PlGF-based testing for suspected preterm pre-eclampsia

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.

Also called PLGF-based testing

Intervention
In this atlas

Overview

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.

About this intervention

Type: Test
Mechanism: Not reported

Claims and evidence

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)

Eligibility: 1 inclusion criterion; 1 exclusion criterion

Included: Suspected preterm pre-eclampsia between 20 weeks and 36 weeks and 6 days of pregnancy
Excluded: Not stated as an exclusion. Separate recommendations advise against using the tests to guide the decision on whether a planned early birth should be offered to people with preterm pre-eclampsia, and advise using a test once for each episode of suspected preterm pre-eclampsia.

Recommendation Guidance Certainty not assessed

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.
Applies to Maternal
- 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.
- Not stated as a setting. The guidance is for the NHS and describes testing used with standard clinical assessment.
- 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.
- Pregnancy, 20 weeks to 36 weeks and 6 days
- Gestational age 20 weeks 0 days to 36 weeks 6 days
- Postnatal age Not reported
Follow-up Not applicable (recommendation context)
Certainty method
Not assessed

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

Next evidence check due
Not scheduled
Sources and citations (6)
1. Supports PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49)
  
  Guideline · National Institute for Health and Care Excellence (NICE) · 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. · Published 2022-07-27 · nice: HTG630
  
  Locator
  1.1, recommendation, tests and population
  
  How it applies
  NICE HTG630, cited and linked only. The four tests, the use with clinical assessment, the purpose and the gestational range.
  
  Retrieved
  2026-10-11T19:10:54Z
  
  Source effective date
  2022-07-27
  
  Source state
  Current
  
  Snapshot hash
  a398cf1b5677008d605646e1ca3792bb0a883ee77eec80f55a16e0f02251d7be
  
  Reuse basis
  The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms were read on 2026-10-11 by the setup cluster and are summarised in research/setup/notes.md: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the pages, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording. Cluster C did not read the terms pages again.
2. Supports PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49)
  
  Guideline · National Institute for Health and Care Excellence (NICE) · 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. · Published 2022-07-27 · nice: HTG630
  
  Locator
  1.1, note on indications for use
  
  How it applies
  Each test is to be used according to its own indications for use.
  
  Retrieved
  2026-10-11T19:10:54Z
  
  Source effective date
  2022-07-27
  
  Source state
  Current
  
  Snapshot hash
  a398cf1b5677008d605646e1ca3792bb0a883ee77eec80f55a16e0f02251d7be
  
  Reuse basis
  The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms were read on 2026-10-11 by the setup cluster and are summarised in research/setup/notes.md: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the pages, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording. Cluster C did not read the terms pages again.
3. Supports PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49)
  
  Guideline · National Institute for Health and Care Excellence (NICE) · 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. · Published 2022-07-27 · nice: HTG630
  
  Locator
  1.4
  
  How it applies
  A limit on use: not for decisions about a planned early birth.
  
  Retrieved
  2026-10-11T19:10:54Z
  
  Source effective date
  2022-07-27
  
  Source state
  Current
  
  Snapshot hash
  a398cf1b5677008d605646e1ca3792bb0a883ee77eec80f55a16e0f02251d7be
  
  Reuse basis
  The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms were read on 2026-10-11 by the setup cluster and are summarised in research/setup/notes.md: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the pages, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording. Cluster C did not read the terms pages again.
4. Supports PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49)
  
  Guideline · National Institute for Health and Care Excellence (NICE) · 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. · Published 2022-07-27 · nice: HTG630
  
  Locator
  1.5, sentence 1
  
  How it applies
  A limit on use: once per episode.
  
  Retrieved
  2026-10-11T19:10:54Z
  
  Source effective date
  2022-07-27
  
  Source state
  Current
  
  Snapshot hash
  a398cf1b5677008d605646e1ca3792bb0a883ee77eec80f55a16e0f02251d7be
  
  Reuse basis
  The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms were read on 2026-10-11 by the setup cluster and are summarised in research/setup/notes.md: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the pages, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording. Cluster C did not read the terms pages again.
5. Background PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49)
  
  Guideline · National Institute for Health and Care Excellence (NICE) · 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. · Published 2022-07-27 · nice: HTG630
  
  Locator
  1.6, sentence 1
  
  How it applies
  A fifth test that NICE does not recommend for routine NHS use.
  
  Retrieved
  2026-10-11T19:10:54Z
  
  Source effective date
  2022-07-27
  
  Source state
  Current
  
  Snapshot hash
  a398cf1b5677008d605646e1ca3792bb0a883ee77eec80f55a16e0f02251d7be
  
  Reuse basis
  The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms were read on 2026-10-11 by the setup cluster and are summarised in research/setup/notes.md: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the pages, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording. Cluster C did not read the terms pages again.
6. Background PLGF-based testing to help diagnose suspected preterm pre-eclampsia (NICE HealthTech guidance HTG630, formerly diagnostics guidance DG49)
  
  Guideline · National Institute for Health and Care Excellence (NICE) · 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. · Published 2022-07-27 · nice: HTG630
  
  Locator
  Overview, paragraph 3
  
  How it applies
  Renumbering from DG49 to HTG630 with unchanged content.
  
  Retrieved
  2026-10-11T19:10:53Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  e9bfd21573bac4a7a5269ae55ef93157c0a3ceb35d8125cb00d2eb7e6dd5fc12
  
  Reuse basis
  The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms were read on 2026-10-11 by the setup cluster and are summarised in research/setup/notes.md: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the pages, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording. Cluster C did not read the terms pages again.

Guidance

Recommended: PlGF-based testing for suspected preterm pre-eclampsia

Applies to Maternal

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.
Not stated as a setting. The guidance is for the NHS and describes testing used with standard clinical assessment.
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.
Pregnancy, 20 weeks to 36 weeks and 6 days
Gestational age 20 weeks 0 days to 36 weeks 6 days
Postnatal age Not reported

Follow-up Not applicable (recommendation context)

Issued by: National Institute for Health and Care Excellence (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.
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.)
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.
Supersession: Not checked

Basis: 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.
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.

Clinical links

Each link reports what one cited claim says about one population. "Evaluated for" means studied, not shown to work. These links do not show that anything is effective or right for you.

Claim, not a settled fact 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 (Recommended for)
Applies to Maternal
- 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.
- Not stated as a setting. The guidance is for the NHS and describes testing used with standard clinical assessment.
- 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.
- Pregnancy, 20 weeks to 36 weeks and 6 days
- Gestational age 20 weeks 0 days to 36 weeks 6 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.
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.

Record details

Record id: maternal:plgf-based-testing
Content hash: e52acadb4a8679d2f12bd71c876e6cc199254801839f102879a1ccb76d56ba30