Prognostic value of a ratio of soluble fms-like tyrokinase1 to placental growth factor in pregnant women with preeclampsia


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Abstract

Objective. To predict preeclampsia in pregnant women, by determining a ratio of soluble fms-like tyrokinase-1 (sFlt-1) to placental growth factor (PlGF). For validation, 550 women were additionally examined. Subjects and methods. The sFlt-1:PlGF ratio threshold point that is of great importance was determined on a cohort of 500 women. Results. The sFlt-1:PlGF ratio threshold point equal to 38 was of great importance for the development of preeclampsia. The sFlt-1:PlGFratio of 38 or lower has negative prognostic value (i.e. the absence of preeclampsia in the following week) in 99.3% (95% confidence interval (CI), 97.9 to 99.9) with a sensitivity of 80.0% (95% CI, 51.9 to 95.7) and a specificity of 78.3% (95% CI, 74.6 to 81.7). The positive prognostic value of the sFlt-1:PlGF ratio of higher than 38 predetermined the development of preeclampsia during 4 weeks and accounted for 36.7% (95% CI, 28.4 to 45.7) with a sensitivity of 66.2% (95% CI, 54.0 to 77.0) and a specificity of 83.1% (95% CI, 79.4 to 86.3). The foregoing confirmed the diagnostic value of the proposed threshold point. Conclusion. The sFlt-1:PlGF ratio may be regarded as a noninvasive diagnostic marker of preeclampsia. However, a search is continuing for predictors of this abnormality with the maximum sensitivity and specif icity at the present developmental stage of science.

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About the authors

Vladimir N. Serov

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_serov@oparina4.ru
MD, PhD; professor, Academician of the Russian Academy of Sciences, main researcher

Natalia E. Kan

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: kan-med@mail.ru
MD, PhD; the head of the Obstetrical observational department

Victor L. Tyutyunik

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: tioutiounnik@mail.ru
MD, PhD; the head of the Obstetric physiological department

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