Email this article Prognostic value of sFlt-1 and PlGF in the diagnosis of abnormally deep placental invasion
- Authors: Godzoeva A.O.1, Zazerskaya I.E.1, Vasilyeva E.Y.1, Mashchenko I.A.1, Yakovleva N.Y.1, Li O.A.1
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Affiliations:
- V.A. Almazov National Medical Research Centre
- Issue: Vol 71, No 2 (2022)
- Pages: 39-48
- Section: Original Research
- URL: https://journals.eco-vector.com/jowd/article/view/88697
- DOI: https://doi.org/10.17816/JOWD88697
- ID: 88697
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Abstract
BACKGROUND: Placental adhesive disorder is associated with a high risk of massive bleeding during pregnancy and caesarean delivery. Abnormal trophoblast invasion and pathological hypervascularization detected in these patients may be due to the imbalance of angiogenic factors such as PlGF and sFlt-1, which makes their study an important area of scientific and clinical practice.
AIM: The aim of this study was to evaluate sFlt-1 and PlGF levels in women with placenta accrete spectrum and to compare the data with the results in women with normal pregnancy.
MATERIALS AND METHODS: This “case-control” study included 71 pregnant women in the third trimester of pregnancy. The main group (n = 32) consisted of patients with prenatally diagnosed placenta previa and abnormally invasive placenta; the control group (n = 39) included patients with normal pregnancy. In the study groups, the levels of sFlt-1 and PlGF were determined, with ultrasound and MRI characteristics evaluated. Statistical analysis was performed using IBM® SPSS® Statistics 26.0.
RESULTS: Serum sFlt-1 and PlGF levels in the study group differed as compared to controls. In women with placenta accreta spectrum, the median sFlt-1 level was 2886.0 [2175.0–4127.0] pg/ml vs. control: 1890.0 [1807.0–2205.0] pg/ml (р < 0.001); the median PlGF level was 233.5 [171.4–460.5] pg/ml vs. control: 880.9 [746.6–1210.0] pg/ml (p < 0.001). A correlation was revealed between the angiogenic factor levels and the degree of pathological hypervascularization and collaterization according to MRI data. When comparing the probability of abnormally invasive placenta (PAS Grades 2 or 3) and the sFlt-1/PlGF ratio, an ROC curve was obtained with the AUC of 0.74 ± 0.13 (95% CI: 0.48–1.0; p = 0.021).
CONCLUSIONS: Patients with placental adhesive disorder had increased sFlt-1 levels and decreased PlGF levels compared to patients with normal pregnancy. The above levels correlated with the degree of pathological hypervascularization and collaterization detected by MRI. A prognostic model has been obtained, according to which the threshold value of the sFlt-1/PlGF ratio of 4.22 allows for distinguishing patients with deep placental invasion (PAS Grades 2 or 3).
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About the authors
Alina O. Godzoeva
V.A. Almazov National Medical Research Centre
Author for correspondence.
Email: godzoevaalina@mail.ru
ORCID iD: 0000-0002-1730-2019
SPIN-code: 7407-3174
Russian Federation, Saint Petersburg
Irina E. Zazerskaya
V.A. Almazov National Medical Research Centre
Email: zazera@mail.ru
ORCID iD: 0000-0003-4431-3917
SPIN-code: 5683-6741
Scopus Author ID: 55981393900
MD, Dr. Sci. (Med.)
Russian Federation, Saint PetersburgElena Yu. Vasilyeva
V.A. Almazov National Medical Research Centre
Email: elena-almazlab@yandex.ru
ORCID iD: 0000-0002-2115-8873
SPIN-code: 8546-5546
Scopus Author ID: 57188759977
Russian Federation, Saint Petersburg
Irina A. Mashchenko
V.A. Almazov National Medical Research Centre
Email: ivikhtinskaya@mail.ru
ORCID iD: 0000-0002-4949-8829
SPIN-code: 5154-7080
Scopus Author ID: 57217019218
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgNatalia Yu. Yakovleva
V.A. Almazov National Medical Research Centre
Email: natalis.1986@mail.ru
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgOlga A. Li
V.A. Almazov National Medical Research Centre
Email: olgalee74@list.ru
ORCID iD: 0000-0002-1237-6107
Scopus Author ID: 57200971015
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgReferences
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