Innovative partnerships improving pregnancy outcomes


The power of productive partnerships is helping health experts arrive more swiftly at treatment breakthroughs – with Professor Annette Briley’s studies into pregnancy and childbirth being a significant beneficiary.

Professor Briley’s joint-appointment with NALHN (Northern Adelaide Local Health Network) and the Caring Futures Institute at Flinders University is proving highly beneficial, with the combined resources of both big organisations being harnessed to help improve pregnancy outcomes for women, babies and families, build research capacity and develop infrastructure to undertake further research that is relevant to the local population and workforce.

A shared-appointment is something Professor Briley had done previously in the UK, so she knows how beneficial the arrangement could be for both partner organisations. “With me being the conduit between a clinical service and the university, it helps to establish clinical research that is relevant to the local population,” she says.

In London, Professor Briley investigated problems of women suffering excessive bleeding, that affects 34% of all births, noting that only a small percentage go on to be serious. However, without immediate treatment a healthy woman would bleed out in 10 minutes.

“It remains a major cause of maternal deaths worldwide, with most occurring in developing countries, but in Australia women still die from this every year,” she explains. “In this country, 49% of women have labour are induced, which can increase the risk of bleeding after the baby is born.”

More attention needs to paid to this serious problem, because the circumstances for women giving birth in developed countries are changing; they are older and heavier when giving birth, which compounds potential bleeding problems during childbirth. To examine this, Professor Briley has created complex models to identify risk factors – which also includes such things as high BMI ratings, the presence of fibroids, and whether twins are onboard – and her guidelines have had an immediate effect.

“When these factors were identified through putting a sticker on the handheld notes, midwives have been able to pick women at risk and reduce the incidence of catastrophic bleeding. Some clinicians hadn’t been acting quickly enough. Now we have checks that ensure much greater efficiency.”

Significant improvements have also come through Professor Briley’s work with Microlife to help create the Cradle VSA blood pressure measuring device, which instantaneously calculates the shock index of patients, so rather than relying on visual estimation of blood loss, or measuring drapes and pads, maternal compromise can also be assessed through shock index – and is vital in emergency situations.

Her continuing work includes measuring the effects of women taking iron infusions during pregnancy (to determine whether such high boosts for women with low iron counts carries unexpected side effects), and an international trial looking at whether women at risk of pre-term birth can be helped by limited doses of steroids, to ensure foetal lung maturity.

Professor Briley is also involved in an international study examining post-traumatic stress disorder and psychological disorder affecting women after childbirth, and she is part of the Begin Better Consortium, which is a major study looking at women who are prepared to delay pregnancy if they are overweight or obese, to see whether lifestyle intervention can improve pregnancy outcomes.

Professor Briley says working on such a spread of diverse health research material simultaneously is only possible due to strong bridges that are built through joint-appointments. “They are tricky to manoeuvre, because a university and a clinical facility have quite different demands, but the benefit is that someone in my position can bring credibility to the work of both organisations simultaneously,” she says.

“Having the backing of a university is particularly important in these roles, because it brings the academic rigour required for effective research that can then be introduced to clinical practice.”

It also means that, having a foot in both camps, Professor Briley’s outcomes are more likely to be readily accepted by clinicians. It therefore provides a valuable means of accelerating the transition of research into practice.

“The transition becomes more seamless, which ultimately means – in the case of my work – that women who have problems with childbirth get better outcomes.”

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