Problem: Progress in understanding the underlying mechanism responsible for the syndrome pre-eclampsia should reconfigure antenatal clinical care and minimize human and financial costs, yet at present there is no accurate theory that permits development of reliable predictive tests and prophylactic intervention to mitigate disease. To contribute to this ongoing effort, we aimed to assess various circulating markers pertaining to different theories. Method of study:Serum samples from thirty-four women with established early onset preeclampsia (ePE) were assessed in terms of oxidative stress (malondialdehyde-MDA), angiogenic status (PlGF & sFLT-1), complement system (The alternative pathway-AP 50 and complement factor H-CFH) and circulating inflammatory markers (Interleukin 6-IL-6 & Procalcitonin-PCT). Control groups of gestational age matched patients included 20 gestational hypertensive (GH) and six normotensive pregnant women (NPW).Results: Our work shows that PlGF is the only serum marker who does exhibit a continued decrease from NPW to GH to ePE (r pearson = -.428, p = .002). The ePE group had a profound impairment in circulating PlGF (66.93 ± 20.62 pg/ml) compared to GH (142.67 ± 39.79 pg/ml; p = .069) and NPW (636.83 ± 392.66 pg/ml; p = .002). Then, PlGF >71.29 pg/ml pg/ml is the cut-off that has the highest negative predictive value enabling exclusion of ePE (Sp 78%, Se 70%, p = .000). No such interesting results could be obtained with the other markers. Conclusion:Our data confirm that the angiogenic factor PlGF may be highly relevant in biological mechanisms underlying the development of ePE.

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