Understanding a high-risk Encompass test result

Understanding your risk for preeclampsia can be confusing and even overwhelming. Encompass can help clarify things, even with a high-risk result. It is good to know your risk because it is an opportunity to take action. You are not alone on this journey.

Continue reading to get answers to your most pressing questions, understand what this result means, and learn the steps you can take to feel more confident and prepared for a healthier pregnancy. 

Why is knowing my preeclampsia risk so important? 

When you know your risk, you can work with your care team to put a plan in place for preventive care. While prevention is possible, you may still develop preeclampsia even if you follow your preventive action plan closely. Complete prevention in any aspect of medical care is not perfect, even in the best situations.

There are a few things you should consider:

• Preventive measures could help lessen the severity of preeclampsia, such as delaying its onset by weeks or months — which is crucial for the health of your baby.
• Knowing what to watch for helps you catch it earlier if it does occur, so you and your care team are ready to act.
• Being informed allows you to feel prepared and aware of how preeclampsia may affect your delivery, helping you think through important decisions ahead of time.
• It can help you avoid the trauma of discovering you have a condition you have not had time to consider or become familiar with.
• You can feel confident that you are doing everything in your power to have the healthiest pregnancy possible.

How did you determine I was high-risk? What did the test look for?

The Encompass test analyzes tens of thousands of RNA messages from the baby, placenta, and the mother to predict preeclampsia risk — all from a simple blood test taken from the mother’s arm. It is the only test capable of doing this, and it is based on the latest scientific advancements.

Why is RNA important? What does it have to do with my baby? 

Pregnancy is profoundly complicated, with dramatic and rapid changes occurring, such as the baby’s growth and the adaptation of the mother’s body. RNA drives these developmental changes by delivering important instructions to cells in the baby, placenta, and mother.

The Encompass test evaluates RNA expression patterns from the mother, baby, and placenta, which change significantly as the pregnancy progresses. Instead of relying on just one biomarker, the test assesses the expression of a collection of RNA patterns that predict the risk of preeclampsia. Having this comprehensive picture allows you to understand your pregnancy’s unique risk for preeclampsia.

I got a high-risk result, but I’m healthy — how can I be at risk?

Preeclampsia can still occur even in the healthiest pregnancies. In fact, the healthier you are, the harder it is to predict without using an objective test like Encompass, and the easier it may be to be caught by surprise.

Is the test reliable and effective? How was it developed?

Encompass identified 9 out of 10 eligible pregnancies that developed preeclampsia between 20 and 37 weeks — months early. Eligible pregnancies include singleton pregnancies in women who are 35 or older and do not have a pre-existing major risk factor for preeclampsia.

The test was developed using the Mirvie RNA platform, which has analyzed over 10,000 pregnancies since 2013 to identify RNA patterns that can predict complications like preeclampsia.

Note: Preeclampsia is known to be much more common in individuals with a pre-existing major risk factor for the condition. However, for those without these risk factors, preeclampsia is still common and very challenging to predict — which is why Encompass was developed to fill this screening gap. Pre-existing major risk factors include diabetes (Type 1 or Type 2), a prior pregnancy with preeclampsia, chronic hypertension, renal disease, systemic lupus erythematosus, or antiphospholipid antibody syndrome. If you have one of these conditions, discuss your risk with your care team and review this discussion guide with them.

Does this mean I’ll get preeclampsia?

No, Encompass is a screening test, not a diagnostic test. A high-risk result means there is an increased risk of developing preeclampsia in this pregnancy. It does not mean you will definitely develop preeclampsia.

In fact, your recommended plan includes tools to try to prevent it. It is critical that you review this plan with your care team and implement an action plan based on evidence-based strategies for preventing preeclampsia. This way, you will be able to do everything possible to prevent preeclampsia and recognize it right away if it does occur.

Is it really preventable? What steps can I take?

1. Know your risk
This is the first and most important step. Now that you know your risk, you’re already off to a great start!

2. Read and understand your personalized care plan
Your test report includes a personalized care plan that covers the following details:

• Medications: Aspirin has been shown to be a safe and effective medication to lower your preeclampsia risk. If your doctor has already recommended it, continue taking it. If not, ask them if you should start.
• Monitoring and labs: High blood pressure is silent but often the first sign of preeclampsia, so it's essential to check it regularly. Your provider may also want to monitor your liver and kidney function and check for protein in your urine.
• Nutrition: Healthy nutrition can have a significant impact on your pregnancy and preeclampsia risk. Following the Mediterranean diet can help lower your risk. Vitamin D and calcium are also important.
• Exercise: Exercise can significantly reduce your preeclampsia risk. Combining aerobic and strength training is ideal. Speak with your provider about the appropriate type and amount of exercise for you.
  
  

3. Review the action plan with your care team
Go through the provided checklist in the report with your care team. You should always review your results and recommended care plan with them. They may recommend additional measures or provide more information regarding your risk and pregnancy care. Together, you can take proactive steps that are tailored to your pregnancy, which can lead to better outcomes for you and your baby.

4. Use the SMS-based virtual assistant to simplify putting your plan into action
The SMS-based virtual assistant provides personalized health check-ins, reminders, tips, and regular updates to ensure your plan stays on track and your pregnancy remains as healthy as possible. It can also help you log your at-home blood pressure readings, which you can review with your care team at each prenatal appointment. Think of it as your own personal concierge supporting your action plan.

5. Watch for symptoms
Preeclampsia can be silent, but there are certain symptoms to be aware of. Contact your healthcare provider if you experience any of the following:

• If your blood pressure is 140/90 or higher (for either number), contact your provider.
• If your blood pressure is 160/110 or higher (for either number), seek immediate medical attention, as this could be an emergency.
  
  

• A constant headache that will not go away
• Shortness of breath, even when sitting at rest
• Persistent pain in the abdomen or shoulder
• Nausea or vomiting in the second half of pregnancy
• Seeing spots, blurry vision, or changes in eyesight
• Sudden swelling of the face or hands
• Sudden weight gain over several days

6. Discuss with your care team what might change if you do develop preeclampsia

Ask your care team the following questions:

• How should I notify you if I start developing symptoms or have questions?
• What treatments might help me or the baby?
• What could change about my delivery?
• How can we be more prepared if preeclampsia develops?

Did I do something to make me high-risk?

No, preeclampsia can occur in any pregnancy — no matter how healthy you were before becoming pregnant. Guilt, shame, and anxiety are common and natural reactions, but this is not your fault. This condition can occur in any pregnancy.

Rest assured that your suggested action plan includes tools to help you take precautions, catch preeclampsia early, and mitigate its severity if it does occur. By taking the step to learn your risk, you are enacting a proactive care plan and doing everything possible to reduce your risk and be prepared.

Why is this test different from what my care team is already doing for me?

Without an objective test like Encompass, doctors often rely on outdated maternal characteristics such as age and race to assess risk. These methods have significant limitations because they can misidentify some individuals as at risk when they are not, while overlooking others who are actually high-risk. Frequently, these older methods are simply not specific enough.

As the incidence of preeclampsia continues to rise, medical practices have become more vigilant in screening using these traditional methods. While this increased awareness is beneficial, these methods still have limitations since not all patients require the same precautionary measures.

The Encompass test provides a personalized assessment of your risk for preeclampsia, allowing for a tailored plan that addresses your specific needs.