Angiogenic factors for planning fetal surveillance in fetal growth restriction and small-for-gestational-age fetuses : A prospective observational study
Bonacina, Erika (Hospital Universitari Vall d'Hebron)
Mendoza, Manel (Hospital Universitari Vall d'Hebron)
Farràs Llobet, Alba (Hospital Universitari Vall d'Hebron)
Garcia-Manau, Pablo (Hospital Universitari Vall d'Hebron)
Serrano, Berta (Hospital Universitari Vall d'Hebron)
Hurtado, Ivan (Hospital Universitari Vall d'Hebron)
Ferrer-Oliveras, Raquel (Hospital Universitari Vall d'Hebron)
Illan, Lidia (Hospital Universitari Vall d'Hebron)
Armengol-Alsina, Mireia (Hospital Universitari Vall d'Hebron)
Carreras Moratonas, Elena (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	The aim of this study was to assess the added value of the soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) ratio for adjusting the periodicity of ultrasound examinations in early-onset fetal growth restriction (FGR) and small for gestational age (SGA). A prospective, observational study. Tertiary referral hospital. One hundred and thirty-four single pregnancies with ultrasonographic estimated fetal weight (EFW) below the 10th centile between 20 +0 and 31 +6 weeks of gestation with antegrade umbilical artery flow. The time from Doppler and sFlt-1/PlGF assessment to delivery was recorded and classified into four ranges: <1, <2, <3 and <4 weeks. Sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of sFlt-1/PlGF values to predict the time to delivery. In the SGA cohort, the NPV calculated for an sFlt-1/PlGF cut-off value of 38 was 100% for delivery before 3 weeks, and 98% for delivery before 4 weeks after diagnosis (95% CI 0. 89-1. 00). In the FGR cohort, the NPV calculated for an sFlt-1/PlGF cut-off value of 38 was 100% for delivery before 2 weeks after diagnosis (95% CI 0. 92-1. 00). By contrast, more than 50% of cases with an sFlt-1/PlGF value of >85 required an elective delivery before 1 week. sFlt-1/PlGF values in early-onset SGA and FGR are predictive of the time to delivery and could be used for planning fetal surveillance, by reducing the frequency of ultrasound in cases with sFlt-1/PlGF < 38 and by providing closer follow-up in cases with sFlt-1/PlGF >85. sFlt-1/PlGF values in early-onset SGA/FGR could be used in addition to Doppler for planning fetal surveillance. sFlt-1/PlGF values in early-onset SGA/FGR could be used in addition to Doppler for planning fetal surveillance. Linked article : This article is commented on by Cecilia Villalaín, pp. 1878 in this issue. To view this minicommentary visit.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Fetal Doppler ; Fetal growth restriction ; Fetal surveillance ; PlGF ; Sflt-1 ; Small for gestational age
Published in:	BJOG, Vol. 129 (april 2022) , p. 1870-1877, ISSN 1471-0528

DOI: 10.1111/1471-0528.17151
PMID: 35303394

8 p, 1.1 MB

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