References

Action on Pre-eclampsia. About Action on Pre-eclampsia. 2020a. https://action-on-pre-eclampsia.org.uk/about-pre-eclampsia/ (accessed 14 March 2023)

Action on Pre-eclampsia. Recent publications involving APEC. 2020b. https://action-on-pre-eclampsia.org.uk/research/recent-publications-involving-apec/ (accessed 14 March 2023)

Action on Pre-eclampsia. Cradle VSA blood pressure monitor. 2020c. https://action-on-pre-eclampsia.org.uk/professional-area/cradle-vsa-blood-pressure-monitor/ (accessed 14 March 2023)

Action on Pre-eclampsia. Welcome to APEC's virtual learning environment. 2022. https://apeceducation.co.uk/ (accessed 20 March 2023)

Beardmoore-Gray A, Greenland M, Linsell L Two-year follow-up of infant and maternal outcomes after planned early delivery or expectant management for late preterm pre-eclampsia (PHOENIX): a randomised controlled trial. BJOG. 2022; 129:(10)1654-1663 https://doi.org/10.1111/1471-0528.17167

Chappell LC, Tucker KL, Galal U Effect of self-monitoring of blood pressure on blood pressure control in pregnant individuals with chronic or gestational hypertension: the BUMP 2 randomized clinical trial. JAMA. 2022; 327:(17)1666-1678 https://doi.org/10.1001/jama.2022.4726

Hurrell A, Sparkes J, Duhig K Placental growth factor repeat sampling for reduction of adverse perinatal outcomes in women with suspected pre-eclampsia: study protocol for a randomised controlled trial (PARROT-2). Trials. 2022; 23:(1) https://doi.org/10.1186/s13063-022-06652-8

The code-professional standards of practice and behaviour for nurses and midwives.London: Nursing and Midwifery Council; 2015

Part 1: standards framework for nursing and midwifery education.London: Nursing and Midwifery Council; 2018

Robbins T, Hanlon C, Kelly AH Pills and prayers: a comparative qualitative study of community conceptualisations of pre-eclampsia and pluralistic care in Ethiopia, Haiti and Zimbabwe. BMC Pregnancy Childbirth. 2021; 21:(1) https://doi.org/10.1186/s12884-021-04186-6

Tucker KL, Mort S, Yu L-M Effect of self-monitoring of blood pressure on diagnosis of hypertension during higher-risk pregnancy: the BUMP 1 randomized clinical trial. JAMA. 2022; 327:(17)1656-1665 https://doi.org/10.1001/jama.2022.4712

Supporting research on pre-eclampsia

02 April 2023
Volume 31 · Issue 4

Abstract

Action on Pre-eclampsia aims to improve the lives of those affected by pre-eclampsia in the UK. Its work includes involvement in research, study days and the provision of online resources

Action on Pre-eclampsia is the UK's leading charity for those affected by the condition. After 30 years, the charity remains committed to finding out the reasons why so many women continue to experience this issue, providing support and educational resources for midwives through study days, online learning and an annual experts day (Action on Pre-eclampsia, 2020a).

The charity receives no statutory funding and relies on the public to do all that it does with a small team based in Evesham. Its largest fundraiser is the London Marathon.

Action on Pre-eclampsia has always recognised the importance of evidence in informing best practice to improve care in pre-eclampsia. Most research funding agencies now expect involvement from patient representatives, including in the development, execution and dissemination of research and its findings. Action on Pre-eclampsia has a unique opportunity to bring this facet to research and is actively involved in many trials and other investigations on pre-eclampsia, both in the UK and internationally. Examples of recent publications can be found on the Action on Pre-eclampsia (2020b) website.

Research

Action on Pre-eclampsia is willing to collaborate with any credible researchers in relevant areas. Recent efforts include defining the most important topics requiring research by The James Lind Alliance, which helps inform policymakers and funding agencies as to the most important research questions that need answering. Their wide representation means the questions are also relevant to women and their babies, and not only driven by medical concerns.

Action on Pre-eclampsia has been integrally involved in many clinical trials of interventions to improve management and outcomes of pre-eclampsia. These include tests to accurately identify those at risk, such novel blood pressure monitoring devices (Action on Pre-eclampsia, 2020c) or new blood tests (Hurrell et al, 2022). Management strategies include blood pressure management (Chappell et al, 2022; Tucker et al, 2022), and timing of birth (Beardmore-Gray et al, 2022). Research to understand why pre-eclampsia occurs also features strongly in the research APEC is involved with (Shennan and Gray, 2018).

The social impact of pre-eclampsia is equally important, and Action on Pre-eclampsia is also involved in research on bereavement support, as well as how women understand pre-eclampsia in low income settings (Robbins et al, 2021).

Action on Pre-eclampsia understands the importance of nurturing the next generation, and has its own student scholarship, the Walker Redman award, in honour of its founders. Chris Redman has always been, and remains, a keen researcher. The scholarship gives support to any student's research project that has the potential to add to the body of knowledge on understanding or managing pre-eclampsia.

Action on Pre-eclampsia recognises that not all research is good, nor properly conducted. The scientific board members are happy to evaluate the integrity of any relevant research and help give an independent judgement as to the research's credibility and validity. This is critical to maintaining the dissemination of quality research and to improve outcomes for mothers and babies.

The reality is that pre-eclampsia has not gone away. Research is likely to remain a mainstay of the charity's activities for the foreseeable future, and Action on Pre-eclampsia is here to add value to this important effort.

Study days

Health education for midwives has been a core issue for Action on Pre-eclampsia since its inception in 1991. The charity runs face-to-face study days that commenced when Action on Pre-eclampsia launched with Professor Chris Redman. They have developed into high-quality, local, cost effective education.

The expert study days are of particular interest to specialist and research midwives. Up-to-date studies and recently published reports are discussed, and there is time to ask questions both during the session or over refreshments. These days are supported by appropriate commercial companies, meaning only a low-cost donation is needed from attendees. One of the valuable aspects of these study days is being able to network with colleagues in both midwifery and medical fields.

Midwives value face-to-face interaction with colleagues and the quality of the expert speakers provided by the charity. In internal surveys conducted after the study days, midwives and students have evaluated them positively, stating they felt more confident in dealing with pre-eclampsia following attendance. Resources and references during the day give attendees the opportunity to delve deeper into both the charity's work and ongoing research.

Online resources

As technology advanced and midwives needed other methods to maintain education, in line with the Nursing and Midwifery Council (2015) code and new midwifery standards (Nursing and Midwifery Council, 2018), the logical way forward was to move online. The charity established two free courses, which are CPD-accredited and available online for all midwives (Action on Pre-eclampsia, 2022). This method of e-learning proved invaluable during the COVID-19 pandemic, when midwives and students still had the professional responsibility to maintain their continuous professional development.

There are 12 modules available that are free to access online, and accredited for health professionals' continuous professional development. Each module looks at hypertensive disorders relevant to the clinical environments in which midwives and students work. They also provide extra information for other health professionals such as doulas and antenatal educators.

As the modules are divided into small sessions, it is easy for professionals to undertake each one separately or tackle several in relatively short time. Midwives taking the module can start and stop each one in their own time and take it at their own pace.

Whatever clinical area a midwife is working, or indeed rotating to (as midwives often rotate through many hospital wards), they can update their knowledge and remain abreast of the latest information. The modules are individualised, since midwives have many specialised and generic roles in maternity services in hospitals and the community. The sessions include general care and management, with specific sessions for antenatal and postnatal areas.

When Action on Pre-eclampsia (2022) was founded, GPs had the responsibility for much work that is now undertaken by midwives; this has left some GPs wanting to enhance their knowledge of antenatal and postnatal care. To this end, the charity now offers a short course for GPs to keep their skillset up to date.

Conclusions

Action on Pre-eclampsia participates in and enables a wide range of research projects to improve our understanding of pre-eclampsia and how it can be managed. The charity also provides educational resources and links that midwives use in day-to-day care throughout the UK.