Fetal lung development research recognised with Mollie Holman Medal for Doctoral Thesis Excellence

Congratulations to Dr Aidan Kashyap on receiving the Mollie Holman Medal for his research on congenital diaphragmatic hernia (CDH). This medal is among the highest student academic honours that Monash University bestows, marking him as a researcher of the highest order who has presented the faculty’s best thesis of the year.

Most babies navigate the transition to newborn life without complications, however some require assistance in breathing at birth because their underdeveloped lungs are not ready for life in the outside world. One devastating cause of impaired lung development is CDH.

In his thesis, Aidan, a PhD student in the School of Clinical Sciences at Monash Health, used an animal model of CDH to better understand the physiology underlying the way infants with CDH transition to newborn life, and then investigated fetal and neonatal interventions that could improve this transition.

Aidan said, "We firstly aimed to better prepare these infants for birth by improving fetal lung development; using a fetal surgical treatment (FETO) to enhance fetal lung growth, and a medication that could be taken by mothers (sildenafil) to enhance the development of blood vessels within the fetal lungs. Sildenafil is now under investigation in a clinical trial by our collaborators in Belgium"

"We then aimed to improve management at birth. During fetal life, the baby is sustained by oxygen from the mother’s placenta, delivered via the umbilical cord. Severing this connection at birth forces newborns with CDH to become entirely reliant on their underdeveloped lungs for oxygen. We found that if umbilical cord clamping was delayed until after filling the lungs with air, then oxygen delivery to the brain was maintained at safe levels during the transition to newborn life and more blood could flow through the newborn lungs at lower pressures. In babies who require resuscitation at birth (such as CDH babies), this form of ""physiologically based cord clamping"" can only be clinically possible using specialised neonatal resuscitation equipment that can be brought to the bedside".

Timely funding from CDH Australia for this specialised neonatal resuscitation equipment has enabled the team to join an international clinical trial and translate their research findings to patients and their families right here at Monash.

Speaking of the award, Aidan said, "I feel so honoured to receive this prestigious award and thankful for the support I have received from my supervisors - Prof Stuart Hooper, Dr Ryan Hodges, Dr Kelly Crossley and Dr Philip DeKoninck - and the wider Ritchie Centre, Hudson Institute of Medical Research and School of Clinical Sciences at Monash Health throughout my PhD. This award recognises the meaningful translational research we can accomplish in this precinct and I look forward to continuing to work closely with scientists, clinicians, patients and their families to improve outcomes in maternal, fetal and neonatal health in our community".