sFlt-1/PlGF ratio as a prognostic marker of adverse outcomes in women with early-onset preeclampsia

2013 ◽  
Vol 3 (3) ◽  
pp. 191-195 ◽  
Author(s):  
Leandro De Oliveira ◽  
José C. Peraçoli ◽  
Maria T. Peraçoli ◽  
Henri Korkes ◽  
Giafranco Zampieri ◽  
...  
Keyword(s):  
Prognostic Marker ◽  
Early Onset ◽  
Adverse Outcomes ◽  
Early Onset Preeclampsia ◽  
Plgf Ratio

sFlt-1/PlGF ratio for the prediction of delivery within 48 hours and adverse outcomes in expectantly managed early-onset preeclampsia

2020 ◽  
Vol 22 ◽  
pp. 17-23
Author(s):  
Elisa Simón ◽  
Celia Permuy ◽  
Laura Sacristán ◽  
María José Zamoro-Lorenci ◽  
Cecilia Villalaín ◽  
...  
Keyword(s):  
Early Onset ◽  
Adverse Outcomes ◽  
Early Onset Preeclampsia ◽  
Plgf Ratio

scholarly journals Outcomes of Early-onset Preeclampsia With Severe Features at the University Hospital in Southern Thailand: a 15-year Experience

2021 ◽  
Author(s):  
Noppasin Khwankaew ◽  
Rapphon Sawaddisan ◽  
Chitkasaem Suwanrath ◽  
Alan Geater
Keyword(s):  
Serum Creatinine ◽  
Early Onset ◽  
Elevated Serum ◽  
Maternal Diabetes ◽  
Maternal Serum ◽  
Adverse Outcomes ◽  
Gestational Age At Delivery ◽  
Early Onset Preeclampsia ◽  
Serum Aminotransferases ◽  
Maternal Diabetes Mellitus

Abstract Purpose: To evaluate outcomes and factors associated with adverse outcomes among patients with early-onset preeclampsia with severe features at Songklanagarind Hospital. Methods: A retrospective study of 326 singleton women with early-onset preeclampsia with severe features treated at Songklanagarind Hospital between 2004-2019 was conducted. Baseline characteristics, management and outcomes were reviewed. Multivariate logistic regression was used to evaluate predictors of adverse outcomes. Statistical significance was set at p < 0.05.Results: There were no maternal mortalities, with 3.1% stillbirths and 6.7% neonatal deaths. High maternal serum creatinine (OR 3.26, 95% CI 1.27-8.36, p = 0.01) was significantly associated with adverse maternal outcomes. Early gestational age at delivery [< 28 weeks (OR 16.63, 95% CI 6.95-39.80, p <0.01), 28-32 weeks (OR 3.24, 95% CI 1.54-6.85, p <0.01)], maternal diabetes mellitus (OR 5.62, 95% CI 1.43-22.06, p = 0.01), high maternal serum creatinine (OR 2.66, 95%CI 1.20-5.93, p = 0.02) and elevated serum aminotransferases (OR 2.26, 95% CI 1.19-4.29, p = 0.01) were associated with serious adverse perinatal outcomes.Conclusions: Early-onset preeclampsia with severe features had favorable outcomes. Maternal diabetes mellitus, high serum creatinine, elevated serum aminotransferases and early gestational age at delivery were factors associated with poor outcomes.

Circulating Angiogenic Factors and the Risk of Preeclampsia in Systemic Lupus Erythematosus Pregnancies

2015 ◽  
Vol 42 (7) ◽  
pp. 1141-1149 ◽  
Author(s):  
Alfredo Leaños-Miranda ◽  
Inova Campos-Galicia ◽  
María Guadalupe Berumen-Lechuga ◽  
Carlos José Molina-Pérez ◽  
Yolanda García-Paleta ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Early Onset ◽  
Late Onset ◽  
Angiogenic Factors ◽  
Systemic Lupus ◽  
Serum Samples ◽  
Early Onset Preeclampsia ◽  
Nested Case Control ◽  
Plgf Ratio

Objective.To investigate whether angiogenic factors are associated with risk of developing preeclampsia in pregnant women with systemic lupus erythematosus (SLE).Methods.We performed a nested case–control study within a cohort of SLE women with singleton pregnancies. The study included 42 patients with SLE who eventually developed preeclampsia and 75 normal SLE pregnancies. Serum samples were collected at 4-week intervals (from weeks 12 to 36). Serum samples were analyzed for soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and soluble endoglin (sEng).Results.Women destined to develop preeclampsia had lower PlGF levels and higher sFlt-1 and sEng levels, and a higher sFlt-1/PlGF ratio than normal pregnancies. These changes became significant at 12 weeks in patients destined to develop either early onset (< 34 weeks, p ≤ 0.003) or late-onset preeclampsia (≥ 34 weeks, p ≤ 0.02). The risk to develop preeclampsia was higher among patients with PlGF concentration values in the lowest quartile or with sFlt-1 and sEng levels, and sFlt-1/PlGF ratio, in the highest quartile of the normal SLE pregnancies distribution. The OR were higher and appeared earlier in patients destined to develop early onset preeclampsia (OR ≥ 16.2, from Week 12 onward) than in patients who presented preeclampsia later (OR ≥ 8.9, from Week 24 onward).Conclusion.Changes in circulating concentrations of sFlt-1, PlGF, sEng, and the sFlt-1/PlGF ratio precede the onset of preeclampsia in SLE pregnancies. The risk profile of circulating angiogenic factors for developing preeclampsia distinctly evolves depending on whether this condition is manifested earlier or later.

scholarly journals Elecsys® and Kryptor immunoassays for the measurement of sFlt-1 and PlGF to aid preeclampsia diagnosis: are they comparable?

2019 ◽  
Vol 57 (9) ◽  
pp. 1339-1348 ◽  
Author(s):  
Holger Stepan ◽  
Martin Hund ◽  
Peter Dilba ◽  
Johanna Sillman ◽  
Dietmar Schlembach
Keyword(s):  
Pregnant Women ◽  
Early Onset ◽  
Late Onset ◽  
Correlation Coefficients ◽  
Serum Samples ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count ◽  
Early Onset Preeclampsia ◽  
Plgf Ratio ◽  
Control Study

Abstract Background For pregnant women with suspected preeclampsia, the soluble fms-like tyrosine-kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio is a biomarker to aid diagnosis. We performed method comparisons between Elecsys® and Kryptor sFlt-1 and PlGF immunoassays and assessed the diagnostic performance for preeclampsia. Methods Serum samples from a case-control study involving 113 pregnant women with preeclampsia/elevated liver enzymes and low platelet count (HELLP) and 270 controls were analyzed. sFlt-1 and PlGF were measured using Roche Elecsys® and BRAHMS Kryptor sFlt-1/PlGF immunoassays. The sFlt-1/PlGF ratios were calculated, and Passing-Bablok regression/Bland-Altman plots were performed. Gestation-specific cut-offs, ≤33 and ≥85/≥110, were assessed. Results Mean (±2 standard deviation [SD]) differences between the Elecsys® and Kryptor values were: sFlt-1, 173.13 pg/mL (6237.66, −5891.40); PlGF, −102.71 pg/mL (186.06, −391.48); and sFlt-1/PlGF, 151.74 (1085.11, −781.63). The Elecsys® and Kryptor immunoassays showed high correlation: Pearson’s correlation coefficients were 0.913 (sFlt-1) and 0.945 (PlGF). Slopes were 1.06 (sFlt-1) and 0.79 (PlGF), resulting in ~20% lower values for Kryptor PlGF. Sensitivities and specificities using the sFlt-1/PlGF ≥85 cut-off for early-onset preeclampsia (20 + 0 to 33 + 6 weeks) were 88.1%/100.0% (Elecsys®) and 90.5%/96.2% (Kryptor), respectively, and using the ≥110 cut-off for late-onset preeclampsia (≥34 + 0 weeks) were 51.3%/96.5% (Elecsys®) and 78.9%/90.1% (Kryptor), respectively. Using Elecsys® and Kryptor sFlt-1/PlGF, 0% and 3.8% of women, respectively, were falsely ruled-in for early-onset, and 3.5% and 9.9%, respectively, for late-onset preeclampsia. Conclusions Despite high correlation between the Elecsys® and Kryptor immunoassays, we observed significant differences between sFlt-1/PlGF and PlGF results. Therefore, sFlt-1/PlGF cut-offs validated for Elecsys® immunoassays are not transferable to Kryptor immunoassays.

scholarly journals Decision Threshold for Kryptor sFlt‐1/PlGF Ratio in Women With Suspected Preeclampsia: Retrospective Study in a Routine Clinical Setting

2021 ◽  
Author(s):  
Lise Lotte Torvin Andersen ◽  
Annemarie Helt ◽  
Lene Sperling ◽  
Martin Overgaard
Keyword(s):  
Retrospective Study ◽  
Early Onset ◽  
Operating Characteristic ◽  
Late Onset ◽  
Characteristic Curve ◽  
Predictive Performance ◽  
Decision Threshold ◽  
Operating Characteristic Curve ◽  
Early Onset Preeclampsia ◽  
Plgf Ratio

Background The objective was to evaluate predictive performance and optimal decision threshold of the Kryptor soluble fms‐like tyrosine kinase‐1 (sFlt‐1)/placental growth factor (PlGF) ratio when implemented for routine management of women presenting with symptoms of preeclampsia. Methods and Results Observational retrospective study of a cohort of 501 women with suspected preeclampsia after 20 weeks of gestation. Women referred to maternity ward for observation of preeclampsia had an sFlt‐1/PlGF ratio test included in routine diagnostic workup. Maternal and offspring characteristic data included maternal risk factors, outcomes, delivery mode, and indication for suspected preeclampsia. Biochemical measurements to determine sFlt‐1/PlGF ratio were performed using the BRAHMS/Kryptor sFlt‐1/PlGF ratio immunoassays. Results were analyzed by area under receiver‐operating characteristic curve. Preeclampsia occurred in 150 of 501 (30%) of symptomatic women with an sFlt‐1/PlGF ratio determined before the time of diagnosis. Area under receiver‐operating characteristic curve for diagnosis of early‐onset preeclampsia within 1 and 4 weeks was 0.98 (95% CI, 0.96–1.00) and 0.95 (95% CI, 0.92–0.98), respectively. For late‐onset preeclampsia, predictive performance within 1 and 4 weeks was lower: 0.90 (95% CI, 0.85–0.94) and 0.85 (95% CI, 0.80–0.90), respectively. The optimal single sFlt‐1/PlGF ratio threshold for all preeclampsia and late‐onset preeclampsia within 1 and 4 weeks was 66. The negative and positive predictive values for ruling out and ruling in developing preeclampsia within 1 week were 96% and 70%, respectively. Conclusions The Kryptor sFlt‐1/PlGF ratio is a useful clinical tool ruling out and in preeclampsia within 1 week. Prediction within 4 weeks is superior for early‐onset preeclampsia. A single decision threshold of 66 is indicated for use in clinical routine.

PP077. New prognostic marker for the risk to develop early-onset preeclampsia

2013 ◽  
Vol 3 (2) ◽  
pp. 95-96 ◽  
Author(s):  
Joost Schuitemaker ◽  
Jannes Woudenberg ◽  
Gerarda Wijbenga ◽  
Sicco Scherjon ◽  
Marielle van Pampus ◽  
...  
Keyword(s):  
Prognostic Marker ◽  
Early Onset ◽  
Early Onset Preeclampsia

scholarly journals Early onset preeclampsia: using population data to assess recurrence risk and adverse pregnancy outcomes

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Christine L. Roberts ◽  
Sean K. Seeho ◽  
Charles S. Algert ◽  
Jane B. Ford
Keyword(s):  
Gestational Age ◽  
Early Onset ◽  
Population Data ◽  
Subsequent Pregnancy ◽  
Adverse Outcomes ◽  
Index Pregnancy ◽  
Nulliparous Women ◽  
Subsequent Birth ◽  
Adverse Pregnancy ◽  
Early Onset Preeclampsia

ABSTRACTObjectiveUse linked perinatal data to determine the subsequent pregnancy rate after a pregnancy with early onset preeclampsia and, among those who have a subsequent pregnancy, the risk of recurrence and adverse pregnancy outcomes. ApproachPreeclampsia is a hypertensive disorder of pregnancy associated with adverse outcomes for the mother and baby. Although rare, when preeclampsia occurs before 34 weeks of gestation, the risk of adverse outcomes is markedly increased primarily due to prematurity. Despite the desire for another child, many women are anxious about becoming pregnant again because of concerns of recurrent complications in a next pregnancy but information for counselling is sparse. We undertook a population-based record linkage cohort study using longitudinally-linked birth and hospital records from New South Wales (Australia) to create medical and obstetric histories. The study population included nulliparous women with a singleton pregnancy and early onset preeclampsia who gave birth between 2001 and 2010 (the index pregnancy), with follow-up for a subsequent birth through 2012. Early onset preeclampsia was defined as a hospital record (antenatal and/or delivery hospitalisations) with a diagnosis of preeclampsia and delivery before 34 weeks gestation. Outcomes included subsequent pregnancy, and among women with a consecutive subsequent birth, the preeclampsia recurrence rate and adverse pregnancy outcome rates. ResultsOf 1473 (4.0/1000) nulliparous women who had early onset preeclampsia in the index pregnancy, 60% had evidence of any subsequent pregnancy compared to 66% for women without preeclampsia (P<0.001). Of 758 women with early onset preeclampsia and a subsequent singleton birth ≥20 weeks gestation, 256 (33.8%) had preeclampsia in the subsequent pregnancy but only 57 (7.5%) had recurrent early onset preeclampsia. Most women (717, 94.6%) progressed to a later gestational age in their subsequent pregnancy. The median overall increase in gestational age at delivery was 6 weeks (interquartile range [IQR] 4 to 8) and among the women with recurrent preeclampsia the median increase in gestation in the subsequent pregnancy was 5 weeks (IQR 2 to 7). Outcomes in the subsequent pregnancy included 4.2% postpartum haemorrhage, 3.4% severe maternal morbidity, 2.6% Apgar <7 at 5 minutes, 16.2% small-for gestational-age and 1.7% perinatal deaths. ConclusionsMost women with early onset preeclampsia had good outcomes in their subsequent pregnancy. For rare conditions, linked population data with accurately recorded information can provide robust estimates of outcomes that can inform clinical counselling.

Use of the sFlt-1/PlGF ratio to rule out preeclampsia requiring delivery in women with suspected disease. Is the evidence reproducible?

2018 ◽  
Vol 56 (2) ◽  
pp. 303-311 ◽  
Author(s):  
Enric Sabrià ◽  
Paloma Lequerica-Fernández ◽  
Paula Lafuente Ganuza ◽  
Edwin Eguia Ángeles ◽  
Ana I. Escudero ◽  
...  
Keyword(s):  
Early Onset ◽  
Pregnancy Termination ◽  
Positive Likelihood Ratio ◽  
Risk Pregnancy ◽  
Published Evidence ◽  
Ratio Determination ◽  
Early Onset Preeclampsia ◽  
Roche Diagnostics ◽  
Plgf Ratio ◽  
Rule Out

Abstract Background: Soluble fms-like tyrosine kinase 1 (sFlt-1) to placental growth factor (PlGF) ratio has been proven to predict preeclampsia occurrence. Methods: Blood samples from 195 pregnant women with suspected preeclampsia were obtained at obstetric triage admission or from the high-risk pregnancy outpatient office. Serum PlGF and sFlt-1 were measured by an electrochemiluminescence immunoassay (ECLIA) on the immunoanalyser Cobas e601 (Roche Diagnostics) and the corresponding ratio was calculated. Final outcomes were reviewed by an independent obstetrician. Only the first determination was considered. Results: A sFlt-1/PlGF ratio of 38 or lower ruled out the need for pregnancy termination due to preeclampsia in the subsequent week with a negative predictive value (NPV) of 99.1% (sensitivity 97.1% and specificity 67.5%). None of the 76 pregnancies with first determination of an sFlt-1/PlGF ratio of 38 or lower between 24 and 34 weeks of gestation delivered due to early-onset preeclampsia. Positive likelihood ratio (PLR) of an sFlt-1/PlGF ratio above 38 for prediction of pregnancy termination due to preeclampsia within 4 weeks is analogous to published evidence. Conclusions: Between 24 and 34 weeks of gestation, no subsequent determination was needed to completely rule out early-onset preeclampsia when the first sFlt-1/PlGF ratio determination was 38 or lower in singleton pregnancies with signs or symptoms of this syndrome. These findings, if confirmed, will reduce costs and facilitate the implementation of the sFlt-1/PlGF ratio in women with clinical suspicion of preeclampsia in the third trimester.

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