Implementation of Placental Growth Factor Testing for Suspected Preeclampsia: Lessons Learned from 3 Canadian Tertiary Centres.

With growing evidence to support the use of placental growth factor (PlGF) testing as a tool to assess suspected preeclampsia, various Canadian tertiary centres have begun integrating biochemical markers for preeclampsia diagnosis and risk stratification into clinical care. Most recently, laboratory-based serum PlGF testing was implemented at The Ottawa Hospital, ON, point-of-care PlGF at the Regina General Hospital, SK, and the sFlt-1:PlGF ratio was implemented at the London Health Sciences Centre, Victoria Hospital, ON. Here we describe the implementation of PlGF testing across three Canadian tertiary care centres, using a parallel, comparative approach examining key components of implementation: (1) the technical aspects of different PlGF assays and their respective reference-value approaches, along with the rationale for assay and reference range selection; (2) differences in reference range interpretation comparing absolute cut-offs versus gestational age-specific centiles; (3) early clinical interpretation and real-world application; (4) implementation processes, operational considerations, and (5) preliminary cost implications. We find that institutions require adoption strategies tailored to their local context.