Current research programmes

Refining Ovarian Cancer Test Accuracy Scores

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.

Information from questionnaires, test and blood results from are being studied so that in the future we can be more accurate in deciding which patients with ovarian cysts and abnormal blood tests need further investigation.

For further information on this study, please call 0151 702 4346 or email research@lwh.nhs.uk.

This study is aimed at people who have been diagnosed as having Lynch syndrome (HNPCC). Liverpool Women’s is part of a national team who aim to find out the best dose of aspirin to prevent cancer. In 2011, the CAPP2 study showed that taking 600mg of aspirin daily reduced the number of cancers by more than half in people with Lynch syndrome. This cancer reduction developed about four years after starting the aspirin. Other studies have shown that lower doses of aspirin may also be effective. The plan in CAPP3 is to provide volunteers with regular aspirin at three different doses. After five years we will be able to see if lower doses are as effective.

If you would like more information then please contact the Genetics Research Nurse on 0151 802 5026 / 07741 271622 or email research@lwh.nhs.uk 

Experiences of children with copy number variations

What are copy number variations (or CNVs)?
The genetic material of every individual can be different from other individuals, even if they are family members. When, compared to others, some people may have extra sections of genetic material, or fewer sections of genetic material. This is called copy number variation (CNV). A CNV can be either a duplication (where an individual has more of the genetic material than most other people) or a deletion (where they have less than most other people). 

Children with copy number variations (CNVs) can experience learning difficulties.  They may also experience behavioural problems at home and in school and may find it more difficult to make friends.  Sometimes, their thinking and speech may be difficult to follow or may seem unusual to others.  It is not clear at the moment to what extent children with different types of CNVs are at risk for these problems. Researchers also don’t know to what extent CNVs play a role in the behavioural and thought problems some children can experience.  It is possible that the learning difficulties these children can have contribute to their risk of behavioural and thought problems.  However, if and to what extent they do is not understood.

The purpose of this study is to try and understand about the relations between learning, behavioural and thought problems in children with genetic deletions or duplications may lead to more effective methods of treatment and prevention, thus improving the lives of children and families affected by these disorders.

The broad aims of this study are to establish:

• The frequency of the presence of learning disability, behavioural problems and thought problems in children with CNVs.
• The relationships between learning disability, behavioural problems and thought problems in children with CNVs.

If you would like more information then please contact the Genetics Research Nurse on 0151 802 5026 / 07741 271622 or email research@lwh.nhs.uk

The inner lining of the womb (endometrium) may play an important part in recurrent pregnancy loss. Recurrent pregnancy loss affects one percent to three percent of women. Recurrent implantation failures may present as infertility. It is possible that an abnormality of special cells in the endometrium called stem cells can cause recurrent pregnancy loss or recurrent implantation failures. If so, the information from this gynaecology study of endometrium stem cells will help us to develop new techniques to diagnose and treat this distressing condition. For further information on this study, please call 0151 702 4332 or email research@lwh.nhs.uk.

Impact of maternally derived antibodies and infant microbiota on the immunogenicity of rotavirus vaccines in African, Indian and European infants

Diarrhoea is one of the common causes of illness in young children. The common cause of diarrhoea in children is an infection with a virus called rotavirus. In the UK, a rotavirus vaccine was added to the childhood immunisation calendar in 2013, and so far this new vaccine has resulted in a very clear reduction in the number of babies suffering from diarrhoea. Despite this, not all children are protected by the vaccine, and this is particularly true for children living in developing countries, were the vaccine efficacy is about half of that in the UK.

In this study we will measure the protection transferred from the mothers to the babies during pregnancy and after birth. We will study the composition of the gut bacteria from birth to the time of rotavirus vaccination and study how this changes over the weeks in the baby and how it relates to the gut and breast milk bacteria of the mother’s. We will also investigate if particular gut bacteria are linked to better or worse responses to the rotavirus vaccine.

This study will be conducted in three places: Liverpool, UK, Vellore, India and Blantyre in Malawi to try to understand why rotavirus vaccines are less protective in the children in Malawi and India. 

For further information on this study, please call 0151 702 4355 or email research@lwh.nhs.uk.

This is a study for women who suffer from heavy menstrual periods; for which the main treatment is a device called the Mirena coil. Recently, a new drug called ulipristal has been found to quickly reduce bleeding in women with large, non-cancerous growths in the womb, known as fibroids. It is not known whether this drug is effective in reducing the impact of heavy menstrual bleeding in women who do not have fibroids, or have small, insignificant fibroids. It is also unclear how ulipristal stops menstrual bleeding and its effect on the womb lining. Both ulipristal tablets and the hormone releasing coil are safe, effective treatments, each with advantages and disadvantages, but doctors do not know which women will benefit from either treatment. Since the way the treatments work and are used are different, it is important to compare them against each other.

Research Nurse - Pam Corlett 0151 702 4496

A research study to compare treatments to prevent recurrence after surgical removal of endometriosis. The study is comparing 4 possible options you will be offered anyway, it is not offering new or experimental drugs. Patients cannot choose which treatment they will receive, however they can say which option(s) they definitely do not want to receive.

Research Nurse - Pam Corlett 0151 702 4496

Pregnancy is a life-changing experience, both physiologically and psychologically. Unfortunately as many as one in five pregnancies end in miscarriage. The purpose of this study is to find out whether progesterone, a natural pregnancy hormone, can help to reduce the risk of miscarriage for women with bleeding in early pregnancy (up to 12 weeks). At the moment we do not know if progesterone helps to reduce the risk of miscarriage or not, but previous small studies show that it may be helpful.

We will compare the experiences of women who take progesterone with the experiences of women who take a dummy (placebo) treatment.

Research Nurse - 0151 702 4346

Doctors often recommend that some women with early stage cervical cancer have an operation called a hysterectomy. Women usually have a radical hysterectomy which involves removal of:

• The cervix
• The womb
• The upper vagina
• All the tissues holding your womb in place
• The lymph nodes around the womb

This is a successful treatment for many women. But some women may have long term side effects such as leaking urine or passing urine more often. Or their sex life may be affected. For example, sexual intercourse may be uncomfortable or painful due to shortening of the vagina or vaginal dryness.

Researchers think that some women may do just as well if they have less extensive surgery. They may only need a simple hysterectomy, this involves the removal of:

• The cervix
• The womb
• A small portion of the upper vagina
• The lymph nodes around the womb

A simple hysterectomy may have fewer side effects in the short and long term.
The aims of this trial are to:

• Find out if a simple hysterectomy is as good as a radical hysterectomy in treating cervical cancer
• To compare the side effects and quality of life following each operation

If you would like more information then please contact the Research Department on 0151 702 4346 or email research@lwh.nhs.uk

Psychological health and relationship Experiences After vaginal Childbirth: The effects of experiencing perineal cuts or tears.

The aim of the study is to explore how first time mothers feel after they have given birth vaginally. For the majority of women, the perineum (the area between the vagina and the anus) will be unaffected. However, some women may need a small cut in the vaginal wall to assist the birth of their baby and others may experience a tear. We are interested in investigating whether a cut or tear that needs stitching affects how women feel about their childbirth experience, and also how they adjust to becoming a new mother in the first year. If we know more about any effects, and what influences them, then we can try to improve future care. If you would like more information about this study please contact Rebeccas Crookall on 0151 795 5537 or email R.Crookall@liv.ac.uk.

An open randomised trial of the Arabin pessary to prevent preterm birth in twin pregnancy, with health economics and acceptability

The study aims to determine whether the Arabin cervical pessary prevents preterm birth in women with a twin pregnancy and a short cervix. Women with a twin pregnancy are at risk of having a baby preterm (before their due date). Women with a short cervix are at extra risk of a preterm birth. Babies born prematurely have increased risk of health problems and are more likely to require admission to the neonatal unit.

The Arabin cervical pessary is placed in the vagina and fits over the cervix. The pessary is made of silicone which is soft and flexible. Fitting the pessary involves minor discomfort only. The pessary is then left in place until 36 weeks of pregnancy but if the woman goes into labour it will be removed. Recent studies indicate the pessary may prevent preterm birth in twins. We want to find out if this is correct.

For further information on this study, please call 0151 702 4355 or email research@lwh.nhs.uk.

Every year approximately 3750 women in the UK will have complications where their cervix (the neck of the womb) becomes loose and opens during the early months of pregnancy. This can require a stitch being sewn into the cervix in an attempt to keep it closed. This is often referred to as ‘cervical suture’ or ‘cervical cerclage’. If this procedure is not performed the cervix can open too early and can result in a miscarriage or premature birth. Inserting a stitch into the cervix does not guarantee to keep the cervix closed, but it can sometimes allow the pregnancy to continue for a few more weeks.

There are two types of threads commonly used for cervical stitches. One thread is made of a single strand; the other is made of strands woven together. Woven threads are sometimes thought to be stronger and easier to remove before birth. However, they might encourage infection, which can trigger an early start to labour.

In contrast, a single strand thread is considered by some to be less likely to cause infection. However, others think this thread can cut the cervix and be harder to remove.

At the moment there is no evidence which is the best type of thread to offer to women having a stitch preventing their baby being born too soon. This is why we are doing C-STICH. Your doctor is happy to use either type of thread.

If you would like more information then please contact the Research Midwives Office on 0151 702 4355 or email research@lwh.nhs.uk

Placental growth factor to Assess and diagnose hypeRtensive pRegnant wOmen

Pre-eclampsia is a common and potentially serious complication of pregnancy, which is thought to start in the placenta and can affect both the mother and her baby. At the moment there is no test to predict who will get pre-eclampsia. The diagnosis is made from monitoring blood pressure, blood tests and urine at antenatal visits throughout the pregnancy. Early diagnosis of pre-eclampsia can reduce complications for both the mother and the baby.

Some studies have suggested that changes in the blood level of a substance produced by the placenta called Placental Growth Factor (PlGF) may help tell us which women are more at risk of needing to be delivered for pre-eclampsia in pregnancy.

The PARROT study would like to know if measuring PlGF between 20+0 and 36+6 weeks would help improve the care of all women with pre-eclampsia. 504 women with pre-eclampsia from several hospitals in England will be involved in this study over 2 years.

For further information on this study, please call 0151 702 4355 or email research@lwh.nhs.uk.

The Research Tissue Bank collects and stores tissue taken with prior consent by patients during caesarean or hysterectomy surgery carried out at Liverpool Women’s for research. By doing this, the Research Tissue Bank builds up a valuable tissue collection for use by research groups to investigate complications of the female reproductive system. It is hoped that the resulting knowledge will help other women in the future. For further information on this study please call 0151 702 4241 or email research@lwh.nhs.uk.

Some women may feel frightened about giving birth. However, little is known about what these fears are about or how they affect women in pregnancy. We are interested in understanding more about women's childbirth fears, so that we can improve ways of identifying and supporting women with fear of childbirth during pregnancy.  We are currently running a study with women who are pregnant and who have reported feelings of fear about giving birth to their midwife. You may be asked if you would like to hear more about taking part in this study, or you can contact the researcher about the study yourself if you think it is relevant to you after seeing this information.  For further information please contact Katie Balling on 07776 491 292 / kballing@liverpool.ac.uk or Kayleigh Sheen Kayleigh.sheen@liverpool.ac.uk.

Pre-eclampsia can be a serious condition for mother and baby. Women with pre-eclampsia are usually admitted to hospital so they can be carefully monitored. We usually try to manage the condition until 37-38 weeks gestation and then would usually Induce labour, as most babies are ready to be born by then. However, sometimes pre-eclampsia can suddenly worsen, and delivery of the baby would be required sooner.

This study aims to find out whether for women with pre-eclampsia between 34 and 36+6 weeks gestation, is it better to plan early birth (usually by Induction) compared to waiting until 37 weeks (unless a serious problem occurs during this time). The study may help improve care for women in the future.

If you took part, you would be randomised to either have you baby within 48 hours, or to continue to be monitored until 37 weeks.

If you think you are eligible and would like to join the study, contact the Research Midwives on 0151-702-4355.

Are you due to undergo first cycle of in vitro fertilisation (IVF) or intra-cytoplasmic sperm injection (ICSI) treatment where embryos are created in the laboratory before being replaced within the uterus. We would like to tell you about a study in which you might wish to consider taking part. 

Traditionally, embryos are put back into the uterus within a few days of being created, by a process known as fresh embryo transfer. Recent research has suggested that delaying embryo replacement until the hormonal effects of the IVF treatment have worn off may lead to higher pregnancy rates and fewer complications.  This is achieved by freezing the created embryos and transferring them within 3 months (thawed frozen embryo transfer). 

Primarily, we want to find out which method of embryo transfer is more likely to increase the chances of having a healthy baby. This study aims to compare fresh embryo transfer with thawed frozen embryo transfer in a large number of couples undergoing IVF treatment across multiple clinics in the U.K.

For further information please contact the E-FREEZE Research Nurse on
Tel: 0151 708 9988 ext 1058
Mob: 07519 837433
Email: IVFTrial@lwh.nhs.uk 

In some pregnancies in order to diagnose certain genetic and chromosomal problems an amniocentesis (a sample taken from the fluid surrounding the baby) or chorionic villus sampling (CVS) (a sample taken from the placenta) is needed. Research has shown that it may be possible to use a simple blood test taken from the mother early in pregnancy to gather information about the health of the baby and predict certain complications of pregnancy. One of the key advantages of the new blood tests will be the ability to make a diagnosis without the need for amniocentesis or CVS which means future testing could be much simpler and much safer for both mother and baby.

Before we can offer the new tests routinely it is important to ensure they work well and are accurate. To do this we need the help of parents with both normal and complicated pregnancies to collect a bank of samples that will allow us to compare these new tests with those in current use.

If you are attending the Fetal Centre or FMU for amniocentesis or chorionic villus sampling and would like to take part in this study, contact the Research Midwives on 0151-702-4355.

prophylactic ANtibiotics for the prevention of infection following Operative DElivery

Previous studies have shown that mothers who have had an assisted delivery (forceps or ventouse) to help deliver the baby’s head, are at greater risk of infection following the birth of their baby. Women may be at risk of local infection at the site of their episiotomy cut or any tears which may happen when you give birth, or an infection of the bloodstream (sepsis). The aim of this study is to find out if giving mothers a single dose of an antibiotic after they have had a forceps or ventouse delivery helps to prevent infection. There are concerns about over prescribing antibiotics but infections can be very serious, so this is an important question to answer which could be of benefit to women in the future.

For further information on this study, please call 0151 702 4355 or email research@lwh.nhs.uk.

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:

• You will be asked to complete a set of questionnaires that will be related to your mood, your relationship with your baby and your lifestyle.  This should take around 30-40 minutes to complete.
• Your answers on the questionnaires will be kept confidential and will not be shared with health professionals involved in your care.  However, if you disclose information that indicates a potential risk to yourself or others the researcher will be required to inform your midwife, which will be done with your consent where possible.
• Taking part in this study is voluntary - you can stop taking part at any time without having to give any reason.
• The questionnaires will be anonymised so that you cannot be identified when the data is being analysed.  The data will be stored securely in accordance with Data Management policies at the University of Liverpool.
• This is a research study and you will not personally benefit from taking part in the study.
• This study has been granted ethical approval by the NHS Research Ethics Committee.

For more information please contact Elizabeth Bickford-Smith: e.bickford-smith@liverpool.ac.uk  or  0151 794 5102.

This study concerns the first phase of a doctoral research study examining what helps patients make use of genetic services and possible reasons for not using these services.  It is funded by the Collaboration for Leadership in Applied Health Research and Care - North West Coast and undertaken in partnership with Liverpool Women’s NHS Foundation Trust.

Research evidence has shown that factors like ethnicity, gender and level of education can affect whether or not people attend genetic services. This study will also examine if factors such as availability of transport or living in the countryside affect whether people attend.                 

We would like to look at data from any new patients referred to the genetics service during the period 01 April 2013 to 31 March 2016.      

Permission to access this data has been approved by an NHS Ethics Committee. Only fully anonymised information will be transferred to the University secure server for further analysis.
               
Geographical Information Mapping methodology, which creates visual maps of the North West Coast area, will be used to explore if there are any relationships between, for example, availability of transport links and the pattern of referrals observed.  These relationships will be discussed with service providers in Phase 2 of the PhD study.

If you would like more information or to opt out of having the referral information the hospital holds being anonymised and included in the study, please contact  the Research and Development Department on 0151 702 4346 or research@lwh.nhs.uk