I HAVE RECENTLY READ - Serum test for prediction of preeclampsia (January 2016)

• Serum test for prediction of preeclampsia (January 2016)

The ratio of soluble fms–like tyrosine kinase 1 (sFlt-1) to placental growth factor (PlGF) is increased in the serum of women with preeclampsia; however, the clinical application for this observation remains unclear. A prospective international observational study (PROGNOSIS) attempted to derive and validate a serum sFlt-1:PlGF ratio that would predict the absence or presence of preeclampsia in women who had signs suggestive of the disease, but who did not meet standard criteria for preeclampsia [21]. An sFlt-1:PlGF ratio cutoff of 38 using a specific automated commercial assay had a negative predictive value (no preeclampsia in the next seven days) of 99.3 percent.

      Few women in the cohort ultimately developed preeclampsia, resulting in a positive predictive value of only 36.7 percent for preeclampsia diagnosis in the next four weeks. Further study is warranted, including determining whether the cut-off varies among laboratories and patient populations, the best interval for repeat testing, and how this information affects clinical decisions, outcomes and costs.(See "Preeclampsia: Clinical features and diagnosis", section on 'Measurement of angiogenic factors'.)



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