Preeclampsia (PE) is characterized by hypertension and proteinuria after the 20th gestational week (GW). It is a significant cause of maternal and fetal perinatal morbidity and mortality during pregnancy. There is increasing evidence suggesting that PE is due to an impaired balance between maternal placental angiogenic and antiangiogenic factors that harm maternal vascular endothelium. The study aimed to assess the clinical and financial aspects of introducing into practice the soluble fms-like tyrosine kinase (sFlt-1) to placental growth factor (PlGF) ratio test to improve the management of preeclampsia and adverse pregnancy outcome, intrauterine growth retardation, iatrogenic prematurity, and placental abruption.
We report a case study in which we used the sFlt-1/PlGF ratio in the management of a high-risk pregnancy. Unnecessary hospitalization was avoided, and the patient was managed appropriately.
5. Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: The role of antiangiogenic factors and implications for later cardiovascular disease. Circulation. 2011;123(24):2856-69.
6. Liu A, Wen SW, Bottomley J, Walker MC, Smith G. Utilization of health care services of pregnant women complicated by preeclampsia in Ontario. Hypertens Pregnancy. 2009;28(1):76-84.
7. Delahaije DH, Smits LJ, van Kuijk SM, Peeters LL, Duvekot JJ, Ganzevoort W, et al. Care-as- usual provided to formerly preeclamptic women in the Netherlands in the next pregnancy: health care consumption, costs and maternal and child outcome. Eur J Obstet Gynecol Reprod Biol 2014;179:240-5.
8. Rath W, Fischer Th. The Diagnosis and Treatment of Hypertensive Disorders of Pregnancy. New Findings for Antenatal and Inpatient Care. Dtsch Arztebl Int 2009;106(45): 733-8.
9. Verlohren S, Galindo A, Schlembach D, Zeisler H, Herraiz I, Moertl MG, et al. An automated method for the determination of the sFlt-1/PIGF ratio in the assessment of preeclampsia. Am J ObstetGynecol2010;202(2):161.e1–161.e11.
10. Verlohren S, Herraiz I, Lapaire O, Schlembach D, Zeisler H, Calda P, et al. New gestational phase specific cutoff values for the use of the soluble fms-like tyrosine kinase-1/placental growth factor ratio as a diagnostic test for preeclampsia. Hypertension 2014;63(2):346-52.
11. Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennstr M, et al. Predictive value of the sFlt-1: PlGF ratio in women with suspected preeclampsia. N Engl J Med. 2016;374(1):13-22.