The evaluation and development of novel diagnostic methods to understand and prevent placentally-related complications of human pregnancy
Pre-eclampsia and fetal growth restriction
Women will be recruited at their dating ultrasound scan, typically performed ~12wkGA. Blood will be obtained at this visit, at their anomaly scan (20wkGA), and at two research appointments (28wkGA and 36wkGA) when research ultrasound scans will be performed. At the 36wkGA visit, women will be consented for participation in the RCT element of the study. For those who consent, their risk of term preeclampsia and/or fetal growth restriction will be calculated using a rule derived from the original POP study and based around the sFLT1/PLGF ratio. Women who screen high risk will then be randomly allocated to either having the result revealed or masked. Where the result is masked, there will be no communication of the risk score with the participant and she will continue to receive the standard of care at the Rosie Hospital. Women who screen high risk and are randomised to intervention will be reviewed and their results discussed. They will be offered early delivery, typically induction of labour between 37wkGA and 39wkGA where the clinical management of induction will follow the standard hospital protocols for high risk women. Both arms will be followed up until the mother is discharged following the hospital admission when she delivered. Randomisation will be with minimisation based on the four elements of the screening assessment. Randomisation: The randomisation list will be computer-generated by an independent statistician and provided for incorporation into the study database by the data manager Updated 24/06/2026: Randomisation will be stratified across the following groups defining high risk: 1. sFLT1:PlGF ratio >110 2. sFLT1:PlGF ratio >38 + 36wkGA ultrasonic estimated fetal weight (EFW) <10th percentile 3. sFLT1:PlGF ratio >38 + 20wkGA uterine artery Doppler pulsatility index >90th percentile 4. sFLT1:PlGF ratio >38 + increased risk of preeclampsia using an adapted version of the NICE Guideline
1. Nulliparous (no previous births >23wkGA) 2. Single viable fetus at the dating ultrasound scan with an ultrasonic estimated gestational age <18wkGA
Does not meet inclusion criteria