Local scientists develop test to gauge pregnancy outcome in women at risk of miscarriage

(Clockwise from top left) NTU's Associate Professor Ling Xing Yi and Associate Professor Tan Nguan Soon; Associate Professor Tan Hak Koon, obstetrics and gynaecology chairman at KK Women's and Children's Hospital; and NTU PhD student Kao Ya-Chuan. PHOTO: NTU SINGAPORE

SINGAPORE - Local researchers have developed a test that can gauge a pregnancy outcome in 30 minutes or less in cases of threatened miscarriage.

Threatened miscarriage refers to a common complication which involves abdominal pain and vaginal bleeding during the early stages of pregnancy.

One-fifth of all pregnant women here show such signs and one-quarter of this group ends up miscarrying within two weeks.

The test, which was jointly developed by the Nanyang Technological University (NTU) and clinicians from KK Women's and Children's Hospital (KKH), will be able to tell women exhibiting such symptoms whether they are actually at a higher risk of miscarriage, thereby putting their minds at ease or allowing them to get help early.

In a joint news release on Thursday (June 18), the institutions said that such a risk is currently detected through a blood test which measures the levels of progesterone in the patient.

Such a test is invasive, requires a lab to process the results and it can take a few hours before the patient gets her results back.

But a team led by NTU researchers Ling Xing Yi and Tan Nguan Soon, together with KKH's Dr Ku Chee Wai, created a test that can be carried out at a clinic in under 30 minutes without the need for a laboratory and requiring only a single droplet of urine.

Associate Professor Ling from NTU's School of Physical and Mathematical Sciences said that molecules associated with risk of miscarriage are typically diluted throughout the body's fluids and it is hard to detect them at low concentrations.

The newly developed test gets around this problem using a chip which is coated with a special chemical targeting agent that can isolate these molecules.

The test will be able to tell women exhibiting such symptoms whether they are actually at a higher risk of miscarriage. PHOTO: NTU SINGAPORE

This allows the chip to detect in a single drop of urine those molecules associated with a higher risk of miscarriage: pregnane and tetrahydrocortisone.

The researchers believe this to be the first test of its kind in the world.

About 15 to 20 per cent of pregnancies seen at KKH end up in miscarriage, a trend that has held steady over the last five years, said the chairman of the hospital's Division of Obstetrics and Gynaecology, Associate Professor Tan Hak Koon.

Dr Ku, from the same division, said that early detection will allow pregnant women with symptoms of threatened miscarriage to receive counselling, medical interventions, or be under close medical management for adverse pregnancy outcomes throughout the rest of their pregnancy.

"It can also allay the fears and worries of pregnant women who are at low risk of miscarriage and improve their pregnancy experience," he added.

The team has patented their invention and is looking to evaluate the performance of the toolkit in hospital settings, with the aim of commercialising it in the future.

The researchers are also working on adapting the toolkit for use in other health conditions.

Associate Professor Tan Nguan Soon, who is a metabolic disorder expert at NTU's Lee Kong Chian School of Medicine, said that the sensitivity offered by the team's test and the small sample volume required for the test to work could make it attractive for clinical use.

This is especially so for cases where it is difficult to obtain large amounts of samples, such as getting tear samples for eye disorders or breath vapour for lung diseases.

He added that the team's diagnostic platform could revolutionise the detection of molecules for medical conditions that are normally challenging to detect and "bring testing for them out of the lab and into the clinic".

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