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Southampton Health Technology Assessments CentreNews

Blood tests to diagnose pre-eclampsia: NICE guidance now available

Published: 13 May 2016
Pregnancy care
Pre-eclampsia is a condition that can arise in pregnancy

The National Institute for Health and Care Excellence (NICE) has issued guidance to the health service on the use of blood tests based on placental growth factor to help diagnose pre-eclampsia, informed by a report produced by SHTAC.

 

Pre-eclampsia is a condition that can arise in pregnancy characterised by abnormal function of the placenta, with potentially serious consequences for the mother and/or baby if not identified and treated. Currently the only cure for pre-eclampsia is to deliver the baby, but there is a trade-off between what is safest for the mother (early delivery) and what is safest for the baby (delivery as close to term as possible). In the National Health Service, routine pregnancy care involves checking for signs and symptoms of pre-eclampsia such as high blood pressure and protein in the urine. However, not all women suspected of having pre-eclampsia develop the condition.

Blood tests have been developed which can detect abnormal levels of placental growth factor and other proteins in blood which may offer a more accurate way of determining whether a woman is likely to have or develop pre-eclampsia. The accuracy of these tests compared to standard clinical assessment for ruling in or ruling out pre-eclampsia has recently been evaluated by NICE as part of the NICE Diagnostics Assessment Programme.

NICE’s guidance is that two specific blood tests (the Alere Triage test and the Roche Elecsys test) are sufficiently accurate that they may be used, in combination with standard clinical assessment, to rule out pre-eclampsia in the short term, in women suspected of having the condition between weeks 20 and 35 of pregnancy. This may help to avoid unnecessary hospital admissions, as well as provide reassurance to women that they do not have a more serious condition. However, due to a lack of evidence about how positive results of these tests would be interpreted by clinicians, NICE does not recommend that the tests should currently be used for ruling in (i.e. diagnosing) pre-eclampsia.

NICE’s guidance is informed by an external assessment group report prepared by SHTAC which included critical appraisal of evidence submitted by companies marketing the blood tests, an independent systematic review of the scientific literature, and an economic analysis. This report will be published as a monograph in the NIHR Journals Library later in 2016.

For more information on SHTAC’s research on diagnostic technologies see our research page.

 

 

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