Document Detail


Circulating angiogenic factors and risk of adverse maternal and perinatal outcomes in twin pregnancies with suspected preeclampsia.
MedLine Citation:
PMID:  22753210     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate whether angiogenic factor levels correlate with preeclampsia-related adverse maternal and perinatal outcomes in women with twin pregnancy, we studied 79 women with suspected preeclampsia in the 3rd trimester. Antiangiogenic soluble fms-like tyrosine kinase-1 (sFlt-1) and proangiogenic placental growth factor (PlGF) were measured at presentation on an automated platform. An adverse outcome was defined as hemolysis, elevated liver enzymes, and low platelets syndrome; disseminated intravascular coagulation; abruption; pulmonary edema; cerebral hemorrhage; maternal, fetal, and neonatal death; eclampsia; acute renal failure; small for gestational age; and indicated delivery. All outcomes were ascertained 2 weeks after initial evaluation. Comparing the 52 women (65.8%) who experienced an adverse outcome with the 27 women (34.2%) without an adverse outcome, the median sFlt-1 was elevated (11461.5 pg/mL [8794.0-14847.5] versus 7495.0 pg/mL [3498.0-10482.0; P=0.0004]), PlGF was reduced (162.5 pg/mL [98.0-226.5] versus 224.0 pg/mL [156.0-449.0]; P=0.005), and sFlt-1/PlGF ratio was elevated (74.2 [43.5-110.5] versus 36.2 [7.1-71.3]; P=0.0005). Among those presenting <34 weeks (n=40), the difference in sFlt-1/PlGF ratio was more striking (97.7 [76.6-178.1] versus 31.7 [6.5-48.7]; P=0.001). Addition of sFlt-1/PlGF to the highest systolic blood pressure and proteinuria improved prediction of adverse outcomes. We conclude that in women with twin pregnancy and suspected preeclampsia, the sFlt-1/PlGF ratio at the time of initial evaluation is associated with subsequent adverse maternal and perinatal outcomes. These findings are similar to those in singleton pregnancies and may implicate common pathogenic pathways.
Authors:
Sarosh Rana; Michele R Hacker; Anna Merport Modest; Saira Salahuddin; Kee-Hak Lim; Stefan Verlohren; Frank H Perschel; S Ananth Karumanchi
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-07-02
Journal Detail:
Title:  Hypertension     Volume:  60     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-20     Completed Date:  2012-12-13     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  451-8     Citation Subset:  IM    
Affiliation:
Division of Maternal Fetal Medicine/Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Kirstein 382, Boston, MA 02215, USA. srana1@bidmc.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Kidney Injury / epidemiology
Adult
Biological Markers / blood
Cohort Studies
Female
Fetal Death / epidemiology
Humans
Infant, Newborn
Pre-Eclampsia / blood*
Predictive Value of Tests
Pregnancy
Pregnancy Complications, Cardiovascular / blood*
Pregnancy Outcome*
Pregnancy Proteins / blood*
Pregnancy Trimester, Third*
Pregnancy, Twin*
Prospective Studies
Pulmonary Edema / epidemiology
Risk Factors
Vascular Endothelial Growth Factor Receptor-1 / blood*
Grant Support
ID/Acronym/Agency:
UL1 RR 025758/RR/NCRR NIH HHS; //Howard Hughes Medical Institute; //Howard Hughes Medical Institute
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Pregnancy Proteins; 144589-93-5/placenta growth factor; EC 2.7.10.1/FLT1 protein, human; EC 2.7.10.1/Vascular Endothelial Growth Factor Receptor-1
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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