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PlGF-based testing for pre-eclampsia

Pre-eclampsia (PE) is a serious hypertensive condition that complicates up to one in 20 pregnancies, usually during the latter stages. It can affect both mother and baby and can lead to small birth weight babies, organ damage and – in extreme cases – death. Delivery of the baby is the only ‘cure’. It is not unusual to induce the baby early, even with mild pre-eclampsia.

Correctly diagnosing PE is notoriously difficult. Clinical teams have a high degree of suspicion for PE and a low threshold to admit pregnant women with suspected PE. However, only a small proportion of these go on to develop it. This highlights the importance of a more accurate test.

In 2017 the Oxford AHSN partnered with Oxford University Hospitals and Roche Diagnostics to prove that a new placental growth factor (PlGF)-based test developed to help in the diagnosis of PE delivers real world benefits. Offering the test to women suspected of having PE meant that clinical teams were better able to identify those women who did not have the disease. These women could safely be sent home – meaning hundreds of women were not admitted unnecessarily to hospital for monitoring for several days at a time.

This initiative brought together the Oxford Patient Safety Collaborative, NHS trust clinical leads, laboratory heads, finance and management functions. As a result, the three trusts successfully adopted PlGF-based testing into standard clinical practice. This led to adoption elsewhere.

The Oxford AHSN’s pre-eclampsia work secured two prizes in 2019: an HSJ Partnership Award and a Univants of Healthcare Excellence Award. It was also a finalist in the HSJ Awards.

In 2019 the NHS Accelerated Access Collaborative provided support for the national AHSN Network to drive spread and adoption of the test across the NHS in England. By February 2021 more than 100 maternity services had adopted this test.

From April 2021 PlGF-based testing will be one of four technologies included under the new NHS MedTech Funding Mandate.