engleski

Soluble Fms-Like Tyrosine Kinase-1 (Sflt-1) to Placental Growth Factor (Pigf) Ratio as Aid in Diagnosis and Prediction of Preeclampsia – Our Experience

BACKGROUND: Preeclampsia (PE) is a heterogeneous, multisystem disorder characterized by hypertension, proteinuria and oedema that develop after 20 weeks of gestation. PE affects 2- 5% of pregnant women and remains one of the leading causes of premature birth worldwide. The aim of this study was a clinical validation of prenatal determination of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PIGF) ratio. METHODS: In the study, we included 35 pregnant women, 12 patients with preeclampsia (PE) and 23 women with normal pregnancy outcomes (CTR). Serum samples were collected according to a standard operating procedure at 24 1/7-28 0/7 weeks of gestation and 28 1/7-32 0/7 weeks of gestation and analysed retrospectively. Levels of antiangiogenic sFLT-1 and proangiogenic PIGF were determined by electro- chemiluminescence immunoassay (Cobas e analyzers, Roche Diagnostics Ltd.Mannheim, Germany) and were used to calculate the sFLT-1/PIGF ratio. Based on the results of the ratio, with cut-off ratio value of 34, PE group was subdivided into PE group with elevated sFLT-1/PIGF ratio > 34 (PE+) and PE sFLT-1/ PIGF ratio < 34 (PE-). RESULTS: Patients in the PE+ group had increased incidence of intrauterine growth restriction (IUGR) (67%), lower gestational age at birth (31 GA (29-36 GA)) and lower birth weight of infants (1095 g (810-2060 g)) compared to PE- (17% ; 39 GA (37-40 GA) ; 3230 g (2400-4420 g)) and CTR group (0% ; 39 GA (36- 41 GA) ; 3350 g (2300-4400 g)). The value of sFLT-1/ PIGF ratio was significantly elevated in PE+ group (46.643 (8.989-155.092) and 123.193 (33.831- 217.457)) at both sample collections (p<0.001 ; p<0.001) compared to PE- (2.330 (0.958-9.544) and 3.375 (0.576-18.103) and CTR group (2.618 (1.087-6.180) and 2.599 (0.808-17.890)). There was no difference of age, body mass index (BMI), smoking habits and coagulopathy parameters between these three groups. CONCLUSION: Our results suggest that the sFLT-1/PIGF ratio has the potential to be implemented in clinical practice and could be used as an indicator for the development and estimation of the severity of PE.

sFlt-1, PlGF, ratio, preeclampsia

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