Geburtshilfe Frauenheilkd 2017; 77(04): 379-395
DOI: 10.1055/s-0037-1600042
Abstracts
Georg Thieme Verlag KG Stuttgart · New York

Outcome of pregnancies with very elevated levels of sFlt-1/PlGF ratio

D Wertaschnigg
1   Universitätsklinikum Salzburg, Paracelsus Medizinische Privatuniversität, Abteilung für Geburtshilfe und Gynäkologie, Salzburg, Österreich
,
C Fazelnia
1   Universitätsklinikum Salzburg, Paracelsus Medizinische Privatuniversität, Abteilung für Geburtshilfe und Gynäkologie, Salzburg, Österreich
,
E Doelzmueller
1   Universitätsklinikum Salzburg, Paracelsus Medizinische Privatuniversität, Abteilung für Geburtshilfe und Gynäkologie, Salzburg, Österreich
,
C Kölblinger
1   Universitätsklinikum Salzburg, Paracelsus Medizinische Privatuniversität, Abteilung für Geburtshilfe und Gynäkologie, Salzburg, Österreich
,
C Wohlmuth
1   Universitätsklinikum Salzburg, Paracelsus Medizinische Privatuniversität, Abteilung für Geburtshilfe und Gynäkologie, Salzburg, Österreich
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
06. April 2017 (online)

 

Introduction:

The implemantation of angiogenic factors like sFlt-1 and PlGF has taken place in our clinical routine to improve prediction and diagnosis of placental dysfunction. Cut off levels for the diagnosis of early (= sFlt-1/PlGF Ratio > 85 before 34 wks GA) and late (= sFlt-1/PlGF Ratio > 110 after 34 wks GA) onset type of placenta-related disorders were published. Additionally it is known that pregnancies complicated by severely elevated sFlt-1/PlGF Ratios are highly associated with the need to deliver within a very short time of period.

Methods:

We analyzed retrospectively all pregnancies after 20 wks GA with sFlt-1/PlGF ratios above 150 from january 2013 to december 2016, which were delivered in our hospital. Primary endpoint was time intervall between the first meassurement of sFlt-1/PlGF higher than 150 and delivery. Second endpoints were mode of delivery, GA at delivery, diagnosis of placenta related disorders and need for neonatal intensive care unit.

Results:

99 Patients met the inclusion criteria, (sFlt-1/PlGF ratio median 231.41 (range 150.11 – 2147.73; (median GA 31+3 range 20+4 – 41+0), 93 singleton pregnancies, 5 twins and one quadriplet pregnancy. There were three cases of IUFD (GA 22+1, 28+0, 28+1).

The mean time between the first meassurement above 150 and date of delivery was 4.3 days, the median was 3 days (range 0 – 78 days). Without the cases of IUFD (n = 3) and multiple pregnancies (n = 6), the caesarean section rate was 77.8% (70/90), 80.8% were delivered prematurely, 50.5% were born before 34 wks GA and 26.3% before 30 wks GA. 54.2% (58/107) of all babies suffered from growth restriction (< 10th percentile and/or abnormal fetal doppler findings), 41.73% were below the 3 rd percentile. 68% of all live births were transmitted to NICU. 76.8% (76/99) off all pregnant women suffered from Preeclampsia, PIH and/or HELLP Syndrome. From 23/99 women who did not show any signs of Hypertension or HELLP Syndrome, all but one need to be delivered prematurely and all but three newborns were growth restricted.

Conclusion:

70.7% of our Patients with a Ratio higher than 150 were delivered within one week, 83.8% within 2 weeks. Only one Patient did not show any signs of placental related disorder with a normal delivery at term.