Value of angiogenic growth factors in complicated pregnancy in women with chronic venous insufficiency

The authors studied variations in the levels of vascular endothelial growth factor receptor-1 (VEGFR-1) and placental growth factor (PlGF) during physiological and abnormal pregnancy in women with chronic venous insufficiency (CVI) and determined their prognostic value for early diagnostic of gestational complications. One hundred and two (98) pregnant patients, including 42 women with CVI and normal pregnancy, 33 with CVI and complicated pregnancy (pregnancy being complicated in 10 of them), 10 with placental insufficiency (PI), and 9 with fetal growth retardation (FGR) were examined. A control group comprised 27 healthy pregnant women.
Blood was taken from the ulnar vein of the patients during the first, second, and third trimesters of pregnancy. Serum angiogenic markers were measured in pg/ml by ELISA; PlGF was assayed using test systems/kits (R&D Systems Quintikine, Minneapolis, USA). VEGFR-1 was determined by the kits manufactured by Bender Medsystems (USA).
In the patients with CVI in PI and in those with FGR, and preeclampsia, the mean level of VEGFR-1 was established to be significantly increased throughout pregnancy as compared with that in healthy women. The concentration of PlGF was higher in patients with PI or FGR while the level of this growth factor in women with preeclampsia was significantly lower than that in healthy pregnant women from the first trimester. With a VEGFR-1 level of above 3700 pg/ml, there was an increased risk for FGR (RR 1.97; 95% CI 1.98-4.94; p = 0.043); with a PlGF concentration of below 178 pg/ml, there was a high risk for preeclampsia (RR 2.57; 95% CI 1.21-5.46; p = 0.024). This abnormal course of pregnancy was ascertained to be accompanied by a statistically significant increase in VEGFR-1/PlGF ratio. Abnormal pregnancy was marked by impaired balance between pro- and antiangiogenic growth factors, in this connection the determination of the levels of VEGFR-1 and PlGF, their ratio in particular, at first trimester is of great importance for the prediction of pregnancy complications, such as PI, FGR, and preeclampsia in pregnant women with CVI.

vascular endothelial growth factor, placental growth factor, chronic venous insufficiency, placental insufficiency, preeclampsia, fetal growth retardation