Pregnancy
Research advances biological understanding of hypertensive disorders of pregnancy
Diagnostics company Mirvie has announced the results of a breakthrough study that reveals new advances in the biological understanding of hypertensive disorders of pregnancy (HDP), including preeclampsia – a leading cause of maternal morbidity and mortality as well as preterm birth.
Researchers used data from more than 9,000 pregnancies within the multi-centre Mirvie-sponsored Miracle of Life prospective study to discover and validate RNA signatures capable of distinguishing between severe and mild hypertensive disorders of pregnancy, including preeclampsia, months before symptoms occur.
The paper also validates the predictive performance of Mirvie’s simple blood test to predict risk of preeclampsia early, at 17.5 to 22 weeks gestational age, in pregnancies without any pre-existing high-risk conditions.
“By the time a patient is symptomatic, it’s a race against the clock to try to get the baby to term and not risk the mother’s health,” said Dr. Kara Rood, a maternal-foetal medicine physician, one of the principal investigators of the study, and Clinical associate professor of Obstetrics and Gynaecology at The Ohio State University Wexner Medical Center.
“Current guidelines are not helping us identify which patients are truly at high risk and we need better tools. Mirvie’s preeclampsia risk prediction test can now improve risk assessment, helping women and their care teams be informed and take actions with the potential to delay onset or prevent the disease.”
Despite current guidelines from US Preventive Services Taskforce and the American College of Obstetrics and Gynaecology that use general maternal characteristics to identify pregnant women at increased risk for preeclampsia, rates of the disease have nearly doubled in the last decade and now affect one in 12 pregnancies.
Mirvie’s blood test uses RNA signatures to resolve this ambiguity, helping pregnant women and their providers focus on the one in four pregnancies that are truly at high risk, ensuring optimal care for the right patients.
The results of this study demonstrate that relying on molecular signals from the underlying biology is far more effective in determining whether risk for preeclampsia is high or low.
Validation results show the simple blood test can identify 91 per cent of pregnancies that will develop preterm preeclampsia in women aged over 35 without pre-existing high-risk conditions, months ahead of symptoms. Those with a low-risk result have 99.7 per cent probability of not developing preterm preeclampsia. The clinically validated blood test will soon be broadly available under the brand name Encompass.
“Over the last 100 years, we have relied on a reactive care model in pregnancy. This study represents a profound opportunity to move toward a proactive care model,” said Dr. Thomas McElrath, vice president of clinical development at Mirvie and a maternal-foetal medicine physician at Brigham and Women’s Hospital in Boston.
“Importantly, these results demonstrate for the first time the unique molecular signatures that distinguish between severe and mild hypertensive disorders of pregnancy, giving us confidence in a much more precise and personalised approach for at-risk pregnancies.”
Today, the adherence to known valuable interventions for pregnancies at high risk of preeclampsia such as daily aspirin is less than 50 per cent, even among high-risk patients. With a blood test available early in the second trimester, pregnant patients and care teams can intervene months before symptoms and more confidently implement an evidence-based prevention care plan to improve the chance for a full-term pregnancy and healthy delivery.
“We are thrilled with the results from our investments in this critical research and collaboration with more than a dozen internationally renowned experts in maternal-foetal medicine,” said Maneesh Jain, co-founder and CEO of Mirvie.
“Much like the discovery of molecular subtypes of breast cancer led to improved outcomes, the discovery of molecular subtypes in HDP offers a bright future for personalising pregnancy care and addressing the rising rates of births with complications.”
The novel findings add to the growing body of research demonstrating the use of the Mirvie RNA platform to predict pregnancy complications months in advance, including studies on preeclampsia risk prediction and preterm birth risk prediction, and research presented in January at the Society for Maternal-Foetal Medicine conference on prediction of fetal growth restriction.
Article produced in association with London Pregnancy Clinic and Spital Clinic
Non-invasive prenatal testing has been part of antenatal care in the UK since the early 2010s.
In the years since its introduction, the test has undergone significant expansion in terms of what it can detect, how early it can be performed, and how its results are interpreted.
In 2026, NIPT is also beginning to incorporate artificial intelligence at the analysis stage.
This article explains what the test currently involves, what has changed, and what the phrase ‘AI NIPT’ actually refers to in clinical practice.
How Non-Invasive Prenatal Testing Works
From around nine weeks of pregnancy, small fragments of fetal DNA circulate in the maternal bloodstream. These are known as cell-free fetal DNA (cffDNA).
NIPT works by extracting this DNA from a maternal blood sample and analysing it to detect chromosomal differences in the fetus.
Because the test uses a maternal blood draw rather than sampling the placenta or amniotic fluid, it carries no risk of miscarriage.
It is a screening test rather than a diagnostic one, meaning a positive result requires confirmation through a diagnostic procedure such as CVS or amniocentesis.
NICE guidance on non-invasive prenatal testing, published as Diagnostics Guidance DG46, sets out the evidence for its use in detecting the three most common trisomies.
Currently, the NHS does not offer Non-Invasive Prenatal Testing (NIPT) to all pregnant individuals, but rather as a contingent or second-line test for a select group deemed at higher chance of carrying a baby with certain chromosomal conditions
What NIPT Can Now Detect
When NIPT was introduced, tests typically screened for trisomies 21, 18 and 13. Detection capabilities have expanded considerably since then.
Tests available in 2026 can screen for:
- All chromosomal trisomies and some monosomies across the 23 pairs of chromosomes
- Sex chromosome conditions including Turner syndrome (45,X) and Klinefelter syndrome (47,XXY)
- Microdeletions: small missing sections of chromosomes associated with conditions such as DiGeorge syndrome, Angelman syndrome and Prader-Willi syndrome
- Single-gene disorders, where parental carrier status has been established
Tests such as the KNOVA NIPT, for which London Pregnancy Clinic was the first UK provider, are now capable of screening for up to 100 conditions from a single blood draw.
This represents a substantial expansion from the three-trisomy scope of a decade ago.
What Has Changed in 2026
Three developments characterise the current state of NIPT in clinical practice.
First, testing is available earlier, with reliable results from nine weeks and some protocols beginning comprehensive genomic assessment from 10 weeks.
Second, expanded condition panels mean that families can choose the level of detection most appropriate for their situation, from basic trisomy screening to comprehensive genomic analysis.
Third, integrated prenatal pathways are becoming more common, combining NIPT with detailed anatomical scanning and genetics counselling rather than treating the test as a standalone investigation.
What AI NIPT Means in Practice
Artificial intelligence has entered NIPT analysis at the stage where raw cfDNA data is processed and interpreted.
Traditional NIPT analysis uses statistical models to compare the proportions of chromosomal DNA fragments in the maternal sample. AI-enhanced platforms apply machine learning to this process.
A study published in Frontiers in Genetics describes the development of an algorithm using cfDNA fragment distance analysis that improves accuracy by modelling the data in a more nuanced way than conventional statistical approaches.
In clinical practice, the most established AI NIPT platform is Panorama AI NIPT, which applies machine learning to cell-free DNA analysis to improve sensitivity and specificity for common aneuploidies and to extend detection to rarer variants.
The term ‘AI NIPT’ describes this category of platform, not a single product, and it is expected to become standard across major NIPT providers as the underlying technology matures.
The key clinical difference between AI-powered and conventional NIPT is not the type of conditions screened for but the quality of the analysis applied to the same data.
This translates to fewer false positives, fewer uninformative results and greater confidence in a negative finding.
Choosing Between Available Tests
The choice of NIPT should be guided by individual clinical circumstances and pre-test genetic counselling. For families with no known genetic risk factors, standard trisomy screening provides high accuracy at lower cost.
For those with a family history of genetic conditions or who have received an abnormal ultrasound finding, an extended panel or AI-powered test may be appropriate.
The Importance of Genetic Counselling
NIPT is a screening test and, like all screening tests, it produces a probability rather than a certainty. A positive result requires follow-up diagnostic testing before any clinical decisions are made.
A negative result substantially reduces risk but does not eliminate it. Understanding what results mean in both directions requires expert clinical input.
Pre-test counselling ensures that patients understand what they are consenting to; post-test counselling ensures that results are interpreted accurately and next steps are clear.
This is particularly important for expanded panels, where the clinical significance of some findings may be uncertain or variable in presentation.
Disclaimer: This article is produced for informational purposes only and does not constitute medical advice, diagnosis or treatment.
Clinical guidance referenced reflects published NHS, NICE and RCOG standards as at March 2026. Individual circumstances vary; readers are advised to consult a qualified healthcare professional before acting on any information in this article.
This piece was produced in association with London Pregnancy Clinic and Spital Clinic, which provided background clinical information for editorial purposes.
Hyperlinks to external sources are included for reference only and do not represent an endorsement of any product, service or organisation.
A ‘miscarriage cradle’ is being introduced at three Scottish hospitals to help women experiencing miscarriage at home and in hospital.
The device was created by engineer Laura Corcoran after she lost her third baby.
Forced to devise her own way of collecting her baby’s remains, she came up with a solution to deal with the physical side so women could focus on their emotional loss.
Corcoran said: “My husband and I are both engineers, we went into problem-solving mode and we ended up using a kitchen sieve to collect baby over the toilet and then we used a Chinese takeout container to store baby in the fridge over the weekend, the hospital said I wasn’t allowed to bring them in out of hours and I miscarried on a Friday evening.”
Corcoran described the ordeal as ‘a really awful time’ and said she felt very vulnerable.
“It was completely undignified and it felt like I didn’t matter, my baby didn’t matter, there was nothing fit for purpose,” she added.
NHS Greater Glasgow and Clyde is the first UK health board to roll out its use.
The Royal Alexandra Hospital in Paisley, the Queen Elizabeth University Hospital and Princess Royal Maternity in Glasgow will offer the device to support women through miscarriage at home and in hospital.
It is believed to be the first time a group of hospitals in the UK has committed to embedding this type of support across multiple sites.
Laura’s invention came out of one of the darkest moments of her life, as she began to miscarry for the third time.
She was bleeding but was told there was no space for her in hospital and that she would have to manage the process at home.
Laura told BBC Scotland News: “Within the NHS, you have to miscarry three times before you are eligible for testing to try to find some answers.”
She said she asked the early pregnancy unit how to collect the baby and they said ‘just to manage’.
During her recovery, Laura became angry that she had not been given the tools she needed to navigate the process.
But then she realised it was not just her, there was nothing fit for purpose for any woman dealing with baby loss.
“Using my background as an engineer, I started cutting up cardboard, taping bits together, sketching ideas.
“When I had something, I went to the 3D printers and printed the first prototype,” Corcoran said.
After patient and clinical feedback, she arrived at the device now in use.
The device is semi-circular and sits under the toilet seat. In the centre is a removable sieve. It filters out what is not needed and keeps the baby.
It then goes into a watertight storage container which can be taken to hospital for testing, or for a burial or cremation.
Corcoran said: “It allows women not to have to think of the practical aspects, to think about the emotional aspects, the grief. It gives them some space and time.
“The possibility that you might not be able to collect the baby and get access to testing adds weight to the problem.
“To be able to collect the baby respectfully and without cross-contamination means women can get access to testing, find potential causes and then prevent them going through it again in their next pregnancy.”
Corcoran said an independent economic report for NHS England showed that 50 per cent uptake would save the NHS in Scotland £11.2m, free up 12,000 gynaecology surgery slots and save 10,000 emergency department visits.
Scotland is set to publish the UK’s first dedicated miscarriage patient charter, giving women and families clear information on NHS care and support.
Commissioned by the Scottish Government and developed with baby-loss charities Tommy’s, Held In Our Hearts and the Miscarriage Association, the charter sets out minimum standards for compassionate, clinically appropriate and culturally competent miscarriage care across Scotland.
It builds on the Scottish Government’s Delivery Framework for Miscarriage Care, which has already changed practice across NHS boards.
Jenni Minto, Scottish public health and women’s health minister, said: “Miscarriage is devastating, and for too long women have not had the care and support they deserve.
“That is changing. Scotland will become the first country in the UK to publish a miscarriage patient charter, meaning women know exactly how they will be supported by health services following their loss.”
Unlike previous UK-wide norms, where women were typically offered enhanced support only after three miscarriages, Scotland’s approach means women can receive appropriate support after their first miscarriage.
The charter also sets out clear rights and expectations so every woman, regardless of location or circumstance, understands the care she should receive.
It includes access to private rooms in hospitals rather than busy clinical areas or maternity settings, progesterone treatment where clinically appropriate, compassionate and culturally competent bereavement support, and clear information in 18 languages, including British Sign Language and audio formats.
Progesterone is a hormone that growing evidence suggests may help reduce the risk of miscarriage in certain cases when given to women who meet specific clinical criteria.
The Scottish Government said the charter is designed to ensure personalised, respectful care and to address long-standing inequalities experienced by women during miscarriage.
It is intended to provide clarity on the support women can expect, consistent standards across all NHS boards, stronger awareness and confidence among healthcare professionals, and better access to emotional and practical support services.
Charities involved in its development said many women still report feeling dismissed, uninformed or unsupported during miscarriage.
They said the new charter marks an important step towards making sure every woman feels heard, respected and cared for.
The charter aligns with Scotland’s wider Women’s Health Plan, which is improving care across reproductive, menstrual, maternal and perinatal health.
Recent national developments include greater investment in women’s health services, improved training for healthcare staff, new digital and in-person support tools, and targeted action to reduce inequalities in access and outcomes.
Together, these measures aim to create a more compassionate and equitable women’s health system.
Minto said: “This charter is a landmark moment.
“It tells women clearly what they should expect from their NHS, and it holds services to account for delivering it.
“Scotland is leading the way, and I am proud of the progress NHS boards and our charity partners have made together.”
The model is expected to inform wider UK discussions on miscarriage support, bereavement care and early pregnancy services.
The charter will be made publicly available, offering women, partners and families clear guidance on their rights and the standards they can expect when seeking care.
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