Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Madrid, Spain; and the Department of Obstetrics, Charité University Medicine, Berlin, Germany.
Obstet Gynecol. 2014 Aug;124(2 Pt 1):265-273. doi: 10.1097/AOG.0000000000000367.
To characterize the values of the soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio in pregnancies with fetal growth restriction with or without concurrent preeclampsia or hemolysis, elevated liver enzymes and low platelets syndrome (HELLP) and in pregnancies with normally grown fetuses with or without concurrent preeclampsia or HELLP.
This is a case-control study performed in two centers (Berlin and Madrid) consisting of 171 singleton pregnancies complicated by fetal growth restriction (n=27), preeclampsia or HELLP (n=105) or preeclampsia or HELLP and fetal growth restriction (n=39) pairwise matched by gestational age with 171 healthy control pregnancies. Automated measurement of sFlt-1 and PlGF in maternal serum samples was performed after diagnosis (cases) and in gestational-age matched healthy control samples. Samples were analyzed for two timeframes: before and at or after 34 weeks of gestation.
Pregnancies with fetal growth restriction, preeclampsia or HELLP, and preeclampsia or HELLP and fetal growth restriction showed higher median values of sFlt-1/PlGF ratio than control pregnancies both before 34 weeks of gestation (90, 231, 514, and 3, respectively, P<.001) and at or after 34 weeks of gestation (117, 66, 165, and 11, respectively, P<.001). The differences among the case subgroups were not statistically different.
Fetal growth restriction is characterized by elevated maternal sFlt-1/PlGF ratio, reaching values as high as those observed in preeclampsia or HELLP.
II.
探讨伴有或不伴有子痫前期或溶血尿毒综合征（HELLP）的胎儿生长受限（FGR）、伴有或不伴有子痫前期或 HELLP 的 FGR 患者以及单纯胎儿生长受限或伴有子痫前期或 HELLP 的正常胎儿孕妇血清中可溶性 fms 样酪氨酸激酶-1（sFlt-1）与胎盘生长因子（PlGF）比值的特征。
本病例对照研究在柏林和马德里的 2 个中心进行，共纳入 171 例单纯胎儿生长受限（n=27）、子痫前期或 HELLP（n=105）或子痫前期或 HELLP 合并 FGR（n=39）患者，按照孕龄配对纳入 171 例健康对照孕妇。在诊断（病例）后及孕龄匹配的健康对照组中，检测母血清 sFlt-1 和 PlGF 的自动测量值。样本分析分为两个时间范围：妊娠 34 周前和妊娠 34 周时或之后。
妊娠 34 周前，胎儿生长受限、子痫前期或 HELLP、子痫前期或 HELLP 合并 FGR 患者的 sFlt-1/PlGF 比值中位数均高于对照组（90、231、514 与 3，P＜0.001），妊娠 34 周时或之后也如此（117、66、165 与 11，P＜0.001）。病例亚组之间的差异无统计学意义。
FGR 患者的母体 sFlt-1/PlGF 比值升高，与子痫前期或 HELLP 患者相似。
Ⅱ级。
