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The Placenta: Our Least Understood Organ

Normal placentaThe placenta, commonly referred to as the afterbirth, is a disc of tissue that connects a mother’s uterus to the umbilical cord, and is ultimately responsible for delivering nutrients and oxygen to a fetus. It plays a critical role in fetal development and yet, researchers know very little about how it functions, and the role it plays in maintaining a healthy pregnancy.

What researchers do know is that abnormal development of the placenta can cause complications in pregnancy including poor fetal growth, preeclampsia – a condition that causes 15 percent of premature births and is the number one reason doctors decide to deliver a baby prematurely – and stillbirth. Now, with the help of funding from the National Institutes of Health (NIH), teams across the nation are working on ways to better understand the placenta and how to monitor it during pregnancy.

Among the grant recipients, a team of researchers at Penn Medicine and the Children’s Hospital of Philadelphia were recently awarded $4.2 million to develop new imaging technologies that will reveal key information about placental development. The project is part of the NIH’s Human Placenta Project. First launched in 2014, today the initiative funds nearly 20 research projects and teams working to unlock the mysteries of this vital and mysterious organ.

Right now, doctors are limited to studying the placenta using ultrasound technology and blood tests, but these techniques do not provide a reliable means of predicting complications or other adverse outcomes. Understanding that new imaging tools are needed to monitor the development of the placenta early in pregnancy, the Penn/CHOP team – co-led by Nadav Schwartz, MD, an assistant professor of Maternal Fetal Medicine at the Hospital of the University of Pennsylvania, and Daniel Licht, MD, a pediatric neurologist and director of the Neurovascular Imaging Lab at CHOP – is working to develop a more precise and user-friendly approach to evaluating placental structure and function. The goal of the project is to introduce new technologies, such as more advanced imaging tools and sensors, which will give doctors a more in-depth idea of the placenta’s function during pregnancy.

Over the next four years, the investigative team – which includes a cross-section of experts in Radiology, Bioengineering, Physics, Nursing, and Women’s Reproductive Health (clinical perinatology, nutrition and placental biology) – will use the latest techniques in ultrasound, MRI, and near-infrared spectroscopy (NIRS) to provide a comprehensive look at placental development in early pregnancy. Schwartz says the diversity of the team is crucial for the development and application of new technologies, as well as analysis of data and decisions regarding research directions over the funding period.

“Ultimately, we’re aiming to develop a simple, clinically useful imaging modality that can be used at the bedside to identify women early in pregnancy who are at highest risk of developing pregnancy complications attributed to abnormal placental development,” Schwartz said. “By working with colleagues who have expertise in both clinical applications and new technique development for each of these modalities, we’ll be able to leverage the strengths of each to create a screening approach that prioritizes bedside modalities.”

Now in its first year of funding, the team is working to recruit participants in both early and later stages of pregnancy to track the placenta, and develop new monitoring techniques. Eventually, the team plans to conduct a pilot study using the information learned in the first phases to determine the impact of maternal nutrition on placental development and function. Stay tuned to the Penn Medicine News Blog for more developments from the study. 

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