Role of sFlt-1/PlGF ratio and feto-maternal Doppler for the prediction of adverse perinatal outcome in late-onset pre-eclampsia.
Adult
Biomarkers
/ blood
Female
Humans
Infant, Newborn
Infant, Small for Gestational Age
/ blood
Placenta Growth Factor
/ blood
Pre-Eclampsia
/ blood
Predictive Value of Tests
Pregnancy
Pregnancy Proteins
/ blood
Premature Birth
ROC Curve
Retrospective Studies
Ultrasonography, Doppler
/ methods
Uterine Artery
/ diagnostic imaging
Vascular Endothelial Growth Factor Receptor-1
/ blood
(anti-) Angiogenic factors
Cerebroplacental ratio
Placental growth factor
Preeclampsia
Soluble fms-like tyrosine kinase 1
Uterine artery Doppler
Journal
Archives of gynecology and obstetrics
ISSN: 1432-0711
Titre abrégé: Arch Gynecol Obstet
Pays: Germany
ID NLM: 8710213
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
01
04
2019
accepted:
30
10
2019
pubmed:
18
11
2019
medline:
24
7
2020
entrez:
18
11
2019
Statut:
ppublish
Résumé
The sFlt-1 (soluble fms-like tyrosine kinase-1)/PlGF (placental growth factor) ratio and uterine artery Doppler have shown to be helpful in the diagnosis of pre-eclampsia (PE). The predictive value of the cerebroplacental ratio (CPR) regarding adverse perinatal outcome (APO) in low-risk pregnancies is intensively discussed. We evaluated the extent to which sFlt-1/PlGF ratio and feto-maternal Doppler may be useful in predicting APO in singleton pregnancies complicated by late-onset PE and/or HELLP syndrome. This is a retrospective study from 2010 to 2018 consisting of singleton pregnancies with confirmed diagnosis of late-onset (lo ≥ 34 weeks) PE/HELLP syndrome in which sFlt-1/PlGF ratio and feto-maternal Doppler (mUtA-PI: mean uterine artery pulsatility index and CPR) were determined. The ability of sFlt-1/PlGF ratio, mUtA-PI, CPR and their combination to predict APO or SGA was evaluated using receiver operating characteristic (ROC) curves. 67 patients were included in the final analysis. Of these, sFlt-1/PlGF was > 110 (defining angiogenic lo PE) in 40.3% (27/67), mUtA-PI was above the 95th centile in 34.3% (23/67) patients and CPR was lower than the 5th centile in 10.4% (7/67). Abnormal sFlt-1/PlGF and mUtA-PI as well as CPR were associated with a lower birth weight (BW). Late-preterm birth (< 37 weeks) as well as postnatal diagnosis of small for gestational age (SGA: BW < 3rd centile) was significantly more often in angiogenic lo PE cases. Neither sFlt-1/PIGF nor CPR or mUtA-PI were APO predictors. Only for sFlt-1/PlGF, ROC analysis revealed a significant predictive value for postnatal SGA (AUC = 0.856, p = 0.001, 95% CI 0.75-0.97). There was no statistical added value of combined SGA predictors as compared to sFlt-1/PlGF alone. In patients with lo PE, adding sFlt-1/PlGF ratio to routine antepartum fetal surveillance may be useful to identify cases of postnatal SGA. However, further prospective studies are warranted to define the role of feto-maternal Doppler and sFlt-1/PlGF ratio as outcome predictors.
Identifiants
pubmed: 31734756
doi: 10.1007/s00404-019-05365-9
pii: 10.1007/s00404-019-05365-9
doi:
Substances chimiques
Biomarkers
0
PGF protein, human
0
Pregnancy Proteins
0
Placenta Growth Factor
144589-93-5
FLT1 protein, human
EC 2.7.10.1
Vascular Endothelial Growth Factor Receptor-1
EC 2.7.10.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
375-385Références
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