Repeat Placental Growth Factor-Based Testing in Women With Suspected Preterm Preeclampsia (PARROT-2): A Multicenter, Parallel-Group, Superiority, Randomized Controlled Trial

Abstract

(Lancet. 2024;403: 619–631. https://doi.org/10.1016/S0140-6736(23)02357-7) Hypertensive disorders affect 10% of pregnant women, including chronic hypertension, gestational hypertension, and preeclampsia, which impacts 2.8% of pregnancies. Preeclampsia, especially when preterm, increases maternal and perinatal complications. Suspected preeclampsia complicates about 10% of pregnancies but lacks an ICD-10 code, complicating accurate identification. Better early detection and risk stratification methods are needed to reduce complications and optimize resources. Abnormal levels of PlGF and sFlt-1 were linked to preeclampsia 25 years ago. Studies show PlGF is lower and sFlt-1 higher in preeclampsia cases. The PARROT-1 trial found that PlGF testing improved diagnosis time and reduced severe maternal outcomes. NICE and ISSHP recommend PlGF testing. Further evaluation is needed to determine the benefits of repeat PlGF testing.