RT Journal Article
T1 sFlt-1/PlGF ratio and timing of delivery in early-onset fetal growth restriction with antegrade umbilical artery flow
A1 Quezada, M. S.
A1 Rodríguez Calvo, J.
A1 Villalain González, Cecilia
A1 Gómez Arriaga, P. I.
A1 Galindo Izquierdo, Alberto
A1 Herraiz García, Ignacio
AB ABSTRACTObjectiveTo analyze the value of the soluble fms‐like tyrosine kinase‐1/placental growth factor (sFlt‐1/PlGF) ratio in predicting the time to delivery in early‐onset fetal growth restriction (FGR) with preserved antegrade umbilical artery (UA) flow at diagnosis.MethodsThis was a prospective observational single‐center cohort study of pregnancies with early‐onset (< 32 + 0 weeks) FGR and antegrade UA flow, in which maternal serum sFlt‐1/PlGF ratio was determined at diagnosis. FGR was defined as estimated fetal weight < 3rd centile or < 10th centile with UA pulsatility index > 95th centile, fetal middle cerebral artery pulsatility index < 5th centile or cerebroplacental ratio < 5th centile. The previously described sFlt‐1/PlGF ratio cut‐off value of 85 for facilitating the diagnosis of pre‐eclampsia was assessed in the prediction of the need to deliver in < 1 week and ≥ 4 weeks.ResultsIn total, 120 cases were included. There were 116 (96.7%) liveborn neonates and 108 (90.0%) perinatal survivors. Median (interquartile range (IQR)) gestational age at diagnosis of early‐onset FGR was 27.1 (25.7–29.4) weeks. Median (IQR) sFlt‐1/PlGF ratio at diagnosis was 196 (84–474). Ninety (75.0%) cases had a sFlt‐1/PlGF ratio ≥ 85. Among pregnancies with a liveborn neonate, median (IQR) interval to delivery in the groups with sFlt‐1/PlGF ratio < 85 and ≥ 85 was 41 (22–54) days and 11 (4–20) days, respectively (P < 0.01). The probability of having to deliver within 1 week after diagnosis was 0% and 35.6% in those with sFlt‐1/PlGF ratio < 85 and ≥ 85, respectively (P = 0.03), and the probability of delaying delivery for ≥ 4 weeks was 72.4% and 19.5%, respectively (P < 0.01).ConclusionsFlt‐1/PlGF ratio < 85 at diagnosis of early‐onset FGR with antegrade UA flow identifies a group of pregnancies in which the need to deliver within 1 week is very low and the interval to delivery is expected to be prolonged for ≥ 4 weeks in > 70% of cases. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
PB Wiley
SN 0960-7692
SN 1469-0705
YR 2020
FD 2020-10
LK https://hdl.handle.net/20.500.14352/114845
UL https://hdl.handle.net/20.500.14352/114845
LA eng
NO Quezada, M. S., Rodríguez‐Calvo, J., Villalaín, C., Gómez‐Arriaga, P. I., Galindo, A., & Herraiz, I. (2020). sflt ‐1/ plgf ratio and timing of delivery in early‐onset fetal growth restriction with antegrade umbilical artery flow. Ultrasound in Obstetrics & Gynecology, 56(4), 549-556. https://doi.org/10.1002/uog.21949
DS Docta Complutense
RD 13 abr 2025