ReMIT-2 – a feasibility study for spotting the early signs of complications

Professor Alexander Heazell, Samantha Ratcliffe, Dr Lindsay Armstrong Buiserret, Ms Eleanor Mitchell, Dr Peter Godolphin, Dr Lucy Bradshaw

We need better ways to spot the early signs of pregnancy complications. The ReMIT-2 study laid the foundations for a large clinical trial of a blood test which could predict which women need urgent care to prevent stillbirth.

Start: March 2013

End: June 2019

This project is now complete.

Why do we need this research?

Pregnant women are encouraged to be aware if their baby is moving less than usual. This can sometimes be a sign that something is wrong and that the baby may need to be delivered early.

However, most women who report that their baby is moving less go on to have a normal healthy pregnancy and delivery. We need better ways to spot if babies are struggling, so that doctors can intervene early if needed.

What happened in this project?

Our scientists have been developing ways to spot pregnancy complications early on. A lot of pregnancy complications can be caused by problems with the placenta. Our researchers think a substance in the blood called Placental Growth Factor (PlGF) could be a useful to spot these problems early.

The team set up a small pilot trial to understand whether it was feasible to use a PlGF blood test to identify which pregnant mothers were the most in need of urgent care. Mothers who reported reduced fetal movements after 36 weeks of pregnancy were asked to participate, and 216 women were recruited to the trial. All the women had a blood test to measure levels of PlGF in the blood. Half the women were given standard care, and for the other half, the results of their blood test were acted upon – for example, by inducing labour or delivering early by Caesarean section.

The pilot study was successful, showing that it would be possible to conduct a large trial to study the impact of a PlGF blood test on pregnancy complications. A larger trial is needed to study this because the rates of pregnancy complications among the group of women studied was relatively low.

What difference will this project make?

This project lays the foundations for larger studies to investigate whether a simple blood test might help to spot pregnancy complications early. This could mean that women either get reassurance that their baby is healthy, or that they could get the urgent care they need to prevent stillbirth.

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