Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt‐1 (Soluble fms‐Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio

Background There is little knowledge about the significance of extremely high values (>655) for the ratio of sFlt-1 (soluble fms-like tyrosine kinase 1) to PlGF (placental growth factor). This study aims to describe the time-to-delivery interval and maternal and perinatal outcomes when such value...

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Autores: Villalain González, Cecilia, Herraiz García, Ignacio, Valle, Leonor, Mendoza, Manel, Delgado, Juan Luis, Vázquez Fernández,María, Martínez Uriarte, Juan, Melchor, Íñigo, Caamiña, Sara, Fernández Oliva, Antoni, Villar, Olga Patricia, Galindo Izquierdo, Alberto
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/114706
Acceso en línea:https://hdl.handle.net/20.500.14352/114706
Access Level:acceso abierto
Palabra clave:Cardiología
Ginecología y obstetricia
3205.01 Cardiología
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spelling Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt‐1 (Soluble fms‐Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) RatioVillalain González, CeciliaHerraiz García, IgnacioValle, LeonorMendoza, ManelDelgado, Juan LuisVázquez Fernández,MaríaMartínez Uriarte, JuanMelchor, ÍñigoCaamiña, SaraFernández Oliva, AntoniVillar, Olga PatriciaGalindo Izquierdo, AlbertoCardiologíaGinecología y obstetricia3205.01 CardiologíaBackground There is little knowledge about the significance of extremely high values (>655) for the ratio of sFlt-1 (soluble fms-like tyrosine kinase 1) to PlGF (placental growth factor). This study aims to describe the time-to-delivery interval and maternal and perinatal outcomes when such values are observed during the assessment of suspected or confirmed placental dysfunction based on clinical or sonographic criteria. Methods and Results A multicenter retrospective cohort study was conducted on 237 singleton pregnancies between 20+0 and 37+0 weeks of gestation, included at the time of first demonstrating an sFlt-1/PlGF ratio >655. Although clinicians were aware of this result, standard protocols for delivery indications were followed. Outcomes were compared for women with and without preeclampsia at inclusion. In the preeclampsia group (n=185, of whom 77.3% had fetal growth restriction), severe preeclampsia features and fetal growth restriction in stages III or IV were present in 49.2% and 13.5% of cases, respectively, at inclusion, and in 77.3% and 28.6% of cases, respectively, at delivery. In the group without preeclampsia (n=52, of whom 82.7% had fetal growth restriction), these figures were 0% and 30.8% at inclusion and 21.2% and 50% at delivery, respectively. Interestingly, 28% of women without initial preeclampsia later developed the condition. The median time to delivery was 4 days (interquartile range: 1–6 days) for women with preeclampsia and 7 days (interquartile range: 3–12 days) for those without preeclampsia (π<0.01). Overall, perinatal mortality was 62.1% before 24 weeks; severe morbidity exceeded 50% before 29 weeks but was absent from 34 weeks onward. Maternal serious morbidity remained high across all gestational ages. Conclusions An sFlt-1/PlGF ratio >655 is almost invariably associated with preeclampsia or fetal growth restriction that progresses rapidly. In tertiary care settings, maternal adverse outcomes were consistently high across gestation, whereas perinatal adverse outcomes decreased as pregnancy advanced.American Heart AssociationUniversidad Complutense de Madrid20202020-04-0920202020-04-09journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://hdl.handle.net/20.500.14352/114706reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/1147062026-06-02T12:44:21Z
dc.title.none.fl_str_mv Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt‐1 (Soluble fms‐Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio
title Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt‐1 (Soluble fms‐Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio
spellingShingle Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt‐1 (Soluble fms‐Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio
Villalain González, Cecilia
Cardiología
Ginecología y obstetricia
3205.01 Cardiología
title_short Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt‐1 (Soluble fms‐Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio
title_full Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt‐1 (Soluble fms‐Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio
title_fullStr Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt‐1 (Soluble fms‐Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio
title_full_unstemmed Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt‐1 (Soluble fms‐Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio
title_sort Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt‐1 (Soluble fms‐Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio
dc.creator.none.fl_str_mv Villalain González, Cecilia
Herraiz García, Ignacio
Valle, Leonor
Mendoza, Manel
Delgado, Juan Luis
Vázquez Fernández,María
Martínez Uriarte, Juan
Melchor, Íñigo
Caamiña, Sara
Fernández Oliva, Antoni
Villar, Olga Patricia
Galindo Izquierdo, Alberto
author Villalain González, Cecilia
author_facet Villalain González, Cecilia
Herraiz García, Ignacio
Valle, Leonor
Mendoza, Manel
Delgado, Juan Luis
Vázquez Fernández,María
Martínez Uriarte, Juan
Melchor, Íñigo
Caamiña, Sara
Fernández Oliva, Antoni
Villar, Olga Patricia
Galindo Izquierdo, Alberto
author_role author
author2 Herraiz García, Ignacio
Valle, Leonor
Mendoza, Manel
Delgado, Juan Luis
Vázquez Fernández,María
Martínez Uriarte, Juan
Melchor, Íñigo
Caamiña, Sara
Fernández Oliva, Antoni
Villar, Olga Patricia
Galindo Izquierdo, Alberto
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv Cardiología
Ginecología y obstetricia
3205.01 Cardiología
topic Cardiología
Ginecología y obstetricia
3205.01 Cardiología
description Background There is little knowledge about the significance of extremely high values (>655) for the ratio of sFlt-1 (soluble fms-like tyrosine kinase 1) to PlGF (placental growth factor). This study aims to describe the time-to-delivery interval and maternal and perinatal outcomes when such values are observed during the assessment of suspected or confirmed placental dysfunction based on clinical or sonographic criteria. Methods and Results A multicenter retrospective cohort study was conducted on 237 singleton pregnancies between 20+0 and 37+0 weeks of gestation, included at the time of first demonstrating an sFlt-1/PlGF ratio >655. Although clinicians were aware of this result, standard protocols for delivery indications were followed. Outcomes were compared for women with and without preeclampsia at inclusion. In the preeclampsia group (n=185, of whom 77.3% had fetal growth restriction), severe preeclampsia features and fetal growth restriction in stages III or IV were present in 49.2% and 13.5% of cases, respectively, at inclusion, and in 77.3% and 28.6% of cases, respectively, at delivery. In the group without preeclampsia (n=52, of whom 82.7% had fetal growth restriction), these figures were 0% and 30.8% at inclusion and 21.2% and 50% at delivery, respectively. Interestingly, 28% of women without initial preeclampsia later developed the condition. The median time to delivery was 4 days (interquartile range: 1–6 days) for women with preeclampsia and 7 days (interquartile range: 3–12 days) for those without preeclampsia (π<0.01). Overall, perinatal mortality was 62.1% before 24 weeks; severe morbidity exceeded 50% before 29 weeks but was absent from 34 weeks onward. Maternal serious morbidity remained high across all gestational ages. Conclusions An sFlt-1/PlGF ratio >655 is almost invariably associated with preeclampsia or fetal growth restriction that progresses rapidly. In tertiary care settings, maternal adverse outcomes were consistently high across gestation, whereas perinatal adverse outcomes decreased as pregnancy advanced.
publishDate 2020
dc.date.none.fl_str_mv 2020
2020-04-09
2020
2020-04-09
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/114706
url https://hdl.handle.net/20.500.14352/114706
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv American Heart Association
publisher.none.fl_str_mv American Heart Association
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,198674

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