condition but currently the major topics of interest are:
• Inherited Renal Cell Carcinoma (RCC)
• Inherited Phaeochromocytoma/Paraganglioma (PPGL)
• Multiple Primary Tumours
• Methylation alterations in congenital imprinting disorders (e.g. Beckwith-Wiedemann syndrome, Silver-Russell syndrome) and chromatin disorders
• Wild type Gastrointestinal Stromal Tumour
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