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Evaluation of angiogenic factors in the decision to admit women with suspected preeclampsia
- Source :
- Pregnancy Hypertension. 21:124-131
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- To compare outcomes, specifically development of preeclampsia with severe features (sPE), between angiogenic biomarker-based admission and admission based on routine clinical care.This secondary analysis of a prospective study evaluated soluble fms-like tyrosine kinase-1 (sFlt1)/placental growth factor (PlGF) ratio in women presenting to triage for preeclampsia evaluation. Biomarkers levels were measured in samples collected from triage and analyzed retrospectively after outcomes were achieved. For this analysis patients would be hypothetically assigned to 'discharged' with a sFlt1/PlGF ratio ≤ 38 and 'admitted' with a sFlt1/PlGF ratio 85. Development of sPE and other outcomes were then compared using the biomarker and clinical criteria for admission.459 patients were included in this analysis. Using biomarker criteria, a larger proportion of patients were hypothetically discharged (67.8% vs 51.0%, p 0.0001). A larger proportion of patients 'admitted' with a high biomarker level developed sPE (69.5% vs 40.9%, p 0.0001). A sFlt1/PlGF ratio ≤ 38 had a negative predictive value of 96.8% for development of sPE within two weeks.Assessment of angiogenic biomarkes that 'discharges' patients with a low sFlt1/PlGF ratio and 'admits' patients with high ratio could result in reduced admissions and increased admission of patients at risk for developing sPE. Randomized trials are needed to determine the effectiveness of angiogenic biomarker use in decision making in a triage setting among women with suspected preeclampsia.
- Subjects :
- Adult
Placental growth factor
medicine.medical_specialty
Gestational Age
Risk Assessment
Preeclampsia
law.invention
Pre-Eclampsia
Randomized controlled trial
Predictive Value of Tests
Pregnancy
law
Secondary analysis
Internal medicine
Internal Medicine
Humans
Medicine
Prospective cohort study
Placenta Growth Factor
Retrospective Studies
Vascular Endothelial Growth Factor Receptor-1
business.industry
Pregnancy Outcome
Obstetrics and Gynecology
medicine.disease
Triage
Hospitalization
Biomarker (medicine)
Angiogenesis Inducing Agents
Female
High ratio
business
Biomarkers
Subjects
Details
- ISSN :
- 22107789
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- Pregnancy Hypertension
- Accession number :
- edsair.doi.dedup.....8fcaac52171f962641e1a0addbbf038d