Prognostic indicators of severe disEAse in women with late preterm pre-eClampsia tO guide deCision-maKing on timing of delivery (PEACOCK study)

Record ID 32016000809
English
Authors' objectives: Pre-eclampsia is a condition occurring only in pregnancy. It is thought to arise from poor attachment of the placenta to the wall of the womb. A woman with pre-eclampsia can suffer from high blood pressure, problems with her kidneys, liver and blood clotting. The problem with the placenta can mean the baby's growth is affected: in severe cases sometimes the baby can be stillborn. Once diagnosed, the only cure is to deliver the baby. If pre-eclampsia occurs before 37 weeks of pregnancy, a woman may need to be admitted to hospital to have blood pressure treatment and monitoring for complications, whilst planning for safe delivery of the baby. Some women become unwell very quickly and need to have their babies delivered. Others have long stays in hospital for monitoring their condition. It is often not possible to identify women and babies at high risk of the severe complications of pre-eclampsia who would benefit from early delivery. Sometimes the decision whether to deliver is very difficult: women can remain well for long periods of time, but in some cases they can become very unwell - suffering consequences such as fitting, kidney failure, strokes and needing admission to the intensive care unit. Sadly women still die from the complications of pre-eclampsia. If the baby is going to be born prematurely it may suffer consequences of early delivery such as long term disability but babies who are not delivered can also become very unwell, sometimes dangerously. We therefore need to know when it is best to deliver the baby for both the woman and the baby s health. We do not know whether it best to always deliver or to deliver only when complications occur in women with pre- eclampsia. In this study, we are planning to investigate 600 women affected by pre-eclampsia to try to improve our assessment of which women will become unwell, and to help detect which babies are struggling the most. If we are able to define better the risks for the woman and baby, it will help doctors and women make decisions about when the baby should be born. We want to use promising new ways of looking at the woman with pre-eclampsia and her baby by measuring substances in the blood. We want to look at markers in the blood, such as placental growth factor and others, which have been shown to be useful for diagnosing pre-eclampsia. We will use information from this blood test, together with the woman s medical history, blood pressure, and other measures of her kidney/ liver function, to see if we can tell which women are likely to need delivery soon. Patient and Public Involvement Pregnant women have been consulted in all stages of planning this project. The study was planned with the national charity and support group called Action on Pre-eclampsia (APEC). The charity has told us what women want to know about pre-eclampsia, and what research they think is important in this disease. Dissemination Once the project is finished, we will give talks about the findings to other doctors and midwives who work in this field. We will write up the study for publication in a scientific journal which can be read by anyone, whether they are a health care professional or a member of the public. We will work with the charity Action on Pre-eclampsia charity to provide information about the findings of the study in a way that women find easy to read.
Details
Project Status: Ongoing
Anticipated Publish Date: 2021
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Risk Factors
  • Decision Making
  • Delivery, Obstetric
  • Female
  • Infant, Newborn
  • Pre-Eclampsia
  • Pregnancy
  • Premature Birth
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: Queen's Printer and Controller of HMSO
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