Published: 2019-08-26

The predictive value of sFlt-1/PIGF ratio in high risk patients for the development of preeclampsia

Isha Sunil, Mitali Sharma


Background: Hypertensive disorders of pregnancy constitute a major cause of maternal morbidity and mortality. Pre-eclampsia/eclampsia ranks second only to haemorrhage as a specific, direct cause of maternal mortality. A number of markers have been under study for the early detection of this disease. The study aims to evaluate the predictive value of sFlt-1/PlGF ratio for preeclampsia.

Methods: This study was conducted in the Department of Gynaecology and Obstetrics of ASCOMS hospital, Jammu for a period of 6 months from Jan 2019 to June 2019. 50 antenatal patients attending the outpatient department with risk factors for developing preeclampsia were enrolled in the study. Their sFlT-1/PIGF ratio was determined at gestational age of 20 weeks to 37 weeks and its predictive value was evaluated.

Results: In the present study, 8 patients developed preeclampsia subsequently. The mean sFlt-1/PIGF ratio values were significantly higher in the patients who developed preeclampsia (73.5) than who did not develop the disease (26.07). The positive predictive value at 1 week was 41.66% and negative predictive value was 100%. At 4 weeks, positive predictive value was 66.66% and negative predictive value was 100%.

Conclusions: The present study suggests sFlt-1/PIGF ratio values are useful marker was a predictor of preeclampsia and values >38 were associated with preeclampsia. It is more useful in ruling out preeclampsia than ruling in the disease.


Preeclampsia, Predictive marker, sFlt-1/PIGF ratio

Full Text:



Nobis PN, Hajong A. Eclampsia in India through the decades. J Obstet Gynaecol India. 2016;66:172-6.

Brown MA, Lindheimer MD, de Swiet M, Van Assche A, Moutquin JM. The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the international society for the study of hypertension in pregnancy (ISSHP). Hypertens Pregnancy. 2001;20:9-14.

Montgomery AL, Ram U, Kumar R, Jha P. Million death study collaborators. maternal mortality in India: causes and healthcare service use based on a nationally representative survey. PLoS One. 2014;9(1):13-7.

Vogel JP, Souza JP, Mori R, Morisaki N, Lumbiganon P, Laopaiboon M. Maternal complications and perinatal mortality: findings of the World Health Organization multicountry survey on maternal and newborn health. BJOG. 2014;121(1):76-88.

Genbacev O, Difederico E, McMaster M, Fisher SJ. Invasive cytotrophoblast apoptosis in pre-eclampsia. Hum Reprod. 1999;14:59-66.

Colbern GT, Chiang MH, Main EK. Expression of the nonclassic histocompatibility antigen HLA-G by preeclamptic placenta. Am J Obstet Gynecol. 1994;170:1244-50.

Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennstrom M. Predictive Value of the sFlt-1: PlGF ratio in women with suspected preeclampsia. N Engl J Med. 2016;374:13-22.

Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005;330(7491):565.

Mrema D, Lie RT, Østbye T, Mahande MJ, Daltveit AK. The association between pre pregnancy body mass index and risk of preeclampsia: a registry based study from Tanzania. BMC Pregnancy Childbirth. 2018;18(1):56.

Sohlberg S, Stephansson O, Cnattingius S, Wikstrom AK. Maternal body mass index, height, and risks of preeclampsia. Am J Hypertens. 2012;25(1):120-5.

Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennstrom M. Predictive value of the sflt-1: plgf ratio in women with suspected preeclampsia. N Engl J Med. 2016;374:13-22.

Tarasevičienė V, Grybauskienė R, Mačiulevičienė R. sFlt-1, PlGF, sFlt-1/PlGF ratio and uterine artery Doppler for preeclampsia diagnostics. Medicina. 2016;52:349-53.

Ghosh SK, Raheja S, Tuli A, Raghunandan C, Agarwal S. Combination of uterine artery Doppler velocimetry and maternal serum placental growth factor estimation in predicting occurrence of pre-eclampsia in early second trimester pregnancy: a prospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2012;161:144-51.

Andrietti S, Silva M, Wright A, Wright D, Nicolaides KH. Competing-risks model in screening for pre-eclampsia by maternal factors and biomarkers at 35-37 weeks' gestation. Ultrasound Obstet Gynecol. 2016;48:72-9.