P 15 PARROT Ireland – Placental growth factor in assessment of women with suspected pre-eclampsia to reduce maternal morbidity – A stepped wedge cluster randomised control trial

Abstract

Introduction Pre-eclampsia complicates 2–8% of pregnancies and is associated with significant maternal and neonatal morbidity and mortality. Previous studies suggest that Placental Growth Factor (PlGF) testing presents a realistic and innovative adjunct to the management of women with suspected pre term pre-eclampsia. NICE has recently advised that further research is completed prior to integration of PlGF testing to routine clinical care. Objectives Our primary aim is to establish the effectiveness of plasma PlGF measurement in reducing maternal morbidity, without increasing neonatal morbidity, in women presenting with suspected pre-eclampsia prior to 37 weeks’ gestation. The long term aim is to demonstrate that knowledge of PlGF measurement enables appropriate stratification of antenatal management of women presenting with suspected pre-eclampsia. Methods A prospective multi-centre, stepped wedge cluster randomised controlled trial of women presenting with suspected pre-eclampsia from 20 to 36 + 6 weeks” gestation inclusive. It will be conducted in the seven largest maternity hospitals in Ireland and will run from April 2017 until Dec 2018. See Figures 1 & 2. Results The study will have 2 co-primary outcomes; maternal morbidity & neonatal morbidity assessed using composite scores as both outcomes are equally important. Secondary outcomes will include a Health Economic impact assessment which will be an important component of the trial. Conclusion If this trail shows benefit for PlGF testing it will influence international guidance and change the way we currently assess women with suspected pre-eclampsia.