Preeclampsia sFlt-1/PIGF (Soluble fms-Like Tyrosine Kinase 1/ Placental Growth Factor) Ratio, Serum (Misc – LAB000, MayoID: PERA)
Preeclampsia sFlt-1/PlGF ratio should only be ordered in women who meet specific inclusion criteria.
- Soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) are angiogenic placental proteins. Their concentrations are promising biomarkers for risk stratification of preeclampsia (PE).
- The sFlt-1/PlGF ratio is used in the risk assessment of patients with clinical signs and symptoms consistent with development of PE with severe features. Based on data from the “Preeclampsia Risk Assessment: Evaluation of Cut-offs to Improve Stratification” (PRAECIS) trial (1) a sFlt-1/PIGF ratio ≥ 40 indicates a high risk for progression to PE with severe features within 2 weeks.
- However, according to the American College of Obstetricians and Gynecologists, there is insufficient data to recommend management strategies after a positive or negative test result (2).
- The sFlt-1/PlGF ratio should not be used in patients who do not meet inclusion criteria for the PRAECIS trial.
- The sFlt-1/PlGF ratio should supplement, but not replace, current clinical criteria for diagnosing or excluding a diagnosis of preeclampsia with severe features.
- Use of the sFlt/PlGF ratio should be strictly limited to the criteria from the PRAECIS clinical trial:
- Singleton pregnancy
- Gestational age between 23 and 34+6/7 weeks
- Hospitalized for a hypertensive disorder of pregnancy
- Test ordered within 2 weeks of presentation
- Has not received anticoagulation therapy
- Thadhani R, Lemoine E, Rana S, et al., Circulating angiogenic factor levels in hypertensive disorders of pregnancy. NEJM. 2022;1 (12).
- Biomarker prediction of preeclampsia with severe features. ACOG Practice Bulletin, Number 222 update. Obstet Gyneco;June 2024.
Written by: Hannah M. Brown, PhD
Reviewed by: Ann M. Gronowski, PhD
Last Edited: 2024-08-28
Last Reviewed: 2024-08-28