NHS Fife has become the first Board in Scotland to introduce a targeted blood test for pregnant women at increased risk of pre-eclampsia.
Pre-eclampsia is serious condition and can pose considerable risks to the health of both women and their babies. Around 10% of pregnant women present with the possible signs of pre-eclampsia, such as high blood pressure or increased levels of protein in their urine, with approximately a third of those developing the condition.
Currently, there are well-developed clinical pathways used to assess pregnant women in Fife with suspected pre-eclampsia, who may then be required to be admitted to the Maternity Assessment Unit at the Victoria Hospital in Kirkcaldy for ongoing monitoring and treatment until stabilised. This may involve a period of inpatient care over 2-3 days.
In May 2024, Health Boards were tasked by Scottish Government with introducing Placental Growth Factor-based Testing (PLGF) to support in confirming or ruling out cases of pre-eclampsia. Recommended by the National Institute for Health and Care Excellence (NICE), PLGF-based testing is highly effective and can accurately rule out where women will not develop pre-eclampsia over the course of the subsequent 7 days.
NHS Fife has now become the first Board in Scotland in introducing PLGF testing for women showing possible signs of pre-eclampsia, in addition to the already well-established clinical pathways. Whilst the test will only be necessary for women who meet the testing criteria, the introduction of PLGF testing will help to significantly reduce the number of unnecessary inpatient admissions for suspected pre-eclampsia in Fife and will minimise disruption to women and their families during pregnancy. This should also enable maternity and obstetric staff to focus more resources on those women at highest risk of complications.
Dr Helen Russell is a consultant in obstetrics and gynaecology and is leading the implementation of the PLGF-based test in Fife. Dr Russell said: “Pre-eclampsia can be a really serious condition which can present in quite a variable way, which means, at times, it can be harder to diagnose or to rule out. Sometimes the condition can be managed with regular outpatient monitoring although, in moderate to severe cases, it can lead to women requiring an induced labour or Caesarean birth and giving birth at an earlier stage of pregnancy.”
“The introduction of PLGF-based testing is a significant step forward and will improve the care we can offer to women at increased risk of pre-eclampsia in Fife during their pregnancy. We anticipate that the development will help us to half the number of women who require inpatient assessment, which minimises disruption to them and allows us to dedicate more time to those at the highest clinical risk.”
The implementation was accelerated by NHS Fife’s participation in a quality improvement project which saw almost 90 women in Fife who presented with potential signs of pre-eclampsia undergo this test, in addition to the routine clinical assessment, earlier this year.
The rollout of the PLGF-based testing in Fife has been supported by international biotech manufacturers, Roche Diagnostics. NHS Fife has a long-standing partnership with Roche Diagnostics, who supply much of the technology for the Board’s blood sciences laboratories at the Victoria Hospital in Kirkcaldy. This has enabled the implementation of PLGF-testing in Fife to be established within six months and be carried out using the existing Roche diagnostic systems. This allows this new test to be performed at the same time to the routine blood tests already performed when assessing pregnant women for pre-eclampsia.
Disease area manager for women's health, Roche Diagnostics UK and Ireland, Kate Quinney, said: “Using PIGF-based testing for pre-eclampsia not only reduces unnecessary hospital admissions for the condition, but crucially ensures expectant parents are getting the care they need. We’re delighted that expectant parents in Fife will now be able to access this. We continue to work with Boards across Scotland to support wider access to PlGF-based testing, so that everyone can access a clear diagnosis for this potentially life-threatening condition – regardless of where they live.”
Director of acute services at NHS Fife, Claire Dobson, added “We are really delighted that we are now able to offer PLGF-based testing to women at risk of pre-eclampsia. The fact that the test has been incorporated into our existing care so quickly is testament to the hard work of our staff, and we grateful to our partners at Roche Diagnostics for their support also.
“We always aim to provide pregnant women in Fife with care that is truly person-centred. The development of PLGF-based testing helps us do exactly that by enabling greater numbers of women to safely remain at home during the entirety of their pregnancy, while at the same time allowing us to devote more resources to those most at risk.”
