Better prediction for FGR (fetal growth restriction) with the sFlt-1/PIGF ratio

Vişan, Valeria; Scripcariu, Ioana Sadiye; Socolov, Demetra; Costescu, Amelia; Rusu, Daniela; Socolov, Răzvan; Avasiloaiei, Andreea; Boiculese, Lucian; Dimitriu, Cristina

doi:10.1097/md.0000000000016069

Cited by 12 publications

(13 citation statements)

References 30 publications

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“…After adding sFlt1/PIGF ratio to the ultrasound fetal biometry and maternal risk factors, the sensitivity increased to 84.21% with the specificity of 84.31% for a false positive rate of 10%. The authors concluded that when associated with maternal factors and ultrasound biometry, the sFlt1/PIGF ratio enhanced the sensitivity for detecting SGA [9]. Efficacy of sFlt-1/PlGF ratio in FGR prediction was assessed by other researchers as well.…”

Section: Discussionmentioning

confidence: 99%

sFlt-1/PlGF Ratio in Prediction of Short-Term Neonatal Outcome of Small for Gestational Age Neonates

Witwicki

Chaberek²,

Szymecka-Samaha³

et al. 2021

Children

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Background: Small for gestational age is a pregnancy complication associated with a variety of adverse perinatal outcomes. The aim of the study was to investigate if sFlt-1/PlGF ratio is related to adverse short-term neonatal outcome in neonates small for gestational age in normotensive pregnancy. Methods: A prospective observational study was conducted. Serum sFlt-1/PlGF ratio was measured in women in singleton gestation diagnosed with fetus small for gestational age. Short-term neonatal outcome analyzed in the period between birth and discharge home. Results: Eighty-two women were included. Women with sFlt-1/PlGF ratio ≥33 gave birth to neonates with lower birthweight at lower gestational age. Neonates from high ratio group suffered from respiratory disorders and NEC significantly more often. They were hospitalized at NICU more often and were discharged home significantly later. sFlt-1/PlGF ratio predicted combined neonatal outcome with sensitivity of 73% and specificity of 82.2%. Conclusions: sFlt-1/PlGF ratio is a useful toll in prediction of short-term adverse neonatal outcome in SGA pregnancies.

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Section: Discussionmentioning

confidence: 99%

sFlt-1/PlGF Ratio in Prediction of Short-Term Neonatal Outcome of Small for Gestational Age Neonates

Witwicki

Chaberek²,

Szymecka-Samaha³

et al. 2021

Children

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“…5 Visan et al discussed the value of routine ultrasonic examination policy for FGR at 32 weeks gestation, which scored a detection rate of 70% (95% CI, 62%-78%) and the AUC was 0.88. 17 The maternal serum biomarkers are a noninvasive placental biochemical activity analysis aimed for better and earlier detection rates. Researchers investigated different biomarkers for third-trimester screening in a Cochrane systemic review.…”

Section: Discussionmentioning

confidence: 99%

Maternal alpha‐1‐antitrypsin as a noval marker for growth restriction in pre‐eclampsia

Nori

Ali

2021

J of Obstet and Gynaecol

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Aim: To verify the role of maternal serum levels of alpha-1-antitrypsin (AAT), an acute-phase inflammatory protein, as a marker for distinguishing between fetal growth restriction (FGR) and normal birth weight in pre-eclamptic women. We correlate serum AAT levels to the essential feto-maternal parameters for an earlier and cost-benefit diagnostic method, thus distinguishing between FGR and normal birth weight in preeclamptic women. Methods: An observational study conducted at the University hospital recruited 100 pregnant women in 32/34 weeks of a singleton single tone pregnancy; all were pre-eclampsia cases. All were tested by laboratory and ultrasound examination. Two sets of data were collected; one is maternal parameters such as blood pressure (BP), maternal serum AAT mean platelet volume (MPV), platelet distribution width (PDW), and serum uric acid levels, and the other is fetal parameters such as amniotic fluid index (AFI), fetal weight centile and estimated fetal weight. Results: A strong negative correlation proved between serum levels of AAT and all study variables except fetal weight (systolic BP, diastolic BP, MPV, PDW, serum uric acid, fetal weight percentile, and AFI) with a correlation coefficient of; À0.95, À0.95, À0.85, À0.93, À0.91, À0.94, and À0.93 respectively. The cut-off value for AAT 0.013 mg/ml showed the highest sensitivity and specificity as a diagnostic marker for FGR. Area under the curve was 0.99. Conclusions: Negative correlations between maternal serum AAT and fetal parameters used to assess FGR were confirmed, suggesting that AAT is closely related to the pathophysiology of FGR among pre-eclamptic patients and may serve as a helpful tool in distinguishing between FGR and normal birth weight babies, pending further validation in feto-maternal outcomes.

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“…The combination of Doppler ultrasound and angiogenic factors (e.g., sFlt-1/PlGF ratio) appears to improve the FGR prediction, as does the combination of fetal biometry and the angiogenic marker 22 , 23 , 24 . However, further studies are still needed before widespread clinical use.…”

Section: Screening Prediction and Preventionmentioning

confidence: 99%

“…Die Kombination der Doppler-Sonografie mit angiogenen Faktoren (z. B. sFlt-1/PlGF-Quotient) scheint die Vorhersage für eine FGR zu verbessern, ebenso wie die Kombination der fetalen Biometrie mit dem angiogenen Marker 22 , 23 , 24 . Allerdings sind auch hier bis zum weiten klinischen Einsatz noch weitere Studien notwendig.…”

Section: Screening Prädiktion Und Präventionunclassified

Fetal Growth Restriction – Diagnostic Work-up, Management and Delivery

Schlembach

2020

Geburtshilfe Frauenheilkd

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Fetal or intrauterine growth restriction (FGR/IUGR) affects approximately 5 – 8% of all pregnancies and refers to a fetus not exploiting its genetically determined growth potential. Not only a major cause of perinatal morbidity and mortality, it also predisposes these fetuses to the development of chronic disorders in later life. Apart from the timely diagnosis and identification of the causes of FGR, the obstetric challenge primarily entails continued antenatal management with optimum timing of delivery. In order to minimise premature birth morbidity, intensive fetal monitoring aims to prolong the pregnancy and at the same time intervene, i.e. deliver, before the fetus is threatened or harmed. It is important to note that early-onset FGR (< 32 + 0 weeks of gestation [wks]) should be assessed differently than late-onset FGR (≥ 32 + 0 wks). In early-onset FGR progressive deterioration is reflected in abnormal venous Doppler parameters, while in late-onset FGR this manifests primarily in abnormal cerebral Doppler ultrasound. According to our current understanding, the “optimum” approach for monitoring and timing of delivery in early-onset FGR combines computerized CTG with the ductus venosus Doppler, while in late-onset FGR assessment of the cerebral Doppler parameters becomes more important.

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Better prediction for FGR (fetal growth restriction) with the sFlt-1/PIGF ratio

Cited by 12 publications

References 30 publications

sFlt-1/PlGF Ratio in Prediction of Short-Term Neonatal Outcome of Small for Gestational Age Neonates

sFlt-1/PlGF Ratio in Prediction of Short-Term Neonatal Outcome of Small for Gestational Age Neonates

Maternal alpha‐1‐antitrypsin as a noval marker for growth restriction in pre‐eclampsia

Fetal Growth Restriction – Diagnostic Work-up, Management and Delivery

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