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PP052. The course of sFlt-1 and PLGF reflects different progression pattern in early- versus late-onset preeclampsia
W Schaarschmidt1, S Rana2, H Stepan1
1Department of Obstetrics, University Hospital Leipzig, Leipzig, Germany.
Insights
Angiogenic factors like sFlt-1 and PlGF help differentiate preeclampsia (PE) and HELLP syndrome progression. Early-onset PE shows a more aggressive increase in the sFlt-1/PlGF ratio compared to late-onset PE.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Cardiovascular Biology
Background:
- Preeclampsia (PE) is a major global cause of pregnancy complications, linked to angiogenic factors.
- Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are key players in PE pathogenesis.
- Understanding these factors aids in managing maternal and fetal health outcomes.
Purpose of the Study:
- To investigate if sFlt-1, PlGF, and their ratio can distinguish clinical progression patterns in early-onset PE, late-onset PE, and HELLP syndrome.
- To analyze the role of angiogenic factors in the differential diagnosis of these pregnancy complications.
Main Methods:
- Retrospective analysis of 30 patients with PE, including 7 with HELLP syndrome.
- Definition of early-onset PE as gestational age <34 weeks.
- Serial measurements of sFlt-1 and PlGF using the Elecsys platform from admission to delivery.
Main Results:
- Early-onset PE demonstrated a significant increase in sFlt-1 (66%) and the sFlt-1/PlGF ratio (137%).
- Late-onset PE exhibited a slower progression, with a 39% increase in the sFlt-1/PlGF ratio.
- HELLP syndrome presented a comparable progression pattern to PE subtypes.
Conclusions:
- Angiogenic factors characterize PE and HELLP syndrome as progressive diseases with a shift towards an antiangiogenic state.
- Early-onset PE subtypes display a more aggressive disease course with rapid sFlt-1 elevation.
- The sFlt-1/PlGF ratio serves as a valuable biomarker for differentiating PE and HELLP syndrome progression.
Introduction:
Preeclampsia (PE), a serious multisystem disorder in pregnancy, is a leading cause of maternal and fetal morbidity and mortality worldwide and angiogenic factors like sFlt-1 and PlGF are closely related to the clinical course of preeclampsia.
Objectives:
We wondered, if these factors and the sFlt-1/PlGF ratio are a tool to differentiate the clinical progression pattern between early and late-onset PE and HELLP syndrome.
Methods:
This retrospective study included 30 patients with PE out of which 7 patients had HELLP syndrome. Early onset PE was defined as patients with gestational age <34 weeks. Serial measurements of sFlt-1 and PlGF using the automated Elecsys platform (Roche®) were done from admission until delivery.
Results:
Early-onset PE is characterized by an increase of sFlt-1 of 66% leading to an 137% increase of the sFlt-1/PlGF ratio. Late-onset PE shows a slower progression with an increase of the sFlt-1/PlGF ratio of only 39%. Patients with HELLP syndrome show comparable progression pattern.
Conclusion:
Angiogenic factors characterize PE and HELLP syndrome as continuously progressive diseases with a uniform development towards an antiangiogenic state. Early-onset subtypes show a more aggressive progression with a faster sFlt-1 increase.
