Ann Lab Med.  2018 Mar;38(2):95-101. 10.3343/alm.2018.38.2.95.

Evaluation of sFlt-1/PlGF Ratio for Predicting and Improving Clinical Management of Pre-eclampsia: Experience in a Specialized Perinatal Care Center

• Caillon H
• Tardif C
• Dumontet E
• Winer N
• Masson D

• KMID: 2403353
• DOI: http://doi.org/10.3343/alm.2018.38.2.95

Abstract

BACKGROUND
Management of pregnant women at high risk of pre-eclampsia (PE) requires frequent monitoring, with referral to specialized perinatal care centers. Reliable tests are necessary to improve prediction of PE and related complications and to assess disease severity and progression. An imbalance in two biomarkers, soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF), is involved in PE pathogenesis. The sFlt-1 to PlGF ratio is increased in pregnant women before the onset of PE. An elevated ratio is highly predictive of PE, whereas the diagnosis of PE can be ruled out within one week for low ratios. The main objective of this study was to assess whether a low sFlt-1/PlGF ratio, below a cutoff of 38, can predict the absence of PE within one week.
METHODS
We performed a prospective, monocentric, observational study to evaluate serum sFlt-1/PlGF ratio (Roche Diagnostics Cobas e411 system) for predicting -PE in a group of 67 high-risk pregnant women (20-37 gestation weeks).
RESULTS
Among the 67 patients included, 53 had a sFlt-1/PlGF ratio lower than 38; none developed subsequent PE leading to a negative predictive value of 100%. Eight patients developed clinical PE. The positive predictive value was 21% at one week and 18% at four weeks, in accordance with previous studies.
CONCLUSIONS
The serum sFlt-1/PlGF ratio showed highly predictive performances for ruling out PE. Using these biomarkers in routine management of PE may improve clinical care and avoid inappropriate hospitalization, which has a significant economic impact.

Keyword

Pre-eclampsia; Soluble fms-like tyrosine kinase 1/placental growth factor ratio; Performance

MeSH Terms

Biomarkers
Diagnosis
Female
Hospitalization
Humans
Observational Study
Perinatal Care*
Pre-Eclampsia*
Pregnancy
Pregnant Women
Prospective Studies
Referral and Consultation
Vascular Endothelial Growth Factor Receptor-1
Biomarkers
Vascular Endothelial Growth Factor Receptor-1

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