OP 44 sFlt-1/PlGF ratio above 150 as an indicator for imminent delivery?

Introduction The implemantation of angiogenic factors like sFlt-1 and PlGF has taken place in our clinical routine to improve prediction and diagnosis of placental dysfunction. Cut off levels for the diagnosis of early (= sFlt-1/PlGF Ratio >85 before 34 weeks GA) and late (= sFlt-1/PlGF Ratio >110 after 34 weeks GA) onset type of placenta-related disorders were published. Additionally it is known that pregnancies complicated by severely elevated sFlt-1/PlGF Ratios are highly associated with the need to deliver within a very short time of period. Methods We analyzed retrospectively all pregnancies after 20 weeks GA with sFlt-1/PlGF ratios above 150 from January 2013 until April 2017. Primary endpoint was time range between the first measurement of sFlt-1/PlGF Ratio >150 and delivery. Secondary endpoints were mode of delivery, GA at delivery, diagnosis of placenta related disorders and need for neonatal intensive care unit. Result 116 Patients met the inclusion criteria, (sFlt-1/PlGF ratio median 239,15 (150,11 −2147,73)) at a median GA of 31 + 6 (20 + 3–40 + 5)), 109 singleton pregnancies, 6 twins and one quadriplet pregnancy. There were three cases of IUFD and one neonatal death. The mean time range between ratio >150 and date of delivery was 7.2 days, the median was 4 days (0–78 d). The caesarean section rate was 79.6%, 77.9% were delivered prematurely, 49.6% were born before 34 GA and 10.6% before 28 GA. 51.2% suffered from growth restriction ( Conclusion 70.7% of our Patients with a Ratio >150 were delivered within one week, 86.2% within 2 weeks.