scholarly journals OC23.07: Maternal serum sFlt-1; PlGF and sFlt-1/PlGF ratio in the assessment of pre-eclampsia in multifetal gestations: comparison to singleton pregnancies

2014 ◽  
Vol 44 (S1) ◽  
pp. 55-55
Author(s):  
L. Droege ◽  
I. Herraiz ◽  
A. Galindo ◽  
H. Zeisler ◽  
D. Schlembach ◽  
...  
Keyword(s):  
Maternal Serum ◽  
Plgf Ratio ◽  
Singleton Pregnancies

scholarly journals Maternal serum sFlt-1/PlGF ratio in twin pregnancies with and without pre-eclampsia in comparison with singleton pregnancies

2015 ◽  
Vol 45 (3) ◽  
pp. 286-293 ◽  
Author(s):  
L. Dröge ◽  
I. Herraìz ◽  
H. Zeisler ◽  
D. Schlembach ◽  
H. Stepan ◽  
...  
Keyword(s):  
Maternal Serum ◽  
Twin Pregnancies ◽  
Plgf Ratio ◽  
Singleton Pregnancies

A more accurate prediction to rule in and rule out pre-eclampsia using the sFlt-1/PlGF ratio and NT-proBNP as biomarkers

2020 ◽  
Vol 58 (3) ◽  
pp. 399-407
Author(s):  
Paula Lafuente-Ganuza ◽  
Paloma Lequerica-Fernandez ◽  
Francisco Carretero ◽  
Ana I. Escudero ◽  
Eduardo Martinez-Morillo ◽  
...  
Keyword(s):  
Predictive Value ◽  
Early Onset ◽  
Retrospective Cohort ◽  
Validation Cohort ◽  
Placental Growth Factor ◽  
Machine Learning Model ◽  
Positive Results ◽  
Plgf Ratio ◽  
Rule Out ◽  
Singleton Pregnancies

AbstractBackgroundThe management of potential pre-eclamptic patients using the soluble FMS-like tyrosine kinase 1 (sFlt-1)/ placental growth factor (PlGF) ratio is characterised by frequent false-positive results.MethodsA retrospective cohort study was conducted to identify and validate cut-off values, obtained using a machine learning model, for the sFlt-1/PlGF ratio and NT-proBNP that would be predictive of the absence or presence of early-onset pre-eclampsia (PE) in singleton pregnancies presenting at 24 to 33 + 6 weeks of gestation.ResultsFor the development cohort, we defined two sFlt-1/PlGF ratio cut-off values of 23 and 45 to rule out and rule in early-onset PE at any time between 24 and 33 + 6 weeks of gestation. Using an sFlt-1/PlGF ratio cut-off value of 23, the negative predictive value (NPV) for the development of early-onset PE was 100% (95% confidence interval [CI]: 99.5–100). The positive predictive value (PPV) of an sFlt-1/PlGF ratio >45 for a diagnosis of early-onset PE was 49.5% (95% CI: 45.8–55.6). When an NT-proBNP value >174 was combined with an sFlt-1/PlGF ratio >45, the PPV was 86% (95% CI: 79.2–92.6). In the validation cohort, the negative and positive values were very similar to those found for the development cohort.ConclusionsAn sFlt-1/PlGF ratio <23 rules out early-onset PE between 24 and 33 + 6 weeks of gestation at any time, with an NPV of 100%. An sFlt-1/PlGF ratio >45 with an NT-proBNP value >174 significantly enhances the probability of developing early-onset PE.

Can Early hCG Levels be a Marker for Pregnancy Outcome in ART Cycles?

2009 ◽  
Vol 1 (3) ◽  
pp. 33-39 ◽  
Author(s):  
Mandakini Parihar
Keyword(s):  
Sensitivity And Specificity ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
High Sensitivity ◽  
Maternal Serum ◽  
Multiple Gestations ◽  
Adverse Result ◽  
Ultimate Outcome ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

ABSTRACT With advancing technology of assisted reproduction, physicians today have the ability to achieve conception in many couples who would have been totally incapable doing so only a few years ago. The anxiety and the uncertainty of pregnancy outcomes using ART procedures is widely accepted as one of the main psychological stresses the couples. The ability to predict outcome as soon as possible after assisted conception treatment is important for clinic staff and patients. The aim of this observational study is to highlight the importance of hCG values in predicting the outcome of ART cycle and counseling the patients in case of adverse result. The ultimate aim is to improve the take home baby rate and initial hCG value can help us counsel our patients towards the ultimate outcome. Embryo development in early pregnancy follows a preprogrammed-timing schedule and depends mainly on the embryonic age of the healthy, successfully implanted conceptus. The appearance of hCG in maternal serum is used to assess the time of clinically detectable implantation. bhCG has provided the best sensitivity and specificity for detection of normal and pathological pregnancies. After IVF, early pregnancy loss or multiple gestations may be predicted with high sensitivity and specificity by using cut-off values of serum hCG. The median HCG concentration was 116 IU/l in viable pregnancies and 31 IU/l in nonviable pregnancies. The median hCG concentration in twin pregnancies was almost double that in singleton pregnancies (201 IU/l vs 116 IU/l). Thus we can reassure normally pregnant patients as well as filter and manage those with nonviable outcomes more efficiently.

scholarly journals Early-pregnancy prediction of risk for pre-eclampsia using maternal blood leptin/ceramide ratio: discovery and confirmation

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e050963
Author(s):  
Qianyang Huang ◽  
Shiying Hao ◽  
Jin You ◽  
Xiaoming Yao ◽  
Zhen Li ◽  
...  
Keyword(s):  
Placental Tissue ◽  
Maternal Blood ◽  
Maternal Serum ◽  
Ratio Test ◽  
Uncomplicated Pregnancy ◽  
Longitudinal Measurement ◽  
Longitudinal Measurements ◽  
Longitudinal Observation ◽  
Tandem Mass Spectrometric ◽  
Plgf Ratio

ObjectiveThis study aimed to develop a blood test for the prediction of pre-eclampsia (PE) early in gestation. We hypothesised that the longitudinal measurements of circulating adipokines and sphingolipids in maternal serum over the course of pregnancy could identify novel prognostic biomarkers that are predictive of impending event of PE early in gestation.Study designRetrospective discovery and longitudinal confirmation.SettingMaternity units from two US hospitals.ParticipantsSix previously published studies of placental tissue (78 PE and 95 non-PE) were compiled for genomic discovery, maternal sera from 15 women (7 non-PE and 8 PE) enrolled at ProMedDx were used for sphingolipidomic discovery, and maternal sera from 40 women (20 non-PE and 20 PE) enrolled at Stanford University were used for longitudinal observation.Outcome measuresBiomarker candidates from discovery were longitudinally confirmed and compared in parallel to the ratio of placental growth factor (PlGF) and soluble fms-like tyrosine kinase (sFlt-1) using the same cohort. The datasets were generated by enzyme-linked immunosorbent and liquid chromatography-tandem mass spectrometric assays.ResultsOur discovery integrating genomic and sphingolipidomic analysis identified leptin (Lep) and ceramide (Cer) (d18:1/25:0) as novel biomarkers for early gestational assessment of PE. Our longitudinal observation revealed a marked elevation of Lep/Cer (d18:1/25:0) ratio in maternal serum at a median of 23 weeks’ gestation among women with impending PE as compared with women with uncomplicated pregnancy. The Lep/Cer (d18:1/25:0) ratio significantly outperformed the established sFlt-1/PlGF ratio in predicting impending event of PE with superior sensitivity (85% vs 20%) and area under curve (0.92 vs 0.52) from 5 to 25 weeks of gestation.ConclusionsOur study demonstrated the longitudinal measurement of maternal Lep/Cer (d18:1/25:0) ratio allows the non-invasive assessment of PE to identify pregnancy at high risk in early gestation, outperforming the established sFlt-1/PlGF ratio test.

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