Pilot study: placental biomarker predictive capability (sFlt-1, PlGF and their ratio) of postpartum maternal outcome

Hamza, A; Gerlinger, Christoph; Radosa, Julia Caroline; Solomayer, Erich‐Franz; Hagmann, Jörg; Sester, Urban; Bohle, Rainer-Maria; Stroeder, Russalina; Takács, Zoltán; Meyberg-Solomayer, G; Juhasz‐Boess, Ingolf; Kasoha, Mariz

doi:10.1007/s00404-019-05128-6

Cited by 3 publications

(3 citation statements)

References 34 publications

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“…According to our findings, increased serum PlGF levels were associated with elevated systolic BP measurements. However, none of these markers could predict the general worsening of postpartum PE [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Effective screening and intervention strategies for preterm PE have been seriously considered. However, little is known about the value of maternal parameters in predicting PE complications postpartum [ 26 ]. The objective of this study is to investigate the correlation between maternal serum hormone levels of estradiol, progesterone, prolactin, and ß-HCG and their influence on the systolic and diastolic BP measurements immediately after delivery, on the first and the third postpartum days.…”

Section: Introductionmentioning

confidence: 99%

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Postpartum Assessment of the Correlation between Serum Hormone Levels of Estradiol, Progesterone, Prolactin and ß-HCG and Blood Pressure Measurements in Pre-Eclampsia Patients

et al. 2022

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Background: Preeclampsia is a pregnancy-related hypertensive disease. Aberrant hormone levels have been implicated in blood pressure disorders. This study investigated the association of postpartum maternal serum hormone levels of estradiol, progesterone, prolactin, and ß-HCG with poorer PE-related complications including arterial hypertension. Methods: Thirty patient women with preeclampsia, and twenty women with uncomplicated pregnancy were included in this study. Serum levels of estradiol, progesterone, prolactin, and ß-HCG were determined immediately after delivery, and on the first and third postpartum days by means of ECLIA. Results: Compared with normal pregnancy cases, preeclampsia cases had higher serum levels of ß-HCG levels on Day-0 (319%), of progesterone on Day-0 (207%) and Day-1 (178%), and of estradiol on Day-1 (187%) and Day-3 (185%). Increased prolactin levels were positively associated with disease severity and estradiol and progesterone levels were decreased in poorer preeclampsia features including disease onset and IUGR diagnosis. No significant correlation between different hormone levels and blood pressure measurements was reported. Conclusions: This study is the first that detected postpartum maternal serum hormone levels and their correlation with blood pressure measurements in preeclampsia. We believe that the persistent arterial hypertension in the puerperium in preeclampsia as well as poorer disease specifications are most likely not of hormonal origin. Larger, well-defined prospective studies are recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Postpartum Assessment of the Correlation between Serum Hormone Levels of Estradiol, Progesterone, Prolactin and ß-HCG and Blood Pressure Measurements in Pre-Eclampsia Patients

et al. 2022

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“…in pregnancy or with hydatidiform mole) and significantly improves postpartum following delivery of the placenta, confirms that the placenta is both necessary and sufficient for the development of this disease. 10,11 Rare cases of post-partum preeclampsia may be related to delayed clearance of antiangiogenic factors from maternal circulation 12,13 and/or excess fluid administration during labor. 14 Considering the essential role of the placenta in preeclampsia, our initial goal was to identify a pathogenic molecule that is not only overexpressed in preeclamptic placentas compared to normal pregnancies but also released into the maternal circulation which could induce widespread endothelial dysfunction.…”

Section: In the Pathogenesis Of Preeclampsiamentioning

confidence: 99%

Translation of mechanistic advances in preeclampsia to the clinic: Long and winding road

Thadhani,

Cerdeira,

Karumanchi

2024

The FASEB Journal

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As one of the leading causes of premature birth and maternal and infant mortality worldwide, preeclampsia remains a major unmet public health challenge. Preeclampsia and related hypertensive disorders of pregnancy are estimated to cause >75 000 maternal and 500 000 infant deaths globally each year. Because of rising rates of risk factors such as obesity, in vitro fertilization and advanced maternal age, the incidence of preeclampsia is going up with rates ranging from 5% to 10% of all pregnancies worldwide. A major discovery in the field was the realization that the clinical phenotypes related to preeclampsia, such as hypertension, proteinuria, and other adverse maternal/fetal events, are due to excess circulating soluble fms‐like tyrosine kinase‐1 (sFlt‐1, also referred to as sVEGFR‐1). sFlt‐1 is an endogenous anti‐angiogenic protein that is made by the placenta and acts by neutralizing the pro‐angiogenic proteins vascular endothelial growth factor (VEGF) and placental growth factor (PlGF). During the last decade, this work has spawned a new era of molecular diagnostics for early detection of this condition. Antagonizing sFlt‐1 either by reducing production or blocking its actions has shown salutary effects in animal models. Further, in early‐stage human studies, the therapeutic removal of sFlt‐1 from maternal circulation has shown promise in delaying disease progression and improving outcomes. Recently, the FDA approved the first molecular test for preterm preeclampsia (sFlt‐1/PlGF ratio) for clinical use in the United States. Measuring serum sFlt‐1/PlGF ratio in the acute hospital setting may aid short‐term management, particularly regarding step‐up or step‐down of care, decision to transfer to settings better equipped to manage both the mother and the preterm neonate, appropriate timing of administration of steroids and magnesium sulfate, and in expectant management decisions. The test itself has the potential to save lives. Furthermore, the availability of a molecular test that correlates with adverse outcomes has set the stage for interventional clinical trials testing treatments for this disorder. In this review, we will discuss the role of circulating sFlt‐1 and related factors in the pathogenesis of preeclampsia and specifically how this discovery is leading to concrete advances in the care of women with preeclampsia.

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Significance of uterine artery blood flow combined with placental growth factor in predicting adverse pregnancy outcomes

Wang¹,

Wang²,

Yan³

et al. 2022

Panminerva Med

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Pilot study: placental biomarker predictive capability (sFlt-1, PlGF and their ratio) of postpartum maternal outcome

Cited by 3 publications

References 34 publications

Postpartum Assessment of the Correlation between Serum Hormone Levels of Estradiol, Progesterone, Prolactin and ß-HCG and Blood Pressure Measurements in Pre-Eclampsia Patients

Postpartum Assessment of the Correlation between Serum Hormone Levels of Estradiol, Progesterone, Prolactin and ß-HCG and Blood Pressure Measurements in Pre-Eclampsia Patients

Translation of mechanistic advances in preeclampsia to the clinic: Long and winding road

Significance of uterine artery blood flow combined with placental growth factor in predicting adverse pregnancy outcomes

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