Ultraschall Med 2019; 40(S 01): S38-S39
DOI: 10.1055/s-0039-1695909
Vorträge
Wissenschaftliche Sitzung: Fetaler Ultraschall
Georg Thieme Verlag KG Stuttgart · New York

Angiogenic factors and novel biomarkers in the prediction of adverse outcome in small for gestational age fetuses

EA Huhn
1   University Hospital Basel, Department of Obstetrics and Gynaecology, Basel, Switzerland
,
A Fuchs
2   Cantonal Hospital Aarau, Department of Gynaecology and Obstetrics, Aarau, Switzerland
,
M Coslovsky
3   University Hospital Basel, Clinical Trial Unit, Basel, Switzerland
,
B Martinez de Tejada
4   Faculty of Medicine, Geneva University Hospitals, Department of Gynaecology and Obstetrics, Geneva, Switzerland
,
S Lange
5   Institution Hospital du Nord Vaudois, Department of Obstetrics and Gynaecology, Yverdon-les-Bains, Switzerland
,
G Manegold-Brauer
6   University Hospital Basel, Department of Obstetrics and Gynaecology, Devision of Gynaecological Ultrasound and Prenatal Diagnosis, Basel, Switzerland
,
O Lapaire
1   University Hospital Basel, Department of Obstetrics and Gynaecology, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
28 August 2019 (online)

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    Aims and objectives:

    Angiogenic markers like soluble vascular endothelial growth factor receptor-1 (sFlt-1) and placental growth factor (PlGF) seem to predict adverse outcome in small for gestational age fetuses. The objective of this study was to descriptively investigate levels of sFlt-1 and PlGF and two novel biomarkers, glycosylated fibronectin (GlyFn) and pregnancy associated plasma protein A2 (PAPPA2) in small for gestational age fetuses with and without indication for delivery.

    Materials and Methods:

    A prospective cohort study was performed at the University Hospital of Basel and Geneva from 1/2012 until 3/2015. Pregnant women with singleton pregnancies and fetuses with estimated birth weight < 10th percentile were selected. Pregnancies complicated by preeclampsia were excluded. Primary outcome was the indication of delivery by worsening Doppler indices or short-term variation or repeated heart rate deceleration in the cardiotocography.

    Results:

    Forty fetuses were included in the analysis and 29 fetuses were diagnosed with fetal growth restriction (FGR). Twenty-eight/29 FGR fetuses had an indication for delivery during follow-up visits. The multiples of the medians (MoM) of PLGF was lower (MoM 0,11; p < 0,001) and sFlt-1 higher (MoM 4,66; p < 0,001) in the indicated delivery group versus the follow-up group. Regression analysis resulted in an area under the curve (AUC) of 0,91 for sFlt-1 and AUC of 0,94 for PlGF for the probability for indication for delivery. The AUCs for GlyFn and PAPPA2 were 0,86 and 0,89, respectively.

    Conclusions:

    Angiogenetic factors like sFlt-1 and PlGF and to a lesser extent GlyFn and PAPPA2 might discriminate between fetuses with an indication for delivery in fetuses with an estimated birth weight below the 10th percentile.


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