Update on the diagnosis and prognosis of pre-eclampsia in singleton pregnancies based on the sFlt-1/PlGF ratio
2018
Pre-eclampsia belongs to a group of obstetric complications that are closely related through placental insufficiency,
which also includes intrauterine growth restriction and placental abruption. Timely and accurate detection
and treatment of pre-eclampsia is usually difficult, since diagnostic criteria are still based on nonspecific
signs and symptoms and there is no clear association between the usual criteria for severity and unfavorable
outcomes for mother and fetus. The discovery of the role of angiogenic factors (sFlt-1 y PlGF) in the pathophysiology
of placental insufficiency is a key step toward improving early diagnosis and establishing a prognosis in cases
occurring before week 34 of pregnancy. At present, ≤ 38 is widely accepted to be threshold value of the sFlt-1/PlGF
ratio that rules out suspected pre-eclampsia. The use of the ratio is considered cost-effective. However, current
data on the treatment and prognosis of women with an abnormally high sFlt1/PlGF ratio are more limited. The
present article summarizes current knowledge on the clinical application of the sFlt-1/PlGF for the diagnosis and
prognosis of pre-eclampsia and highlights those areas that should be addressed with respect to biomarkers, for
example, their role as targets in the development and follow-up of new treatments
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