Our research falls within the field of maternal and foetal health, covering the period of time from the moment of conception to labour and delivery. The main lines of research focus on areas of especial importance in current obstetrics.
The first line of research is "Rationalization of Caesarean rate". Due to the progressive increase of worldwide Caesarean rate; new studies, which provide scientific evidence of different procedures which could reverse this situation, are required. In this line of research, the two most developed areas in our group are external cephalic version and the induction of labour. The first one is a procedure used to turn a foetus from a breech position or side-lying (transverse) position into a head-down (vertex) position before labour begins; and therefore Caesarean rate is reduced. With over 10 years of experience, our group is national leader as well as research and teaching reference centre in this field. We have assessed the impact of this technique in Caesarean rate, the success clinical factors and have generated an index in predicting outcome in clinical practice. Several studies have been designed in order to reduce patients' pain and to improve security and success of the technique, such as the use of novel tocolytic agents, painkillers and maternal hydration. In addition to several scientific publications and communications in congresses, our group is responsible for the development of a consensus document about the external cephalic version by the Spanish Obstetrics and Gynaecology Society. Currently, a randomized prospective clinical trial with two analgesic drugs is conducted; and ongoing work is done in order to include new modifications in the procedure and improve its outcome.
As part of this first line, our research also focuses on elective induction of labour. This situation is very common and is regarded as one of the causes of increase in Caesarean rate. In order to improve the outcome in this area, the two main objectives are to reduce the number of inductions performed due to scientifically no-justified reasons and to improve the systems of induction of labour. In this regard, there are several past and ongoing studies on the Bishop score for the prediction of Caesarean rate in induction of labour, the effect on Caesarean rate of variations in the induction's date in prolonged pregnancies or the outcomes of induction in twin pregnancies. Our group has participated in an international multicentre clinical trial of cervical ripening with dinoprostone and have analysed its use in the induction of labour in pregnancies which previously had caesarean delivery. Moreover, we have collaborated with the Spanish Obstetrics and Gynaecology Society in the development of a consensus document about induction of labour and birth attendance. Our group has participated in several projects and clinical practice guidelines development, for instance "Análisis del uso de la técnica de cesárea en el País Vasco y definición de pautas de actuación en las diferentes posibilidades y de las indicaciones de cesárea en general. Elaboración de recomendaciones de práctica clínica" (funded by the Health Department, Basque Government) and "Guía de Práctica Clínica sobre la Asistencia al Parto de las Mujeres Sanas" (funded by the Health Department – Osteba/Basque Government and Carlos III Health Institute ISCIII).
The second line of research focuses on maternal and foetal pathology. In this regard, several studies about prematurity has been carried out, for example the international multicentre randomized clinical trial Tractocile Efficacy Assessment Survey in Europe (TRASURE) or the collaborative research project "Resultados de la asistencia perinatal de los embarazos prematuros en la red sanitaria del País Vasco" funded by the Health Department – Osteba (Basque Government). Other area of interest is the placental insufficiency; currently we are taking part in two funded projects: 1) a multicentre randomized clinical trial for its prevention (Heparina de bajo peso molecular para la prevención de complicaciones derivadas de la insuficiencia placentaria en las pacientes de riesgo sin trombofilia [MSC EC10-205]) and 2) a multicentre prospective observational study for the analysis of brain injury factors (Factores pronóstico de lesión cerebral en fetos con crecimiento intrauterino restringido precoz [MSC PI11/02613]). In addition, we have started a prospective observational study on the prediction of newborn morbidity in pregnancies with impaired foetal growth and we participate in the generation of a prospective cohort of pregnant women with autoimmune diseases.
Moreover, a new line of research in Foetal Medicine has been introduced with the creation of a foetal therapy unit and the addition to our group of an internationally well-known investigator who has worked at King's College Hospital (London). Our group has participated in several funded projects, for example a multicentre study for the development and validation of novel non-invasive molecular diagnostic tools, based on genetic analysis of foetal cells isolated from maternal blood samples, and a study for prenatal diagnosis of hereditary ocular diseases. Recently several projects have been initiated, such as the study of maternal attitude towards the diagnosis of congenital malformations during the first trimester of pregnancy; and we will conduct a national multicentre study for the assessment of clinical feasibility of volumetric tele-ultrasonography in prenatal diagnosis of foetal central nervous system congenital malformations.
This is an emerging group whose main goal is to improve healthcare quality for postpartum women and newborns (particularly of those who have been identified as late preterm infants) who are admitted to the Nursing Unit in the Obstetrics/Gynaecology Department at Cruces University Hospital. The first launched project, which was funded by the Health Department (Basque Government), aimed the design and implementation of nursing intervention in healthcare provided to late preterm infants. This is a collaborative project with several groups at Cruces University Hospital, including the Clinical Epidemiology Unit, Dr. Rodríguez-Alarcón who is the Head of the Perinatology Section (Paediatrics Department) and Dr. Martínez-Astorquiza who is the Head of the Obstetrics/Gynaecology Department.
Life & Medical Sciences
- Biosciences & Health
How to arrive
- Rationalization of Caesarean rate: External cephalic version at term; Induction of labour
- Maternal and Foetal Pathology: Foetal growth pathology; Pre-eclampsia and Autoimmune Diseases; Foetal Medicine
- Improvement of healthcare quality for postpartum women and newborns (in particular, late preterm infant)