Placental growth factor measurements in the assessment of women with suspected Preeclampsia: A stratified analysis of the PARROT trial

Duhig, Kate; Myers, Jenny; Gale, Chris; Girling, Joanna; Harding, Kate; Sharp, Andrew; Simpson, Nigel; Tuffnell, Derek; Seed, Paul; Shennan, Andrew; Chappell, Lucy C

doi:10.1016/j.preghy.2020.10.005

Cited by 19 publications

(14 citation statements)

References 25 publications

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“…Adding PlGF to the work up of those with suspected preeclampsia, compared to usual care, shortened time to diagnosis and reduced severe maternal adverse outcomes for women with an intermediately low PlGF of 12-100pg/ml À potentially otherwise triaged as lower risk. 26 These improved maternal outcomes could also be achieved with reduced cost and reduced inconvenience of outpatient attendances, 27 highlighting the clinical and financial value of 'point of care' biomarker testing in cases of suspected preeclampsia. When compared, the sFlt-1:PlGF ratio and PlGF alone performed similarly in predicting delivery within two weeks in cases of suspected preterm preeclampsia.…”

Section: Biomarker Testing To Triage Care In Suspected Preterm Preeclampsiamentioning

confidence: 99%

Clinical tools and biomarkers to predict preeclampsia

et al. 2022

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Preeclampsia is pregnancy-specific, and significantly contributes to maternal, and perinatal morbidity and mortality worldwide. An effective predictive test for preeclampsia would facilitate early diagnosis, targeted surveillance and timely delivery; however limited options currently exist. A first-trimester screening algorithm has been developed and validated to predict preterm preeclampsia, with poor utility for term disease, where the greatest burden lies. Biomarkers such as sFlt-1 and placental growth factor are also now being used clinically in cases of suspected preterm preeclampsia; their high negative predictive value enables confident exclusion of disease in women with normal results, but sensitivity is modest. There has been a concerted effort to identify potential novel biomarkers that might improve prediction. These largely originate from organs involved in preeclampsia's pathogenesis, including placental, cardiovascular and urinary biomarkers. This review outlines the clinical imperative for an effective test and those already in use and summarises current preeclampsia biomarker research.

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Section: Biomarker Testing To Triage Care In Suspected Preterm Preeclampsiamentioning

confidence: 99%

Clinical tools and biomarkers to predict preeclampsia

et al. 2022

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“…At onset of preeclampsia, our patients showed the lowest values of PlGF (mean = 66.93 ± 20.62 pg/ml) compared to normo‐ and hypertensive patients (Table 1). Knowing that PlGF ˂100 pg/ml confidently predict that preeclampsia will occur over the next 2 weeks, 3 and since our calculated thresholds to rule out preeclampsia was 71.29 pg/ml for the best sensitivity and 101 pg/ml for the best specificity (Se 55%; Sp 84%), we suppose high risk for preeclampsia for patient with PlGF within the range of [71.29 ‐100] pg/ml which has a minimal that is much higher than the range proposed by the PARROT trial (PlGF of 12–100pg/ml) 12 . If so, as recommended by Teresa M MacDonald et al.…”

Section: Discussionmentioning

confidence: 90%

The evaluation of some serum immunochemical markers in early onset pre‐eclamptic women from Algeria

Kerboua

Saadia

2022

American J Rep Immunol

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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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“…17 Kate E, Duhig et al did a stratified analysis of the PARROT trial where 1006 women were included. 18 PlGF <100pg/ml identified women with more marked hypertension, increased adverse maternal outcomes and preterm delivery rates, and higher rates of small for gestational age infants. There was a reduction in adverse maternal outcomes in women whose results were revealed when PlGF levels were 12-100pg/ml compared to usual care (3.8% vs 6.9%; a OR 0.15(95% CI 0.03-0.92).…”

Section: Discussionmentioning

confidence: 95%

Association of serum placental growth factor and pregnancy associated plasma protein A between 11 to 14 weeks and pre-eclampsia

Kumar

Das

Agrawal

et al. 2021

Int J Reprod Contracept Obstet Gynecol

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Background: Pre eclampsia complicates around 5-10% of pregnancies worldwide. Many countries in the world are far away of having interventions to predict and prevent preeclampsia. A number of biochemical, biophysical and sonographic parameters are emerging as a potential tool which can help us in a long way. This study was aimed to study association of biochemical markers of preeclampsia in early pregnancy with the development of preeclampsia.Methods: This cohort study was conducted over a period of one year in the Department of Obstetrics and Gynecology at King George’s Medical University, Lucknow.Results: Total number of women enrolled at 11-14 weeks were 56. The mean age of women enrolled was 28±4.2 years. Out of total 44.6% women were nulliparous. Mean crown rump length at testing was 60.55±11.26mm. There was a significant correlation between the levels of Placental growth factors and development of PE (p<0.01) and especially severe early onset disease, however we did not found a significant correlation between Pregnancy associated plasma protein and Preeclampsia.Conclusions: Placental growth factor is an emerging marker which could be incorporated in essential bundle of care at 11 to 14 weeks testing in order to enhance the detection rates of preeclampsia.

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Placental growth factor measurements in the assessment of women with suspected Preeclampsia: A stratified analysis of the PARROT trial

Cited by 19 publications

References 25 publications

Clinical tools and biomarkers to predict preeclampsia

Clinical tools and biomarkers to predict preeclampsia

The evaluation of some serum immunochemical markers in early onset pre‐eclamptic women from Algeria

Association of serum placental growth factor and pregnancy associated plasma protein A between 11 to 14 weeks and pre-eclampsia

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