sFlt-1/PlGF Ratios Indicate Impending Delivery for Women with Preeclampsia

Research has shown that the soluble fms-like tyrosine kinase (sFlt-1)/placental growth factor (PlGF) ratio can be used to assess and identify women who develop preeclampsia. Now, research has demonstrated that the sFlt-1/PlGF ratio may help to predict which women are at risk for imminent delivery. The study results are available electronically through the American Journal of Obstetrics and Gynecology.
   
Dr Stefan Verlohren, department of obstetrics at the Campus Virchow-Clinic of Charit University Medicine at Berlin in Germany, and colleagues investigated a total of 630 pregnant women. Of them, 388 were singleton pregnancies with normal pregnancy outcomes.  The cohort also included 164 women who had preeclampsia, 36 women who had gestational hypertension, and 42 women who had chronic hypertension. Verlohren and colleagues obtained sFlt-1 and PlGF for all women from serum samples. As part of the study, the researchers closely observed the remaining time of pregnancy in patients with preeclampsia.

Verlohren et al. found that patients with preeclampsia had a significantly increased sFlt-1/PlGF ratio as compared with control patients; they also had increased sFlt-1/PlGF ratios as compared with patients who had chronic hypertension and gestational hypertension in <34 weeks and ≥34 weeks. The researchers also found that the sFlt-1/PlGF ratio was associated with time to delivery. In women who had preeclampsia in the highest quartile of the sFlt-1/PlGF ratio, Verlohren and colleagues found that time to delivery was significantly reduced (p <0.001). In fact, in patients who had especially high resulting ratios, the researchers found that delivery occurred within 48 hours.

The researchers concluded, “The sFlt-1/PlGF ratio allows the identification of women at risk for imminent delivery and is a reliable tool to discriminate between different types of pregnancy-related hypertensive disorders.”

Although the researchers noted that the results need to be further validated, the implications of this study are clinically important. The blood test results can help clinicians determine the due date as well as provide crucial information to help clinicians avoid complications for mother and child. In discussing the results of this study with the press, Verlohren explained, “With this test we can assess the severity of preeclampsia and give a short-term prognosis of the disease course.”

Related Information:

Gaining Insight Into Preeclampsia Versus Superimposed Preeclampsia Pre-eclampsia and Complexities of Measuring Uteroplacental Blood Flow

References:

References:
Verlohren S, Herraiz I, Lapaire O, et al. The sFlt-1/PlGF ratio in different types of hypertensive pregnancy disorders and its prognostic potential in preeclamptic patients. Am J Obstet Gynecol. 2011 Jul 30 [Epub].
Charité - Universitätsmedizin Berlin Press Release. Preeclampsia: early detection and immediate treatment. Oct. 20, 2011.