What do you do, Lisa?

Lisa is a consultant in obstetrics and fetal medicine and senior lecturer at King's College London
Colourful question marks drawn by a child

""March 2024

What is your current role?

I'm a consultant in obstetrics and fetal medicine at St Thomas' Hospital and a National Institute for Health and Care Research (NIHR) Advanced Fellow in women's and children's health.

In both my research and clinical practice, I focus on pregnancies at high risk of preterm delivery (birth before 37 weeks of pregnancy) or fetuses with known abnormalities before birth. I work with a number of different research groups within this field encompassing fetal imaging, clinical trials of interventions to reduce the incidence of preterm birth, and psychological support for women who are experiencing complications associated with these conditions.

What do you enjoy about this field?

Understanding what the challenges are in clinical practice and trying to find solutions to them can be really rewarding and has the potential to really improve care for women and birthing people. Every day is different and working closely with patients who have gone through these experiences is very inspirational!

Why is imaging in pregnancy important?

Most of the imaging we perform clinically during pregnancy uses ultrasound. Ultrasound scanning is really good at identifying if there are major problems with a pregnancy. If certain conditions or problems are identified on the ultrasound scan, MRI is already used to provide additional information, such as how the brain is developing.

Research using fetal MRI scans is evolving rapidly and we now have the ability not only to assess how the baby is developing but also to identify more subtle changes that may be occurring in the baby's organs, such as within the baby's brain or lungs.

How are you using imaging in maternity research?

We know preterm birth is common and affects 8% of all pregnancies but the outcome for the babies can vary hugely. It depends on a number of things, such as the number of weeks pregnant the parent is when they give birth, or whether there is an infection. We know an infection makes the outcome worse for both the parent and the child. However, we don't currently have a test in clinical practice to diagnose infection in a baby and have to rely on quite non-specific indicators which can be abnormal for many different reasons, such as the pregnant woman or birthing person's temperature, heart rate and blood tests. 

We are undertaking a study, funded by NIHR, using advanced MRI scans to see if we can look at the placenta and parts of the baby's immune system during pregnancy to identify if an infection is present after birth and see whether the baby is developing normally. In the future this may improve counselling so we can provide more individualised information to people in our care about their baby. It may also help us know when is the most appropriate time to deliver a baby or give medicines that may help the baby's development in the future. 

We're also running another study to see if these advanced MRI techniques can improve how we diagnose fetuses that have complications with their lungs. This also involves Medway Maritime Hospital and King's College Hospital and is funded by the Medical Research Council.

Who do you work with?

I'm really lucky to work with a number of fantastic teams spanning parts of the clinical service and university. These include the preterm birth research teams, the perinatal imaging group within the School of Biomedical Engineering and Imaging Sciences around the use of cutting-edge fetal imaging and clinical psychologists with whom we are trying to improve the care women and birthing people receive during complex pregnancies.

Most importantly we work very closely with the Guy's and St Thomas' Preterm Birth Patient and Public Involvement Group and a patient advocacy group called Little Heartbeats founded by Ciara Curran, an amazing woman who sadly lost her daughter, Sinead, to preterm prelabour rupture of the membranes (PPROM), a condition associated with a number of significant complications, premature delivery being one of them. These women are instrumental to improving care and their experiences are vital to developing and executing a lot of the research that we undertake.

How does what you learn impact patient care?

A lot of the research that I undertake has been developed with women and birthing people with lived experience of complex conditions. They very much help us identify relevant questions that are important to them and also help execute the research. They highlighted the psychological impact of preterm birth to us and they have been a driving force in the work that we're doing in this area.

What's next on the horizon at Guy's and St Thomas' and King's College London in this area?

As well as continuing with our ongoing imaging studies we're also looking at the psychological impact that high-risk pregnancies have on women. We're about to start a pilot study looking at psychological support for pregnancies complicated by PPROM in collaboration with Little Heartbeats and funded by Tommy's.

What are you most proud of?

I'm really proud to work with such amazing people and hope that we'll improve care in the future.

Colourful question marks drawn by a child

Thank you to the children and young people who have so brilliantly illustrated our blog pages.

What do you do?

We love highlighting our staff and their amazing career journeys.

Read other pieces in this series:

  • What do you do, Willis? As a counsellor, Willis supports the mental health of parents and carers so they can protect the children at the centre of their world.
  • What do you do, Mandy? Hear from Mandy about how research has grown at Evelina London, so that medicines can become available to more children.
  • What do you do, Bren? As part of the 'pioneering team' in our children's day surgery unit, Bren shares what he loves about the unit, from the outer space artwork to the superb training opportunities.

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