Dr Prachi Khandkar1
1Royal Prince Alfred Hospital
Biography:
Prachi Khandkar is an O&G Senior Resident Medical Officer at Royal Prince Alfred Hospital, Sydney. She completed her MD in 2021 at The University of New England – School of Rural Medicine, Armidale.
Abstract:
Background: The ratio of soluble fms-like tyrosine kinase 1 (sFlt1) to placental growth factor (PlGF) is an emerging biomarker for assessing placental vascular health, enabling clinicians to exclude preeclampsia within one week with a threshold of ≤38. Clinical implications of levels >38 remain poorly understood, particularly for predicting timing of delivery.
Objective: This retrospective cohort study aims to explore the value of sFlt1/PlGF levels >38 in determining latency to delivery in women with suspected and confirmed preeclampsia.
Methods: Data was retrospectively analysed from pregnant patients from a single centre who delivered between January 2020 and March 2023 and underwent at least one antenatal sFlt1/PlGF test. Results were categorised into ≤38, 39-85, 86-110 and >110.
Descriptive variables included indications for testing, latency from test to delivery, gestational age at delivery, and various maternal/neonatal parameters.
Results: A cohort of 451 women underwent sFlt1/PlGF testing, and 172 women had a ratio >38.
We found that women with diagnosed preeclampsia at the time of testing demonstrated a shorter median latency to delivery (7 days for sFlt1/PlGF levels 39-85, 5 days for 86-110 and 5 days for >110) compared to those with suspected preeclampsia (12 days for sFlt1/PlGF levels 39-85, 5 days for 86-110 and 5 days for >110).
Interestingly, the median latency to delivery in preeclamptic women both under and over 34 weeks gestation was identical (6 days). In contrast, women with suspected preeclampsia at <34 weeks gestation, had a longer median latency to delivery (12 days).
Conclusion: To our knowledge this is the first study exploring latency from testing to delivery in women with sFlt1/PlGF >38. Our findings indicate that high sFlt1/PlGF levels, while suggestive of preeclampsia, do not uniformly predict delivery timing or risk of pre-term delivery. These insights call for further research to refine the role of sFlt1/PlGF in clinical practice.
Keywords
sFlt1/PlGF, Preeclampsia
References
Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennström M, Olovsson M, Brennecke SP, Stepan H, Allegranza D, Dilba P. Predictive value of the sFlt-1: PlGF ratio in women with suspected preeclampsia. New England Journal of Medicine. 2016 Jan 7;374(1):13-22.