Clinical and Healthcare, and is funded for use across
A life-saving test for
preeclampsia
Researchers at the Nuffield Department of
Women’s & Reproductive Health have developed a
life-saving diagnostic test for pre-eclampsia which is
now being adopted across the UK and internationally.
Preeclampsia (PE) is a life-threatening disease of
pregnancy, which causes high blood pressure, organ
damage, and impairment in mothers and babies.
Preeclampsia (PE) is a life-threatening disease of
pregnancy, which causes high blood pressure, organ
damage, and impairment in mothers and babies.
Globally, it is responsible for more than 70,000
maternal and 500,000 neonatal deaths every year
and leaves a legacy of ill-health and disability.
Until recently, diagnosis of PE relied on interpretation
of clinical signs such as elevated blood pressure and
protein in a mother’s urine. But these symptoms are
also indicators of diabetes and kidney diseases. Such
clinical diagnosis was unreliable, picking up only 20%
of adverse events and producing a high level of false
positives.
Now a test, developed by Oxford University
researchers, accurately identifies women at risk of
developing the disease.
PE is caused by an abnormality in the placenta’,
explains lead researcher Professor Manu Vatish.
‘With the help of Roche Diagnostics, and obstetric
and clinical bio-chemistry teams from the Oxford
Universities Hospital Trust, we developed and trialed
a diagnostic test that picks up the presence of two
molecules produced by the placenta in the mother’s
blood. The respective levels of these molecules tell us
which women are likely to develop the disease and
those that are extremely unlikely to develop it within
the next week. The test has a 70% positive predictive
value and a very low rate of false negatives.’
‘The potential benefit of the test is enormous,’ Vatish
continues. ‘In the UK, PE requires that a woman is
admitted to hospital for monitoring. Ultimately, the
removal of the placenta is required to prevent
eclampsia (fitting and organ failure) and save mother
and baby. This often involves early delivery of the
baby by caesarean or induction, which can negatively
affect their health.’
‘The new test means that we can direct health
resources to monitoring and treating ‘at risk women’.
And women who are at little risk of PE are not
admitted to hospital or subjected to unnecessary
treatment.’
The test was first developed in 2018 and was rapidly
adopted by Oxford Hospitals and across the Thames
Valley. It is now offered by 90% of hospitals in the UK,
has been approved by the National Institute of
the NHS by the MedTech Funding Mandate.
It is now also being used internationally including
Brazil, South Africa, Germany, Portugal. And the team
has also developed a clinical protocol to ensure that
health staff using it anywhere in the world will
achieve accurate results.
‘It’s fantastic that the test has been adopted so
quickly in the UK and further afield,’ continues Vatish.
‘But its potential to improve health outcomes in low-
resource contexts is particularly significant.
‘Low-income countries will be able to direct scarce
resources to those women who require treatment.
And women who are not at risk can avoid an
expensive, unnecessary and worrying trip to hospital,
and the attendant loss of income and care capacity
this may involve. We’re currently talking to the Gates
Foundation about the potential to include the test in
its strategy to tackle pre-eclampsia in low-income
countries.’
Dr Sofia Cerdeira was also involved in the
development of the new test. ‘One of the things that
surprised and delighted us about rolling out the test’,
she adds, ‘was how rapidly other departments,
commercial companies, NHS bodies, and others
recognised the potential of the test – and the efforts
they made to help us take it to trial and
implementation. It showed the potential of
collaboration across diverse sectors to achieve
positive health results.’
Manu Vatish ends: ‘The test is probably the most
significant innovation in pregnancy care for twenty
years and we’re delighted to see how rapidly it has
moved to international implementation. We hope it
will be adopted even more widely in the coming
years and will make a real difference to outcomes for
mothers and babies worldwide.’
Professor Manu Vatish is full Professor of Obstetrics
and Consultant Obstetrician at the Nuffield
Department of Women’s and Reproductive Health
Dr Sofia Cerdeira is NIHR Academic Clinical Lecturer in
the Nuffield Department of Women’s and
Reproductive Health
Other team members
Professor Tim James is a full Professor of
Biochemistry and Head Biomedical Scientist for
Clinical Biochemistry at Oxford
Funder: Roche Diagnostics
Reference:
https://www.ox.ac.uk/research/research-impact/life-
saving-test-preeclampsia#:~:text=mothers%20and
%20babies.-,Preeclampsia%20(PE)%20is%20a%20life
%2Dthreatening%20disease%20of%20pregnancy,of
%20ill%2Dhealth%20and%20disability.