2024, Number 7
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Med Crit 2024; 38 (7)
Association of Soluble fms-like tyrosine kinase 1/Placental Growing Factor + Platelet count/mean platelet volume ratios as a predictor of adverse outcomes in preeclampsia
Gallardo RJJ, Hernández PJA, Nares TMÁ, Vargas TS
Language: Spanish
References: 19
Page: 568-571
PDF size: 255.15 Kb.
ABSTRACT
Introduction: the use of detection of the ratio of imbalance between proangiogenic/antiangiogenic factors (sFlt-1/PlGF) in maternal blood has been a useful tool for the diagnosis of preeclampsia. Platelet aggregation also plays a crucial role in the development of the disease, platelet parameters such as the ratio platelet count/mean platelet volume (PC/MPV) have the advantage of being easy, fast and low cost in the detection of preeclampsia, if we add these ratios the ability to predict preeclampsia can be improved, however there is no evidence on the prognosis and prediction of adverse outcomes.
Objective: to evaluate the association of soluble vascular endothelial growth factor receptor 1/placental growth factor + Platelet Count/Mean Platelet Volume (sFlt-1/PlGF + PC/MPV) ratios as a predictor of adverse outcomes in preeclampsia.
Material and methods: descriptive, retrospective, analytical, cross-sectional, single-center study, where information was obtained from electronic records of patients diagnosed with preeclampsia who had serum measurements of sFlt-1, PlGF, PC and MPV. Statistical analysis of the association of the result of the sum of sFlt-1/PlGF + PC/MPV ratios and adverse maternal outcomes was performed taking into account Acute Kidney Injury, Eclampsia, Neurological Complications, Pulmonary Edema, HELLP, Liver Injury, ICU stay days, use of renal function replacement therapy, Obito and Maternal Death. The cut-off point was calculated and the receiver operating characteristic (ROC) curve was used to calculate sensitivity and specificity.
Results: 57 records were analyzed, with ages ranging from 15 to 43 years with a mean of 32 years, finding an area under the curve (AUC) of 0.768 (95% CI: 0.63-0.90) for the cut-off point of 62.4, sensitivity of 97.2% and specificity of 86.7%, P 0.001 and an estimated risk of 4.7 (95% CI: 0.40-56.1).
Conclusions: the addition of the sFlt 1/PlGF + PC/MPV ratios does not predict adverse events related to complications from preeclampsia.
REFERENCES
Detección, Diagnóstico y Tratamiento de Enfermedades Hipertensivas del Embarazo. Guía de Evidencias y Recomendaciones: Guía de Práctica Clínica. México, IMSS; 2017.
World Health Organization. WHO Recommendations for prevention and treatment of pre-eclampsia and eclampsia. World Health Organization; 2011: 1-38. Disponible en: https://www.who.int/publications/i/item/9789241548335
Hernández-Pacheco JA, Espino-y Sosa S, Figueroa-Damián R. Preeclampsia-eclampsia, hemorragia postparto y sepsis obstétrica. 2da edición. México: Intersistemas. 2019. p. 7.
Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365(9461):785-799. doi: 10.1016/S0140-6736(05)17987-2.
Magee LA, Nicolaides KH, von Dadelszen P. Preeclampsia. N Engl J Med. 2022;386(19):1817-1832. doi: 10.1056/NEJMra2109523.
Serra B, Mendoza M, Scazzocchio E, Meler E, Nolla M, Sabria E, et al. A new model for screening for early-onset preeclampsia. Am J Obstet Gynecol. 2020;222(6):608.e1-608.e18.
Dimitriadis E, Rolnik DL, Zhou W, Estrada-Gutierrez G, Koga K, Francisco RPV, et al. Pre-eclampsia. Nat Rev Dis Primer. 2023;9(1):8.
Goel A, Maski MR, Bajracharya S, Wenger JB, Zhang D, Salahuddin S, et al. Epidemiology and mechanisms of de novo and persistent hypertension in the postpartum period. Circulation. 2015;132(18):1726-1733.
Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennstrom M, et al. Predictive value of the sFlt-1:PlGF ratio in women with suspected preeclampsia. N Engl J Med. 2016;374(1):13-22.
Cerdeira AS, O'Sullivan J, Ohuma EO, Harrington D, Szafranski P, Black R, et al. Randomized interventional study on prediction of preeclampsia/eclampsia in women with suspected preeclampsia: INSPIRE. Hypertension. 2019;74(4):983-990.
Dragan I, Georgiou T, Prodan N, Akolekar R, Nicolaides KH. Screening for pre-eclampsia using sFlt-1/PlGF ratio cut-off of 38 at 30-37 weeks' gestation. Ultrasound Obstet Gynecol. 2017;49(1):73-77. doi: 10.1002/uog.17301.
Campello E, Spiezia L, Radu CM, Dhima S, Visentin S, Valle FD, et al. Circulating microparticles in umbilical cord blood in normal pregnancy and pregnancy with preeclampsia. Thromb Res. 2015;136(2):427-431.
Stepan H, Hund M, Andraczek T. Combining biomarkers to predict pregnancy complications and redefine preeclampsia: the angiogenic-placental syndrome. Hypertension. 2020;75(4):918-926.
Liu Y, Zhao Y, Yu A, Zhao B, Gao Y, Niu H. Diagnostic accuracy of the soluble Fms-like tyrosine kinase-1/placental growth factor ratio for preeclampsia: a meta-analysis based on 20 studies. Arch Gynecol Obstet. 2015;292(3):507-518.
Cui L, Shu C, Liu Z, Tong W, Cui M, Wei C, et al. The expression of serum sEGFR, sFlt-1, sEndoglin and PLGF in preeclampsia. Pregnancy Hypertens. 2018;13:127-132.
Lecarpentier E, Tsatsaris V. Angiogenic balance (sFlt-1/PlGF) and preeclampsia. Ann Endocrinol (Paris). 2016;77(2):97-100.
AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J, Adam I. Platelet count and platelet indices in women with preeclampsia. Vasc Health Risk Manag. 2016;12:477-480.
Li Y, Sun L, Zheng X, Liu J, Zheng R, Lv Y. The clinical value of platelet parameters combined with sFlt-1/PlGF in predicting preeclampsia. Ann Palliat Med. 2021;10(7):7619-7626. doi: 10.21037/apm-21-1244.
González D, Castaldi L, Bravo E, Acuña A. Marcadores hematológicos predictores de preeclampsia con datos de severidad. Perinatol Reprod Hum. 2022;36(2):33-39.