The findings - based on the scans of 1,684 women - could make the difficult task of determining whether labour should be induced in the final stages of pregnancy easier, resulting in fewer complications, say the researchers.

Published today in the Lancet Obstetrics, Gynaecology and Women’s Health, the study was led by gynaecologist Sanne Gordijn of the University Medical Center Groningen (UMCG) in collaboration with Wessel Ganzevoort of Amsterdam University Medical Centre and Professor Alexander Heazell from ����Vlog�ٷ�.

When pregnant women feel their baby is moving less in the final weeks of pregnancy, they are referred to hospital where an examination is carried out to assess the condition of the baby.

The examination consists of monitoring the baby’s heart rate and an assessment of its growth and amniotic fluid - the fluid around the baby it.

Now the researchers have discovered that an extra ultrasound scan - in addition to the other tests-  is able to significantly help doctors to see whether a baby would benefit from being born earlier.

By measuring the resistance in the blood vessels of the umbilical cord and the baby's brain they were able to accurately assess the functioning of the placenta and the condition of the baby, making it easier to decide if doctors needed to induce delivery earlier.

The perception from mothers that their baby is moving less commonly can occur when a baby has changed position or the mother hasn’t noticed the movement because she is busy or distracted.

However in some cases, reduced movement could be a sign that the baby is unwell, which can be worrying for pregnant women and midwives.

Professor Heazell said: “We know that a reduction in baby’s movements is a common reason to attend maternity services. Thankfully, in the majority of cases the baby is ok.

“The findings of this study will help us to reassure the majority of mothers that their baby is healthy, and help us to focus intervention for the babies who will benefit from being born because they are not receiving enough oxygen or nutrients in the womb.”

Sanne Gordijn said: “We call the ratio between the two ultrasound measurements the Cerebro Placental Ratio (CPR). The idea is that an abnormal value may indicate that the placenta is not functioning properly.

“In that case, it is better for the baby to be born in the short term. We do this by inducing labour. If the value is normal, it would be better to wait for the natural moment of delivery, as the baby may not be completely ready yet. Women who want to give birth at home can still do so.”

“The results of this study show better outcomes for the baby when the result of the CPR measurement is known.

“This means that we see fewer complications during childbirth when this measurement is taken, compared to the current policy where it is not done.”

She added: “If doctors know the results of this measurement, they can better distinguish whether the baby's reduced movement has a harmless cause or whether it requires action.

“This ensures that mother and baby receive the care that best suits their situation.' The guideline on reduced fetal movements will soon be updated; the professional association will incorporate the results of this study into it.”

The study was funded by ZonMw from the Netherlands.

Sanne Gordijn conducted this CEPRA study together with researchers from Amsterdam UMC in 23 hospitals. Laura Lens, the MD, PhD student on this study presented at the international SMFM conference in Denver (USA) and Sanne in London. The study is published on July 10 in the authoritative scientific journal The Lancet Obstetrics, Gynaecology & Women’s Health.

• The study is published in the Lancet Obstetrics, Gynaecology and Women’s Health and is available
• doi.org/10.1016/j.lanogw.2025.100002

During the COVID-19 pandemic it has been vital to keep people out of hospital where possible to minimise the risk of virus transmission. For pregnant women, who are recognised as at higher risk from COVID-19, it is essential that, where possible, hospital attendances are avoided.

Avoiding face-to-face appointments posed significant challenges for antenatal services as many women receive vital care during these clinics, including blood pressure measurement and glucose monitoring. Both checks are important as they can pick up signs of serious complications, such as pre-eclampsia or diabetes.

The MyMaternity app was developed with clinicians at Saint Mary’s Hospital, part of Manchester University NHS Foundation Trust (MFT), and used feedback from people previously under their care to help inform design and content. The app allows pregnant women to record their blood pressure and glucose measurements at home, with information sent to their midwifery team in real-time. Midwives monitor the results and escalate for additional treatment if there is a need. The app also provides guidance and information for the users.

The app is now available at three hospitals in Greater Manchester and has supported more than 400 pregnant women so far.

Professor Jenny Myers, Consultant Obstetrician at Saint Mary’s Hospital and Professor of Obstetrics and Maternal Medicine at ����Vlog�ٷ�, said: “During COVID-19 it has been vital to keep our pregnant women safe and reduce hospital attendances where they can be avoided. By being able to monitor our pregnant women remotely, maintain regular contact with them and view their results easily in the new app we can continue their care and limit the number of people needing to attend hospital during the pandemic.”

Rose’s Story

Rose McGarty said the app was reassuring to know she was being closely monitored by her clinicians during her recent pregnancy.

Rose (39), from Cheshire, has nephrotic syndrome, a kidney disease which can lead to extra complications such as high blood pressure. Her medical condition meant she was at risk of hypertension and pre-eclampsia during her pregnancy and so needed specialist care and monitoring at Saint Mary’s Hospital.

Through the MyMaternity app, Rose was able to monitor her blood pressure at home and send the results directly to the team providing her care.

Rose, who gave birth to baby Arlo in July, said: “It was so reassuring to be able to log my blood pressure readings into the app and get guidance directly from the app itself or from the team at Saint Mary’s.

“During the pandemic it was really helpful to have that additional link and contact to the team, especially as being pregnant and my other health conditions put me at high risk for COVID. Having the app available meant I could be monitored at home and I didn’t need to worry about travelling to the hospital unless it was necessary or for a scan.

“I always knew I could call the team if I needed to, but taking the blood pressure myself at home became part of my pregnancy routine and reassured me that I was doing the right thing for myself and my baby.

"I can't thank the dedicated team at Saint Mary's, especially the Manchester Antenatal Vascular Service (MAViS), enough for the care they have provided during my pregnancies. I now have my two miracle babies "

Rose, who is also mum to five-year-old Ruby, was especially happy to use the app after providing her opinions and experience to the development team while it was being created.

Rose added: “It was really interesting to contribute to the app development process and share my thoughts and experiences. It’s very important that patients and the public are involved in the process to make sure it works for the people who will be using it, making sure it is simple, easy to use and easy to understand.

“I never thought I’d actually use it myself but when I found out I was pregnant a few months later I was excited to try it out from a patient perspective. It was really easy and simple to use and I’d recommend it to anyone concerned about high blood pressure during their pregnancy.”

The technology

The app has been developed by tech company Graphnet, which specialises in developing health and care IT solutions, and supported by Health Innovation Manchester’s delivery team. It has also been developed in collaboration with users.

The functionality of the MyMaternity app is set to be integrated into the GM Care Record, which is also powered by Graphnet. The GM Care Record collates information held by different health and care organisations to ensure that GPs, doctors, nurses, midwives and practitioners can see up to date medical records, care plans, medications and test results. It now informs the right care and treatment for almost all 2.8m people across Greater Manchester.

Guy Lucchi, Digital Innovation Director at Health Innovation Manchester, said: “The MyMaternity app is a fantastic example of using technology to improve patient care and support clinicians. It is also a testament to the strength of our existing devolved partnerships across GM to take swift action on things that will directly benefit patients and frontline services during the COVID-19 pandemic and beyond.”

Brian Waters, chief executive of Graphnet, said: “We are delighted to have been able to help Health Innovation Manchester respond quickly and use our technology to provide important monitoring services safely to pregnant women.”

An international study of 115 mums who gave birth during the pandemic shows far more physical abnormalities in the placenta (baby’s support system in the womb) than doctors would expect to see in a pre-2020 pregnancy. Rates of placenta problems tripled among mothers with Covid-19 but doubled even among those who tested negative, suggesting these changes can be caused by the sheer stress of the pandemic as well as the virus itself.

Stress in pregnancy can lead to inflammation and functional changes in the placenta, which can raise pregnancy risks and have long-term consequences for babies’ development. As Covid-19 triggers inflammation, the concern for expectant mothers who catch the virus is whether this can damage the placenta – but despite being classed as higher risk in the pandemic to protect their physical health, their mental wellbeing is more easily overlooked.

Although other studies are investigating how Covid-19 infection affects pregnancy, this is the first to look at pandemic-related stress more broadly in mums without the virus. that mums who gave birth during the pandemic are more likely to have clinical depression and anxiety, and a across the UK found that 9 in 10 felt more anxious because of Covid-19. While some were isolated in lockdown, others faced the stress of being unable to avoid unsafe environments; almost half of pregnant women didn’t feel safe going out to work, and 1 in 10 were (or expected to be) made

Study co-author Professor Alexander Heazell, Director of Tommy’s Stillbirth Research Centre at the University of Manchester, said: “The increase of placental problems we’ve seen during the pandemic is concerning, but we need more long-term research to understand the full effects of Covid-19 and related stresses on pregnancy; both clearly affect the placenta, but we still can’t tell exactly what that means for the health of mothers and babies. In the meantime, there must be appropriate psychological care and support available throughout pregnancy, to help reduce the pandemic’s impact on maternal wellbeing.”

Prof Heazell and his team at Tommy’s research centre took samples from the placenta, umbilical cord and fetal membranes of mums who gave birth at Saint Mary’s Hospital in Manchester from March to September 2020; study authors in Canada and France also took samples for analysis from their local hospitals. When an expectant mother tested positive for Covid-19, researchers randomly selected someone without the virus who gave birth in the same hospital at the same time, as well as comparing these groups with historic patient data.

More than three-quarters of mums with Covid-19 had abnormalities in their placentas (92.9% in the UK / 80.6% in Canada / 87.5% in France) compared to half of those who gave birth during the pandemic without having the virus (45.5% in the UK / 52.6% in Canada) and a quarter of the pre-2020 group (25% in Canada, consistent with other ).

Trends varied across countries, but common issues found in the UK were excess of a blood-clotting protein called fibrin (which can restrict babies’ growth) and calcification (calcium in the placenta builds up in late pregnancy to prepare for birth, but too much too soon can cause dangerous deterioration). Some abnormalities were only found in mums who had Covid-19, suggesting they’re caused by infection – but others happened across 2020 pregnancies and not in the control group, implying links to the stress of the pandemic rather than the virus itself.

Researchers concluded that both Covid-19 and pandemic-related stress can affect the placenta, but more long-term studies are needed to properly assess the pandemic’s impact on the health of mothers and babies. Tommy’s CEO Jane Brewin said: “Good research evidence takes time, and the pandemic is still unfolding – so while our scientists keep working to understand how this affects pregnancy health, it’s vital that mums-to-be are supported mentally as well as physically. We’ve seen a huge rise in calls to the midwives on our helpline throughout the last 18 months, as the pandemic has created extra confusion and anxiety for many families along the pregnancy journey. Services are adapting but they’re still running, so mums shouldn’t hesitate to raise any concerns with their care team and seek help when needed.”

30-year-old content marketer Rachel from Rhyl found out she was expecting her first child just before the Government deemed pregnant women a higher risk group in the pandemic, which she describes as “extremely anxiety-inducing”. Rachel recalled: “I didn’t know what to do because I’ve never been through this before – and even if I had, Covid changed everything. I couldn’t just go to my midwife, and in fact I hardly saw any professionals until I was close to giving birth. I didn’t want to be a burden with my concerns when the NHS was in crisis, so I must’ve spoken to Tommy’s midwives on their helpline dozens of times; it really made such a difference to have a professional reassuring me that my anxieties weren’t unreasonable and giving advice to improve my mental wellbeing. ����Vlog�ٷ�ing with fellow mums-to-be online helped too, and I got to a place where my stress and anxiety levels were manageable.”

Tommy’s midwife Amina Hatia advised: “Any pregnancy can be stressful, and anxiety is a normal response to a threatening situation, so it’s completely understandable to struggle in times like these – but there are things expectant parents can do to feel more in control. We’re all different so the only advice that will apply to everyone is to focus on your physical and mental health, distracting yourself with things you enjoy or find relaxing, instead of being drawn into ‘what ifs’. Try to avoid the constant news cycle, which can be overwhelming, and only get updates from reliable sources when you need information. Talk to someone you’re close to, or release emotions into a journal, but don’t keep things in. Take it a day at a time, be kind to yourself, and reach out for support if you need it.”

The team, who publish in the journal Human Reproduction today (14/09/21), reveal for the first time that embryos are able to detect foreign (non-self) cells – including pathogens – in their environment.

The in vitro (procedures performed outside of the body, usually in a lab) study was funded by the and

According to the research team, when foreign cells are detected by special proteins called Toll Like Receptors (TLRs) in the embryo, it releases a type of protein called a cytokine.

Elsewhere in the body, the cytokine – called Interleukin-8 (IL8) – usually plays a role in the immune system by recruiting neutrophils to a site of inflammation.

However, its role in the relationship between embryo and mother to be is yet to be discovered.

The scientists observed the behaviour on days five and six of the embryos’ development, when it is free living in the female body, just before it implants in the lining of uterus and pregnancy begins.

Scientists already know that TLRs are found in the fallopian tube and vagina – known as the maternal tract.

Human sperm have also been shown to express TLRs 2 and 4, however, there has not been similar investigations of human embryos, until now.

Lead author Professor Daniel Brison is an Honorary Professor at ����Vlog�ٷ� and Scientific Director at the

He said: “Early human embryos are highly sensitive to their local environment, however before this study, relatively little was known about how they detect and respond to specific environmental cues.

“We have discovered a signalling system generated by the embryo which allows communication with mum in a new way.

”We already knew that embryos communicate with mum when they begin to implant, but we don’t know why this new signalling happens.

“Perhaps this is an additional way of signalling an inflammatory response to the maternal tract in response to pathogens, or to modulate the implantation process and the initiation of pregnancy.

“Our data also suggests a balance between suppression and stimulation of the innate immunity response in embryos. That may reflect the need for embryo survival in the presence of benign foreign cells, versus the need for the maternal tract to respond to infection.”

The expression of Toll Like Receptors and related genes in human embryos was assessed by a literature search of published data.

Then, 25 five-day-old human embryos were cultured in the presence of Poly (I: C) and flagellin – molecules – or ligands – known to bind to Toll Like Receptors TLR3 and TLR5.

Other TLRs – expressed from the 22 known TLR genes – were not investigated by the team.

Then on day six, they measured gene expression and cytokine production and compared the results to controls.

Professor Brison added: “Though it’s very early days, this research gives us a basic understanding of what happens to the embryo in early pregnancy.

“It has implications for both natural and artificial conception, since infections can occur in both the maternal tract and In vitro Fertilisation media used for embryo culture and transfer to the uterus.

“It might one day shine a light on infertility: why some embryos do not implant into the uterus, or even help us to identify the quality of IVF embryos developing in culture.

“But much work needs to be done before we can reach that stage. And further investigations are required to determine whether the TLR stimulation response is effective during the embryonic journey in the fallopian tube.”

Human embryos surplus to treatment requirements were donated with informed consent from several Human Assisted Reproductive Technology centres.

The expression and activity of Toll-like receptors in the preimplantation human embryo suggest a new role for innate immunity is published in Human Reproduction

A study has linked babies conceived through a type of IVF to lower birth weight followed by increased growth after birth.

����Vlog�ٷ� led study of 5,200 IVF children found that singleton babies conceived from fresh embryo transfers - used in two thirds of all IVF - are associated with lower birth weights, head circumference and length, but then grow more quickly, catching up to naturally conceived children by school age.

The team are also monitoring birth weight in IVF babies over a 25-year period, and initial results show that weight seems to be increasing. It may be that recent improvements in IVF technology are responsible, though it’s too early to know for sure, say the team.

Babies conceived from frozen embryo transfers – used in about one third of IVF- have greater weight, head circumference and length at birth and show similar growth to naturally conceived children.

“Though the effects are small, they do justify considering using the safest form of IVF treatment where possible, and continuing to monitor the long-term health of these children,” said reproductive biologist Professor Daniel Brison who led the study.

“Overall IVF babies are just as likely to be born healthy as any other, and the lifestyle choices they make in later life will far outweigh any small effect of low birthweight and altered growth,” explained Professor Brison.

Using Scottish data, it is the first large-scale study of early growth in IVF children from birth to school age anywhere in the world, and only the second study of health in UK IVF children using the Human Fertilisation and Embryology Authority register of IVF treatments.

The European Union funded study, which involved researchers from the Universities of Manchester and Southampton, is published today in BMC Medicine.

Among the headline findings are:

• The birthweight of babies born from fresh embryo transfer cycles is on average 93·7g less than naturally conceived babies.
• Babies born from frozen embryo transfers are on average 57·5g heavier.
• Fresh embryo babies grew faster from birth by on average 7·2g/week but remained lighter by 171g, at 6-8 weeks, than normally conceived babies and 133g smaller than frozen embryo transfer babies; who were similar to normally conceived babies.
• By school entry (4-7 years), weight, length and BMI in boys and girls conceived by fresh and frozen embryo transfer were similar to those in naturally conceived children.

Professor Brison said: “We don’t yet know why fetal and child growth for children conceived through this form of fertility treatment is affected.

“Babies born from IVF appear largely healthy, though the oldest of them, Louise Brown, is still only 40 so we feel there is a duty to monitor this cohort of children for diseases which show up only in later life.

“The impact of fresh embryos transfer on birth weight is after all nearly as great as that of maternal smoking in pregnancy. One possible explanation, say the team, is that fetal growth is restricted with fresh embryo transfer because of impaired placental function associated with dysregulated maternal hormones. Freezing embryos, they argue, may also help to preserve them to establish pregnancy later on when the mother’s body has recovered from IVF.

“But IVF children need not be alarmed: the greatest risk from IVF is multiple pregnancy, and the IVF field and government regulator (HFEA) have worked together to improve this greatly over the last 5-10 years.”

“” is published in BMC Medicine.