Soluble fms‐like tyrosine kinase‐1 to placental growth factor ratio: ruling out pre‐eclampsia for up to 4 weeks and value of retesting

• DOI: 10.1002/uog.19178
• Publication Date: 2018-07-17T05:06:10Z
• Authors: H. Zeisler; E. Llurba; F. J. Chantraine; M. Vatish; A. C. Staff; M. Sennström; M. Olovsson; S. P. Brennecke; H. Stepan; D. Allegranza; M. Schoedl; S. Grill; M. Hund; S. Verlohren
• Keywords: Adult; Vascular Endothelial Growth Factor Receptor-1; 610; Gestational Age; Prognosis; Original Papers; 618; 03 medical and health sciences; Fetus; 0302 clinical medicine; Pre-Eclampsia; Predictive Value of Tests; Pregnancy; Prenatal Diagnosis; Humans; Female; Prospective Studies; Biomarkers; Placenta Growth Factor; Retrospective Studies

ABSTRACT Objectives The soluble fms‐like tyrosine kinase‐1 (sFlt‐1) to placental growth factor (PlGF) ratio is generally elevated some time before and at the clinical onset of pre‐eclampsia. PROGNOSIS study validated a sFlt‐1/PlGF cut‐off ≤ 38 rule out pre‐eclampsia within 1 week testing in women with suspected disease. aim this was assess predictive value for up 4 weeks, repeat measurements. Methods This an exploratory post‐hoc analysis data from performed pregnant aged ≥ 18 years pre‐eclampsia, who were 24 + 0 36 6 weeks' gestation their first clinic visit. Serum samples collected visit weekly thereafter. sFlt‐1 PlGF levels measured using Elecsys® immunoassays. Whether used could predict absence 2, 3, weeks post‐baseline assessed. assessed by examining difference 2 3 after measurement with, those without, or adverse fetal outcome. Results On 550 women, ruled high negative values (NPV) 97.9% 95.7%, respectively. NPV (94.3%) sensitivity specificity (66.2% 83.1%, respectively). Compared did not develop developed had significantly larger median increases (∆, 31.22 vs 1.45; P < 0.001) 48.97 2.39; initial Women and/or outcome compared greater increase over same period 21.22 1.40; 0.001 weeks; ∆, 34.95 2.30; weeks). Conclusion immunoassay can help © 2018 Authors. Ultrasound Obstetrics & Gynecology published John Wiley Sons Ltd on behalf International Society Gynecology.