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Blood test predicts women not at risk of pre-eclampsia

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Clinicians can rule out if a pregnant woman will develop pre-eclampsia in the next week using one blood test, according to a new study.

Results of the study suggest that the test, developed by pharmaceutical company Roche, can better predict which women will, and will not, develop pre-eclampsia over the next few weeks.

“This latest study is indeed interesting, being able to foresee if a mother may be at risk of developing pre eclampsia marks a positive step forward”

Louise Silverton

The PROGNOSIS study found the test – called the Elecsys sFlt-1/PlGF immunoassay ratio – could predict with 99.3% confidence which women will not develop pre-eclampsia in the next week.

It also predicts which patients will develop pre-eclampsia in the next four weeks but with a much lower confidence level of 33.7% – though this is still significantly more accurate than current prediction methods.

The test assesses the ratio of two proteins sFlt-1 (soluble fms-like tyrosine kinase-1) and PlGF (placental growth factor) found in the mother’s blood.

Between December 2010 and January 2014, researchers studied more than 1,270 pregnant women at 30 sites in 14 countries.

Their results demonstrated that a ratio of the proteins sFlt-1/PlGF of 38 and below predicts an absence of pre-eclampsia for one week, while an sFlt-1/PlGF ratio above 38 predicts onset of pre-eclampsia within four weeks.

The findings were published this week in the New England Journal of Medicine.

The National Institute for Health and Care Excellence is currently consulting on guidance on pre-eclampsia tests.

“Being able to rule out if a mother is at risk of developing pre-eclampsia is a huge leap forward for antenatal care”

Ann Marie Barnard

Final recommendations are not expected from NICE until May but the latest draft provisionally recommends that Roche’s test is used to help rule out pre-eclampsia.

Louise Silverton, director for midwifery at the Royal College of Midwives, described the study as “interesting”, noting that being able to foresee if a woman was at risk of developing pre-eclampsia marked a “positive step forward for antenatal care”.

“Pre-eclampsia is a common condition in pregnancy which in its mild stages can be managed,” she said. “However, it does need to be taken very seriously because in its severe form pre-eclampsia can have serious and harmful effects on the mother and baby.

“The only effective treatment is to deliver the baby and if severe pre-eclampsia occurs before term, the baby also has risks of prematurity to add to any growth problems that may have occurred,” said Ms Silverton.

She added: “Being able to differentiate symptoms of impending pre-eclampsia from other conditions could be of value. This is a small but encouraging study and more research is needed.”

Ann Marie Barnard, chief executive of the charity Action on Pre-eclampsia, said: “Being able to rule out if a mother is at risk of developing pre-eclampsia is a huge leap forward for antenatal care.”

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