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

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.

PlGF, sFlt-1, preeclampsia, placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1)