Pre-ecla (sflt/plgf Ratio)

Preeclampsia is a pregnancy complication characterized by high blood pressure. Often signs of organ damage are also seen, most often the liver and kidneys. If left untreated is cause serious even fatal consequences to mother and baby. The best treatment is delivery. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had been normal. However, it may be possible that preeclampsia is diagnosed early in pregnancy. In such cases, it is considered as high risk pregnancy and many other medications and precautions are necessary.

Signs and symptoms of preeclampsia may include:

• Excess protein in your urine (proteinuria) or additional signs of kidney problems
• Severe headaches
• Changes in vision, including temporary loss of vision, blurred vision or light sensitivity
• Upper abdominal pain, usually under your ribs on the right side
• Nausea or vomiting
• Decreased urine output
• Decreased levels of platelets in your blood (thrombocytopenia)
• Impaired liver function
• Shortness of breath, caused by fluid in your lungs

Severity of preecalmsia and time of detection plays critical role in management. Ie. More severe condition and preeclamsia occurring early in pregnancy pose greater risks for you and your baby. Preeclampsia may require induced labor and delivery. There are many other complications that may occur with preeclamsia pregnancy such as

• Fetal growth restriction: Preeclampsia affects the arteries carrying blood to the placenta. Which inturn loweres blood and nutrient supply to baby. This can lead to slow growth known as fetal growth restriction, low birth weight or preterm birth.
• Preterm birth: early delivery to save mother but can lead to breathing and other problems for your baby.
• Placental abruption: placenta separates from uterus before delivery. It can cause heavy bleeding, which can be life-threatening.
• HELLP syndrome.HELLP — which stands for hemolysis (the destruction of red blood cells), elevated liver enzymes and low platelet count — syndrome is a more severe form of preeclampsia, and can rapidly become life-threatening for both you and your baby.
• Eclampsia: it preeclampsia plus seizures — can develop.
• Other organ damage.Preeclampsia may result in damage to the kidneys, liver, lung, heart, or eyes, and may cause a stroke or other brain injury. The amount of injury to other organs depends on the severity of preeclampsia.
• Cardiovascular disease.Having preeclampsia may increase your risk of future heart and blood vessel (cardiovascular) disease.

Make sure you attend your prenatal visits so that your care provider can monitor your blood pressure. If you experience any of the symptoms above, please contact your doctor immediately, who can assess your risk better and advise you to the tests.

This test includes the following

• Placental Growth Factor: produced by placenta. important marker for Preeclampsia.
• Soluble Fms-Like Tyrosine Kinase-1: produced by placenta. important marker for Preeclampsia.
• Sflt-1/PLGF Ratio: these both factors are opposing each other. Ie preecalpsia patient will high lower PLGF and higher SFLT-1. Hence, their ratio is critical to access risk and complication of preeclamsia.

Normal range: valus of PLGF increases in the beginning while decreases towards end of pregnancy and value of SFLT-1 in lower in beginning and increases towards end of pregnancy.

Interpretation

All of the above factors together offer predication, diagnosis and treatment for preeclamsia. Generally lower PLGF is observed in patients who develop preeclamsia. However, other factors such as weeks of pregnancy, pre-existing conditions of mother, maternal screening tests and other markers tests are also required for effective diagnosis of the condition. It is always advisable to consult your doctor, to understand risk and management of the disease in your case.