Current Projects
Understanding and explaining preeclampsia - Haemodynamics in healthy pregnant women and in women with preeclampsia using transthoracic echocardiography and cardiac magnetic resonance
These projects investigate cardiac function in healthy pregnant women and also in women with preeclampsia. Cardiac magnetic resonance imaging and transthoracic echocardiography (TTE) are used to measure cardiac function and determine cardiac structure. TTE and CMR are accurate, non-invasive, safe technologies that can easily be applied to pregnant women. This project aims to improve our understanding of healthy heart function and structure in healthy pregnant women and to further increase our knowledge of the heart changes that occur in women with preeclampsia
The use of transthoracic echocardiography in obstetric anaesthesia and obstetric critical illness
This project uses The ROSE Scan (or Rapid Obstetric Screening Echocardiography Scan) to rapidly assess critically ill pregnant, and recently pregnant, women and to observe changes after interventions in day-to-day clinical practice. Case reports, teaching workshops and educational videos are generated which enable students, anaesthetic trainees and consultants to learn the basic examination technique.
The use of high flow heated humidified nasal oxygen delivery in pregnant women
High flow heated humidified nasal oxygen delivery may increase the safety of general anaesthesia in pregnant women and have applications in pregnant women for pre-oxygenation and apnoeic oxygenation. Our department is investigating the use of this technology in pregnant women through both primary physiological studies and observational studies of its use during general anaesthesia in pregnant women.
The use of epidural ultrasound in obstetric anaesthesia
Epidural ultrasound is an emerging technology in obstetric anaesthesia. It may have advantages in pregnant women in that it may assist with locating the epidural space, improving the safety of lumbar epidural analgesia and may improve maternal satisfaction with analgesia. Our department is investigating the use of this technology in pregnant women by producing summaries of the current literature, writing case reports and teaching the technique.
Maternal critical care
For most women pregnancy is a joyous uncomplicated event however for a small group of women, pregnancy is associated with life-threatening illness. In our department we are examining the vitally important area of classification and data collection in obstetric critical illness through audits of critical care admissions, summarising and classifying the pathophysiology of critically ill pregnant and recently pregnant women, and generating review articles in these areas. Our current areas of interest include acute fatty liver of pregnancy, acute renal failure in pregnancy and the postpartum period, and complex cardiac disease in pregnancy.
Cochrane systematic reviews
Three Cochrane systemic reviews are currently being undertaking within the department. The review, ‘Interventions of the prophylaxis of nausea and vomiting in women undergoing elective caesarean section under regional anaesthesia’, will create an evidence based review of treatments that may assist with reducing the likelihood of nausea and vomiting during one of the most commonly performed surgeries in young women, caesarean section. The review, ‘Combined spinal-epidural versus spinal anaesthesia for caesarean section’, aims to review the literature on the risks and benefits of these two commonly used techniques for women undergoing caesarean birth. The review, ‘Combined spinal-epidural versus epidural analgesia in labour’ will provide an updated review of the risks and benefits of these two commonly used techniques in women in labour.
International multicentre research collaborations
2013 – continuing – Principal & coordinating investigator – ACTRN12615000964516
The Six Minute Walk test in pregnant women HREC 15/23 Chelsea and Westminster Hospital, London, England, University of Cape Town and Mowbray Maternity Hospital, Cape Town South Africa, and The University of Melbourne and The Royal Women’s Hospital, Parkville Australia - A Dennis, S Yentis, R Dyer, E Paxton, S de Silva, O Al-bazzaz, N Fammartino, L Leeton, M Salman, R Smith, J Castro, F Roodt, M Flint, D van Dyk, M Nejthardt
2010 – continuing – Co-investigator – Development of a severity of preeclampsia score study –W Pollock, S McDonald, A Shub, K Konig, N Harley, S Lapinsky, S Chan, AT Dennis – LaTrobe University, Melbourne, Mercy Hospital for Women, Heidelberg, Royal Women’s Hospital, Parkville, The Royal Melbourne Hospital, Parkville, Mount Sinai Hospital and Toronto University, Toronto, Canada
2010 – continuing – Co-investigator – Development of a severity of preeclampsia score study –W Pollock, S McDonald, A Shub, K Konig, N Harley, S Lapinsky, S Chan, AT Dennis – LaTrobe University, Melbourne, Mercy Hospital for Women, Heidelberg, Royal Women’s Hospital, Parkville, The Royal Melbourne Hospital, Parkville, Mount Sinai Hospital and Toronto University, Toronto, Canada
National multicentre research collaborations
2014 – 2016 – Principal site investigator – Determination of the Minimal Clinically Important Difference using Quality of Recovery Instruments. Paul S. Myles, Daniel B. Myles, Wendy Galagher, Colleen Chew, Neil MacDonald, Alicia T Dennis. Alfred Hospital and Monash University and The Royal Women’s Hospital and University of Melbourne
2013 – continuing – Principal site investigator - ACTRN1261300060876
Association between maternal size and outcomes for caesarean section: a multicentre prospective observational study (The MUM SIZE Study) HREC/13/SHB/28 - D Story, AT Dennis, J Lew, S Simmons, G Teale, J DuPlessis, D Casalaz, K Lamb, F Martin-Sanchez –The University of Melbourne, The Royal Women’s Hospital, Parkville, The Northern Hospital, Epping, The Mercy Hospital for Women, Heidelberg, The Western Hospital, Footscray, Ballarat Base Hospital, Ballarat, Goulburn Valley Hospital, Shepparton, Wangaratta Base Hospital, Wangaratta, Victoria, Australia
Single centre collaborations
2014 – continuing Principal Investigator – Optimal positioning in term pregnant women HREC 15/07 - Dennis A Buckley A, Leeton L, Mahendrayogam T. (The Royal Women’s Hospital, Parkville, Australia)
2015 – continuing Principal Investigator – ACTRN12615000160538 Effect of lying in the prone position on blood pressure in women with preeclampsia, women with gestational hypertension and healthy pregnant women study HREC 14/41 - Dennis AT, Hardy L, Leeton L. (The Royal Women’s Hospital, Parkville, Australia)
2014 – continuing – Principal Investigator – Haemodynamics and myocardial tissue characteristics in women with
preeclampsia – HREC 14/06 A/ AT Dennis, S Chen, J Castro, Dr J DuPlessis, S Brennecke, I Arhanghelschi (The Royal Women’s Hospital, Parkville, Australia)
2014 – continuing – Principal Investigator – What is normal? Defining a reference range for vital signs in pregnant women on the day of their caesarean birth - Hardy L, Dennis AT (The Royal Women’s Hospital, & The University of Melbourne Parkville, Australia)
2014 – continuing – Principal Investigator – Gestational trophoblastic disease and preeclampsia - Benita Knox Dennis AT (The Royal Women’s Hospital, & The University of Melbourne, Parkville, Australia)
2014 – continuing – Principal Investigator – Emergency caesarean section – a review of current practice and outcomes for women and babies - Warren M, Kamania J, Dennis AT (The Royal Women’s Hospital & The University of Melbourne, Parkville, Australia)
2013 – continuing – Associate Investigator – Maternal ophthalmic artery Doppler waveform analysis in the assessment and management of pre-eclampsia – HREC 13/29 S Kane, S Brennecke, L Kornman, F Da Silva Costa,
AT Dennis (The Royal Women’s Hospital, Parkville, Australia)
2013 – continuing – Associate Investigator – Blood pressure lability in primate pregnancy –S Pears, A Hennessy, N Sunderland, A Makris, AT Dennis (University of Sydney, Australia)
2010 – continuing – Principal Investigator – ACTRN12611000853943
Cardiac function in women with preeclampsia – HREC 10/37, , – AT Dennis, J Castro, E Chambers, S Early, I Arhanghelschi, S Brennecke (The Royal Women’s Hospital, Parkville, Australia)
Student Projects available
Many projects are available for students to join and prospective students including The University of Melbourne’s MD students should contact the Anaesthetics Department to discuss.