Skip to main content

Advertisement

SpringerLink
Log in

A Prospective Study of Placental Growth Factor Assay as a Novel Biomarker in Predicting Early-Onset Preeclampsia in High-Risk Patients

  • Original Article
  • Published:
The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Introduction

Preeclampsia is a leading cause of maternal and perinatal mortality and morbidity, but signs and symptoms are non-specific and may vary. The root cause is imbalance of circulating angiogenic factors of placental (syncytiotrophoblast) origin, with consequent low levels of placental growth factor (PlGF) which may aid in diagnosis and prediction of disease.

Aims and Objectives

To study the incidence of women at risk of developing early-onset preeclampsia by plasma placental growth factor biomarker assay in high-risk patients, to assess the maternal outcome in patients with PlGF values below cutoff for presenting gestational age, to calculate sensitivity, specificity, positive predictive value and negative predictive value of PlGF assay in predicting preeclampsia and to conclude whether PlGF biomarker assay can be an effective screening test in high-risk patients for prediction of early-onset preeclampsia.

Materials and Methods

The study was carried out in the Department of Obstetrics and Gynecology at a tertiary care center. It is a prospective study, and study period extended from April 2012 to October 2013. One hundred pregnant women with 20- to 34-week gestational age with possible high risk of developing preeclampsia attending the antenatal clinics and high-risk OPDs were screened in the present study after explaining the nature of the study. PLGF concentration was quantitated using plasma and processed in Triage kit device (fluorescence immunoassay device). PLGF concentration was categorized against a specific range for specific gestation, and values below the range or <12 pg/ml were considered screened positives. The cases were followed up till delivery.

Results

Twenty-two cases were screened positive, of which 20 developed preeclampsia with a strong positive prediction value of more than 90 %.

Conclusion

PLGF is a strong predictor and a useful assay for early-onset preeclampsia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Menzies J, Magee LA, Macnab YC, et al. Current CHS and NHBPEP criteria for severe preeclampsia do not uniformly predict adverse maternal or perinatal outcomes. Hypertens Pregnancy. 2007;26:447–62.

    Article  CAS  PubMed  Google Scholar 

  2. Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103:981–91.

    Article  PubMed  Google Scholar 

  3. Magee LA, von Dadelszen P, Chan S, et al. The control of hypertension in pregnancy study pilot trial. BJOG. 2007;114:770.e13–20.

    Article  Google Scholar 

  4. Chappell LC, Duckworth S, Seed PT, et al. Diagnostic accuracy of placental growth factor in women with suspected preeclampsia: a prospective multicenter study. Circulation. 2013. doi:10.1161/CIRCULATIONAHA.113.003215.

    PubMed  Google Scholar 

  5. Maynard S, Min J, Merchan J, et al. Excess placental soluble FMS-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J Clin Invest. 2003;111:649–58.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Venkatesha A, Toporsian M, Lam C, et al. Soluble endoglin contributes to the pathogenesis of preeclampsia. Nat Med. 2006;12:642–9.

    Article  CAS  PubMed  Google Scholar 

  7. Levine R, Lam C, Qian C, et al. Soluble endoglin and other circulating antiangiogenic factors in preeclampsia. N Engl J Med. 2006;355:992–1005.

    Article  CAS  PubMed  Google Scholar 

  8. Taylor R, Grimwood J, Taylor R, et al. Longitudinal serum concentrations of placental growth factor: evidence for abnormal placental angiogenesis in pathologic pregnancies. Am J Obstet Gynecol. 2003;188:177–82.

    Article  CAS  PubMed  Google Scholar 

  9. Buhimschi C, Norwitz E, Funai E, et al. Urinary angiogenic factors cluster hypertensive disorders and identify women with severe preeclampsia. Am J Obstet Gynecol. 2005;192:734–41.

    Article  CAS  PubMed  Google Scholar 

  10. Levine R, Maynard S, Qian C, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 2004;350:672–82.

    Article  CAS  PubMed  Google Scholar 

  11. Wikstrom A, Larsson A, Eriksson U, et al. Placental growth factor and soluble fms-like tyrosine kinase-1 in early-onset and late-onset preeclampsia. Obstet Gynecol. 2007;109:1368–74.

    Article  PubMed  Google Scholar 

  12. Romero R, Nien J, Espinoza J, et al. A longitudinal study of angiogenic (placental growth factor) and anti-angiogenic (soluble endoglin and soluble vascular endothelial growth factor receptor-1) factors in normal pregnancy and patients destined to develop preeclampsia and deliver a small for gestational neonate. J Matern Fetal Neonatal Med. 2008;21:9–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Ohkuchi A, Hirashima C, Matsubara S, et al. Alterations in placental growth factor levels before and after the onset of preeclampsia are more pronounced in women with early onset severe preeclampsia. Hypertens Res. 2007;30:151–9.

    Article  CAS  PubMed  Google Scholar 

  14. Benton SJ, Hu Y, Xie F, et al. Angiogenic factors as diagnostic tests for preeclampsia: a performance comparison between two commercial immunoassays. Am J Obstet Gynecol. 2011;205:469.e1–8.

    Article  Google Scholar 

  15. Sharon Maynard Annu. Rev. Med. 2008.59:61–78. Downloaded from arjournals.annualreviews.org by Mr Paul Sheard on 03/19/08.

  16. Triage® PLGF Test Product Insert.2011.

  17. Sibai BM. Hypertension. In: Gabbe SG, Niebyl JR, Galen H, et al., editors. Obstetrics: Normal and problem pregnancies. 6th ed. New York: Elsevier; 2012. p. 779–822.

    Chapter  Google Scholar 

  18. Hirashima C, Ohkuchi A, Arai F, et al. Establishing reference values for both total soluble Fms-like tyrosine kinase 1 and free placental growth factor in pregnant women. Hypertens Res. 2005;28:727–32.

    Article  CAS  PubMed  Google Scholar 

  19. Cnossen JS, ter Riet G, Mol BW, et al. Are tests for predicting pre-eclampsia good enough to make screening viable? A review of reviews and critical appraisal. Acta Obstet Gynecol Scand. 2009;88:758–65.

    Article  PubMed  Google Scholar 

  20. Verlohren S, Galindo A, Schlembach D, et al. An automated method for the determination of the sFlt-1/PlGF ratio in the assessment of preeclampsia. Am J Obstet Gynecol. 2009;201:e1–11.

    Google Scholar 

  21. Knudsen UB, Kronbog CS, von Dadelszen P, et al. Pregnancy hypertension: an international Journal of Women’s Cardiovascular. Health. 2012;2:8–15.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. MGM Medical College Indore, F-5 Radio Colony, Residency Area, Indore, 452001, India

    Pooja Mathur, Poonam Mathur, Laxmi Maru & Anupama Dave

Authors
  1. Pooja Mathur
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Poonam Mathur
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laxmi Maru
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anupama Dave
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pooja Mathur.

Ethics declarations

Conflict of interest

Authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the research ethics committee of the institution. All the procedures followed were in accordance with the ethical standards.

Additional information

Pooja Mathur Third Year; Poonam Mathur Assistant Professor; Laxmi Maru Prof & Head of Department; Anupama Dave Associate Professor Department of Obstetrics & Gynecology Maharaja Yashwant Rao Hospital & MGM Medical College Indore.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mathur, P., Mathur, P., Maru, L. et al. A Prospective Study of Placental Growth Factor Assay as a Novel Biomarker in Predicting Early-Onset Preeclampsia in High-Risk Patients. J Obstet Gynecol India 66 (Suppl 1), 98–103 (2016). https://doi.org/10.1007/s13224-015-0793-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13224-015-0793-7

Keywords

Search

Navigation