Coiling of the Umbilical cord in pRegnancy and LIfelong health (CURLI)
Placental dysfunction
We will recruit pregnant participants at any point from 12+0 weeks' gestation up until delivery. When recruited before 30 weeks' gestation, participants will be invited to up to three study visits during pregnancy, with at least 8 weeks between visits. If recruited after 30 weeks' gestation, participants will be invited to a single study visit only. Study visits will involve multimodal placental and umbilical cord imaging, including: 1. Functional and anatomical assessment of the placenta and umbilical cord through a non-contrast MRI of the uterus. MRI assessment may be carried out a maximum of two times per participant. 2. Ultrasound assessment of the placenta and umbilical cord, including capture of two-dimensional images and three-dimensional volumes containing the placenta, umbilical cord insertion site, and free umbilical cord loops. Doppler ultrasound assessment of blood flow within umbilical vessels will also be performed. 3. Additional maternal and fetal metrics may be gathered during the ultrasound scan including maternal uterine artery Doppler indices, fetal Doppler indices (from the middle cerebral artery and ductus venosus), and fetal biometric measurements. We will collect maternal blood samples at study visits for measurement of angiogenic biomarkers PlGF and sFlt-1. Where possible, placental and umbilical cord specimens will be collected at birth for macroscopic and histological assessment. Maternal demographic information and pregnancy outcomes will be collected within 2 weeks of birth from the electronic health record.
1. Aged 16-50 years 2. Able to give informed consent 3. Singleton non-anomalous viable pregnancy with gestational age >12 completed weeks 4. Pregnancy booked in NHS Lothian 5. No contraindication to MRI
1. Women who are not pregnant 2. Aged under 16 or over 50 years 3. Women who are classified as Adults with Incapacity (AWI) as determined by midwife, GP, or research team 4. Multiple pregnancy 5. Diagnosed major congenital abnormality affecting fetal cardiovascular or nervous system 6. Contraindication to MRI (presence of non-compatible prostheses, implants, conductors or metallic foreign bodies, severe claustrophobia)