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Predictive value of the sFlt‑1/PlGF ratio in women with suspected preeclampsia: An update (Review)
Alexandros Velegrakis1, Elisavet Kouvidi2, Persefoni Fragkiadaki3
1Department of Obstetrics and Gynecology, University Hospital of Heraklion, 71500 Heraklion, Greece.
Insights
Preeclampsia (PE) prediction is improved using the sFlt-1/PlGF ratio, a biomarker for angiogenic factors. This aids in early detection and management of pregnancy complications like intrauterine growth retardation (IUGR).
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Biomarker Discovery
Background:
- Preeclampsia (PE) affects 2-8% of pregnancies, causing significant maternal and fetal morbidity/mortality.
- Severe PE leads to intrauterine growth retardation (IUGR), fetal hypoxia, and neurodevelopmental disorders.
- Current diagnostic methods require improvement for timely intervention.
Purpose of the Study:
- To evaluate the predictive value of angiogenic factors, specifically the sFlt-1/PlGF ratio, for preeclampsia development.
- To assess the clinical utility of maternal serum biomarkers for early PE and IUGR detection.
- To highlight the need for standardized guidelines for biomarker implementation in clinical practice.
Main Methods:
- Analysis of maternal serum concentrations of placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1).
- Calculation of the sFlt-1/PlGF ratio as a predictive tool.
- Utilizing screening models for early pregnancy complication detection.
Main Results:
- The sFlt-1/PlGF ratio demonstrates significant clinical value in predicting PE development.
- Maternal serum concentrations of sFlt-1 and PlGF serve as effective predictive markers for PE and IUGR.
- The ratio is identified as an optimal predictive tool for preeclampsia.
Conclusions:
- The sFlt-1/PlGF ratio is a promising biomarker for predicting preeclampsia and intrauterine growth retardation.
- Further research is needed to enhance clinical applicability and establish global guidelines for PE management.
- Improved biomarker utilization can lead to more consistent clinical management of preeclampsia.
Abstract:
Preeclampsia (PE) is a major complication of pregnancy with an incidence rate of 2‑8% and is a leading cause of maternal mortality and morbidity. The various consequences of severe preeclampsia for the fetus, neonate and child include intrauterine growth retardation (IUGR), fetal hypoxia, oligohydramnios, intrauterine fetal demise, increased perinatal mortality and morbidity, neurodevelopmental disorders and even irreversible brain damage (cerebral palsy). A number of studies have demonstrated that differences in maternal serum concentrations of angiogenic factors between preeclampsia and normotensive pregnancies can be used as biomarkers, either alone or in combination with other markers, to predict the development of PE. The presence in the maternal circulation of two proteins of placental origin, placental growth factor (PlGF) and soluble fms‑like tyrosine kinase 1 (sFlt‑1), has been shown to be of clinical value, as the sFlt‑1/PlGF ratio appears to be the optimal predictive tool for the development of PE. The measurement of their concentration in maternal serum in screening models, serves as predictive marker for the development of PE or IUGR later in gestation. However, further research is required to improve its clinical applicability and provide guidelines for its use worldwide to achieve more consistent clinical management of women with PE.
