£2.4 million awarded to investigate the leading cause of stillbirth


Researchers have been awarded over £2.4 million to investigate the best technique to manage poor growth in babies during the later stages of pregnancy. Fetal growth restriction (FGR) is when an unborn baby is smaller than it should be because it is not growing at a normal rate inside the womb. FGR accounts for half of the cases of stillbirth in the UK and is caused mainly by problems with blood flow through the placenta, which supplies oxygen and blood to the baby, causing the fetus’ growth to slow or stop and leading to health complications. Fetuses with FGR often have to be delivered prematurely.

There is no consensus for the optimal timing of delivering such babies in late preterm pregnancy (32-36 weeks) and babies are delivered at different times. Doctors make their decisions based on considering and balancing the risks of keeping the baby in the womb versus the risks of preterm delivery.

The Trial of Randomised Umbilical and Fetal Flow in Europe 2 (TRUFFLE 2) study aims to help clarify the decision process and move towards harmonisation of practice across Europe. This new international study, funded by the National Institute for Health Research (NIHR), will investigate the best time to deliver babies who are diagnosed with FGR in late preterm pregnancy.

The research is led by Professor Christoph Lees, from the Department of Department of Metabolism, Digestion & Reproduction at Imperial College London, who is Head of Fetal Medicine at Imperial College Healthcare NHS Trust (ICHT). The TRUFFLE 2 study follows TRUFFLE 1, which looked at managing FGR during earlier stages of pregnancy and informed national and international guidelines. TRUFFLE 1 study was supported by the NIHR Imperial BRC and ICHT Research Capability Funding (RCF).

Professor Lees said: “Poor growth of babies during pregnancy affects 3 in 100 pregnancies and 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. Although we have different tests for monitoring babies with FGR, there is no real consensus for when babies with FGR should be delivered in the later stages of pregnancy, leading to varying outcomes for women and their babies following delivery and beyond. This trial could have real implications on outcomes for women and their babies and reduce the long-term complications associated with FGR.”

Read the full story by Maxine Myers, Imperial College London here.

  • Professor Christoph Lees
    Professor Christoph Lees
    Reader in Obstetrics & Fetal Medicine / Consultant in Obstetrics