23-OR

Abstract

Objectives In singleton pregnancies, sFlt-1, PlGF and the sFlt-1/PlGF-ratio have shown utility as a diagnostic test for preeclampsia (PE). Previous case control studies have determined cut-off values for singleton pregnancies. The objective of this study was to characterize angiogenic factor levels of sFlt-1, PlGF and sFlt-1/PlGF-ratio in normal and preeclamptic multifetal gestations. Methods In a European multicentre case-control study, 52 women with multifetal gestation were recruited. A total of 34 patients with uneventful pregnancy outcome and 18 with PE were enrolled in the third trimester. sFlt-1 and PlGF were measured and ROC analysis was performed. The results of the median sFlt-1, PlGF maternal serum concentration and sFlt-1/PlGF-ratio were then compared to a gestational age- matched singleton cohort with PE (n = 54) and with uncomplicated pregnancy outcome (n = 238). Results In multiple pregnancies with PE, sFlt-1 and the sFlt-1/PlGF ratio were increased and PlGF was decreased as compared to multiple gestations with uneventful pregnancy outcome. In multiple pregnancies with PE, sFlt-1/PlGF-Ratio was significantly decreased as compared to controls due to higher median PlGF levels. In multiple pregnancies with uneventful pregnancy outcome, sFlt-1 and sFlt-1/PlGF-ratio were increased, but no differences in PlGF concentration were found when compared to singleton controls. ROC analysis determined 53 as an optimal cut-off for the sFlt-1/PlGF-ratio, yielding a sensitivity of 94.4% and a specificity of 73.5%. The cut-off values for singleton pregnancies of 33 and 85 lead to a sensitivity of 100% (83.3%) and a specificity 64.7% (79.4%). Conclusions Significant differences in the marker levels in singleton-versus multiple gestations were detected. Established reference ranges for singleton pregnancies are therefore not transferable to multiple pregnancies. Disclosures L. Droge: None. I. Herraiz: Research Support Recipient; Commercial Interest: Roche Diagnostics. H. Zeisler: Consultant, Research Support Recipient, Commercial Interest: Roche Diagnostics; D. Schlembach: Research Support Recipient; Commercial Interest: Roche Diagnostics. H. Stepan: Consultant, Research Support Recipient, Commercial Interest: Roche Diagnostics.W. Henrich: None. A. Galindo: Research Support Recipient; Commercial Interest: Roche Diagnostics. S. Verlohren: Consultant, Research Support Recipient, Commercial Interest: Roche Diagnostics, ThermoFisher, Novartis.