sFlt-1 / PlGF - Ratio | Marker of preeclampsia

General Information

Pre-eclampsia is a heterogeneous (with several causes of development) disease that is manifested by arterial hypertension (increased blood pressure) and proteinuria (increased protein in the urine) at 20 weeks of pregnancy. It occurs in 2-5% of pregnant women.

The clinical manifestations of the disease and the final solution are diverse.

Preeclampsia remains one of the leading causes of maternal and fetal/neonatal mortality.

The pathogenesis of the disease is multifactorial. The main reason is the pathological transformation of the blood vessels of the placenta, which leads to a decrease in blood supply to the placenta and fetus and dysfunction of the placenta.

Dysfunction of the placenta leads to an imbalance of circulating angiogenic factors (these are the factors that ensure the development of placental blood vessels and adequate circulation), which ultimately leads to the development of preeclampsia-eclampsia.

sFlt-1/PlGF (Ratio of soluble Fms-like tyrosine kinase-1 to placental growth factor) is a specific test to assess the risk of preeclampsia.

Placental growth factor PlGF The concentration in the first trimester is low, it starts to increase from 11-12 weeks. It reaches its peak by 30 weeks, after which the tendency to decrease again is observed.

sFLT-1  represent extracellular domains of vascular endothelial growth factor receptor-1. sFLT-1 is elevated in preeclampsia.

sFLT-1/PlGF  The ratio of angiogenic factors, together with the patient's anamnesis and ultrasound data, provides an opportunity to predict preeclampsia.

Long-term clinical studies have shown that pregnant women who will develop preeclampsia in the future have circulating sFLT-1  Increase in concentration and PlGF A decrease in concentration, a few weeks before the development of preeclampsia.     sFLT-1/PlGF   The ratio is directly related to the severity of the disease.

Risk factors for preeclampsia

• Preeclampsia in previous pregnancy
• Multiple pregnancy
• Concomitant diseases: hypertension, chronic kidney disease, type I diabetes, antiphospholipid syndrome, systemic lupus erythematosus.
• Family history of preeclampsia (mother, sister)
• Obesity
• Age above 40
• thrombophilia
• In-vitro fertilization

sFLT-1/PlGF  Determination of the ratio is informative in determining the need for hospitalization of pregnant women with hypertension, especially if:

• Non-specific symptoms of preeclampsia are present: pain in the epigastrium (upper abdomen), swelling of the face, sudden weight gain, headache, visual disturbances, decreased platelets in the blood, increased serum transaminase levels
• It is necessary to differentiate between oroteinuria (increased protein in the urine) and other pathologies
• Intrauterine growth retardation of the fetus is established

Determining the severity of the disease

In hospitalized patients, it is often necessary to repeat the ratio in 48 hours. A sharp increase in the index indicates the worsening of the disease. If the indicator is unchanged, it indicates more or less stability of the situation. Verification is required no later than 2 weeks.

Study material: Venous blood

Reference norms:

Interpretation of results

Development of preeclampsia in the early stage of gestation (20-33 weeks + 6 days)

The development of preeclampsia in the late stage of gestation (> 34 week later)