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This study will look at the accuracy of women testing their urine for protein (proteinuria) in comparison to health care professional and laboratory testing. We will also assess the view and experiences of the pregnant women and healthcare professionals who took part.

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WHY IS THIS IMPORTANT?

This research is part of a wider programme of work to explore the use of self-monitoring of blood pressure and self-testing of urine during pregnancy. The overall aim is to improve the detection of pre-eclampsia in the higher risk and hypertensive population.

Proteinuria testing and blood pressure monitoring are the most commonly performed antenatal screening tests: they are carried out at every antenatal visit and are central to the diagnosis of pre-eclampsia (a potentially serious condition for both mother and baby).

A number of women in the UK develop pre-eclampsia within the interval between antenatal visits. It is possible that self-testing using urine dipsticks could improve the detection of pre-eclampsia. The most likely group to benefit from home testing would be those with raised blood pressure.

Previous work has suggested that self-testing of urine during pregnancy may have a similar accuracy to health care professional testing, that self-testing could be easily implemented during an antenatal appointment, and that most women would find self-testing acceptable. https://bit.ly/2mKOtqj 

METHODS:

This is a diagnostic accuracy study: Pregnant women with hypertension (gestational or chronic) will be asked to test their urine for protein alongside one of their routine antenatal care visits.

The sample will be tested by:

·         The participant (primary index test)

·         Laboratory uPCR (reference test)

·         A midwife

·         An automated reader

·         Laboratory ACR (alternate reference test for sensitivity analyses)

At the end of their visit, participating women will be provided with an opportunity to provide feedback about their thoughts and feelings about self-testing using free text postcards or interviews. Healthcare professionals will also be given the opportunity to provide feedback using free text postcards, interviews, and focus groups.

HOW COULD THIS BENEFIT PATIENTS?

Self-testing has the potential to improve the detection and management of proteinuria in pregnancy by providing much more data on women’s health without a large increase in burden for women, who might not need to attend hospital so often. Increasing women’s involvement through self-testing could underpin a new cost-effective model of care during pregnancy, which improves satisfaction and delivers quality outcomes.

Research team: