Anti-angiogenesis and Preeclampsia in 2016

Preeclampsia remains one of the most important complications in pregnancy worldwide. With this review, we aim to give an overview on important research findings over the last years and their effects on current clinical management.

The association between preeclampsia and altered angiogenesis is nowadays widely accepted. Only during the last years, assessment of angiogenic factors such as the soluble fms-like tyrosine kinase-1-to-placental growth factor (sFlt-1/PlGF) ratio has become available to everyday clinical practice with commercially available automated measurements. With these, preeclampsia can be confirmed or ruled out in uncertainty of diagnosis, and a short-term prognosis can be given in patients with symptoms of preeclampsia. Pilot studies show that maternal serum levels of sFlt-1 can be reduced by therapeutic apheresis and that this might prolong pregnancy in case of very early severe preeclampsia. The automated measurement of the sFlt-1/PlGF ratio is starting to influence clinical management of preeclampsia. Apheresis might offer new treatment options, but still needs to be evaluated in randomized trials.