Прогностическая значимость соотношения ангиогенных факторов sFlt-1/PlGF в качестве маркера преэклампсии у беременных двойней

Abstract

Objective. To develop reference values for the sFlt-1/PlGF ratio in twin pregnancy and to establish its significance as a marker for pre-eclampsia (PE). Patients and methods. Sixty-two women with a dichorionic diamniotic (DCDA) twin pregnancy were examined: 44 women without PE and 18 women with PE. Levels of sFlt-1 and PlGF and their ratio were studied at 15,0–19,6; 20–23,6; 24–28,6; 29–33,6; 34–36,6 weeks’ gestation. Serum sFlt-1 and PlGF concentrations were measured by the cobas e 411 immunochemical analyzer (Roche Diagnostics GmbH, Germany) that uses electrochemiluminescence technology. Results. In uncomplicated twin pregnancy, serum concentrations of sFlt-1 and PlGF and their ratio were significantly elevated, which were higher than those in singleton pregnancy (SP); the sFlt-1/PlGF ratio was 13.7 by the end of the 37th week of pregnancy versus 9.0 in SP. In patients with PE, the median sFlt-1/PlGF ratio was 66.56, which was 4.8 times higher than in uncomplicated twin pregnancy. Using ROC analysis, threshold values for the sFlt-1/PlGF ratio were determined, allowing us with a high level of significance to exclude (<20.06; 100% sensitivity and 90% specificity) and to diagnose PE (>50.07; 60% sensitivity and 100% specificity). Conclusion. The developed accurate reference values for the sFlt-1/PIGF ratio in twin pregnancy enable early diagnosis of PE and prediction of the course of the disease. Key words: angiogenic factors, twins, twin pregnancy, pre-eclampsia