الفهرس 
PRE-ECLAMPSIAOnly 14 pages are availabe for public view
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Abstract
Objective: To assess the clinical utility of placental growth factor and soluble fms-like tyrosine kinase-1, as early predictors of pre-eclampsia and their role in the diagnosis.
Study design: A pilot retrospective case-control study was conducted on 80 pregnant women. The study included all 30 women who eventually developed pre-eclampsia and 50 normotensive controls. Serum samples were collected twice; during the second and the third trimesters. PlGF and sFlt-1 were measured using a chemiluminescence immunoassay.
Results: Women destined to develop pre-eclampsia had a significant lower PlGF levels and higher sFlt-1 levels and sFlt-1/PlGF ratio than women with normal pregnancies as early as the second trimester of pregnancy. These changes were even more profound during the third trimester. The predictive role of sFlt-1 alone during the second trimester was hindered by its low diagnostic sensitivity (66.7%), diagnostic specificity (64%), at the chosen cut-off value of 2,330 pg/mL. However, PlGF at a cut-off value of 92 pg/mL showed a better performance. The sFlt-1/PlGF ratio added an important value in improvement of the diagnostic sensitivity for prediction of pre-eclampsia. The diagnostic performance was much better by the combined use of sFlt-1/PlGF ratio together with PlGF as early as 15 weeks of gestation. Also, the diagnostic performance of the combined use of these markers was better than each marker alone during the third trimester. The odds ratios were evaluated among the four quartiles to assess the risk of occurrence of pre-eclampsia early during the second trimester.
Conclusion: Changes in circulating concentrations of PlGF, sFlt-1, and in the sFlt-1/PlGF ratio precede the onset of pre-eclampsia. Moreover, the additive performance of combined use of these markers is more valuable for the prediction and diagnosis of pre-eclampsia than each marker alone..