The use of PLGF based tests in women with suspected pre-eclampsia

Pre-eclampsia is a complication of pregnancy which can have serious consequences for both mother and baby if left unrecognised or untreated. It is thought to be related to problems with the development of the placenta and occurs in around 5% of pregnancies.

A new blood test (known as PLGF based tests) indicates whether the women has the disease and when used in women with suspected pre-eclampsia can reliably indicate who will need delivery soon. It is a reliable test of whether the baby is at risk. This test can be used to indicate who needs admission and intensive monitoring to determine when delivery is required, or who can be discharged home. Many other tests can frequently be avoided and it is therefore cost effective. There are currently 3 versions of these tests available in the UK. All of them measure PLGF, and one also measures SFlt, and uses it as a ratio with PLGF. The PLGF is not the same in each assay, as there are 4 subtypes (isoforms) and each assay measures them differently. Each test is equally valuable, but has different levels to indicate action.

These tests will be available in the NHS, and the clinicans will be aware of which values to use. If the test is normal in women with worrying features, it is unlikely that pre-eclampsia will develop. If the test is abnormal, then more monitoring can be instigated to both mother and baby and delivery arranged when appropriate. Blood pressure may be treated in the meantime and drugs (magnesium sulphate) given while delivery is being arranged. At the moment PLGF based tested are not used to determine who needs delivery, or how severe the pre-eclampsia.