sFlt-1/PlGF at 36 weeks' gestation: association with spontaneous onset of labor and intrapartum fetal compromise in low-risk pregnancies.
Angiogenic factor
Parturition
fetal compromise
fetal distress
placental dysfunction
pregnancy
term
Journal
American journal of obstetrics and gynecology
ISSN: 1097-6868
Titre abrégé: Am J Obstet Gynecol
Pays: United States
ID NLM: 0370476
Informations de publication
Date de publication:
22 Aug 2024
22 Aug 2024
Historique:
received:
10
06
2024
revised:
18
08
2024
accepted:
19
08
2024
medline:
26
8
2024
pubmed:
26
8
2024
entrez:
24
8
2024
Statut:
aheadofprint
Résumé
Prior evidence showed that placental dysfunction triggers spontaneous preterm or term births, and intrapartum fetal compromise, often requiring urgent delivery and exposing both fetus and mother to significant risks. Predicting spontaneous labor onset and intrapartum fetal compromise could improve obstetric management and outcomes, but this is currently difficult, particularly in low-risk population. The objective of this study is to examine whether placental dysfunction assessed at 36 weeks by the soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio, associates with interval to spontaneous onset of labor and intrapartum fetal compromise requiring cesarean delivery, in a routinely examined population. Retrospective analysis of prospectively collected data of women with singleton pregnancies undergoing routine assessment at 35 This study shows that increased sFlt1/PLGF ratio at 36 weeks associates with earlier gestational age at spontaneous onset of labor and higher rates of intrapartum fetal compromise. There are two major implications: sFlt1-/PLGF ratio ˃50 indicates imminent labor onset with about 40% mean risk increase and immediate clinical translation for term pregnancies monitoring. Additionally raising sFlt1-/PLGF ratios increase the risk of intrapartum fetal compromise, though outcome variability indicates reassessment within multi-marker models.
Sections du résumé
BACKGROUND
BACKGROUND
Prior evidence showed that placental dysfunction triggers spontaneous preterm or term births, and intrapartum fetal compromise, often requiring urgent delivery and exposing both fetus and mother to significant risks. Predicting spontaneous labor onset and intrapartum fetal compromise could improve obstetric management and outcomes, but this is currently difficult, particularly in low-risk population.
OBJECTIVE
OBJECTIVE
The objective of this study is to examine whether placental dysfunction assessed at 36 weeks by the soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio, associates with interval to spontaneous onset of labor and intrapartum fetal compromise requiring cesarean delivery, in a routinely examined population.
STUDY DESIGN
METHODS
Retrospective analysis of prospectively collected data of women with singleton pregnancies undergoing routine assessment at 35
CONCLUSIONS
CONCLUSIONS
This study shows that increased sFlt1/PLGF ratio at 36 weeks associates with earlier gestational age at spontaneous onset of labor and higher rates of intrapartum fetal compromise. There are two major implications: sFlt1-/PLGF ratio ˃50 indicates imminent labor onset with about 40% mean risk increase and immediate clinical translation for term pregnancies monitoring. Additionally raising sFlt1-/PLGF ratios increase the risk of intrapartum fetal compromise, though outcome variability indicates reassessment within multi-marker models.
Identifiants
pubmed: 39181498
pii: S0002-9378(24)00865-2
doi: 10.1016/j.ajog.2024.08.025
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.