Duhig KE, et al. - In this multicenter, pragmatic, stepped-wedge cluster-randomized controlled trial, researchers determine if knowledge of the circulating concentration of the placental growth factor (PlGF), an angiogenic factor integrated with a clinical management algorithm, has reduced clinicians' time to diagnose women with suspected pre-eclampsia, as well as if this approach has reduced subsequent adverse maternal or perinatal outcomes. One thousand thirty-five women were enrolled and evaluated at 11 maternity units with suspected pre-eclampsia between June 13, 2016, and October 27, 2017. When using PlGF-based testing relative to routine clinical care, the investigators observed a significant decline in the time taken for a clinician to make a diagnosis of pre-eclampsia. They found no variation in perinatal adverse outcomes (15% vs 14%) or gestation at delivery (36·6 weeks vs 36·8 weeks). They noted a lower incidence of maternal adverse outcomes when PlGF was implemented.