Self testing of proteinuria in pregnancy

Protein leaking into the urine combined with high blood pressure defines pre-eclampsia, a condition affecting 2-8% of pregnancies in the UK. Pre-eclampsia is important as it can lead to eclampsia; a serious condition with seizures and a high mortality rate. Around one in six women who die in pregnancy have pre-eclampsia or eclampsia.

Diagnosing pre-eclampsia requires monitoring of blood pressure and urine, typically by midwives at intermittent times during pregnancy, generally coinciding with antenatal visits. Women considered to be at higher risk for pre-eclampsia, for instance due to age or a previous history, require more frequent monitoring.

This project will examine the home use of proteinuria dipsticks alongside a study of self-monitoring of blood pressure in higher risk pregnancy. The proposed work aims to evaluate whether testing for protein in the urine by pregnant women themselves is feasible and acceptable. Additionally the study will examine if self-testing for proteinuria could add value to the self-monitoring blood pressure intervention.

Team expertise: This work brings together leading experts in home monitoring, obstetric medicine, pre-eclampsia diagnostics, statistics and evidence based medicine.

Costs: The requested funding will cover the additional staff time required to complete this work. Additional costs include some additional consumables and laboratory testing.

Ethical considerations: This is an observational study of pregnant women. We are aware of the need not to worry participants unduly and will monitor this throughout the study as well as gaining detailed views from women and professionals via qualitative work. A future trial based on the current proposal will observe women at high risk who are likely to have increased clinical assessment with the aim of reducing clinic based monitoring and improving women’s experience.