Prediction of pre-eclampsia during early pregnancy in primiparas with soluble fms-like tyrosine kinase-1 and placental growth factor.
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Date
2012-03
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Abstract
Background. We hypothesized that pre-eclampsia (PE)
can be predicted early in primiparas by measuring serum levels
of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental
growth factor (PlGF).
Methods. All normotensive primiparas attending the
antenatal clinics of Aga Khan University Hospital and Aga Khan
Hospital for Women, Karachi, Pakistan without any known risk
factor for PE were invited to participate in the study. They were
divided into two groups based on the development of PE. Their
blood samples were collected at 8–15, 16–22, 23–28, 29–
34 weeks of pregnancy and once within 1 week of delivery. All
samples were analysed for sFlt-1 and PlGF.
Results. Six hundred and eleven (46.7%) of 1307 recruited
primiparas completed the study according to the protocol. Of
these, 39 (6.4%) women developed PE. The difference in serum
sFlt-1 was evident as early as 15 weeks of gestation. Higher levels
of serum sFlt-1 were present in women who later developed PE.
Relatively higher levels of PlGF were observed in non-PE women
compared to PE women up to 22 weeks of gestation. However,
after 23 weeks of pregnancy, PlGF levels increased in both the
groups, but less so in the PE group. Receiver operator characteristics
(ROC) curve analysis showed that even in early pregnancy (<15
weeks of gestation), serum sFlt-1 alone has the potential to
predict PE with area under the curve (AUC), sensitivity and specificity of 0.81, 75.9 and 72.4, respectively.
Conclusion. PE can be predicted in primiparas in the early part of second trimester with serum levels of sFlt-1 and in the later part of second trimester with serum levels of PlGF.
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Rohra D K, Zeb A, Qureishi R N, Azam S I, Khan N B, Zuberi H S, Sikandar R. Prediction of pre-eclampsia during early pregnancy in primiparas with soluble fms-like tyrosine kinase-1 and placental growth factor. National Medical Journal of India. 2012 Mar-Apr; 25(2): 68-73.