SFlt-1, PIGF, SFlt-1 / PIGF Hypertensive Disorders In Pregnancy Diagnosis And Predictive Value

Objective:The purpose of this study was to test if the angiogenic and antiangiogenic factors soluble fins-like tyrosine kinase (sFlt-1), placental growth factor (PIGF) and their ratio sFlt-1/PIGF are a reliable tool in the assessment of preeclampsia and different types of hypertensive pregnancy disorders, to estimate the predictive value of sFlt-1, PIGF and their ratio sFlt-1/PIGF on PE in the second trimester.Method:In this nested case-control study, we investigated351singleton pregnancies with normal pregnancy outcome with their plasma samples collected from10weeks’ gestation to term. Meanwhile,54with preeclampsia(PE group) and44with gestation hypertension(GH group) were included, plasma samples were collected from Down’s screening sample during15and20weeks’gestation (PE, n=41; GH, n=44),1-h50-g glucose challenge test between24and28weeks’ gestation (PE, n=14; GH, n=40) and at admission for the onset of the disease(PE, n=54; GH, n=18), sFlt-1and P1GF were measured in serum samples using an automated platform.Results:1. Maternal serum concentrations of sFlt-1and PIGF significantly separated healthy women and women with PE(P<0.001). Using2787.00pg/ml as a cutoff value(AUC=0.899) of sFlt-1, the sensitivity and specificity for daignosis are83.0%and89.8%. A cutoff value of11.96(AUC=0.950) for the sFlt-1/PIGF ratio resulted in better sensitivity and specificity for the diagnosis of all preeclampsia (89.4%and91.8%, respectively), better performance was obtained for the diagnosis of early-onset preeclampsia, using2804.00pg/ml as a cutoff value (AUC=0.945) of sFlt-1, the sensitivity and specificity are92.9%and90.9%, respectively. using37.26as a cutoff value (AUC=0.945) of sFlt-1/PIGF, the sensitivity and specificity are92.9%and98.2%, respectively.2. Patients with preeclampsia had a significantly increased sFlt-1/P1GF ratio as compared with controls and with patients with gestational hypertension, chronic hypertension, CTD(SLE), sub group with urine protein.3. between24and28weeks’ gestation, concentrations of sFlt-1, PIGF and their ratio significantly separated preeclampsia (P<0.001), using11.35as a cutoff value(AUC=0.951) of sFlt-1/PIGF, the sensitivity and specificity for prediction preeclmpsia are85.7%and98.8%, respectively.Conclusions:concentrations of sFlt-1, measurement of plasma sFlt-1/PIGF ratio determined by Elecsys sFlt-1and Elecsys PIGF might assist in the diagnosis of preeclampsia, especially for early-onset preeclampsia, as well as a reliable tool to discriminate preeclampsia with other types of pregnancy-related hypertensive disorders, and perhaps a potential predictive test for preeclampsia in second trimister.