POINT-OF-CARE TESTING
Pre-eclampsia risk stratification: a paradigm shift using POC PIGF test
Novel technology for detecting pre-eclampsia at the point of care has the potential to transform patient pathways for this tricky to diagnose condition, particularly in under-served communities, explains Naomi Chant.
Every year, thousands of expectant mothers face a silent threat: pre- eclampsia. Affecting approximately 3-5% of pregnancies worldwide, this potentially life-threatening condition can develop rapidly, often without clear warning signs.1
Thought to stem from abnormal placental development, pre-eclampsia is typically marked by high blood pressure
and the presence of protein in the urine – symptoms that are non-specific and often overlap with other common pregnancy- related issues.
In the UK alone, 8-10% of pregnant women develop hypertension during pregnancy, underscoring the urgent need for more precise tools to identify those truly at risk. Yet only a subset of
this number are true pre-eclampsia. The challenge lies in distinguishing those at genuine risk of severe complications from those with less concerning symptoms. When missed or misdiagnosed, pre- eclampsia can escalate rapidly – leading to seizures (eclampsia), organ failure, preterm delivery, or even death for both mother and baby. Despite advances in maternal healthcare, diagnosing and predicting who will develop pre- eclampsia – and when – remains a major clinical challenge.
A biomarker revolution: PlGF and sFlt-1
Early detection and intervention are crucial to improving outcomes for both mother and child. Although the cause of pre-eclampsia is still a debated topic, a number of biomarker imbalances are associated with the condition. Of these biomarkers, angiogenic factors soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) play a particularly key role. In pre-eclampsia, sFlt-1 levels rise and PlGF levels fall – disrupting blood vessel formation in the placenta and impairing blood flow to the fetus. This imbalance occurs well before the onset of clinical symptoms, making PlGF an especially powerful tool for early detection. Low PlGF levels can be detected weeks before any clinical signs appear, offering a vital window for risk stratification and proactive management.
In the UK 8-10% of pregnant women develop hypertension during pregnancy. The challenge lies in distinguishing those at genuine risk of severe complications from those with less concerning symptoms.
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A landmark study was published in 2016 that evaluated 47 biomarkers, alone and in combination, to predict the need for delivery within 14 days in women with suspected pre-eclampsia. No combination outperformed PlGF alone, highlighting its singular value as a predictive biomarker.2 Compared to standard measures like
DECEMBER 2025
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