Title: sFlt-1/PLGF Ratio: A Promising Marker for Early Detection of Preeclampsia in the Second and Third Trimester

• Dr Mandeep Kaur,*  
• Sahiba Kukreja,  
• Siddhant Arora,  
• Sukhjeet Kaur,  
• MANMEET Kaur GILL

Abstract

Abstract Introduction: Preeclampsia (PE), characterized by endothelial dysfunction, remains a significant concern in obstetrics due to its association with maternal and fetal morbidity and mortality. One significant contributor to the clinical manifestations of PE is the imbalance in the placental release of various angiogenesis regulatory factors into the maternal circulation. Low levels of the pro-angiogenic biomarker Placental Growth Factor (PLGF) and high levels of antiangiogenic biomarker sFlt-1 (soluble Fms like tyrosine kinase -1) levels are detectable several weeks before the clinical presentation of PE, making them a promising marker for early diagnosis. Aim: This study investigates the utility of the sFlt-1/PLGF ratio in predicting and diagnosing preeclampsia during the second and third trimesters of pregnancy. Material and Methods: A prospective cohort study was conducted with 150 study participants comprising normotensive controls and preeclamptic cases, diagnosed based on blood pressure and proteinuria criteria. Serum samples collected in the second trimester (24-28 weeks) and third trimester (>28 weeks) were analyzed for PLGF and sFlt-1 levels using ELISA kit method. The sFlt-1/PLGF ratio was calculated and evaluated for its diagnostic accuracy through ROC curve analysis. Results: Significantly lower PLGF levels and higher sFlt-1 levels in preeclamptic pregnancies compared to normotensive pregnancies were seen in both trimesters (p < 0.001). The sFlt-1/PLGF ratio was markedly elevated in preeclampsia, showing strong predictive characteristics with an AUC of 0.929 (sensitivity 90%, specificity 90%) in the second trimester and an AUC of 0.986 (sensitivity 90%, specificity 96.7%) in the third trimester. These findings highlight the potential of the sFlt-1/PLGF ratio as a biomarker for early detection and risk stratification in pregnancies complicated by preeclampsia. Keywords: diagnostic marker, sFlt-1/PLGF ratio, endothelial dysfunction, angiogenic imbalance pregnancy complications

Keywords

Keywords: diagnostic marker, sFlt-1/PLGF ratio, endothelial dysfunction, angiogenic imbalance pregnancy complications Running Title : "sFlt-1/PLGF Ratio: Early Preeclampsia Detection Marker"