Changes of angiogenesis factors around delivery in preeclampsia and high risk patients

Background:

The soluble fms-like tyrosine kinase (sFlt-1)/placental growth factor (PlGF) ratio seems to predict early-onset-preeclampsia (PE) and severe PE accurately. We tested if changes of sFlt-1, PIGF and sFlt-1/PIGF ratio directly before and after delivery are able to identify women at risk of complicated puerperal course in women delivering above 34 weeks of gestation.

Methods:

We investigated 22 singleton pregnancies with women at risk of PE (36.4% with gestational diabetes, 8.3% chronic hypertension, 13.6% gestational hypertension), but normal pregnancy outcome and 11 with PE. SFlt-1 and PlGF were measured at hospital admission before and 48 hours after delivery in serum samples.

Results:

Women with late-onset PE had no significantly increased sFlt/PIGF ratio compared with women at risk for PE before (p = 0.34) or after delivery (p = 0.58). The puerperal decrease of PIGF and sFlt/PIGF ratio was also not significant with p = 0.23 and 0.46. Only the decrease in sFlt values was significantly higher in women with PE after delivery compared to at risk patients.

Conclusion:

The sFlt/PIGF ratio could not identify women with late-onset PE. This might be due to small sample size. A statement of the predictive value of sFlt/PIGF ratio in complicated puerperal course cannot be made due to only one case of puerperal PE and one case of persisting hypertension.