Short-Term Prediction of Adverse Outcomes Using the sFlt-1 (Soluble fms-Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio in Asian Women With Suspected Preeclampsia

Abstract

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From first‐trimester screening to risk stratification of evolving pre‐eclampsia in second and third trimesters of pregnancy: comprehensive approach

“…Subsequently, the PROGNOSIS Asia study also demonstrated the value of the sFlt-1/PlGF ratio for the short-term prediction of pre-eclampsia in pregnant Asian women with suspected pre-eclampsia 55 . The inclusion criteria for this study were similar to those used for the PROGNOSIS study (excessive edema, severe swelling, headache and sudden weight gain were not included as pre-eclampsia-related symptoms).…”

“…In this study, a sFlt-1/PlGF ratio cut-off of ≤ 38 was shown to have an NPV of 98.6% (95% CI, 97.2-99.4%) for ruling out pre-eclampsia within 1 week and a ratio > 38 demonstrated a PPV of 30.3% (95% CI, 23.0-38.5%) for ruling in pre-eclampsia within 4 weeks in a cohort of 700 evaluable women. The PPV for the occurrence of a combined endpoint of pre-eclampsia/eclampsia/HELLP syndrome, maternal and/or maternal or fetal adverse outcomes within 4 weeks was 65.0% (95% CI, 56.6-72.8%) 55 .…”

Current Researches, Rationale, Plausibility, and Evidence Gaps on Metformin for the Management of Hypertensive Disorders of Pregnancy

“…sFlt-1, a representative type of antiangiogenic factor secreted primarily by syncytiotrophoblasts into maternal circulation ( Karumanchi, 2016 ), is typically implicated in restricted vascularization, endothelial dysfunction, and elevated maternal blood pressure via decreasing the bioavailability of free VEGF and PIGF ( Tomimatsu et al, 2019 ). Additionally, the maternal serum concentration of sFlt-1 is directly proportional to the severity of PE, and the sFlt-1/PlGF ratio is of significant clinical value for the short-term prediction in women with suspected PE ( Bian et al, 2019 ). sENG, another typical type of placenta-derived antiangiogenic factor, inhibits the formation of capillary tubes in vitro and induces hypertension and vascular permeability in vivo, thus, in concert with sFlt-1, inducing severe vascular compromise in PE ( St-Jacques et al, 1994 ; Li et al, 1999 ; Toporsian et al, 2005 ; Venkatesha et al, 2006 ).…”

Pregnancy hypertension diagnosis and care in COVID‐19 era and beyond

“…Any woman with suspected pre-eclampsia requires a face-to-face evaluation by her healthcare team. Angiogenic markers have been recommended as part of this evaluation in the UK 20 , based on their good-to-excellent performance at ruling out a diagnosis of pre-eclampsia (defined as new-onset proteinuria) within 7 days or pre-eclampsia requiring delivery within 14 days [21][22][23][24] . However, angiogenic markers may be useful even if women meet diagnostic criteria for pre-eclampsia; many Figure 2 Suggested dose titration of first-line antihypertensive therapy in pregnancy.…”