SFLT-1/PIGF NEW BIOMARKERS FOR MULTIPLE ADVERSE PREGNANCY OUTCOMES
Abstract
SFLT-1/PIGF NEW BIOMARKERS FOR MULTIPLE ADVERSE PREGNANCY OUTCOMES (Abstract): Placenta insufficiency and some related pregnancy outcomes are the result of the imbalance between angiogenic and antiangiogenic factors expressed at placenta level. From the angiogenesis factors, only a few have found practical applications, such as the serum soluble fms-like tyrosine kinase-1 (SFlt-1) / PIGF (Placenta growth factor) ratio, named also the angiogenic fraction, which is increased in pregnant women before the clinical onset of a Preeclampsia (PE), intrauterine growth restriction (IUGR) or uterine apoplexy. PROGNOSIS study demonstrated that sFlt-1 / PIGF ratio<38 predicts the absence of PE, eclampsia and HELLP (Hemolysis, Elevated Liver enzymes , Low Platelet count) syndrome within four weeks with a PPV(Positive Predictive value), (95%CI range) of 99.3% (97.9-99.9).Other approaches used different cutoffs for early and late preeclampsia (onset before or after 34 weeks), to enhance the diagnostic accuracy, or included the sFlt-1 / PIGF ratio in a statistical model, along with maternal risk factors, mean arterial pressure (MAP) measurement and uterine artery pulsatility index (UtA-PI), to improve first trimester prediction of PE. Considering the therapeutic applications of angiogenic factors, the use of statins (pravastatin) on animal models to treat PE seems to be promising, as well as the administration of (Vascular endothelial growth factor) VEGF 121 or extracorporeal removal of sVEGF-1.
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