The role of periodic measurement of sFlt-1 and PlGF in predicting the remaining pregnancy duration in hypertensive disorders of pregnancy

Objectives: This study aimed to explore whether one-time or periodic measurement of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) could contribute to the prediction of the remaining pregnancy duration in hypertensive disorders of pregnancy.

Study design: In this retrospective study, we enrolled pregnant women with singleton pregnancies who were admitted to our hospital due to a new rise in blood pressure at or after 20 weeks of gestation or because of worsening chronic hypertension (CH).

Main outcome measures: The concentrations of sFlt-1 and PlGF, as well as the sFlt-1/PlGF ratio, were measured only on admission or on admission and every week until delivery. The effect of these concentrations was correlated with the remaining pregnancy duration.

Results: In this study, we enrolled 32 pregnant women: 13 were diagnosed with preeclampsia (PE), 9 with gestational hypertension (GH), and 10 with CH on admission. In the PE group, the concentration of sFlt-1 on admission had a significant negative correlation with the remaining pregnancy duration (R = -0.61, P = 0.03). In three women with PE, the concentrations were measured periodically, with increasing sFlt-1 concentrations. Among the pregnant women with CH on admission, two developed superimposed PE and their measured concentrations of sFlt-1 periodically increased.

Conclusions: Only the concentration of sFlt-1 on admission in the PE group was associated with the remaining pregnancy duration. The concentrations of sFlt-1 in PE cases periodically measured increased towards delivery. Pregnant women with CH could develop sPE if the sFlt-1 value measured periodically increase.