Innovation and collaboration in NHS Wales
Innovation that matters: Working with the NHS to improve pregnancy care By Daniele Gaudiosi Women’s Health Market Manager, Roche Diagnostics UK and Ireland Pre-eclampsia is a serious complication that occurs in 3-5 % of pregnancies and is one of the leading causes of maternal and perinatal mortality worldwide.1 Whilst it can be a life-threatening condition, with a clear diagnosis both mother and baby can receive the care they need. Placental Growth Factor (PlGF)-based testing, a blood test which can confirm or exclude pre-eclampsia in pregnant women within the same day, received NICE approval in 2016.2 It took some time for the test to become available consistently across England, but by February 2021 more than 100 maternity services had adopted one of the NICE recommended tests and more than 40,000 women had benefited from them. What’s more, projected annual savings in England are estimated at £4m per year due to a reduced hospital bed occupancy3 and this summer NHS England announced that it would make testing for pre-eclampsia available across the country.4 In Wales, we are at the start of a similar journey, with health boards and clinicians looking together at how the test could be used to help prioritise treatment and care for those pregnant women at highest risk and, at a time when the NHS is facing such enormous challenges, alleviate pressure on much-needed inpatient beds and save clinical time. Routine antenatal appointments involve the assessment of clinical signs and symptoms. Women with suspected pre-eclampsia are usually referred to hospital for further assessment, which includes multiple checks of blood pressure and urine protein, as well as a suite of blood tests.5 But preeclampsia diagnosis can still be challenging, as these tests are non-specific so healthcare professionals must rely on their own clinical
judgement.6 This is why swift prediction or rule-out of pre-eclampsia can be vital, both for patient safety and for managing cases efficiently.7 Not only does the test help those that have the condition, it’s also important in helping women to return home from hospital if preeclampsia can be ruled out, freeing up muchneeded beds. One study demonstrated that PlGF-based testing enabled clinicians to exclude pre-eclampsia for one week with very high confidence, reassuring women suspected of having the disease that it is safe to go home.8 Healthcare professionals are discovering this firsthand. Trusts in Greater Manchester have been using the PlGF-based testing for some time in all their maternity units thanks to support from Health Innovation Manchester.
“The PlGF 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.”
Professor Jenny Myers Consultant Obstetrician and Professor of Obstetrics and Maternal Medicine The University of Manchester
We at Roche Diagnostics are proud that our PlGF-based test for the assessment of pre-eclampsia are becoming more widely available across the UK and to support the positive discussions going on in Wales to help improve the pre-eclampsia pathway, including the introduction of PlGF-based testing to help ensure pregnant women get the specialised treatment they need or avoiding unnecessary hospital admission.
www.roche.com
Verlohren, S., et al. (2012). Am J Obstet Gynecol 206(1), e1-8; Verlohren, S., et al. (2010). Am J Obstet Gynecol 202(161), e1-11; Verlohren, S., et al. (2014). Hypertension 63(2), 346-352 www.nice.org.uk/guidance/dg23 (Accessed Sept 2021) www.ahsnnetwork.com/more-than-40000-pregnant-women-have-benefited-from-pre-eclampsia-test-following-national-ahsn-rollout (Accessed Sept 2021) 4 www.england.nhs.uk/2021/08/life-saving-world-first-nhs-test-for-pregnant-women/ (Accessed Sept 2021) 5 Overview | Hypertension in pregnancy: diagnosis and management | Guidance | NICE. www.nice.org.uk/guidance/ng133 (Accessed Sept 2021) 6 Herraiz, I., Llurba, E., Verlohren, S. & Galindo, A. Update on the Diagnosis and Prognosis of Preeclampsia with the Aid of the sFlt-1/ PlGF Ratio in Singleton Pregnancies. Fetal Diagn. Ther. 43, 81–89 (2018) 7 www.oxfordahsn.org/our-work/strategic-and-industry-partnerships/the-innovation-exchange/spread-and-adoption-of-supported-innovations/pre-eclampsia/ (Accessed Sept 2021) 8 Hund, M., et al. (2014). BMC Pregnancy and Childbirth 14, 324; Zeisler, H., et al. (2016). N Engl J Med 374(1), 13-22 1
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