Clinical rationale for determinig the ratio sFlt-1/PIGF for the early detection and evaluation of the severity of preeclampsia


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Abstract

Objective. Study of the effectiveness of determining the sFlt-1/PIGF ratio in the diagnosis of pre-eclampsia at the preclinical stage and in cases of erased/atypical course. Subjects and methods. The investigation included 206 pregnant women with suspected PE. According to the sFlt-1/PlGF ratio, all the patients were divided into 2 groups: 1) 118patients with a sFlt-1/PlGF ratio of <38 (a negative test); 2) 88 with a sFlt-1/PlGF ratio of >38 (a positive test). Results. In Group 1, 6 (5.4%) patients were found to have moderate PE; 112 (96.4%) patients did not develop PE. In Group 2, 32 (36.4%) patients were diagnosed with severe PE; moderate PE was present in 23 (26.1%) patients, PE was absent in 33 (37.5%). In Group 2, the sFlt-1/PlGF ratio in the patients with severe PE was significantly higher than that in those with moderate and no PE: 268 (128-540) vs 80.5 (61.9-116.4) vs 57.5 (42.5-110), P1 < 0.0001 and P2 < 0.0001. Comparing the examined groups in perinatal outcomes and clinical symptoms of PE ascertained that adverse perinatal outcomes (antenatal and postnatal fetal death) and symptoms indicating the development of a critical situation (transient ischemic attack, epigastric pain, and acute renal failure) occurred only in Group 2patients. Conclusion. Determination of the sFlt-1/PlGFratio can serve as an additional method to diagnose PE, to evaluate the severity of preeclampsia, and to predict adverse perinatal and maternal outcomes.

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About the authors

Mark A. Kurtser

Pirogov Russian National Research Medical University

Email: m.kurtser@mcclinics.ru
academician of the Russian Academy of Sciences, professor, MD, Head of the Department of Obstetrics and Gynecology; CEO of the Group of Companies «Mother and Child». Perinatal medical center of the group of companies «Mother and Child».

Maria B. Shamanova

Perinatal Medical Center Group of Companies «Mother and Child»

Email: m.shamanova@mcclinics.ru
Head of the Department of Miscarriage Treatment

Olga V. Sinitsina

Clinical hospital «Lapino» group of companies «Mother and Child»

Email: o.sinitsina@mcclinics.ru
Head of the Laboratory Service

Alexander A. Nikolaeva

Clinical hospital «Lapino» group of companies «Mother and Child»

Email: a.nicolaev@mcclinics.ru
Head of the Clinical Diagnostic Laboratory

Anastasia I. Dedlovskaya

Separate structural division «Clinical Hospital IDK»

Email: a.dedlovskaya@mcclinics.ru
doctor obstetrician-gynecologist

Magshuka A. Samsonova

Perinatal Medical Center group of companies «Mother and Child»

Email: ma.samsonova@mcclinics.ru
Clinical Resident

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