Evaluation of sFlt-1/PlGF Ratio and Uterine Artery Doppler in Stratifying Early and Late-Onset Preeclampsia in High-Risk Pregnancies

Abstract

Background: Preeclampsia (PE) is a significant hypertensive disorder of pregnancy, leading to maternal and fetal morbidity. Early detection and stratification of preeclampsia are crucial for high-risk pregnancies. Objective: This study aims to evaluate the efficacy of the sFlt-1/PlGF ratio and uterine artery Doppler in predicting and stratifying early and late-onset preeclampsia in high-risk pregnancies. Methods: A prospective cohort study was conducted at the Department of Obstetrics and Gynecology, University of Utah Health, from January 2020 to June 2022. A total of 122 high-risk pregnant women were enrolled. The sFlt-1/PlGF ratio was measured through blood samples, and uterine artery Doppler assessments were performed using ultrasonography. The diagnostic accuracy of these tests was evaluated for early and late-onset preeclampsia. Results: The study revealed a sensitivity of 85.4% for the sFlt-1/PlGF ratio and 78.6% for uterine artery Doppler in identifying early-onset preeclampsia. In late-onset cases, sensitivity increased to 92.1% for the sFlt-1/PlGF ratio and 87.3% for uterine artery Doppler. The combined use of both tests had an overall sensitivity of 89.2%, specificity of 82.5%, and a positive predictive value of 75.6%. The mean sFlt-1/PlGF ratio was 95.4 (±22.7), with a p-value of 0.03, indicating significant correlation with preeclampsia severity. Conclusion: The sFlt-1/PlGF ratio and uterine artery Doppler are highly effective in stratifying early and late-onset preeclampsia in high-risk pregnancies, aiding in better clinical management.