Placenta growth factor (PlGF) blood test for pre-eclampsia recommended by NICE then rolled out more widely by NHS England speeding up diagnosis and helping determine those most at risk

Narrative

Placenta growth factor (PlGF) is a molecule made by the placenta which can be detected in a simple blood test as a way to detect pre-eclampsia. Previously diagnosis was made clinically but presentations can be atypical, not all women hit the clinical test thresholds used to diagnose clinically and clinical diagnosis was not possible in women who had pre-existing conditions such as chronic vascular disease, chronic hypertension or underlying kidney disease.

In March 2016, NICE recommended use of the PlGF diagnostic test to rule out eclampsia, based on UoM research. PELICAN was an included study and Jenny Myers was a member of this assessment committee.

The PARROT study lead by Kings, ran from June 2016 to Oct 2017 in 11 maternal units across the UK and involved over 1000 patients. Results showed that using PlGF testing improved diagnosis accuracy, allowed diagnosis earlier, helped to determine which women are at most risk of developing severe complications and reduced severe adverse maternal outcomes. Crucially babies were also not delivered earlier. Economic analysis showed a cost saving of £219 per pregnancy because of reductions in the number outpatient scans and in patient stays needed.

In April 2019, the results from the PARROT study led NHS England to confirm the PlGF blood test would be made more widely available. In August 2021 NHS England news reported "three-quarters of maternity units are using the test which has helped tens of thousands of women already and will be available across all of England within the next two years."

In 2020-21 PlGF tests were included in the NHS England Innovation and Technology Payments programme which helps the NHS to adopt new innovations nationally.

In July 2022, NICE diagnostic guidance was updated. Whilst NICE previously recommended the test only to rule-out pre-eclampsia, based on the PARROT study, they now recommend use with clinical assessment to rule-in or to diagnose pre-eclampsia.

Impact date	2016
Category of impact	Health and wellbeing, Economic
Impact level	Adoption