OP08.06: Assessing quality standards in measurement of uterine artery pulsatility index at 11 to 13+6 weeks of gestation, multicentric study

Abstract

Objectives: The soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio has shown to be a useful tool for the diagnosis of pre-eclampsia (PE). An elevated sFlt-1/PlGF ratio is associated with adverse perinatal outcome (APO) in singleton pregnancies complicated by PE. Data on APO prediction in twin pregnancies using sFlt-1/PlGF ratio are scarce. We evaluated the predictive value of the sFlt-1/PIGF ratio regarding APO in twin pregnancies with suspected PE and/or HELLP syndrome. Methods: This is a single centre retrospective cohort study. All twin pregnancies with suspected PE/HELLP, in which sFlt-1/PIGF ratio was determined, were included. APO was defined as the presence of at least one of following outcomes: small for gestational age (SGA: birthweight below the 10th centile), respiratory distress syndrome (RDS), intubation, admission to neonatal intensive care unit (NICU), arterial umbilical cord pH value < 7.20, and 5min APGAR ≤ 7. Results: 51 twin pregnancies were included. Of these patients, 75% (38/51) were diagnosed with PE/HELLP. Mean sFlt-1/PIGF ratio was higher in patients with APO (79.4 ± 65.5 vs. 60.1 ± 40.1), without reaching statistical significance (p = 0.09). ROC analysis for individual APO indices showed a significant predictive value for sFlt-1/PIGF ratio and SGA at birth (AUC = 0.753, 95% CI: 0.578-0.929, p = 0.005). No significant association was found for other APO indices. Conclusions: In twin pregnancies with suspected PE and/or HELLP syndrome, sFlt-1/PIGF ratio may be helpful for APO prediction. However, further prospective studies are warranted to define the role of sFlt-1/PlGF ratio as APO predictor in twin pregnancies.