PP052. The course of sFlt-1 and PLGF reflects different progression pattern in early- versus late-onset preeclampsia and HELLP syndrome

W Schaarschmidt; S Rana; H Stepan

doi:10.1016/j.preghy.2012.04.163

PP052. The course of sFlt-1 and PLGF reflects different progression pattern in early- versus late-onset preeclampsia and HELLP syndrome

Pregnancy Hypertens. 2012 Jul;2(3):269. doi: 10.1016/j.preghy.2012.04.163. Epub 2012 Jun 13.

Authors

W Schaarschmidt¹, S Rana², H Stepan¹

Affiliations

¹ Department of Obstetrics, University Hospital Leipzig, Leipzig, Germany.
² Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States.

PMID: 26105375
DOI: 10.1016/j.preghy.2012.04.163

Abstract

Introduction: Preeclampsia (PE), a serious multisystem disorder in pregnancy, is a leading cause of maternal and fetal morbidity and mortality worldwide and angiogenic factors like sFlt-1 and PlGF are closely related to the clinical course of preeclampsia.

Objectives: We wondered, if these factors and the sFlt-1/PlGF ratio are a tool to differentiate the clinical progression pattern between early and late-onset PE and HELLP syndrome.

Methods: This retrospective study included 30 patients with PE out of which 7 patients had HELLP syndrome. Early onset PE was defined as patients with gestational age <34 weeks. Serial measurements of sFlt-1 and PlGF using the automated Elecsys platform (Roche®) were done from admission until delivery.

Results: Early-onset PE is characterized by an increase of sFlt-1 of 66% leading to an 137% increase of the sFlt-1/PlGF ratio. Late-onset PE shows a slower progression with an increase of the sFlt-1/PlGF ratio of only 39%. Patients with HELLP syndrome show comparable progression pattern.

Conclusion: Angiogenic factors characterize PE and HELLP syndrome as continuously progressive diseases with a uniform development towards an antiangiogenic state. Early-onset subtypes show a more aggressive progression with a faster sFlt-1 increase.