Urinary Placental Growth Factor Research Articles

Urinary sFlt-1 and PlGF as preeclampsia predictors: sFlt-1/creatinine ratio improves the prediction value

ObjectivesTo evaluate the correlation between maternal serum and urinary soluble Fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) levels and to assess their potential value in preeclampsia and fetal growth restriction. Study DesignThis case-control longitudinal prospective study was performed in 49 singleton pregnant women, divided into two clinical groups, low risk pregnancy (n = 23) and pregnancy complicated by preeclampsia (n = 26). Maternal serum and urinary sFlt-1 and PlGF levels were quantified by electrochemiluminescence. Every patient underwent an ultrasound for fetal biometry. Doppler assessment was done when estimated fetal weight was under the 10th centile. ROC curves were used to evaluate the predictive capability of serum and urinary angiogenic biomarkers and their ratios on preeclampsia. Linear regression was used to compare the values of serum and urinary sFlt-1 and PlGF and their ratios. ResultsUrine biomarkers were positively associated with their serum values, being the best associated urinary PlGF (R2 = 0.73), which also showed the highest predictive capability of preeclampsia of urine biomarkers (AUC 0.866). The predictive capability of urinary sFlt-1 was much lower (AUC 0.640), but increased when adjusting by serum creatinine, a more precise parameter (AUC 0.863). ConclusionsUrinary PlGF could be a lesser invasive alternative to circulating biomarkers to monitor pregnancies complicated with preeclampsia that need repeated controls of their pregnancy complication. Urinary sFlt-1 values need adjustment by serum creatinine to be reliable.

Urinary placental growth factor determined in the first trimester of pregnancy as a predictor of preeclampsia.

Urinary placental growth factor determined in the first trimester of pregnancy as a predictor of preeclampsia.

Urinary Placental Growth Factor for Prediction of Placental Adverse Outcomes in High-Risk Pregnancies.

To evaluate whether urinary levels of placental growth factor (PlGF) during pregnancy are associated with the subsequent development of composite adverse outcomes (preeclampsia, fetal growth restriction, placental abruption, perinatal death, maternal death) occurring at less than 34 weeks of gestation. This is a preplanned ancillary study of the Heparin-Preeclampsia trial, a randomized trial in pregnant women with a history of severe early-onset preeclampsia (less than 34 weeks of gestation). In the parent study, all women were treated with aspirin and then randomized to receive either low-molecular-weight (LMW) heparin or aspirin alone. For this substudy we measured urinary levels of PlGF and urinary creatinine at the following gestational windows: 10-13 6/7, 14-17 6/7, 18-21 6/7, 22-25 6/7, 26-29 6/7, 30-33 6/7, and 34-37 6/7 weeks of gestation. Urine samples were available from 187 patients: LMW heparin plus aspirin (n=93) and aspirin alone (n=94). The two groups had comparable baseline characteristics and had similar adverse composite outcomes at less than 34 weeks of gestation (14/93 [15.1%] vs 11/94 [11.7%]; P=.50). There were no significant differences in urine PlGF levels in the patients who received LMW heparin plus aspirin compared with those who received aspirin alone. However, median [interquartile range] urinary PlGF/creatinine concentrations (pg/mg) measured at mid-pregnancy (22-26 weeks of gestation) were significantly lower among women who developed composite adverse outcome at less than 34 weeks of gestation (42.7 [32.4-80.8] vs 255.6 [118.7-391.8] P<.001) and significantly lower among women who developed preeclampsia at less than 34 weeks of gestation (42.7 [27.5-80.7] vs 244.6 [112.9-390.6] P<.001). For a fixed false-positive rate of 10% the sensitivity of urinary PlGF concentrations at mid-pregnancy was 75.2% (area under the curve 0.93) for the subsequent development of composite adverse outcomes. Decreased urinary PlGF at mid-gestation (22-26 weeks of gestation) is associated with the subsequent development of preeclampsia-related adverse outcomes at less than 34 weeks of gestation. ClinicalTrials.gov, NCT00986765.

Urinary and Serum Angiogenic Markers in Women With Preexisting Diabetes During Pregnancy and Their Role in Preeclampsia Prediction.

To determine the correlation between urinary and serum placental growth factor (PlGF) and investigate the predictive value as pregnancy progresses of urinary PlGF compared with serum PlGF, soluble fms-like tyrosine kinase 1 (sFLT-1), and the sFLT-1-to-PlGF ratio for the outcome of preeclampsia in women with preexisting diabetes. A multicenter prospective cohort study was conducted of 158 women with preexisting insulin-requiring diabetes (41 with type 1 and 117 with type 2). Urinary PlGF and serum PlGF, sFLT-1, and the sFLT-1-to-PlGF ratio were assessed four times (14, 24, 30, and 36 weeks' gestation), and the association with the outcome of preeclampsia was investigated. A correlation between urinary and serum PlGF was demonstrated from 24 weeks' gestation onward (P < 0.001). At all time points, those who developed preeclampsia had lower serum PlGF levels (P < 0.05), and receiver operating characteristic curves demonstrated that serum PlGF in this cohort performed better than the serum sFLT-1-to-PlGF ratio as a predictive test for preeclampsia. Preconception HbA1c ≥6.5% (48 mmol/mol) was an important discriminative predictor for preeclampsia (P = 0.01). This study prospectively describes the longitudinal changes in urinary PlGF alongside serum angiogenic markers throughout pregnancy in women with preexisting diabetes. We demonstrate correlation between urinary and serum PlGF and that in women with preexisting diabetes in pregnancy, serum PlGF is a better predictor of preeclampsia than the sFLT-1-to-PlGF ratio.

Urinary placental growth factor in preeclampsia and fetal growth restriction: An alternative to circulating biomarkers?

To correlate plasma and urinary soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PIGF) in preeclampsia (PE) and fetal growth restriction (FGR) and assess the performance in detecting established disease. A cross-sectional case-control study recruited 26-40 weeks gestation pregnancies into four clinical groups: normal pregnancy, PE, PE + FGR, and FGR. enzyme-linked immunosorbent assay (ELISA) measurements of urinary and plasma sFlt-1 and PlGF levels were performed. Urinary levels of sFlt-1 and PIGF were normalized to creatinine. Spearman's rank correlation was used to assess the association between plasma and urinary levels of sFlt-1 and PIGF, and receiver operating characteristic graphs were used to quantify the performance of each individual marker and their ratios in predicting normal versus pathological pregnancies affected by preeclampsia and/or FGR. There was a significant correlation between plasma PlGF and urinary PlGF (r = 0.718, P < 0.001) in all groups. In the pathological groups, plasma sFlt-1 and urinary sFlt-1 as well as plasma sFlt-1: PIGF ratio and urinary sFlt-1: PlGF ratio were higher, but plasma PIGF and urinary PlGF were lower when compared to normal pregnancy. Plasma PIGF and plasma sFlt-1: PlGF ratio was comparable in performance to urinary PlGF and urinary sFlt-1: PIGF ratio for the diagnosis of preeclampsia and/or FGR. Urinary PIGF can be used as an alternative to circulating biomarkers in preeclampsia and FGR. Plasma sFlt-1, PlGF and sFlt-1: PlGF ratio as well as urinary PIGF and sFlt-1: PlGF ratio can be used to differentiate between normal pregnancy and pregnancies complicated by preeclampsia and FGR.

Placental Growth Factor in Bladder Cancer Compared to the Diagnostic Accuracy and Prognostic Performance of Vascular Endothelial Growth Factor A

To evaluate the diagnostic accuracy and prognostic performance of urinary and plasma levels of placental growth factor (PLGF) and provide their comparison with the results of vascular endothelial growth factor A (VEGF-A) in patients with primary and recurrent urinary bladder cancer. The enzyme-linked immunosorbent assay (ELISA) was used to assess urinary and plasma concentrations of PLGF and VEGF-A in 240 individuals. PLGF levels in urine and plasma were significantly higher in patients with primary bladder cancer than in healthy individuals (p=0.003, p=0.005, respectively). Area under the curve (AUC) of urinary PLGF was 0.68; AUC of plasma PLGF levels was 0.65. Patients with the urine levels of PLGF higher than 82.33 pg/ml had three times higher risk of recurrence. In patients with recurrent bladder cancer, the urinary concentrations of PLGF did not significantly differ from the concentrations in patients without current disease (p=0.61). However, plasma PLGF levels were significantly higher in patients diagnosed with tumor recurrence (p=0.001); AUC of plasma PLGF levels was 0.69. Moreover, patients with plasma levels higher than 10.09 pg/ml had a five-times higher risk of future tumor recurrence. The diagnostic accuracy of PLGF was comparable with VEGF-A. From a clinical point of view, PLGF could be considered a valid diagnostic test for the detection of primary and recurrent bladder cancer. In patients with recurrent bladder cancer, plasma PLGF levels can differentiate individuals at risk of tumor recurrence.

Use of serum and urinary soluble sFlt-1 and PLGF in the diagnosis of preeclampsia

ABSTRACTObjective: Preeclampsia (PE) is a disorder of pregnancy marked by hypertension and proteinuria with no known treatment aside from pregnancy termination. The pathogenesis of PE is poorly understood, but is thought to originate in the placenta. We assessed the value of measuring serum and urinary soluble deformylase-like tyrosine kinase receptor 1 (sFlt-1), a known target of placental factors, and placental growth factor (PLGF), a key placental signaling molecule, in the diagnosis of PE.Methods: Eighty patients with PE were classified as either exhibiting mild (44 cases) or severe (36 cases) symptoms of PE. Forty normal pregnant women were selected as controls. Serum and urinary PLGF and sFlt-1 levels, along with the ratio of sFlt-1 to PLGF, were compared across groups.Results: Serum and urinary sFlt-1 and sFlt-1/PLGF ratios in severe PE patients were significantly higher than those in the mild PE group, and measurements from mild PE patients were significantly higher than controls (all P values <0.01). The serum and urinary PLGF levels in severe PE patients were significantly lower than mild PE patients, and mild PE patients had significantly lower PLGF levels than controls (all P values <0.01). As expected, serum sFlt-1 and PLGF levels and ratios were highly correlated with urinary sFlt-1 and PLGF levels and ratios.Conclusions: The severity of PE was closely correlated with these measurements, suggesting that they may be useful tools in the diagnosis and evaluation of PE.

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Objectives Assess the accuracy of serum soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF) and soluble endoglin (sEng) and urinary PlGF as predictors of preeclampsia in a prospective multicountry study. Methods From 2006-9, 5121 pregnant women from centers in Argentina, Colombia, India, Italy, Kenya, Peru, Switzerland and Thailand had their serum tested for sFlt-1, PlGF and sEng levels and their urine for PlGF levels at ⩽20 (index tests, results kept blind from care givers), 23–27 and 32–35 weeks’ gestation. During prenatal care, women were closely monitored for signs of preeclampsia, diagnosed by systolic blood pressure ⩾140 mmHg and/or diastolic blood pressure ⩾90 mmHg, and proteinuria with protein/creatinine ratio ⩾0.3, protein ⩾1 g/l or, one dipstick measurement ⩾2+ appearing after gestational week 20, and defined as early preeclampsia when these signs appeared before 34 weeks’ gestation. Results Preeclampsia was diagnosed in 3.9% (198 of the 5121 women) whom 47 (0.9%) had early disease. No test performed well at Conclusions Angiogenic biomarkers, alone or combined with clinical risk factors, performed poorly as predictors of preeclampsia, when measured early in pregnancy ( Disclosures M. Widmer: None. C.B. Cuesta: None. K. Khan: None. A.M. Gulmezoglu: None. S.A. Karumanchi: Consultant: Roche, Beckman, Siemens. M.D. Lindheimer: None.

The relationship of angiogenic factors to maternal and neonatal manifestations of early-onset and late-onset preeclampsia.

An imbalance between angiogenic and antiangiogenic factors has been implicated in the pathogenesis and severity of preeclampsia. In this study, we evaluated serum levels of an angiogenic factor and an antiangiogenic factor - placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1), respectively - in pregnant women with preeclampsia, as well as evaluating the impact of those factors on maternal and fetal outcomes. We studied 44 pregnant women diagnosed with preeclampsia and admitted to an intensive care unit (ICU). The preeclampsia was classified (by weeks of gestation at delivery) as early-onset (<34 weeks) or late-onset (≥34 weeks). We analyzed serum PlGF and sFlt-1, as well as urinary PlGF at admission to the ICU. In the early-onset preeclampsia group, the sFlt-1/PlGF ratio was higher, as was serum sFlt-1, whereas serum PlGF was lower. Serum sFlt-1 and the sFlt-1/PlGF ratio correlated positively with proteinuria and length of maternal hospital stay and correlated negatively with birth weight. The sFlt-1/PlGF ratio correlated positively with length of newborn stay in the neonatal ICU. Angiogenic imbalance is more pronounced in patients with early-onset preeclampsia and correlates with worse clinical outcomes, especially for the neonates.

How accurate are placental growth factor, urate, lactate dehydrogenase and proteinuria in diagnosing preeclampsia and its severity?

The objective was to assess the diagnostic accuracy of serum and urinary placental growth factor (sPlGF and uPlGF, respectively), urate, lactate dehydrogenase (LDH), and proteinuria for diagnosing and differentiating between women with preeclampsia and women with a normal healthy pregnancy, gestational hypertension, and gestational proteinuria. Urine and blood samples were taken from pregnant women diagnosed with late-onset severe preeclampsia (30 patients), mild preeclampsia (30 patients), gestational hypertension without meeting the criteria for preeclampsia (30 patients), gestational proteinuria without meeting the criteria for preeclampsia (30 patients), and healthy pregnant control women (30 patients). A receiver operating characteristic (ROC) curves analysis was performed to evaluate the diagnostic accuracy and to select the optimal cutoff points for different markers. sPlGF is the best test for differentiating women with severe preeclampsia from women in all of the other groups (p=0.001). However, there was no significant difference between sPlGF and proteinuria in the 24-h urine collection (p=0.329) in this differentiation. uPlGF can be used to differentiate women with severe preeclampsia from women in all of the other groups. However, proteinuria in the 24-h urine collection is better than uPlGF for this differentiation (p=0.013). sPlGF and uPlGF can be used to diagnose women with severe preeclampsia and should be considered at least as important as proteinuria in the diagnosis of preeclampsia. A large study that considers the cost-effectiveness of adding these markers to the diagnosis of preeclampsia should be conducted before our recommendation is applied.

Effects of Angiogenic Factors, Antagonists, and Podocyte Injury on Development of Proteinuria in Preeclampsia

Proteinuria is universal to all patients with preeclampsia. We examined the urinary podocytes in women with preeclampsia (n = 14), gestational hypertension (n = 14), and normal pregnancy. Maternal serum and urinary concentrations of vascular endothelial growth factor (VEGF), placental growth factor (PlGF), and the antiangiogenic factor soluble fms-like tyrosine kinase 1 (sFlt-1) were detected. These concentrations were used to evaluate the urinary excretion of podocytes and the alteration of angiogenic factors and to assess their relationships to proteinuria in preeclampsia. Our studies suggest that the urinary podocyte number and angiogenic factors are correlated with random urine albumin/creatinine ratio and blood pressure. Receiver-operating characteristic (ROC) curves of serum and urinary PlGF and the PlGF/sFlt-1 ratio as well as the presence of podocyturia confirmed their usefulness in distinguishing preeclamptic and normotensive pregnant women. In addition, combinations of serum or urinary PlGF or podocyturia tests in parallel or in series provided the best clue for identifying patients with preeclampsia. We considered that the dysregulation of angiogenic factors and its subsequent podocyte injury may contribute to the mechanism of proteinuria development in preeclampsia.

Urinary placental growth factor differentiates the hypertensive disorders of pregnancy

To evaluate the discriminating capacity of urinary placental growth factor (uPlGF) for different hypertensive diseases of pregnancy during the third trimester. A prospective descriptive case-control study conducted in an urban tertiary referral hospital and district general hospital, Sydney South West Area Health Service, Australia. Inpatients and outpatients with and without hypertension in the third trimester were recruited. Eligible patients provided a urine sample for protein, creatinine and a uPlGF level by ELISA. Patients were categorised into clinical hypertensive groups based on the diagnostic criteria of SOMANZ. Eighty-eight women were evaluated; 41 had hypertension (15 pre-eclampsia; 13 gestational hypertension; eight chronic hypertension; five pre-eclampsia superimposed on chronic hypertension) and 47 women without hypertension as the control group. There was a significant difference in uPlGF levels between the pre-eclamptic group (median 2.56 IQR 1.12-4.51) and the normotensive controls (median 13.18 IQR 5.95-31.39) (P < 0.0001); the gestational hypertensive group (median 3.74 IQR 2.49-4.91) and the normotensive group (median 13.18 IQR 5.95-31.39) (P=0.002) and for a subgroup comparison of placental-mediated hypertension (median 2.75 IQR 1.38-4.82) versus non-placental-mediated hypertensives (median 6.96 IQR 3.87-12.54) (P=0.007). Urinary placental growth factor is a simple non-invasive test, which is discriminatory for pre-eclampsia in the third trimester of pregnancy. Results from this study indicate that it may be discriminatory for hypertension related to placental dysfunction (pre-eclampsia and gestational hypertension) when compared with hypertension unrelated to placental function. Further work is required to assess the ability to detect hypertensive diseases before they are clinically apparent.

Preeclampsia, a disease of the maternal endothelium: the role of antiangiogenic factors and implications for later cardiovascular disease.

Preeclampsia is a clinical syndrome defined as the new onset of hypertension and proteinuria during the second half of pregnancy.1 It afflicts 3% to 5% of pregnancies and is a leading cause of maternal mortality, especially in developing countries.2,3 Because the only known remedy is delivery of the placenta, in developed countries preeclampsia is an important cause of premature delivery, usually medically indicated for the benefit of the mother. This results in infant morbidity and substantial healthcare expenditure.4 Despite the considerable morbidity and mortality, the cause of preeclampsia has remained enigmatic. Both hypertension and proteinuria implicate the endothelium as the target of the disease. The hypertension of preeclampsia is characterized by peripheral vasoconstriction and decreased arterial compliance.5,6 The proteinuria of preeclampsia is associated with a pathognomonic renal lesion known as glomerular endotheliosis, in which the endothelial cells of the glomerulus swell and endothelial fenestrations are lost.7,8 Podocyturia has been recently associated with preeclampsia during clinical disease9; however, whether this is the cause or effect of proteinuria is unknown. The glomerular filtration rate is decreased compared with normotensive pregnant women; in rare cases, acute renal failure may develop. Preeclampsia is a systemic vascular disorder that may also affect the liver and the brain in the mothers. When the liver is involved, women may present with abdominal pain, nausea, vomiting, and elevated liver enzymes. Pathological examination of the liver reveals periportal and sinusoidal fibrin deposition and, in more extreme cases, hemorrhage and necrosis.10 The severe preeclampsia variant HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) occurs in ≈20% of women with severe preeclampsia,11 and is named not only for the liver involvement, but also for the disorder of the coagulation system that develops.12 Approximately 20% of …

T13.5 Placental growth factor as a diagnostic for early onset pre-eclampsia and normotensive intrauterine growth restriction of placental origin

T13.6 – Table 2. Comparison table Normal Chronic hypertension Superimposed hypertension Pre-eclampsia Gestational hypertension Normal – P = 0.377 P = 0.031 P< 0.0001 P = 0.002 Chronic hypertension P = 0.377 – P = 0.107 P = 0.003 P = 0.021 Superimposed hypertension P = 0.031 P = 0.107 – P = 0.218 P = 0.673 Pre-eclampsia P< 0.0001 P = 0.003 P = 0.218 – P = 0.201 Gestational hypertension P = 0.002 P = 0.021 P = 0.673 P = 0.201 – sensitivity and specificity increased to 100% and 92%, respectively. Combined, a positive PlGF test was able to diagnosis early onset pre-eclampsia or nIUGR with 94% sensitivity and 93% specificity. Conclusion: This evidence suggests that PlGF can be used to confirm diagnosis of early onset pre-eclampsia and identify nIUGR of placental origin from mimics. Funding: Biosite, CIHR, MSFHR, CFRI T13.6 Urinary placental growth factor differentiates the hypertensive disorders of pregnancy Neil Campbell1, Robert Ogle1, Annemarie Hennessy2, Charlene Thornton1. 1Royal Prince Alfred Hospital, Sydney, Australia; 2University of Western Sydney and Heart Research Institute, Australia Objective: The objective of this study is to establish whether urinary placental growth factor (uPlGF) is capable of discriminating between the different types of hypertensive disease in pregnancy in the third trimester. Design: This is a prospective descriptive case control study. Setting: Royal Prince Alfred Hospital, Urban tertiary referral hospital in Sydney, Australia. The Canterbury Hospital, district general hospital, Sydney, Australia Patients: Women in the third trimester of pregnancy who were currently inpatients on the antenatal ward or patients attending the antenatal outpatients department. Interventions: Patients in the third trimester of pregnancy were selected from the above settings, reviewed for eligibility and demographic data extracted. Patients were then asked to provide a urine specimen some of which was analysed for protein and creatinine and the rest stored and then later analysed for urine PlGF level. These levels after correction for creatinine concentration were then used in the final analysis. Measurements & main results: We have identified 36 women in the hypertensive group (preeclampsia (n=15), Gestational hypertension (n=13), Chronic hypertension (n=8), Preeclampsia superimposed on chronic hypertension (n=5)) and 47 women in the normal control group. There is a statistically significant difference in PlGF levels between the preeclamptic group and the normotensive controls (P<0.0001) and also between the gestational hypertensive group and the normotensive group (P=0.002) Distributions of the preeclamptic group and gestational hypertensive group taken as a whole when compared to the chronic hypertensive group and preeclampsia superimposed on chronic hypertension group also taken as a whole showed a significant difference as well (P=0.007). Table 1. Group characteristics

T13.6 Urinary placental growth factor differentiates the hypertensive disorders of pregnancy

To evaluate the clinical performance of a rapid point-of-care test, Triage PLGF (Alere, San Diego) in the diagnosis of preeclampsia.For the reference range 2212 plasma samples were collected from 595 subjects with normotensive pregnancies, between week 17 of gestation and delivery. In the case-control part, two cohorts of women with preeclampsia (80 women) were matched for maternal age, gestational age (GA) at sampling and parity with normotensive women who delivered at 37 weeks or more.The areas under the receiver operating characteristic curves (GA < 35 weeks) were 1.0 and 0.994 (cohort 1 and 2, respectively). The clinical sensitivity of the Triage PLGF test for the pooled GA range of 21 ⩽ GA < 35, using a GA dependent cut-off, was 1.0 for both cohorts with specificities of 1.0 and 0.940.The Triage PLGF test distinguishes well between preterm pregnancies with and without preeclampsia.

First trimester urinary placental growth factor and development of pre‐eclampsia

To compare urinary placental growth factor (PlGF) concentration at 11(+0) to 13(+6) weeks of gestation in women who subsequently develop pre-eclampsia with normotensive controls. Nested case-control study within a prospective study for first trimester prediction of pre-eclampsia. Routine antenatal visit in a teaching hospital. Fifty-two women who developed pre-eclampsia and 52 controls matched for gestational age and sample storage time. Urinary PlGF concentration and PlGF to creatinine ratio were measured in women who developed pre-eclampsia and their matched controls. Comparisons between groups were performed using Student's t test. Development of pre-eclampsia. In the pre-eclampsia group, the median urinary PlGF concentration (20.6 pg/ml, interquartile range [IQR] 9.1-32.0 pg/ml) and median urinary PlGF to creatinine ratio (1.6 pg/mg, IQR 1.2-2.5 pg/mg) were not significantly different from the control group (11.8 pg/ml, IQR 5.5-29.8 pg/ml, P=0.1 and 1.7 pg/mg, IQR 1.2-2.3 pg/mg, P=0.3, respectively). There were no significant differences between women with early-onset pre-eclampsia requiring delivery before 34 weeks (n=13) and those with late-onset pre-eclampsia (n=39) and between women with pre-eclampsia and fetal growth restriction (FGR) (n=25) and those with pre-eclampsia and no FGR (n=27) in either median PlGF concentration or median urinary PlGF to creatinine ratio. The development of pre-eclampsia is not preceded by altered urinary PlGF concentration in the first trimester of pregnancy.

447: Urinary placental growth factor in chronic hypertensives and pregestational diabetics

To investigate if urinary placental growth factor (PlGF) in those who are typically at increased risk for developing preeclampsia [chronic hypertensives (CHTN) and pregestational diabetics (PGD)] may be used as a screening tool to identify those who will develop preeclampsia (PRE).

Low urinary placental growth factor is a marker of pre-eclampsia

Recent reports of increased serum levels of soluble fms-like tyrosine kinase 1 (sFlt-1) and decreased levels of placental growth factor (PlGF) suggest the key role of angiogenic factors in development of pre-eclampsia. PlGF is excreted in urine, and reduced urinary level has been suggested as a marker of this condition as well as help in its prediction. We measured urinary PlGF and creatinine values in 69 pregnant women (35 with pre-eclampsia and 34 normotensive controls). Over 70% patients had severe pre-eclampsia. Compared to controls, the urinary PlGF and PlGF/creatinine levels were significantly reduced in women with pre-eclampsia. The hospital stay was longer and fetal outcomes poorer in this group. Three normotensive women who showed very low levels developed pre-eclampsia 2-6 weeks later. Reduced urinary PlGF level in a pregnant woman is a marker of pre-eclampsia. The value of reduced urinary PlGF levels in predicting pre-eclampsia in currently normotensive pregnant women needs to be evaluated. A simple predictive test is likely to be of value in the developing countries.

Urinary Placental Growth Factor and Risk of Preeclampsia

Urinary Placental Growth Factor and Risk of Preeclampsia

Urinary Placental Growth Factor and Risk of Preeclampsia

Urinary Placental Growth Factor and Risk of Preeclampsia