To find out about some of the research going on at Guy’s and St Thomas’, our intern Jasmine Ebanks has interviewed some of our researchers about their work and their career path into research.

She caught up with Dr Melanie Nana, an Obstetric Medicine Fellow at Guy’s and St Thomas’, who is working on projects relating to severe sickness during pregnancy.

Dr Melanie Nana first became interested in women’s health research after hearing a talk delivered by Professor Catherine Williamson on endocrine problems in pregnancy at the European Endocrine Conference in Lisbon. Dr Nana was fascinated by the way that medical problems can complicate pregnancy and was inspired to learn more about the field of obstetric medicine.

At the time Dr Nana was working as a diabetes and endocrinology registrar in Wales. After reaching out to Professor Williamson, Dr Nana was invited to work with her in London analysing a survey of  over 5,000 women who had severe hyperemesis gravidarum, a condition causing severe vomiting in pregnancy.

The study was conducted by Guy’s and St Thomas and King’s College London with the BBC and the Pregnancy Sickness Support charity. The survey showed that these women experienced vomiting up to 60 times a day during their pregnancy, causing some women such physical distress that they were not able to get out of bed for their entire pregnancy, or look after their pre-existing children. This led to a higher risk of terminating a wanted pregnancy and suicidal thoughts during pregnancy.

Dr Nana commented on the impact this survey had on her and her motivation to research this area: “This survey was very powerful to me because I read all of the comments from those 5000 women which described some of the challenges that they had during their pregnancy in terms of accessing safe medications and worrying about the safety of medications. I think as doctors we now understand a lot about those safe medications, and I am keen to be part of the group trying to disseminate accurate information and to carry out research to learn more about the condition so these women can have better care.”

Babies born to women with this condition are more likely to have neurodevelopmental problems and an increased risk of metabolic disease, but the cause is not fully understood. Dr Nana hopes to do a project during her PhD looking at possible nutrient deficiencies in women with severe hyperemesis gravidarum which could help explain this.

“When we looked into the literature to learn more about this, we realized that babies that were born to mums who were pregnant during the Chinese and Dutch famine had the same outcomes, so we’re interested in looking at whether a nutrient deficiency exists in these women and whether that has an effect on the baby’s brain development and metabolic risk,” she says.

Dr Nana spoke about the difference this research could make to patients: “I think that it’s an under-researched area and if we find that nutrient deficiency does exist in these women, which I think is highly likely, and we are able to identify which nutrients are low and which of the low nutrients might contribute to brain development problems or metabolic risk in the babies, we will be able to go on to develop intervention trials or treatments that replace these nutrients and improve the outcomes for the mothers and their babies.”

Dr Nana is now working towards applying for a PhD supervised by Professor Williamson. The pilot work for her research is funded by the Fetal Medicine Foundation, the Lauren Page Trust and Wellbeing of Women. Her typical week involves working to develop this pilot data, planning future research with collaborators, applying for grants to fund a prospective study and clinical work in the obstetric medicine clinic.

Dr Nana’s advice to healthcare professionals interested in research is to focus on patients.

“I think that coming from a very clinical background, my advice is that if you want to research a field of medicine, it’s important that you learn about the patients that have that disease. Go along to clinics where you’ll see those patients, talk to them about their experience, talk to them about the things that they think are important in research. Once you’ve established what’s important for the patients and which areas of research interest you the most, you can then collaborate with those that are working in the field. It is rewarding and a real privilege to be able to work alongside those working towards improving outcomes for our patients.”

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