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New pre-eclampsia diagnosis tool

30 March, 2017

New pre-eclampsia diagnosis tool

A new triage tool that could save mothers’ and babies’ lives by predicting whether pregnant women diagnosed with early onset pre-eclampsia are safe to prolong pregnancy, has been developed.

The PREP study, funded by the National Institute for Health Research (NIHR), was published in BMC Medicine today (March 30).  

Led by Queen Mary University (QMU), it led to the development of two prediction models, which were able to accurately predict the risk of complications in up to 84% of mothers.

The PREP-S model predicted individualised risk to mothers at various time points after pre-eclampsia diagnosis, while PREP-L measured the overall risk of experiencing complications by postnatal discharge.

Around 1% of pregnant women are diagnosed with early onset pre-eclampsia, which occurs before 34 weeks and is much more severe than pre-eclampsia occurring later in pregnancy.

The complications necessitate intensive care in a third of these women who are at risk of unexpected clinical deterioration. An estimated 1000 babies a year die from complications caused by pre-eclampsia.

The models used information routinely gathered in the NHS to predict the risk of complications. Data used included, mother’s age, gestation at which pre-eclampsia was diagnosed, blood pressure, urine protein level, liver and kidney function, oxygen levels in blood and the need for treatment to control blood pressure and prevent seizures.

Of the 946 women with early onset pre-eclampsia recruited from 53 NHS Trusts for the study, 169 (18%) suffered complications within 48 hours of being diagnosed. Overall 633 (67%) mothers experienced a complication by the time they were discharged from hospital after their babies were delivered.

The PREP-S accurately predicted risk of complications in 84% of mothers by 48 hours of diagnosis, while PREP-L accurately predicted in 82% of mothers by discharge after delivery.

Yvonne Muwalo, senior research midwife at St Barts Health NHS Trust, London, who was involved in the study, said: ‘The tool will help provide women with a better understanding of the risks of their condition. It will aid clinicians in planning management of mothers’ care and to plan appropriate follow-ups and transfer to specialist units if required.’

To read the full article, click here.

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