PMID- 31840879
OWN - NLM
STAT- MEDLINE
DCOM- 20211203
LR  - 20211214
IS  - 1469-0705 (Electronic)
IS  - 0960-7692 (Linking)
VI  - 56
IP  - 4
DP  - 2020 Oct
TI  - sFlt-1/PlGF ratio and timing of delivery in early-onset fetal growth restriction 
      with antegrade umbilical artery flow.
PG  - 549-556
LID - 10.1002/uog.21949 [doi]
AB  - OBJECTIVE: To analyze the value of the soluble fms-like tyrosine 
      kinase-1/placental growth factor (sFlt-1/PlGF) ratio in predicting the time to 
      delivery in early-onset fetal growth restriction (FGR) with preserved antegrade 
      umbilical artery (UA) flow at diagnosis. METHODS: This was a prospective 
      observational single-center cohort study of pregnancies with early-onset 
      (< 32 + 0 weeks) FGR and antegrade UA flow, in which maternal serum sFlt-1/PlGF 
      ratio was determined at diagnosis. FGR was defined as estimated fetal weight 
      < 3(rd) centile or < 10(th) centile with UA pulsatility index > 95(th) centile, 
      fetal middle cerebral artery pulsatility index < 5(th) centile or 
      cerebroplacental ratio < 5(th) centile. The previously described sFlt-1/PlGF 
      ratio cut-off value of 85 for facilitating the diagnosis of pre-eclampsia was 
      assessed in the prediction of the need to deliver in < 1 week and >/= 4 weeks. 
      RESULTS: In total, 120 cases were included. There were 116 (96.7%) liveborn 
      neonates and 108 (90.0%) perinatal survivors. Median (interquartile range (IQR)) 
      gestational age at diagnosis of early-onset FGR was 27.1 (25.7-29.4) weeks. 
      Median (IQR) sFlt-1/PlGF ratio at diagnosis was 196 (84-474). Ninety (75.0%) 
      cases had a sFlt-1/PlGF ratio >/= 85. Among pregnancies with a liveborn neonate, 
      median (IQR) interval to delivery in the groups with sFlt-1/PlGF ratio < 85 and 
      >/= 85 was 41 (22-54) days and 11 (4-20) days, respectively (P < 0.01). The 
      probability of having to deliver within 1 week after diagnosis was 0% and 35.6% 
      in those with sFlt-1/PlGF ratio < 85 and >/= 85, respectively (P = 0.03), and the 
      probability of delaying delivery for >/= 4 weeks was 72.4% and 19.5%, respectively 
      (P < 0.01). CONCLUSION: sFlt-1/PlGF ratio < 85 at diagnosis of early-onset FGR 
      with antegrade UA flow identifies a group of pregnancies in which the need to 
      deliver within 1 week is very low and the interval to delivery is expected to be 
      prolonged for >/= 4 weeks in > 70% of cases. Copyright (c) 2019 ISUOG. Published by 
      John Wiley & Sons Ltd.
CI  - Copyright (c) 2019 ISUOG. Published by John Wiley & Sons Ltd.
FAU - Quezada, M S
AU  - Quezada MS
AD  - Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, Hospital 
      Universitario 12 de Octubre, Instituto de Investigacion Hospital 12 de Octubre 
      (imas12), Universidad Complutense de Madrid, Madrid, Spain.
FAU - Rodriguez-Calvo, J
AU  - Rodriguez-Calvo J
AD  - Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, Hospital 
      Universitario 12 de Octubre, Instituto de Investigacion Hospital 12 de Octubre 
      (imas12), Universidad Complutense de Madrid, Madrid, Spain.
FAU - Villalain, C
AU  - Villalain C
AUID- ORCID: 0000-0002-9456-4100
AD  - Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, Hospital 
      Universitario 12 de Octubre, Instituto de Investigacion Hospital 12 de Octubre 
      (imas12), Universidad Complutense de Madrid, Madrid, Spain.
FAU - Gomez-Arriaga, P I
AU  - Gomez-Arriaga PI
AD  - Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, Hospital 
      Universitario 12 de Octubre, Instituto de Investigacion Hospital 12 de Octubre 
      (imas12), Universidad Complutense de Madrid, Madrid, Spain.
FAU - Galindo, A
AU  - Galindo A
AD  - Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, Hospital 
      Universitario 12 de Octubre, Instituto de Investigacion Hospital 12 de Octubre 
      (imas12), Universidad Complutense de Madrid, Madrid, Spain.
FAU - Herraiz, I
AU  - Herraiz I
AUID- ORCID: 0000-0001-6807-4944
AD  - Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, Hospital 
      Universitario 12 de Octubre, Instituto de Investigacion Hospital 12 de Octubre 
      (imas12), Universidad Complutense de Madrid, Madrid, Spain.
LA  - eng
GR  - PI13/02405/Instituto de Salud Carlos III/
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Ultrasound Obstet Gynecol
JT  - Ultrasound in obstetrics & gynecology : the official journal of the International 
      Society of Ultrasound in Obstetrics and Gynecology
JID - 9108340
RN  - 0 (Biomarkers)
RN  - 0 (PGF protein, human)
RN  - 144589-93-5 (Placenta Growth Factor)
RN  - EC 2.7.10.1 (FLT1 protein, human)
RN  - EC 2.7.10.1 (Vascular Endothelial Growth Factor Receptor-1)
SB  - IM
MH  - Adult
MH  - Biomarkers/blood
MH  - Delivery, Obstetric/*statistics & numerical data
MH  - Female
MH  - Fetal Growth Retardation/*diagnosis/physiopathology
MH  - Fetal Weight
MH  - Gestational Age
MH  - Humans
MH  - Live Birth
MH  - Middle Cerebral Artery/embryology/physiopathology
MH  - Placenta Growth Factor/*blood
MH  - Predictive Value of Tests
MH  - Pregnancy
MH  - Prospective Studies
MH  - Pulsatile Flow
MH  - Time Factors
MH  - Umbilical Arteries/*embryology/physiopathology
MH  - Vascular Endothelial Growth Factor Receptor-1/*blood
OTO - NOTNLM
OT  - early-onset
OT  - fetal growth restriction
OT  - placental growth factor
OT  - soluble fms-like tyrosine kinase-1
OT  - umbilical artery Doppler
EDAT- 2019/12/17 06:00
MHDA- 2021/12/15 06:00
CRDT- 2019/12/17 06:00
PHST- 2019/07/28 00:00 [received]
PHST- 2019/10/23 00:00 [revised]
PHST- 2019/12/04 00:00 [accepted]
PHST- 2019/12/17 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2019/12/17 06:00 [entrez]
AID - 10.1002/uog.21949 [doi]
PST - ppublish
SO  - Ultrasound Obstet Gynecol. 2020 Oct;56(4):549-556. doi: 10.1002/uog.21949.