Open AccessUpdate on the Diagnosis and Prognosis of Preeclampsia with the Aid of the sFlt-1/ PlGF Ratio in Singleton Pregnancies
Author(s) -
Ignacio Herraı̀z,
Elisa Llurba,
Stefan Verlohren,
Alberto Galindo
Publication year - 2017
Publication title -
fetal diagnosis and therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.976
H-Index - 60
eISSN - 1421-9964
pISSN - 1015-3837
DOI - 10.1159/000477903
Subject(s) - placental growth factor , medicine , preeclampsia , placental abruption , soluble fms like tyrosine kinase 1 , obstetrics , disease , pregnancy , intrauterine growth restriction , gestational age , fetus , vascular endothelial growth factor , vegf receptors , biology , genetics
Preeclampsia (PE) is involved in a group of obstetrical conditions closely related by the presence of placental dysfunction (PD), which also includes intrauterine growth restriction and placental abruption. The timely and accurate recognition and management of PE are often challenging because diagnostic criteria are still based on nonspecific signs and symptoms and because common severity criteria correlate poorly with adverse maternal and fetal outcomes. The discovery of the role of angiogenesis-related factors - soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) - in the underlying pathophysiology of PD has marked an important step for improving its early diagnosis and prognosis assessment before gestational week 34. Nowadays, an sFlt-1/PlGF ratio cutoff level of ≤38 is widely accepted for ruling out PE in patients with suspicion of the disease, and its use is cost-effective. However, the evidence is more limited regarding the management and prognosis of women with an abnormally high sFlt-1/PlGF ratio. This review summarizes the current evidence of the clinical application of the sFlt-1/PlGF ratio for the diagnosis and prognosis assessment of PE and points out the next challenges for these biomarkers, including their role as target for the development and monitoring of new therapies.