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One-third of patients with eclampsia at term do not have an abnormal angiogenic profile.

Authors :
Chaiworapongsa T
Romero R
Gotsch F
Gomez-Lopez N
Suksai M
Gallo DM
Jung E
Levenson D
Tarca AL
Source :
Journal of perinatal medicine [J Perinat Med] 2022 Dec 27; Vol. 51 (5), pp. 652-663. Date of Electronic Publication: 2022 Dec 27 (Print Publication: 2023).
Publication Year :
2022

Abstract

Objectives: An abnormal angiogenic profile is present in about one-half of women with preeclampsia at term. Few studies examined the roles of angiogenic biomarkers in eclampsia. The aims of this study were to determine (1) whether the degree of an anti-angiogenic state, reflected by a low placental growth factor (PlGF) to soluble fms-like tyrosine kinase-1 (sFlt-1) ratio, in women with eclampsia differed from that of women with severe preeclampsia; and (2) the prevalence of women who had an abnormal angiogenic profile at the diagnoses of preterm and term eclampsia.<br />Methods: A cross-sectional study was conducted to include women in the following groups: (1) uncomplicated pregnancy (n=40); (2) severe preeclampsia (n=50); and (3) eclampsia (n=35). Maternal serum concentrations of PlGF and sFlt-1 were determined by immunoassays.<br />Results: Women with preterm, but not term, eclampsia had a more severe anti-angiogenic state than those with severe preeclampsia ( lower PlGF and PlGF/sFlt-1 ratio, each p<0.05). However, the difference diminished in magnitude with increasing gestational age (interaction, p=0.005). An abnormal angiogenic profile was present in 95% (19/20) of women with preterm eclampsia but in only 67% (10/15) of women with eclampsia at term.<br />Conclusions: Angiogenic biomarkers can be used for risk assessment of preterm eclampsia. By contrast, a normal profile of angiogenic biomarkers cannot reliably exclude patients at risk for eclampsia at term. This observation has major clinical implications given that angiogenic biomarkers are frequently used in the triage area as a test to rule out preeclampsia.<br /> (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

Details

Language :
English
ISSN :
1619-3997
Volume :
51
Issue :
5
Database :
MEDLINE
Journal :
Journal of perinatal medicine
Publication Type :
Academic Journal
Accession number :
36567427
Full Text :
https://doi.org/10.1515/jpm-2022-0474