A paper has been released on 7th June by Science magazine on 'noninvasive blood tests for fetal development predict gestational age and preterm delivery'. Read ISUOG Board Member Mr Christoph Lees' comments on the paper here.

ISUOG Board Member Mr Christoph Lees commented:

"This is a fascinating ‘proof of principle’ but very early stage work. The authors of this paper show two potentially important results from taking a sample of the mother’s blood and looking at tiny RNA particles shed into the bloodstream. Firstly that it might be possible to determine how many weeks a pregnancy is, and secondly that the technique could predict early (preterm) delivery.

Both these questions are really important. In the US, Europe, Asia-Pacific the availability of ultrasound is good and most pregnancies are dated by ultrasound. Ultrasound can also determine whether there are additional problems with the pregnancy, but sometimes-particularly later in pregnancy-ultrasound dating isn’t accurate. Rather than ‘either-or’, if this technique worked, it might be particularly useful in combination with ultrasound. But we need to know better how this technique and ultrasound work ‘head to head’ in a much larger sample of women.

As far as preterm delivery is concerned, though checking the length of the mother’s cervix using ultrasound can in some cases predict very early delivery, as can taking a sample from the vagina for fibronectin. Neither is a perfect test. So a blood test taken from the mother that would better predict this would have potentially major implications  in developed and developing countries-for example in determining where the mother might give birth, and targeting treatments better. This RNA blood test does seem to predict preterm delivery better than established methods, but as the test was used in women at high risk of preterm delivery, the test will always in this setting appear to predict better. The authors are careful to point to the limitations of the work, the number of women in whom the test was undertaken was small, it didn’t work in all cases and it is essential for proper validation in prospective studies.

In summary-interesting and potentially game changing, but too early to use in clinical practice."

Perinatal Doppler and Vascular Focus Group (Chair), UOG Editorial Board

Christoph Lees is Professor of Obstetrics as Imperial College London; Honorary Consultant in Obstetrics and Head of Specialty for Fetal Medicine at the Centre for Fetal Care, Queen Charlotte’s and Chelsea Hospital, Imperial College Healthcare NHS Trust; Clinical Director for Fetal Medicine for North West London and Visiting Professor KU Leuven (Belgium).  His research interest is on fetal assessment and in particular the use of Doppler ultrasound to assess the health of the baby, scanning in labour, and non-invasive fetal surgery. He is the Chief Investigator of The Trial of Umbilical and Fetal Flow in Europe (TRUFFLE), a Collaboration of 51 Centres across Europe; co-founder of the International Working Group of Maternal Haemodynamics and Intrapartum ultrasound ISLANDs group. He was awarded £2.2m grant from the Medical Research Council for first in human studies of high-intensity focused ultrasound in 2017, a £2.5m grant from the NIHR in 2019 to undertake the TRUFFLE 2 RCT and a £2.1M grant from the NIHR for a study on ultrasound of breech pregnancy at 36 weeks in 2023. 
 
Country: UK

Field: Obstetrics

Specialties: Fetal anomaly screening T2; fetal biometry and wellbeing; aneuploidies; fetal anomalies; fetal growth restriction; maternal and fetal Doppler; preeclampsia; safety of ultrasound

Language: English
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For more from ISUOG on this subject, view our Virtual Issue on prediction and prevention of preterm birth.

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