Comparison of Maternal Serum Soluble Fms-Like Tyrosine Kinase-1/Placental Growth Factor Ratio in Preeclamptic and Normotensive Pregnant Women

98 DO I: 10.4274/eamr.galenos.2018.01328 Eur Arch Med Res 2019; 35 (2): 98-101 Tuğba Kılık, Veli Mihmanlı, Sehtap Nazlı Kılıç Çetin, Orhan Şahin, Gökhan Demirayak, Berk Bulut University of Health Sciences, İstanbul Okmeydanı Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey ORIGINAL ARTICLE Cite this article as: Kılık T, Mihmanlı V, Çetin Kılıç SN, Şahin O, Demirayak G, Bulut B. Comparison of Maternal Serum Soluble Fms-Like Tyrosine Kinase-1/Placental Growth Factor Ratio in Preeclamptic and Normotensive Pregnant Women. Eur Arch Med Res 2019; 35 (2): 98-101 Address for Correspondence: Tuğba Kılık, University of Health Sciences, İstanbul Okmeydanı Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul,Turkey Tel.: +90 537 343 70 12 E-posta: tbsklk@gmail.com ORCID ID: orcid.org/0000-0001-7339-9081 ©Copyright 2019 by the Health Sciences University, Okmeydanı Training and Research Hospital European Archives of Medical Research published by Galenos Publishing House. Received: 24.01.2018 Accepted: 18.03.2018 INTRODUCTION Preeclampsia is a multisystemic disorder characterized by hypertension accompanied by proteinuria and/or end organ damage in a normotensive woman after 20 weeks of gestation. It is seen in approximately 3-8% of pregnancies and is responsible for 18% of maternal mortality and 40% of fetal mortality worldwide (1, 2). Despite its high mortality and morbidity, its etiology and pathophysiology are still unclear. Abnormal placentation with insufficient trophoblastic invasion and extensive endothelial damage is the main proposed pathology. Immunological intolerance, genetic abnormalities, metabolic and nutritional factors between fetoplacental tissue and maternal tissue are factors suggested in the pathogenesis (3). The imbalance between angiogenic factors such as vascular endothelial growth factor (VEGF) and placental growth factor (PGF) and antiangiogenic factors such as Soluble Fms-like Tyrosine Kinase-1 (sFlt-1) and soluble endoglin (s-Eng) has been suggested to play a role in the pathogenesis of preeclampsia by causing endothelial dysfunction (4, 5). sFlt-1 is over-produced in trophoblastic tissues of pregnant women who will encounter preeclampsia. sFlt-1 is a variant of the Flt-1 receptor for PGF and VEGF. The increase in maternal serum sFlt-1 levels affects the free PGF and VEGF in the circulation and causes endothelial dysfunction. Although not yet clearly explained, it is thought that the hypoxia caused by the deterioration of placental perfusion leads to over-production of antiangiogenic proteins in the placenta (6).