The outbreak of COVID-19 has put significant pressure on all hospital services, including obstetrics which provides antenatal care to pregnant women. One of the key priorities for secondary care during the COVID-19 outbreak is to keep patients out of hospital wherever possible to minimise the risk of virus transmission.

Avoidance of face-to-face encounters poses significant challenges for antenatal services as many pregnant women receive vital care during face-to-face clinics. This includes blood pressure monitoring and monitoring the risk of pre-eclampsia.

Pre-eclampsia is a condition that affects some pregnant women, usually during the second half of pregnancy (from around 20 weeks) or soon after their baby is born. Although most cases are not severe, the condition can lead to serious complications for both mother and baby if it is not monitored and treated.

Early signs of pre-eclampsia include high blood pressure (hypertension) and this is usually picked-up during routine antenatal appointments. The earlier pre-eclampsia is diagnosed and monitored, the better the outlook for mother and baby.

As part of the response to COVID-19, Health Innovation Manchester is supporting maternity services in Greater Manchester and East Cheshire to provide self-monitoring of blood pressure for women at risk of pre-eclampsia.

Women are provided with free blood pressure monitors and an app to record their readings at home, without needing to attend at hospital or a clinic. The results can then be accessed by their midwives who can monitor the readings and start additional treatment if necessary.

The project is being escalated during the COVID-19 outbreak and forms part of Health Innovation Manchester’s work in improving the detection of pre-eclampsia through adoption and spread of Placental Growth Factor (PlGF)- based testing.

PlGF is a diagnostic blood test, measuring protein biomarkers linked to pre-eclampsia and placental function. These tests provide the ability to better confirm or exclude pre-eclampsia.

The tests offer clinical teams the ability to better manage risk, improve patient safety through faster and accurate diagnosis and ensure the women and their unborn baby receive appropriate care.

PlGF-based testing was included in the ITP programme for 2019/20 and has now been extended to the end of 2020/21. It is also one of seven Rapid Uptake Products (RUPs) identified through the Accelerated Access Collaborative (AAC).

PlGF testing and remote blood pressure monitoring during COVID-19 have been recommended nationally by NHS England and by the Royal College of Obstetricians and Gynaecologists.