Placental growth factor testing for suspected pre-eclampsia: a cost-effectiveness analysis

BJOG. 2019 Oct;126(11):1390-1398. doi: 10.1111/1471-0528.15855. Epub 2019 Jul 17.


Objective: To calculate the cost-effectiveness of implementing PlGF testing alongside a clinical management algorithm in maternity services in the UK, compared with current standard care.

Design: Cost-effectiveness analysis.

Setting: Eleven maternity units participating in the PARROT stepped-wedge cluster-randomised controlled trial.

Population: Women presenting with suspected pre-eclampsia between 20+0 and 36+6 weeks' gestation.

Methods: Monte Carlo simulation utilising resource use data and maternal adverse outcomes.

Main outcome measures: Cost per maternal adverse outcome prevented.

Results: Clinical care with PlGF testing costs less than current standard practice and resulted in fewer maternal adverse outcomes. There is a total cost-saving of UK£149 per patient tested, when including the cost of the test. This represents a potential cost-saving of UK£2,891,196 each year across the NHS in England.

Conclusions: Clinical care with PlGF testing is associated with the potential for cost-savings per participant tested when compared with current practice via a reduction in outpatient attendances, and improves maternal outcomes. This economic analysis supports a role for implementation of PlGF testing in antenatal services for the assessment of women with suspected pre-eclampsia.

Tweetable abstract: Placental growth factor testing for suspected pre-eclampsia is cost-saving and improves maternal outcomes.

Keywords: Economic analysis; placental growth factor; pre-eclampsia.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Biomarkers / blood
  • Cluster Analysis
  • Cost-Benefit Analysis
  • Diagnostic Techniques, Obstetrical and Gynecological / economics*
  • Female
  • Gestational Age
  • Humans
  • Models, Economic
  • Placenta Growth Factor / blood*
  • Pre-Eclampsia / blood*
  • Pre-Eclampsia / diagnosis*
  • Pre-Eclampsia / epidemiology
  • Pre-Eclampsia / physiopathology
  • Pregnancy
  • Pregnancy Complications / blood*
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / physiopathology
  • Pregnancy Outcome
  • United Kingdom / epidemiology


  • Biomarkers
  • PGF protein, human
  • Placenta Growth Factor