Introduction: Existing methods of assessing women with suspected pre-eclampsia are expensive and labour intensive, yet perform poorly.
Objectives and methods: The PELICAN multi-centre observational cohort study demonstrated that PlGF predicts need for delivery for pre-eclampsia within 14 days. We constructed a decision analytical model using outcome data from 100 women comparing resource use by final diagnosis and PlGF level. Costs were obtained from 2012-2013 NHS tariffs.
Results: Of the 100 women, 40 had a final diagnosis of pre-eclampsia and delivered within 14 days of the PlGF test; 10 were healthy pregnancies with normal PlGF levels. 82% of women with pre-eclampsia were admitted during the final 2 weeks of pregnancy, with a 5-day (SD=5) length of stay, compared with 30% of healthy pregnancies with normal PlGF (1 day; SD=0.58). Resource use for outpatient appointments, scans and day unit admissions was similar for the two groups although higher in the group with a final diagnosis of pre-eclampsia. Total costs, excluding delivery, were approximately a third higher in the pre-eclampsia group.
Conclusions: This interim analysis suggests pre-eclampsia is associated with significantly higher resource use, although there is some inappropriate resource use in healthy women. PlGF can assist diagnosis and identify women requiring increased care and could be used to direct appropriate resource allocation in women over 37 weeks.
Copyright © 2013. Published by Elsevier B.V.