Clinical Utility of sFlt-1 and PlGF in Screening, Prediction, Diagnosis and Monitoring of Pre-eclampsia and Fetal Growth Restriction Comment

Preeclampsia is a serious hypertensive disorder of pregnancy that can deteriorate into eclampsia or HELLP syndrome and ultimately result in severe maternal morbidity or mortality. In addition to possible complications for the mother, preeclampsia and its additional complications can lead to adverse outcomes for infants, both before and after birth. Because of the serious consequences associated with preeclampsia, current practice guidelines recommend the screening of all pregnant patients for risk of preeclampsia in the first trimester and consistent monitoring for the development of preeclampsia later in pregnancy. Recommendations also include that women who are diagnosed with preeclampsia are closely monitored to prevent further complications such as preterm birth, as well as monitoring for fetal growth restriction (FGR). There are serum markers that are known to be related to preeclampsia, such as proangiogenic placental growth factor (PlGF) and antiangiogenic soluble fms-like tyrosine kinase-1 (sFlt-1). This article is a review aiming to summarize current knowledge about PlGF and sFlt-1, their performance, and potential alteration in diagnosis and monitoring of preeclampsia. Factors such as these have trends that occur in normal pregnancy and different trends that tend to occur in a pregnancy that is abnormal. In a healthy pregnancy, sFlt-1 increases in the third trimester, but in patients who later develop preeclampsia or FGR, it tends to increase sooner. Recent studies have shown that the interaction between sFlt-1 and PlGF reduces the amount of PlGF in circulating in the blood, causing a cascade of other effects. In addition, a decrease in PlGF is known to be associated with the development of preeclampsia. Because of this interaction, the ratio of sFlt-1 to PlGF can be used as a diagnostic tool; an increasing ratio can indicate development of preeclampsia. © 2023 Lippincott Williams and Wilkins. All rights reserved.