Midwives can now offer one of four blood tests to help diagnose suspected preterm pre-eclampsia, a potentially serious condition.
The independent National Institute for Health and Care Excellence (NICE) diagnostic advisory committee has now recommended four tests that can be used between 20 to 36 weeks and six days of pregnancy to help diagnose suspected preterm pre-eclampsia. This allows medical professionals to make calculated decisions about pregnant women’s treatment going forward.
Pre-eclampsia is a condition that affects some pregnant women and typically arises during the second half of pregnancy or soon after the baby is delivered. Early signs of this condition include high blood pressure and protein in the urine. Pre-eclampsia affects up to 6% of pregnancies and severe pre-eclampsia affects around 1-2% of UK pregnancies.
Testing for preterm pre-eclampsia
NICE has recommended tests that measure levels of placental growth factor (PLGF) in the blood. PLGF is a protein that helps the development of new blood vessels in the placenta. In pre-eclampsia, levels of PLGF can be abnormally low and can indicate that the placenta is not developing correctly.
Previously, tests were recommended by NICE for use to support ruling out preterm pre-eclampsia. By diagnosing pre-eclampsia, elevated and personalised care can be provided for the mother and unborn baby. With preterm pre-eclampsia, it is only cured by the delivery of the baby. Evidence presented to the committee highlighted that the use of the tests did not lead to unnecessary early delivery.
“This is extremely valuable to doctors and expectant mothers as now they can have increased confidence in their treatment plans and preparing for a safe birth.” Commented Jeanette Kusel, acting director for MedTech and digital at NICE.
NICE’s antenatal care guideline
Recommendations on preterm pre-eclampsia in NICE’s antenatal care guideline include measuring blood pressure and checking the urine for protein at each antenatal visit to check for pre-eclampsia. The guideline also recommends determining risk factors for preterm pre-eclampsia at the booking appointment (by ten weeks of pregnancy).
Jeanette Kusel said: “These tests represent a step-change in the management and treatment of pre‑eclampsia.
“New evidence presented to the committee shows that these tests can help successfully diagnose pre‑eclampsia, alongside clinical information for decision-making, rather than just rule it out.
“This is extremely valuable to doctors and expectant mothers as now they can have increased confidence in their treatment plans and preparing for a safe birth.”
Dr Mark Kroese, chair of the NICE diagnostics advisory committee, said: “The committee called for further research when it looked at this topic in 2016. Following some excellent research, we can now issue draft guidance for four tests which the NHS can use to help diagnose pre‑eclampsia.”
