The sFlt-1/PlGF ratio as a triage tool to identify superimposed preeclampsia in women with chronic hypertension in emergency rooms

Pregnancy Hypertens. 2020 Jul:21:38-42. doi: 10.1016/j.preghy.2020.04.014. Epub 2020 Apr 28.

Abstract

Objectives: Assess the usefulness of the sFlt-1/PlGF ratio for the differential diagnosis of uncontrolled chronic hypertension vs. superimposed preeclampsia.

Study design: We performed a cross-sectional study from 2015 to 2017 and 42 women with initial diagnosis of superimposed preeclampsia were enrolled in the emergency room. After a 12 week follow up patients were grouped as superimposed preeclampsia (Group A) and uncontrolled chronic hypertension (Group B) according to the American College of Obstetricians and Gynecologist criteria. A group of 33 healthy women paired by gestational age were included as controls (Group C). Maternal serum levels of sFlt-1 and PlGF were measured at enrollment, and the ratios of the groups were compared.

Main outcome measures: Superimposed preeclampsia vs. uncontrolled chronic hypertension.

Results: After follow-up, group distribution was 30 women in Group A, 12 women in Group B, and 25 women in Group C. The sFlt-1/PlGF ratio was higher in women with superimposed preeclampsia than in women with uncontrolled chronic hypertension (215.5 vs. 9.65, p < 0.001). The control group displayed lower ratio values (3.66, p < 0.001). The sFlt-1 concentration was higher in Group A than in Group B (7564 vs. 1281 pg/mL, p < 0.001) and the PlGF level was lower in Group A (34.39 vs. 169 pg/mL, p < 0.001).

Conclusions: The sFlt-1/PlGF ratio exhibits good performance for the differential diagnosis of superimposed preeclampsia vs. uncontrolled chronic hypertension.

Keywords: Chronic hypertension; Superimposed preeclampsia; sFlt/PlGF ratio.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Case-Control Studies
  • Cross-Sectional Studies
  • Diagnosis, Differential
  • Emergency Service, Hospital
  • Female
  • Humans
  • Hypertension / diagnosis
  • Middle Aged
  • Placenta Growth Factor / blood*
  • Pre-Eclampsia / diagnosis*
  • Pregnancy
  • Triage / methods
  • Vascular Endothelial Growth Factor Receptor-1 / blood*

Substances

  • Biomarkers
  • PGF protein, human
  • Placenta Growth Factor
  • FLT1 protein, human
  • Vascular Endothelial Growth Factor Receptor-1