Title

P23. Prediction of preeclampsia during early pregnancy in primiparas with soluble fms-like tyrosine kinase-1 and placental growth factor

Document Type

Article

Department

Obstetrics and Gynaecology

Abstract

Objective: To test the hypothesis that preeclampsia (PE) can be predicted in primiparas early by measuring serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF).

Methods: All normotensive primiparas attending 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. Blood samples of the participants were collected at 8–15; 16–22; 23–28; 29–34 weeks of pregnancy and a postnatal sample and were analyzed for sFlt-1 and PlGF.

Results: 611 (46.7%) out of 1307 recruited primiparas completed the study according to the protocol. Out of these, 39 (6.4%) women developed PE. Difference in the serum sFlt-1 was evident as early as up to 15 weeks of gestation. Higher levels of 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 Groups but less so in PE Group. ROC curve analysis showed that even in early pregnancy (<15 weeks of gestation); sFlt-1 alone has the potential to predict PE with AUC, sensitivity and specificity of 0.81, 75.9 and 72.4, respectively.

Conclusions: PE can be predicted in primiparas in early part of second trimester with serum sFlt-1 and in later part of second trimester with serum PlGF.

Publication

Pregnancy hypertension