(1144) Rapid PlGF: A Pilot Study of Clinical Utility

Objective:
Placental growth factor (PlGF) is a key biomarker of placental dysfunction. Traditional assays require centralized lab processing, delaying results. The Ronia™ platform (Research Use Only) enables rapid, point-of-care PlGF testing from a finger-prick sample, with results in 30 minutes. This pilot study evaluated its feasibility in ruling out placental dysfunction by assessing associations between PlGF levels and delivery timing, indication, and outcomes in pregnancies with suspected preeclampsia (PE).

Study Design:
We assessed PlGF in singleton pregnancies at 20–34.6 weeks with suspected PE using the Ronia™ rapid PlGF assay. Clinical outcomes were obtained by chart review. The primary outcome was medically indicated delivery for placental dysfunction within 7 or 14 days of testing. The results were stratified with preliminary concentration PlGF level cut-offs: low = < 20; indeterminate = 20–60; and normal= >60 pg/mL.

Results:
85 patients were enrolled: 34 had low PlGF, 9 were indeterminate, and 42 were normal. Baseline characteristics were similar. PlGF < 60 pg/mL showed high sensitivity and negative predictive value (NPV) for ruling out delivery (Table 1). Within 14 days, 61.8% with low PlGF delivered, compared to 55.6% indeterminate and 16.7% normal (p< 0.001). Medically indicated deliveries and contraindications to expectant management were more frequent in the low vs normal group (20.6% vs 2.4%, p=0.037; 29.4% vs 4.8%, p=0.014). Composite delivery indication for placental dysfunction within 14 days was more common with low PlGF (50.0% vs 7.1%, p< 0.001). Adverse maternal/neonatal outcomes trended higher in low PlGF groups but were not statistically significant (Table 2).

Conclusion:
In this pilot study, a novel point-of-care PlGF test showed high sensitivity and NPV for ruling out medically indicated delivery within 7 and 14 days with rare adverse outcomes among those with normal PlGF levels. These findings support the feasibility and potential of rapid PlGF testing to improve triaging, reduce unnecessary interventions, and better target care for high-risk pregnancies.