Clinical rationale for determinig the ratio sFlt–1/PIGF for the early detection and evaluation of the severity of preeclampsia
Objective. Study of the effectiveness of determining the sFlt-1/PIGF ratio in the diagnosis of pre-eclampsia at the preclinical stage and in cases of erased/atypical course. Subjects and methods. The investigation included 206 pregnant women with suspected PE. According to the sFlt-1/PlGF ratio, all the patients were divided into 2 groups: 1) 118 patients with a sFlt-1/PlGF ratio of <38 (a negative test); 2) 88 with a sFlt-1/PlGF ratio of >38 (a positive test). Results. In Group 1, 6 (5.4%) patients were found to have moderate PE; 112 (96.4%) patients did not develop PE. In Group 2, 32 (36.4%) patients were diagnosed with severe PE; moderate PE was present in 23 (26.1%) patients, PE was absent in 33 (37.5%). In Group 2, the sFlt-1/PlGF ratio in the patients with severe PE was significantly higher than that in those with moderate and no PE: 268 (128–540) vs 80.5 (61.9–116.4) vs 57.5 (42.5–110), P1 < 0.0001 and P2 < 0.0001. Comparing the examined groups in perinatal outcomes and clinical symptoms of PE ascertained that adverse perinatal outcomes (antenatal and postnatal fetal death) and symptoms indicating the development of a critical situation (transient ischemic attack, epigastric pain, and acute renal failure) occurred only in Group 2 patients. Conclusion. Determination of the sFlt-1/PlGF ratio can serve as an additional method to diagnose PE, to evaluate the severity of preeclampsia, and to predict adverse perinatal and maternal outcomes.Kurtser M.A., Shamanova M.B., Sinitsina O.V., Nikolaeva A.A., Dedlovskaya A.I., Samsonova M.A.
Keywords
preeclampsia
placental growth factor (PlGF)
soluble fms-like tyrosine kinase-1 (sFlt-1)
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Received 25.10.2018
Accepted 09.11.2018
About the Authors
Kurtser, Mark A., academician of the Russian Academy of Sciences, professor, MD, Head of the Department of Obstetrics and Gynecology of the Russian National Research Medical University named after N.I. Pirogov, CEO of the Group of Companies «Mother and Child». Perinatal medical center of the group of companies «Mother and Child». Address: 117209, Moscow, Sevastopolsky pr. 24/1. Tel.: +74957197896. E–mail: m.kurtser@mcclinics.ruShamanova, Maria B., Head of the Department of Miscarriage Treatment, Perinatal Medical Center Group of Companies «Mother and Child».
Address: 117209, Moscow, Sevastopolsky Avenue, 24, k1. Tel.: 8(495)3322078. E–mail: m.shamanova@mcclinics.ru
Sinitsina, Olga V., Head of the Laboratory Service of the Perinatal Medical Center Group of Companies «Mother and Child».
Address: 142081, Moscow region, Odintsovo district, 1st Uspenskoe highway, village Lapino, 111. Tel.: 8(495)5266083. E–mail: o.sinitsina@mcclinics.ru
Nikolaev, Alexander A., Head of the Clinical Diagnostic Laboratory of the Clinical Hospital Lapino Group of Companies «Mother and Child».
Address: 142081, Moscow region, Odintsovo district, 1st Uspenskoe highway, village Lapino, 111. Tel.: 8(495)5266083. E–mail: a.nicolaev@mcclinics.ru
Dedlovskaya, Anastasia I., doctor obstetrician–gynecologist, Separate structural division «Clinical Hospital IDK». Address: Samara, Volzhskoye Highway, 70.
E–mail: a.dedlovskaya@mcclinics.ru
Samsonova, Magshuka A., Clinical Resident, Perinatal Medical Center Group of Companies «Mother and Child».
Address: 117209, Moscow, Sevastopolsky Avenue, 24, k1. E–mail: ma.samsonova@mcclinics.ru
For citations: Kurtser M.A., Shamanova M.B., Sinitsina O.V., Nikolaev A.A., Dedlovskaya A.I., Samsonova M.A. Clinical rationale for determining the ratio sFlt-1/PlGF for the early detection and evaluation of the severity of preeclampsia. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (11): 114-20. (in Russian)
https://dx.doi.org/10.18565/aig.2018.11.114-120
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