Role of sFlt-1/PlGF Ratio in Diagnosing Preeclampsia

Vidya Lala; Samone Franzese

VIDYA LALA, MD, Madigan Army Medical Center, Tacoma, Washington

SAMONE FRANZESE, MD, MPH, Billings Clinic, West Yellowstone, Montana

Am Fam Physician. 2024;109(5):470-471

Author disclosure: No relevant financial relationships.

Soluble fms-like tyrosine kinase-1 (sFlt-1) is a vascular endothelial growth factor and antagonist of placental growth factor (PlGF) that causes vasoconstriction and endothelial damage, which may result in preeclampsia.¹ There is no standardized value for the sFlt-1/PlGF ratio in the diagnosis or exclusion of preeclampsia.^2,3 The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine recommend against measurement of these angiogenic markers for diagnosis or exclusion of preeclampsia.⁴

Test	Indication	Population	Cost^*
sFlt-1/PlGF immunoassays†	Assist with predicting likelihood of developing preeclampsia	Asymptomatic pregnant patients between 24 weeks and 0 days' and 36 weeks and 6 days' gestation	$100

Zeisler H, Llurba E, Chantraine F, et al. Predictive value of the sFlt-1: PlGF ratio in women with suspected preeclampsia. N Engl J Med. 2016;374(1):13-22.

Verlohren S, Brenneck SP, Galindo A, et al. Clinical interpretation and implementation of the sFlt-1/PlGF ratio in the prediction, diagnosis and management of preeclampsia. Pregnancy Hypertens. 2022;27:42-50.

Liu Y, Zhao Y, Yu A, et al. Diagnostic accuracy of the soluble fms-like tyrosine kinase-1/placental growth factor ratio for preeclampsia: a meta-analysis based on 20 studies. Arch Gynecol Obstet. 2015;292(3):507-518.

Gestational hypertension and preeclampsia: ACOG practice bulletin, number 222. Obstet Gynecol. 2020;135(6):e237-e260.

Hund M, Allegranza D, Schoedl M, et al. Multicenter prospective clinical study to evaluate the prediction of short-term outcome in pregnant women with suspected preeclampsia (PROGNOSIS): study protocol. BMC Pregnancy Childbirth. 2014;14:324.

Cerdeira AS, O’Sullivan J, Ohuma EO, et al. Randomized interventional study on prediction of preeclampsia/eclampsia in women with suspected preeclampsia: INSPIRE. Hypertension. 2019;74(4):983-990.

Leaños-Miranda A, Nolasco-Leaños AG, Carrillo-Juárez RI, et al. Usefulness of the sFlt-1/PlGF (soluble fms-like tyrosine kinase-1/placental growth factor) ratio in diagnosis or misdiagnosis in women with clinical diagnosis of preeclampsia. Hypertension. 2020;76(3):892-900.

Austin Health Pathology. Austin pathology test directory: sFlt-1: PlGF. Accessed October 30, 2023. https://www.austinpathology.org.au/test-directory/1766

Stepan H, Hund M, Dilba P, et al. Elecsys and Kryptor immunoassays for the measurement of sFlt-1 and PlGF to aid preeclampsia diagnosis: are they comparable?. Clin Chem Lab Med. 2019;57(9):1339-1348.

Roche Diagnostics. Elecsys^® sFlt-1/PlGF (preeclampsia). Hoffman La Roche Ltd.; 2024. Accessed October 30, 2023. https://diagnostics.roche.com/global/en/products/params/elecsys-sflt-1-plgf-preeclampsia.html

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