Dr Louise Webster
Clinical Lecturer in Women’s Health
Pre-eclampsia is being identified in pregnant women via a rapid, quantitative fluorescence immunoassay, being rolled out across the NHS in England.
A highly specific blood test, is helping pick up the potentially dangerous condition of pre-eclampsia among pregnant women.
PlGF (placental growth factor) testing is available across the NHS in England to identify the condition, which is thought to relate to the placenta.
High blood pressure, protein in the urine and liver function issues are among the tell-tale signs for a condition that can be confirmed by the routine test.
Consultant Obstetrician Louise Webster says pre-eclampsia can range from being mild to very severe and occur late in pregnancy or in the early stages from gestation week 20.
If not picked up, it can, affect development of the unborn child, lead to stillbirth, or develop into full-blown eclampsia, which can result in seizures.
Dr Webster explains: “Placental growth factor is a molecule produced by the placenta. In healthy placentas, we see it rise across gestation to a peak of around 32 weeks and then it slowly starts to fall after that.”
If PlGF is not at the levels doctors expect, they can increase monitoring of the mother and baby, though there is no established way of treating pre-eclampsia other than delivering.
Conversely, a normal PlGF level can reassure doctors and pregnant women that they don’t have pre-eclampsia, reducing the number of times they need to attend the hospital.
If identified around the 37-week mark, doctors can take the decision for the baby to be born ahead of full term.
PlGF testing for pre-eclampsia is becoming a routine part of antenatal care when blood pressure is high or protein is found in the urine. Midwives will also ensure women are aware of symptoms of the condition, which include headaches, visual disturbance, swelling of the hands or face and concerns about baby’s movements.
Studies have shown that PlGF is better than other currently used tests at predicting which women have pre-eclampsia. A further trial demonstrated that the PlGF test halved the time it took to diagnose pre-eclampsia in women and also led to reduced adverse outcomes.
Dr Webster’s department at a hospital in London use the Quidel platform for the test, which returns results within 15 minutes and shows if a woman has pre-eclampsia, or not, or if a higher level of surveillance needs to be instigated.
The test reassures women that are at less risk, leaving doctors to focus of those at higher risk of developing pre-eclampsia.
The PlGF-based test, which has NICE endorsement, is available in hospitals across England and the hope is that it will soon be adopted in Wales, Scotland and Northern Ireland.