Research projects - Obstetics and Gynaecology

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Fetal regenerative medicine

Magnus Westgren, professor, head of the division

From fetal tissue, it is possible to isolate fetal stem cells. These cells have special properties in regard to expansion capacity and neurological function. Our resource group have developed techniques for isolation and characterisation of fetal stem cells and we have also used these cells for intrauterine fetal stem cell transplantation. More recently, we are working on fetal stem cells in regards to tissue engineering with the aim to produce transplants for reconstructive surgery at severe congenital malformations.

I Human embryonic stem cells and induced pluripotent cells:

derivation, clinical grade, optimal culture, banking and differentiation to germ cell and neural lineages. II. Optimal cryopreservation and maturation of human ovarian follicles and oocyt

Outi Hovatta, professor

We have derived 30 human embryonic stem cell lines, optimising the conditions during this process to xeno-free clinical direction. We use human skin fibroblasts as feeder cells, or feeder-free cultures on human recombinant laminin 511 or matrigel, mechanical isolation of the inner cell mass of the blastocyst, and chemically defined xeno-free culture media.We have established several induced pluripotent cell lines usin non-reprlicating lentivirus vectors, and are now developing non-viral methods. Exploring regulation of early differentiation of human pluripotnet cells by using high throughput sequencing is ongoing. We differentiate pluripotent cells to germ cells and to neural cells.

In the other demanding culture project we are utilising a three-step culture system to obtain mature oocytes from the primordial human ovarian follicles to be used clinically in treatment of women who have lost their fertility due to chemotherapy of genetic causes. In this requiring long-term project we are approaching the goal by getting regularly antral follicles from the tiny primordial ones which are located in the cortex of the ovary. We still have to test the normality of such long term in vitro matured oocytes. After that this method can be used for infertility treatment of women whose ovarian cortical tissue we cryostored before cancer treatment or other disappearance. The clinical cryopreservation has been optimised.

Local oxytocin reverse vaginal atrophy in postmenopausal women

Aino Fianu Jonasson, Ass. professor, Senior researcher

Up to 50 % of all postmenopausal women, experience vaginal dryness, irritation, burning, itching, or discomfort, which often make sex to become difficult or painful. These symptoms combined are known as vaginal atrophy. Several studies show that the vaginal discomfort is relieved by oestrogen therapy, systemic or local and that the vaginal mucosa becomes normalized as observed by visual inspection of the vagina.The primary objective of this study is to investigate if topical oxytocin can reverse vaginal atrophy. The aim of the study is to evaluate if oxytocin applied locally in the vagina might restore the atrophic mucosa in postmenopausal women.This is done by the help of cytological and histological examination of vaginal mucosa epithelium in postmenopausal women after 12 weeks treatment compared with placebo.

Resistance vasculature and cardiovascular health: characterization of pathogenetic mechanisms and therapeutical implications

Karolina Kublickiene, MD PhD, Senior Researcher, Associate Professor

Investigations concentrate on vascular physiology and pathophysiology with focus on resistance artery function primarily in women at reproductive age and after menopause. In addition, patients with coronary heart disease, chronic kidney disease and healthy female and male volunteers are included. Studies involve a range of different isolated small artery bioassays, pharmacological and molecular assesments of endothelial dysfunctional markers and cellular signaling in combination with in in vivo assessment of large artery function and measurements of known and recently recognised biochemical markers for increased cardiovascular risk.

Adipose tissue derived from mesenchumal stem cells in repair of female urinary incontince

Aino Fianu Jonasson, Ass. professor, Senior researcher

Urinary Incontinence is a big problem for the individual that suffers from it and for the society, It disable the person during their regular work. It is also costly and has negative effects on the quality of life. In Sweden, it is calculated that about 500 000 are affected, which is 12-15% of all the women or 15-20% of the women within the age of 40-49. Only 10% av these women seeks help for their disease symptoms. The aim with this study is to test if we can extract and grow stem cells from the females abdominal fat tissue. This tissue could possibly replace the tissue that is malfunctioning and also replace the syntetic material that is used in the treatment of women that has SUI.

Prevention of pregnancy and childbirth complications

Pelle G Lindqvist, Associate Professor, Senior Consultant

Research on prevention of pregnancy and childbirth complications. Pregnancy complications such as preeclampsia, growth restriction, thromboembolism and prematurity causes a great proportion of both maternal and fetal complications. Through the identification and evaluation of risk factors, strategies for the avoidance of complications are assessed. Methods range from large prospective epidemiological studies, population-based case-control studies, laboratory studies, DNA association studies, and studies on stem cell differentiation. A major effort is made to implement the results at the clinic, both locally and nationally.

Clinical obstetrics

Henry Nisell, Assoc. Professor, head of undergraduate education

Retrospective case-control studies to identify risk factors for development of birth related injuries of the brachial plexus and to define clinical variables, which affect the outcome of extraction by ventouse

Vascular function in normal and abnormal pregnancy (Principle investigator: Karolina Kublickiene)

Henry Nisell, Assoc. Professor, head of undergraduate education

Together with Karolina Kublickiene: Small arteries from myometrial and subcutaneous fat biopsies from healthy pregnant women and women with preeclampsia are examined with regard to endothelial function. The groups are compared with respect to endothelial dependent and independent vasodilatation. Specific attention is paid to the importance of endothelial derived hyperpolarizing factor in this context.

New strategies to prevent fetal and neonatal complications in rhesus D isoimmunization

Eleonor Tiblad, MD., PhD.

The incidence of RhD immunization in pregnancy in Sweden is about 1% in spite of the current prophylaxis strategy. RhD immunization causes hemolytic disease of the newborn och these pregnancies demand large resources in terms of management and intervention during pregnancy and neonatal intensive care of the newborn. Modern molecular biology techniques allow us to determine fetal RHD type from maternal plasma in the first trimester of pregnancy. Targeted anti-D prophylaxis in the beginning of the third trimester can then be offered to RhD negative women carrying an RHD positive faetus. With this strategy, the incidence of RhD immunization can most likely be reduced to 0,3%. The clinical effectiveness and cost effectiveness of this strategy is currently evaluated in a prospective cohort study including all RhD negative women in Stockholm County with ending date 31st of December 2011.