OP 43 The predictive power of placental biomarkers regarding the postpartal course after pre-eclamptic pregnancies

Abstract

Objective To assess whether placental biomarker maternal serum levels (sFlt-1,PlGF) are predictive for the postpartal course in cases of pre-eclampsia. Material and method We examined a patient cohort of 30 pre-eclamptic cases attending the labor ward in our university hospital. Placental biomarker levels were assessed together with routine lab and clinical parameters prior to delivery, 2 h, 1 day, 2 days, 3 days, 4 days and 6 weeks after delivery. We examined sFlt-1 and PlGF using Human sFlt-1 und PlGF ELISA Kit (R&D). The correlation with different postpartal courses were performed using Chi-Square test, Fischer Exact Test and Mann–Whitney-U-Test. A p-value 0.05 was considered to be statistically significant. The statistical analysis was performed using SPSS 20,0 (SPSS Inc., Chicago, IL). Results 73% of the patients had no clinical and/or laboratory improvement during the postpartal course. The cumulative postpartal course could not be predicted using the palcental biomarkers. Several clinical and laboratory parameters could be predicted using the biomarkers. Elevated liver enzymes were predicted by high sFlt-1 levels 2 h after dleivery and sFlt-1/PlGF Ratio on day 1 after delivery. A persistent high blood pressure correlated significantly with high sFlt-1 levels 2 h after delivery and elevated PlGF and sFlt-1/Ratio on day 1 after delivery. Reduced renal functions correlated with high sFlt-1 and PlGF levels throughout the whole postpartal period. The predictive power of Sflt-1 and PlGF regarding unfavourable outcome within 24 h was evaluated using the CHI-Square-Test. A rising PlGF level on day predicted increased liver enzymes. A rising sFlt-1 on day 2 was able to predict an elevated ASt and average blood pressure. Conclusion A cumulative worsening of postpartal clinical and laboratory course in pre-eclamptic patients was not predicted using the placental biomarkers. Yet, some clinical and laboratory parameters correlated with these biomakers. Given a possible different pathomechanism of each grade of pre-eclampsia, we think a higher of patients is needed for further evaluation.