PP052. Diagnosis of pre-eclampsia and prediction of time to delivery in women with suspected pre-eclampsia presenting before 36 weeks’ gestation

Abstract

The pro-angiogenic factor PlGF has an important role in the development and maintenance of the placenta. Incomplete remodelling of uterine spiral arteries is associated with placental oxidative stress, placental dysfunction, and the complications of pre-eclampsia and fetal growth restriction. Abnormally low PlGF levels identify placental dysfunction and an increased risk for pregnancy complication. To evaluate the correlation between abnormally low PlGF concentration, a diagnosis of pre-eclampsia or IUGR, and a short interval to delivery. We recruited a total of 45 pregnant women with suspected pre-eclampsia between 23+0 to 36+0 weeks of gestation. The concentration of PlGF was measured in maternal EDTA plasma samples (Alere, Triage® PlGF), a rapid assay using monoclonal antibodies raised against free PlGF. Pre-eclampsia was diagnosed clinically in 25 women. PlGF was abnormal (<100pg/mL) in all 25 women (100% sensitivity). Eighteen women (72%) had a PlGF level <12pg/mL (very abnormal) and, of these, 14 (78%) had IUGR and a birthweight below the 10th centile. The mean time to delivery in women with a PlGF level <12pg/mL was 7.5 days (0-18d), compared with 23 days (0-67d) for a PlGF level in the range ⩾12<100pg/mL, in agreement with data recently reported by Chappell [1]. The high sensitivity of PlGF for pre-eclampsia with/without IUGR and its strong prediction of time-to-delivery allows PlGF to be a valuable diagnostic tool. PlGF has the potential to remove the uncertainty in clinical decision-making in women with suspected pre-eclampsia.