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Soluble Flt‐1 as a diagnostic marker of pre‐eclampsia
Author(s) -
WOOLCOCK Jane,
HENNESSY Annemarie,
XU Bei,
THORNTON Charlene,
TOOHER Jane,
MAKRIS Angela,
OGLE Robert
Publication year - 2008
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2007.00804.x
Subject(s) - interquartile range , medicine , confidence interval , eclampsia , gestational hypertension , preeclampsia , soluble fms like tyrosine kinase 1 , blood pressure , endocrinology , gestational age , pregnancy , biology , placental growth factor , genetics , vascular endothelial growth factor , vegf receptors
Backgound: Serum levels of soluble fms‐like tyrosine kinase (sFlt‐1) increase in pre‐eclampsia (PE). Aims: To determine whether concentrations of serum sFlt‐1 can differentiate PE or superimposed PE (SPE) from gestational hypertension (GH) or chronic hypertension (CH). Methods: Blood was collected from pregnant women being investigated for hypertension (blood pressure of > 140 and/or 90 mmHg). Normotensive (NP) and pre‐eclamptic (PE‐C) control ranges were measured. Results: Patients with evolving hypertension in pregnancy eventually fell into four groups: GH ( n = 14), PE ( n = 7), CH ( n = 9) and SPE ( n = 9). Patients who later developed pre‐eclampsia had a higher sFlt‐1 (PE: 2.61 ng/mL and SPE: 2.77 ng/mL, respectively) than GH ( P < 0.001) or CH (1.05 ng/mL, P = 0.11). Women with established PE at recruitment (PE‐C; ( n = 18) (3.13 ng/mL; interquartile range (IQR): 2.14–4.17 ng/mL) had a median sFlt‐1 higher than NP ( n = 18) (0.47 ng/mL; IQR: 0.11–0.89) ( P < 0.0008). Patients with GH compared to NP had a slight increase (1.33 ng/mL, P < 0.003). Using a sFlt‐1 cut‐off of ≥ 1.9 ng/mL yielded a sensitivity of 94% (95% confidence interval (CI) 73–100%) and specificity of 78% (95% CI 64–82%). Conclusions: sFlt‐1 was elevated in women with PE compared to NP. The sFlt‐1 also differentiated women destined to develop PE among those who presented with a diagnostic rise in maternal blood pressure. The sFlt‐1 test is a useful diagnostic test for PE.