José Antonio Hernández-Pacheco1, Claudia Ivet Rosales-Zamudio1, Héctor Borboa-Olivares2, Aurora Espejel-Núñez3, Sandra Parra-Hernández3, Guadalupe Estrada-Gutiérrez4, Lisbeth Camargo-Marín5, Diana Medina-Bastidas6, Mario Guzmán-Huerta7. 1. Unidad de Terapia Intensiva Adultos, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico. 2. Department of Nutrition and Bioprogramming, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico. 3. Department of Immunobiochemistry, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico. 4. Research Division, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico. 5. Departamento de Medicina Traslacional, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico. 6. Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes-Facultad de Química, UNAM, Mexico City, Mexico. 7. Departamento de Medicina Traslacional, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico. Electronic address: traslacional.inv2019@yahoo.com.
Abstract
OBJECTIVES: Assess the usefulness of the sFlt-1/PlGF ratio for the differential diagnosis of uncontrolled chronic hypertension vs. superimposed preeclampsia. STUDY DESIGN: We performed a cross-sectional study from 2015 to 2017 and 42 women with initial diagnosis of superimposed preeclampsia were enrolled in the emergency room. After a 12 week follow up patients were grouped as superimposed preeclampsia (Group A) and uncontrolled chronic hypertension (Group B) according to the American College of Obstetricians and Gynecologist criteria. A group of 33 healthy women paired by gestational age were included as controls (Group C). Maternal serum levels of sFlt-1 and PlGF were measured at enrollment, and the ratios of the groups were compared. MAIN OUTCOME MEASURES: Superimposed preeclampsia vs. uncontrolled chronic hypertension. RESULTS: After follow-up, group distribution was 30 women in Group A, 12 women in Group B, and 25 women in Group C. The sFlt-1/PlGF ratio was higher in women with superimposed preeclampsia than in women with uncontrolled chronic hypertension (215.5 vs. 9.65, p < 0.001). The control group displayed lower ratio values (3.66, p < 0.001). The sFlt-1 concentration was higher in Group A than in Group B (7564 vs. 1281 pg/mL, p < 0.001) and the PlGF level was lower in Group A (34.39 vs. 169 pg/mL, p < 0.001). CONCLUSIONS: The sFlt-1/PlGF ratio exhibits good performance for the differential diagnosis of superimposed preeclampsia vs. uncontrolled chronic hypertension.
OBJECTIVES: Assess the usefulness of the sFlt-1/PlGF ratio for the differential diagnosis of uncontrolled chronic hypertension vs. superimposed preeclampsia. STUDY DESIGN: We performed a cross-sectional study from 2015 to 2017 and 42 women with initial diagnosis of superimposed preeclampsia were enrolled in the emergency room. After a 12 week follow up patients were grouped as superimposed preeclampsia (Group A) and uncontrolled chronic hypertension (Group B) according to the American College of Obstetricians and Gynecologist criteria. A group of 33 healthy women paired by gestational age were included as controls (Group C). Maternal serum levels of sFlt-1 and PlGF were measured at enrollment, and the ratios of the groups were compared. MAIN OUTCOME MEASURES: Superimposed preeclampsia vs. uncontrolled chronic hypertension. RESULTS: After follow-up, group distribution was 30 women in Group A, 12 women in Group B, and 25 women in Group C. The sFlt-1/PlGF ratio was higher in women with superimposed preeclampsia than in women with uncontrolled chronic hypertension (215.5 vs. 9.65, p < 0.001). The control group displayed lower ratio values (3.66, p < 0.001). The sFlt-1 concentration was higher in Group A than in Group B (7564 vs. 1281 pg/mL, p < 0.001) and the PlGF level was lower in Group A (34.39 vs. 169 pg/mL, p < 0.001). CONCLUSIONS: The sFlt-1/PlGF ratio exhibits good performance for the differential diagnosis of superimposed preeclampsia vs. uncontrolled chronic hypertension.