Pre-eclampsia test team wins international award

A team that developed and introduced a new blood test to rule out pre-eclampsia (PE) in pregnant women at Oxford University Hospitals (OUH) has won an international award.

The Oxford team - including Tim James, Head Biomedical Scientist in OUH's Clinical Biochemistry department, Dr Manu Vatish, an academic obstetrician at Oxford University, and Dr Sofia Cerdeira, OUH obstetrician and Academic Clinical Lecturer at the University of Oxford - won a UNIVANTS of Healthcare Excellence Award.

The award, a new annual prize created by the healthcare company Abbott, recognises "teams that collaborate across disciplines, including the core laboratory, to reshape care pathways and ultimately achieve better outcomes for patients, clinicians, payers and entire health systems".

The test, developed by Roche Diagnostics, was trialled at the John Radcliffe Hospital's Women's Centre. It predicts with almost 100 percent accuracy that a pregnant woman will not develop pre-eclampsia within the following seven days. After being accepted as routine clinical practice at OUH in 2018, it is now being rolled out across the NHS by the Oxford Academic Health Science Network (AHSN).

The test measures the ratio of two placental factors - maternal serum soluble fms-like tyrosine kinase (sFlt-1) and placental growth factor (PlGF) - that are released into the mother's blood. It is used in conjunction with standard clinical practice.

Pre-eclampsia is a serious disease that occurs in around four percent of all pregnancies. It causes high blood pressure, protein in the urine and oedema and can result in liver failure, kidney failure and seizures in the mother. It can lead to restricted growth in the baby and often premature delivery.

Before the test, there was no accurate method to determine who would get the disease. 

Currently, patients with suspected PE are often admitted to hospital, sometimes for several days in order to make the diagnosis. PE is diagnosed by excluding all the other possible causes of high blood pressure and protein in the urine through a series of tests, which take time and cause anxiety for the mother-to-be and her family. 

Before the introduction of the test at OUH, almost 70 percent of patients admitted did not actually have PE.

"If you don't have a firm diagnosis, you either incorrectly send someone with PE home or incorrectly admit someone who doesn't have PE," Dr Vatish said. "Those are both bad outcomes for the professionals involved in their care."

"Now, we'll have a decision in about 25 minutes with 99 percent confidence. What patients aren't going to like that?"

The test demonstrates how clinical chemists can make significant strides in improving care if they engage internal users. "We often lock ourselves away and think we'll just do the lab work, but we've got to build a relationship with clinicians and think about how we improve and create quality initiatives that will help patients," Tim James said. "These are relatively simple methods, which means the patient benefits can be widely delivered."

The Univants award attracted 300 applications from 97 countries. 

Pictured: from left to right, Guy Checketts (Oxford AHSN), Tim James (OUH), Julia Eades (Roche Diagnostics), Manu Vatish (University of Oxford/OUH), Matthew Covill (OUH). Not pictured: Sofia Cerdeira (OUH/University of Oxford)