P13.05: Correlation between placental mass, sFlt‐1 and PlGF level and Doppler examinations of the uterine and umbilical arteries in PE, IUGR and controls

Abstract

The placental overexpression of sFlt-1 and the decreased PlGF level play a key role in the pathogenesis of preeclampsia (PE). There is uncertainty about the association between the placental mass, the sFlt-1 and PlGF serum level and Doppler results indicating a placental dysfunction. The aim of this study was to evaluate this correlation in healthy controls and cases with PE and IUGR. We included n = 45 controls, n = 137 cases with PE, n = 40 with IUGR and n = 26 with PE+IUGR with available sFlt-1/PlGF ratio 14 days prior to delivery between 07/2010 and 03/2018 in our outpatient clinic. The correlation between the placental mass, sFlt-1, PlGF and the pulsatility indices (PI) of the umbilical and uterine arteries were investigated using a bivariate correlation correcting for gestational age. In contrast to controls, cases with a PE-associated outcome showed a significant correlation between placental mass and PlGF level (PE: r = 0.440, p < 0.01, IUGR: r = 0.328, p = 0.041, PE+IUGR r = 0.719 p < 0.01, Controls: r = -0.037, p = 0.808). In PE+IUGR, the sFlt-1 level also correlated with the placental weight (r = 0.516, p = 0.007), whereas this was not demonstrable in PE, IUGR or controls. A tendency to a negative correlation between the PI of the uterine arteries and the placental mass could be demonstrated in controls (r = -0.497 p = 0.06) and PE –(r = 0.212 p = 0.066). Interestingly, this correlation was significant in cases with PE+IUGR (p = -0.598, p < 0.01) and IUGR (p = -0.491 p = 0.039). The PI of the umbilical artery showed a negative correlation with the placental mass in IUGR+PE (r = -0.616, p < 0.01) and PE (r = -0,272, p < 0.01), but not in controls. The clear correlation between PlGF and the placental mass and the negative correlation between the placental mass and the PI of the uterine arteries in PE, IUGR and PE+IUGR reflect the pathology of the placental architecture and support the concept of an angiogenic continuum in pregnancies complicated by a placental dysfunction. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.