The sFlt-1/PlGF ratio and its predictive value concerning time to delivery in patients with preeclampsia – preliminary data
20 September 2018 (online)
The outcome of preeclampsia can't easily be predicted. Laboratory markers like the soluble fms-like tyrosine kinase (sFlt-1) and the placental growth factor (PlGF) are said to be predictive markers. A study of Verlohren evaluated cutoffs determining the predictive value concerning time to delivery in patients with elevated sFlt-1/PlGF ratio. This study retrospectively compares those findings in patients with elevated sFlt-1/PlGF ratio delivering at the Kepler University Hospital in Linz.
A retrospective study of patients with preeclampsia delivering at the Kepler University Hospital from 1.1.2011 – 31.10.2017 with an elevated sFlt-1/PlGF ratio was performed.
Group 1 (24+0 – 33+6): sFlt-1/PlGF > 655,5.
Group 2 (34+0 – 36+6): sFlt-1/PlGF > 201.
Above all we investigated the time to delivery to evaluate former established cutoffs. Baseline characteristics as well as patient and infant outcome parameter were recorded and compared.
The groups 1 (n = 37) and 2 (n = 45) were comparable for baseline characteristic parameters: age, height, weight, blood pressure, gravidity, parity, preeclampsia history and gestational age at blood sampling. In group 1 56.8% (n = 21) delivered ≤48h with a mean sFlt-1/PlGF ratio of 1244.4. 43.2% remained pregnant. In group 2 only 33.3% (n = 15) delivered ≤48h, whereas 66.7% remained pregnant. The mean sFlt-1/PlGF ratio of patients with early delivery was 356.3, which is clearly higher than the former established cutoff.
The sFlt-1/PlGF ratio does seem to be useful for assessing the risk of imminent delivery in preeclampsia, however we could not confirm the former evaluated cutoffs. Prospective studies with more patients will be needed.