Clinical Assessment of Soluble FMS-Like Tyrosine Kinase-1/Placental Growth Factor Ratio for the Diagnostic and the Prognosis of Preeclampsia in the Second Trimester.

BACKGROUND: Preeclampsia is one of the most common and serious complications of pregnancy. Various reports have demonstrated that disturbances in angiogenic and antiangiogenic factors are implicated in its pathogenesis and have possible relevance in its diagnosis and prognosis.

METHODS: In this case-control study, we enrolled 73 patients with 34 preeclamptic cases diagnosed according to clinical criteria and dosing of proteinuria. The cases were matched to controls at the same age and parity. Controls had normal tension and no apparent risk factors for preeclampsia. The dosage of PLGF and sFlt - 1 were performed and correlated to the clinical issue of each group.

RESULTS: Our results show a significant decrease in PLGF levels in the cases compared to the control group (average PLGF levels in cases 28.3 pg/mL vs. 664.52 pg/mL in controls); p = 0.0006. sFlt-1 level was significantly higher in cases compared to controls. The average sFtl-1 levels in cases was 5780.72 pg/mL vs. 1886.05 pg/mL in controls; p = 0.0008. The (sFlt-1/PLGF) ratio was significantly higher in cases compared to controls (mean ratio of sFlt-1/PLGF cases is 884.12 pg/mL vs. 12.12 pg/mL in controls); p = 0.0002. Patients who developed a complication had a ratio of sFlt-1/PLGF higher than the rest of patients in the severe preeclampsia group (mean ratio of sFlt-1/PLGF 2727 pg/mL vs. 1207.41 pg/mL). The higher the ratio of sFlt1/PLGF, the shorter the period of fetal extraction was (24 hours to a ratio of 2159.16, 48 hours for a ratio of 811.9, more than 48 hours for a ratio of 184).

CONCLUSIONS: PLGF and sFtl-1 could allow discrimination of women with normal pregnancies from those at high risk for developing pregnancy complications. Their ratio may have a value for the diagnosis and prediction of pregnancy outcome.