# PlGF-based testing for suspected preterm pre-eclampsia Intervention · id `maternal:plgf-based-testing` · Maternal & Newborn Atlas · release `15708f235d73cd42` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Also called: PLGF-based testing Browse, life stage: Pregnancy ## In plain language A blood test for placental growth factor (PlGF), alone or as a ratio with a second protein, used together with a clinician's usual assessment when pre-eclampsia is suspected before 37 weeks (preterm). NICE in England recommends four named tests to help rule pre-eclampsia in or out between 20 weeks and 36 weeks and 6 days. NICE recommends against using the tests to guide the decision on whether a planned early birth should be offered to people with preterm pre-eclampsia. ## Technical summary The intervention NICE HTG630 (formerly DG49) recommends in recommendation 1.1: four named tests, to be used alongside the usual clinical assessment, two measuring PLGF alone (DELFIA Xpress PLGF 1-2-3 and Triage PLGF Test) and two using the sFlt-1/PLGF ratio (DELFIA Xpress sFlt-1/PLGF 1-2-3 ratio and Elecsys immunoassay sFlt-1/PLGF ratio). Each test is to be used within its manufacturer's stated indications for use, and some manufacturers do not indicate their tests for the whole gestational range. Recommendations 1.4 and 1.5 limit the use. This record is the NICE intervention only. It is not the US FDA-cleared use of the Elecsys test, which has a different stated purpose and population. ## Claims, with the population each applies to ## Context: Suspected preterm pre-eclampsia, 20 weeks to 36 weeks and 6 days (NICE HTG630) Recipient: Maternal; Population: People with suspected preterm pre-eclampsia between 20 weeks and 36 weeks and 6 days of pregnancy. NICE treats a woman who meets only part of the pre-eclampsia criteria as having suspected pre-eclampsia.; Care setting: Not stated as a setting. The guidance is for the NHS and describes testing used with standard clinical assessment.; Geography: England (NHS). NICE's terms and conditions present the information on its websites as support for people in England who make decisions about funding care (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guidance page states no jurisdiction of its own. The guidance refers to routine use in the NHS.; Life stage: Pregnancy, 20 weeks to 36 weeks and 6 days; Gestational age: 20 weeks 0 days (140 days) to 36 weeks 6 days (258 days); Postnatal age: Not reported; Follow-up: Not applicable (recommendation context) ### NICE recommends four named tests that are based on placental growth factor (PLGF). They are to be used alongside the usual clinical assessment, as an aid to ruling pre-eclampsia in or out in people who are suspected of having preterm pre-eclampsia at 20 weeks to 36 weeks and 6 days of pregnancy, so that decisions about care can be made. The four tests are DELFIA Xpress PLGF 1-2-3, DELFIA Xpress sFlt-1/PLGF 1-2-3 ratio, Elecsys immunoassay sFlt-1/PLGF ratio and Triage PLGF Test. NICE adds that each test is to be used within its manufacturer's stated indications for use, and adds that some manufacturers do not indicate their tests for the whole gestational range. - Category: Recommendation - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Maternal; Population: People with suspected preterm pre-eclampsia between 20 weeks and 36 weeks and 6 days of pregnancy. NICE treats a woman who meets only part of the pre-eclampsia criteria as having suspected pre-eclampsia.; Care setting: Not stated as a setting. The guidance is for the NHS and describes testing used with standard clinical assessment.; Geography: England (NHS). NICE's terms and conditions present the information on its websites as support for people in England who make decisions about funding care (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guidance page states no jurisdiction of its own. The guidance refers to routine use in the NHS.; Life stage: Pregnancy, 20 weeks to 36 weeks and 6 days; Gestational age: 20 weeks 0 days (140 days) to 36 weeks 6 days (258 days); Postnatal age: Not reported; Follow-up: Not applicable (recommendation context) - Limitations: NICE recommends against using the tests to guide the decision on whether a planned early birth should be offered to people with preterm pre-eclampsia (recommendation 1.4), and recommends using a test once for each episode of suspected preterm pre-eclampsia (recommendation 1.5). NICE also does not recommend a fifth test, the BRAHMS sFlt-1 Kryptor/BRAHMS PLGF plus Kryptor PE ratio, for routine NHS use (recommendation 1.6). That statement is kept here and not as a separate recommendation, because no product record exists for that test. The recommendation is NICE's for the NHS and is not the US FDA-cleared use of the Elecsys test. The page gives no strength grade or certainty rating, and no performance figures are recorded here. The guidance was migrated from diagnostics guidance 49 with its content unchanged. Only the NICE pages read on 2026-10-11 were checked for a later edition. - Last checked: 2026-10-12 - Sources: 1. Supports: PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49) (Guideline, edition Three pages as shown on 2026-10-11: the Overview, chapter 1 Recommendations and chapter 2 The diagnostic tests. The page header gives the reference number and the publication date. The Overview says diagnostics guidance 49 was migrated to HealthTech guidance 630 with its recommendations and content unchanged. The old DG49 address was fetched too (fetch-log label mc-nice-htg630-dg49.html) and says the guidance itself has not changed; it has no snapshot record.) Locator: 1.1, recommendation, tests and population. Retrieved 2026-10-11T19:10:54Z. Source state: Current. Snapshot hash: a398cf1b5677008d605646e1ca3792bb0a883ee77eec80f55a16e0f02251d7be. How it applies: NICE HTG630, cited and linked only. The four tests, the use with clinical assessment, the purpose and the gestational range. 2. Supports: PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49) (Guideline, edition Three pages as shown on 2026-10-11: the Overview, chapter 1 Recommendations and chapter 2 The diagnostic tests. The page header gives the reference number and the publication date. The Overview says diagnostics guidance 49 was migrated to HealthTech guidance 630 with its recommendations and content unchanged. The old DG49 address was fetched too (fetch-log label mc-nice-htg630-dg49.html) and says the guidance itself has not changed; it has no snapshot record.) Locator: 1.1, note on indications for use. Retrieved 2026-10-11T19:10:54Z. Source state: Current. Snapshot hash: a398cf1b5677008d605646e1ca3792bb0a883ee77eec80f55a16e0f02251d7be. How it applies: Each test is to be used according to its own indications for use. 3. Supports: PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49) (Guideline, edition Three pages as shown on 2026-10-11: the Overview, chapter 1 Recommendations and chapter 2 The diagnostic tests. The page header gives the reference number and the publication date. The Overview says diagnostics guidance 49 was migrated to HealthTech guidance 630 with its recommendations and content unchanged. The old DG49 address was fetched too (fetch-log label mc-nice-htg630-dg49.html) and says the guidance itself has not changed; it has no snapshot record.) Locator: 1.4. Retrieved 2026-10-11T19:10:54Z. Source state: Current. Snapshot hash: a398cf1b5677008d605646e1ca3792bb0a883ee77eec80f55a16e0f02251d7be. How it applies: A limit on use: not for decisions about a planned early birth. 4. Supports: PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49) (Guideline, edition Three pages as shown on 2026-10-11: the Overview, chapter 1 Recommendations and chapter 2 The diagnostic tests. The page header gives the reference number and the publication date. The Overview says diagnostics guidance 49 was migrated to HealthTech guidance 630 with its recommendations and content unchanged. The old DG49 address was fetched too (fetch-log label mc-nice-htg630-dg49.html) and says the guidance itself has not changed; it has no snapshot record.) Locator: 1.5, sentence 1. Retrieved 2026-10-11T19:10:54Z. Source state: Current. Snapshot hash: a398cf1b5677008d605646e1ca3792bb0a883ee77eec80f55a16e0f02251d7be. How it applies: A limit on use: once per episode. 5. Background: PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49) (Guideline, edition Three pages as shown on 2026-10-11: the Overview, chapter 1 Recommendations and chapter 2 The diagnostic tests. The page header gives the reference number and the publication date. The Overview says diagnostics guidance 49 was migrated to HealthTech guidance 630 with its recommendations and content unchanged. The old DG49 address was fetched too (fetch-log label mc-nice-htg630-dg49.html) and says the guidance itself has not changed; it has no snapshot record.) Locator: 1.6, sentence 1. Retrieved 2026-10-11T19:10:54Z. Source state: Current. Snapshot hash: a398cf1b5677008d605646e1ca3792bb0a883ee77eec80f55a16e0f02251d7be. How it applies: A fifth test that NICE does not recommend for routine NHS use. 6. Background: PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49) (Guideline, edition Three pages as shown on 2026-10-11: the Overview, chapter 1 Recommendations and chapter 2 The diagnostic tests. The page header gives the reference number and the publication date. The Overview says diagnostics guidance 49 was migrated to HealthTech guidance 630 with its recommendations and content unchanged. The old DG49 address was fetched too (fetch-log label mc-nice-htg630-dg49.html) and says the guidance itself has not changed; it has no snapshot record.) Locator: Overview, paragraph 3. Retrieved 2026-10-11T19:10:53Z. Source state: Current. Snapshot hash: e9bfd21573bac4a7a5269ae55ef93157c0a3ceb35d8125cb00d2eb7e6dd5fc12. How it applies: Renumbering from DG49 to HTG630 with unchanged content. ## Guidance, authorization and access ### Recommendation `maternal:rec-nice-htg630-1-1` - Intervention: PlGF-based testing for suspected preterm pre-eclampsia (`maternal:plgf-based-testing`) - Direction: Recommended - Issued by: National Institute for Health and Care Excellence (NICE) (`maternal:nice`) - Guideline: PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49), edition Three pages as shown on 2026-10-11: the Overview, chapter 1 Recommendations and chapter 2 The diagnostic tests. The page header gives the reference number and the publication date. The Overview says diagnostics guidance 49 was migrated to HealthTech guidance 630 with its recommendations and content unchanged. The old DG49 address was fetched too (fetch-log label mc-nice-htg630-dg49.html) and says the guidance itself has not changed; it has no snapshot record.; snapshot `maternal:nice-htg630-recs-2026-10-11` - Jurisdiction: England (NICE HealthTech guidance for the NHS). NICE's terms and conditions present the information on its websites as support for people in England who make decisions about funding care (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guidance page states no jurisdiction of its own. - Strength: Recommended (no graded strength label) (NICE HealthTech guidance wording, which recommends or does not recommend a test. The page gives no GRADE rating for recommendation 1.1.) - Effective: 2022-07-27 (The guidance was published as diagnostics guidance 49 and later migrated to HealthTech guidance 630 with its recommendations unchanged.) - Supersession: Not checked - Applies to: Recipient: Maternal; Population: People with suspected preterm pre-eclampsia between 20 weeks and 36 weeks and 6 days of pregnancy. NICE treats a woman who meets only part of the pre-eclampsia criteria as having suspected pre-eclampsia.; Care setting: Not stated as a setting. The guidance is for the NHS and describes testing used with standard clinical assessment.; Geography: England (NHS). NICE's terms and conditions present the information on its websites as support for people in England who make decisions about funding care (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guidance page states no jurisdiction of its own. The guidance refers to routine use in the NHS.; Life stage: Pregnancy, 20 weeks to 36 weeks and 6 days; Gestational age: 20 weeks 0 days (140 days) to 36 weeks 6 days (258 days); Postnatal age: Not reported; Follow-up: Not applicable (recommendation context) - Basis: claim `maternal:claim-nice-htg630-1-1` ## Connected pages - Two of the four NICE-recommended tests use the sFlt-1/PlGF ratio; two measure PlGF alone: Paired sFlt-1 and PlGF immunoassays (`maternal:sflt1-plgf-immunoassay`) - NICE HTG630 1.1: used with standard clinical assessment to help rule pre-eclampsia in or out when preterm pre-eclampsia is suspected (20 weeks to 36 weeks 6 days): Pre-eclampsia (`maternal:preeclampsia`) [a claim, not a settled fact; see claim `maternal:claim-nice-htg630-1-1` and its context] ## Provenance Content hash: e52acadb4a8679d2f12bd71c876e6cc199254801839f102879a1ccb76d56ba30 Last substantive edit: 2026-10-12 Evidence last checked: 2026-10-12