The role of placental growth factor, soluble-Fms-like tyrosine kinase-1 and diastolic notch uterine artery to predict the early onset of preeclampsia
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Preeclampsia is a global problem that affects 2-8% of pregnancies, and an estimated 8.3 million pregnant women experience preeclampsia every year. In preeclampsia there will be an increase in sFlt-1 levels and decreased levels PlGF. This condition will cause disorders of vasculogenesis and angiogenesis in fetomaternal circulation which will eventually lead to preeclampsia syndrome such as proteinuria, hypertension and endothelial dysfunction. The study used both an analytic study design and nested case control. The study was conducted at Sundari Hospital, Tanjung Mulia Mitra Medika Hospital, Bunda Thamrin Hospital and private clinic, from March to November 2018 with a sample of 70 research subjects. Many as 50% of subjects have characteristics without a diastolic notch. A total of 27 subjects (38.6%) had unilateral diastolic notch and 8 subjects (11.4%) had bilateral diastolic notch. Pulsatility index of uterine artery with 1.228 cut-off points, Area Under Curve (AUC) of 78.2% (95% CI 59.3% - 97%), sensitivity 80%, specificity 64.6%. PIGF levels with a 441 pg/ml cut-off point, Area Under Curve (AUC) amounted to 82.5% (95% CI 61.5% - 100%), sensitivity 80%, specificity 87.7%. The level of sFlt-1 with a cut-off point of 10087.5 pg / ml, Area Under Curve (AUC) was 81.2% (95% CI 63.6% - 98.9%), sensitivity 80%, specificity 67.7 %. From these results in pregnant women of 22-24 weeks of pregnancy, the levels of PIGF and sFlt-1 can be a predictor of early onset preeclampsia. Examination of PIGF levels alone is sufficient as a predictor of early onset preeclampsia.
KEY WORDS: Placental growth factor - Uterine artery pulsatile index - Soluble-Fms-like tyrosine kinase-1 - Preeclampsia.