Correlation between uterine artery Doppler and the sFlt-1/PlGF ratio in different phenotypes of placental dysfunction

Fabjan-Vodušek, Vesna; Kumer, Kristina; Osredkar, Joško; Verdenik, Ivan; Geršak, Ksenija; Premru-Sršen, Tanja

doi:10.1080/10641955.2018.1550579

Cited by 11 publications

(9 citation statements)

References 33 publications

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“…The soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio has been proposed as a short-term predictor to rule out pre-eclampsia in women in whom this condition is suspected clinically 33 . Although some reports suggest that use of the sFlt-1/PlGF ratio might be helpful in the management of and differentiation between SGA and FGR [34][35][36][37][38] , the lack of interventional trial data precludes the recommendation of these tests as an adjunct to ultrasound imaging. The rapidly evolving research-based discussion of the use of biomarkers in screening for SGA and FGR is beyond the scope of this Guideline.…”

Section: Biomarkersmentioning

confidence: 99%

“…Early FGR is particularly associated with maternal vascular malperfusion of the placenta, characterized by abnormal transformation of the spiral arteries, pathologic features of the placental villi and multifocal infarction; these disease components result in so-called 'placental insufficiency' and form the most common basis for placenta-mediated FGR 53,54 . Chronic ischemia of the placental villi impairs PlGF secretion and leads to excessive sFlt-1 release by syncytial knots, thus resulting in elevated sFlt-1/PlGF ratio which typifies early FGR and the associated hypertensive disorders of pregnancy [34][35][36][37][38] . Elevated Doppler UA-PI typically precedes a cascade of Doppler alterations, fetal heart rate changes and BPP modifications, with end-stage cardiovascular deterioration caused by severe hypoxemia followed by acidosis [55][56][57] .…”

Section: Early-onset Fetal Growth Restrictionmentioning

confidence: 99%

See 1 more Smart Citation

ISUOG Practice Guidelines: diagnosis and management of small‐for‐gestational‐age fetus and fetal growth restriction

Lees

Stampalija

Baschat

et al. 2020

Ultrasound in Obstet & Gyne

457

454

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ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction Clinical Standards CommitteeThe International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice, and high-quality teaching and research related to diagnostic imaging in women's healthcare. The ISUOG Clinical Standards Committee (CSC) has a remit to develop Practice Guidelines and Consensus Statements as educational recommendations that provide healthcare practitioners with a consensus-based approach, from experts, for diagnostic imaging. They are intended to reflect what is considered by ISUOG to be the best practice at the time at which they are issued. Although ISUOG has made every effort to ensure that Guidelines are accurate when issued, neither the Society nor any of its employees or members accepts any liability for the consequences of any inaccurate or misleading data, opinions or statements issued by the CSC. The ISUOG CSC documents are not intended to establish a legal standard of care, because interpretation of the evidence that underpins the Guidelines may be influenced by individual circumstances, local protocol and available resources. Approved Guidelines can be distributed freely with the permission of ISUOG (

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Section: Biomarkersmentioning

confidence: 99%

Section: Early-onset Fetal Growth Restrictionmentioning

confidence: 99%

ISUOG Practice Guidelines: diagnosis and management of small‐for‐gestational‐age fetus and fetal growth restriction

Lees

Stampalija

Baschat

et al. 2020

Ultrasound in Obstet & Gyne

457

454

View full text Add to dashboard Cite

show abstract

“…54 In a prospective study, assessing 66 patients with either preeclampsia (with or without FGR) or isolated FGR, mean uterine artery PI was normal in 24.2% (16/66), while all preeclamptic pregnancies had low abnormal PlGF. 55 By contrast, the identification of patients with low circulating PlGF, viewed as an "end product" of a variety of diseases that compromise the function of the placental villi, is likely to be more effective than uterine artery Doppler since both uterine artery Doppler is typically normal in pregnancies with chronic histiocytic inter-villositis and massive peri-villous fibrin deposition. In comparison with a maternal blood test for PlGF, the costs incurred by the patient's travel, consultation and comprehensive ultrasound assessment of the fetus and placenta are far greater in all health care systems, especially for patients residing in rural settings.…”

Section: Results In the Context Of Other Observationsmentioning

confidence: 99%

“…In a similar fashion, around 85% of patients who develop preterm preeclampsia show underlying MVM pathology 21 whereas the remainder show other diseases that are unrelated to the ischemia‐reperfusion injury that is characteristic of MVM pathology 54 . In a prospective study, assessing 66 patients with either preeclampsia (with or without FGR) or isolated FGR, mean uterine artery PI was normal in 24.2% (16/66), while all preeclamptic pregnancies had low abnormal PlGF 55 . By contrast, the identification of patients with low circulating PlGF, viewed as an “end product” of a variety of diseases that compromise the function of the placental villi, is likely to be more effective than uterine artery Doppler since both uterine artery Doppler is typically normal in pregnancies with chronic histiocytic inter‐villositis and massive peri‐villous fibrin deposition 46,56,57 …”

Section: Commentmentioning

confidence: 96%

Comparison of circulating maternal placenta growth factor levels and sonographic evaluation of patients with abnormal first trimester screening analytes

et al. 2023

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Objective: To evaluate the role of mid-trimester placental growth factor (PlGF) in patients with abnormal circulating levels of first-trimester biomarkers.Methods: Retrospective cohort study including singleton pregnancies complicated by abnormal first-trimester biomarkers (2017-2020). Pregnancies complicated with chromosomal/structural anomalies were excluded. All patients had ultrasound imaging including uterine artery Doppler combined with measurement of maternal circulating PlGF. Sonographic findings, maternal and perinatal outcomes, and placental histopathology were compared between pregnancies with normal and low (<10th percentile for gestational age) PlGF levels. The diagnostic accuracy of PlGF for the prediction of specific placental-mediated complications was compared with the uterine artery Doppler assessment and additional sonographic findings.Results: Seventy-one pregnancies were assessed, of which 35 (49.3%) had low PlGF levels. Maternal sociodemographic characteristics, nulliparity, and aspirin consumption were comparable. In comparison with patients with normal PlGF levels, individuals with low PlGF levels had a higher rate of fetal growth restriction (EFW <3rd centile; 42.9% vs. 8.3%, p = 0.001), preterm-preeclampsia (22.9% vs. 0%, p = 0.002), preterm delivery <34 weeks (54.3% vs. 8.3%, p < 0.001) and maternal vascular malperfusion placental pathology (72.7% vs. 21.7%, p < 0.001) following delivery. Adjusting for uterine artery Doppler and fetal biometry status, midtrimester low PlGF remained significantly associated with these placentalmediated complications. The predictive capacity of PlGF outperformed ultrasound imaging with only minimal diagnostic improvement when ultrasound information was combined with PlGF status. Conclusion:In pregnancies with unexplained abnormal first-trimester biomarkers, mid-trimester PlGF outperformed a comprehensive ultrasound assessment in the identification of a subset of patients destined to develop placental dysfunction. This blood test may be an alternative initial approach in this context, especially where access to specialist care is more geographically challenging.

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“…For example, VEGF can effectively influence trophoblast cell proliferation and invasion, embryo implantation and promote placenta angiogenesis and the growth of maternal and fetal blood vessels in the uterus [19,20]. There are also reports suggesting that VEGF mRNA levels in the chorionic villus tissue of women with abortion were significantly higher than in the control group and could play an important role in fetal and placental angiogenesis [21][22][23]. It has also been demonstrated that VEGF can play a vital role in promoting angiogenesis and affecting trophoblast cell proliferation that can lead to abortion [24,25].…”

Section: Introductionmentioning

confidence: 99%

Placenta-Specific miR-125b Overexpression Leads to Increased Rates of Pregnancy Loss in Mice

Sun

Cai

Tan

et al. 2022

IJMS

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Pregnancy loss (PL) is one of the common complications that women can experience during pregnancy, with an occurrence rate of 1 to 5%. The potential causes of pregnancy loss are unclear, with no effective treatment modalities being available. It has been previously reported that the level of miR-125b was significantly increased in placentas of PL patients. However, the role of miR-125b in the development of PL still remains unknown. In the current study, an miR-125b placenta-specific over-expression model was constructed by lentiviral transfecting zona-free mouse embryos followed by embryo transfer. On gestation day 15, it was observed that the placenta was significantly smaller in the miR-125b placenta-specific overexpression group than the control group. Additionally, the abortion rate of the miR-125b placenta-specific overexpression group was markedly higher than in the control group. The blood vessel diameter was larger in the miR-125b-overexpressing specific placenta. In addition, miR-125b-overexpressing HTR8 and JEG3 cell lines were also generated to analyze the migration and invasion ability of trophoblasts. The results showed that miR-125b overexpression significantly suppressed the migration and invasion ability of HTR8 and JEG3 cells. Overall, our results demonstrated that miR-125b can affect embryo implantation through modulating placenta angiogenesis and trophoblast cell invasion capacity that can lead to PL.

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Correlation between uterine artery Doppler and the sFlt-1/PlGF ratio in different phenotypes of placental dysfunction

Cited by 11 publications

References 33 publications

ISUOG Practice Guidelines: diagnosis and management of small‐for‐gestational‐age fetus and fetal growth restriction

ISUOG Practice Guidelines: diagnosis and management of small‐for‐gestational‐age fetus and fetal growth restriction

Comparison of circulating maternal placenta growth factor levels and sonographic evaluation of patients with abnormal first trimester screening analytes

Placenta-Specific miR-125b Overexpression Leads to Increased Rates of Pregnancy Loss in Mice

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