A new study led by King’s College London suggests the availability of placental growth factor (PlGF) testing substantially reduces the time to clinical confirmation of pre-eclampsia.
The multicentre, stepped-wedge cluster-randomised controlled trial was carried out in 11 maternity units in the United Kingom, which were each responsible for 3000-9000 deliveries per year. Women aged 18 years and older who presented with suspected pre-eclampsia between 20 weeks and 0 days of gestation and 36 weeks and 6 days of gestation, with a live, singleton foetus were included. The primary outcome was time from presentation with suspected pre-eclampsia to documented pre-eclampsia with usual care (in which PlGF measurements were concealed) and intervention (in which circulating PlGF measurement was revealed and a clinical management algorithm was used).
The results, published in the Lancet, showed median time to pre-eclampsia diagnosis was 4.1 days with concealed testing versus 1.9 days with revealed testing (time ratio, 0.36; 95% CI, 0.15-0.87; P=.027).
Maternal severe adverse outcomes were reported in 24 (5%) of 447 women in the concealed testing group versus 22 (4%) of 573 women in the revealed testing group (adjusted OR, 0.32; 95% CI, 0.11-0.96; P=.043), but there was no evidence of a difference in perinatal adverse outcomes (15% vs 14%) or gestation at delivery (36.6 vs 36.8 weeks; mean difference, 0.52, 95% CI, −0.63 to 0.73).
The findings provide novel evidence supporting the adoption of PlGF testing as a diagnostic adjunct in women presenting with suspected pre-eclampsia.
In response to the trial results, NHS England has announced that PlGF testing will be more widely available across the NHS.