Romero-Arauz JF, Álvarez-Jiménez MG, Encalada-Mijangos A, Pérez-Valdés MC, Chan-Verdugo RG, Leaños-Miranda A

Language: Spanish
References: 11
Page: 561-568
PDF size: 304.49 Kb.

ABSTRACT

Background: Preeclampsia is a major cause of maternal and fetal morbidity and mortality. The loss of the balance between pro-angiogenic and antiangiogenic factors precedes the clinical presentation of preeclampsia. This alteration is greater in early and severe forms of the disease and shows association to adverse perinatal outcome.
Objetive: To determine the relationship between serum concentrations of angiogenic factors and the severity of preeclampsia and gestational hypertension with the maternal and perinatal outcome.
Materials and Methods: A cross-sectional comparative study from September 2013 to August 2015 was performed in the Hospital of Gynecology and Obstetrics No. 4 IMSS Luis Castelazo Ayala. A total of 196 patients were analyzed including singleton pregnancies ≥ 20 weeks’ gestation diagnosed with preeclampsia and gestational hypertension. The patients were divided in five groups: mild gestational hypertension (n = 46), mild preeclampsia (n = 20), severe gestational hypertension (n = 19), severe preeclampsia (n = 89), and severe complicated preeclampsia (n = 22). Additionally the total patients were divided in two groups: with and without adverse maternal outcome and the second group with and without adverse perinatal outcome. The serum concentration of sFlt-1, PlGF and the respective sFlt1/PLGF ratio were determinate with electrochemiluminescence. The management and timing of the termination of pregnancy was performed based on established guidelines for clinical practice.
Results: The serum concentration of sFlt-1, PlGF and the respective sFlt1/PLGF ratio were significant different between the 5 groups analyzed (p ‹ 0.001). Moreover, the difference of the concentrations of angiogenic factors are closely associated with the severity of hypertensive disease of pregnancy (p ‹ 0.001). The sFlt1/PLGF ratio was higher in those with adverse maternal and fetal outcomes compared to those who did not had (222.5 vs 112.8 and 158.3 vs 53.1 respectively) p ‹ 0.001.
Conclusion: Major alteration was observed in the concentration of angiogenic factors as the greater the severity of hypertensive disease in pregnancy. Likewise, the sFlt-1/PlGF ratio was higher in those with adverse maternal and perinatal outcomes compared to those who did not have. Therefore this relationship has potential use as a biochemical marker of severity and risk stratification.

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