Pregnant women in Greater Manchester benefit from rapid testing and remote monitoring for pre-eclampsia during COVID-19

Pregnant women being cared for at Manchester University NHS Foundation Trust (MFT) are benefiting from a quick, accurate blood test to spot pre-eclampsia – a condition which can lead to serious complications if not monitored and treated.

Pre-eclampsia affects around three per cent of pregnant women, during the second half of pregnancy (from around 20 weeks), or soon after their baby is delivered.

Although most cases occur in the last few weeks of pregnancy and do not sustain serious complications, the condition can lead to severe complications for both mother and baby if it is not monitored and treated.

The earlier pre-eclampsia is diagnosed and monitored, the better the outlook for mother and baby.

Placental Growth Factor (PlGF)-based testing

NHS trusts across Greater Manchester – including MFT – are now using Placental Growth Factor (PlGF)-based testing, a blood test which can confirm or exclude pre-eclampsia and assess the risk for complications.

The new test offers clinical teams the ability to better manage risk, improve patient safety through faster and accurate diagnosis and ensure the women and their unborn baby receive appropriate care.

Faye, a patient at Saint Mary’s Hospital, part of MFT, had two pregnancies complicated by pre-eclampsia and clinicians were able to closely monitor her again during her recent pregnancy with regular ultrasound scans and blood pressure tests.

When the PlGF-based test placed her in an intermediate risk of pre-eclampsia, clinicians were able to increase her monitoring and ensure she gave birth to a healthy baby boy.

Faye said: “I was really grateful that extra monitoring and blood tests are now available, it’s really different to my first pregnancy.

The blood tests in this pregnancy made a big difference, I was so worried given everything we’d been through before.

Professor Jenny Myers, Consultant Obstetrician at Saint Mary’s Hospital and Professor of Obstetrics and Maternal Medicine at The University of Manchester, said: “The Placental Growth Factor test enables us to make the right decisions for the women in our maternity care.

We can ensure that those with pre-eclampsia or who are at the highest risk of developing pre-eclampsia are getting the care they need, when they need it.

Health Innovation Manchester (HInM), the organisation responsible for accelerating the spread of proven innovation into Greater Manchester’s health and care system, has been supporting maternity units to adopt PlGF-based testing as part of a national initiative through the Accelerated Access Collaborative (AAC) Rapid Uptake Products (RUPs).

Amanda Risino, Chief Operating Officer of Health Innovation Manchester, said: “The PlGF-based testing is an example of better diagnostics leading to improvements in clinical care and system efficiencies.

Health Innovation Manchester has been proud to work with our NHS trusts, including MFT, to improve the uptake of this proven innovation.

Karen Connolly, Chief Executive of Saint Mary’s Hospital, added: “This is a fantastic example of our ‘One Manchester’ approach in action; with research and innovation pioneered here at MFT working seamlessly with HInM – which has the platform to accelerate this new rapid testing across our region, ensuring that more people can benefit, as quickly as possible.

“It further embodies our Trust values of ‘working together’ and ‘dignity and care’, which guide the way we work every day to ensure our services are the very best they can be for our patients.”

Supporting remote monitoring at home during COVID-19

In addition to supporting the ongoing use of PlGF testing during COVID-19, HInM has supported some maternity services to enable remote blood pressure monitoring services for pregnant women at risk of pre-eclampsia.

One of the key priorities during the COVID-19 outbreak has been to keep patients out of hospital wherever possible to minimise the risk of virus transmission. Pregnant women have been identified as a vulnerable group and therefore it is essential that, where possible, hospital attendances are avoided.

Avoiding face-to-face appointments posed significant challenges for antenatal services as many women receive vital care during these clinics, including blood pressure measurement.

An early sign of pre-eclampsia is having high blood pressure (hypertension), which is usually picked-up during routine antenatal appointments and requires regular monitoring.

During COVID-19, some maternity units in Greater Manchester – including Saint Mary’s Hospital – have provided pregnant women with blood pressure monitors which allows them to take their blood pressure measurements at home and record them in an app or by telephone to their midwives. Midwives can monitor the results and escalate for additional treatment if there is a need.