sFlt-1/PlGF ratio is used as a biomarker in pre-eclampsia prediction. A value of sFlt-1/PlGF ≤38 at 24–37 weeks has what clinical significance?
- A Rules out development of pre-eclampsia within the next 1 week with high negative predictive value (>99%) ✓
- B Confirms the diagnosis of pre-eclampsia
- C Predicts eclampsia within 24 hours
- D Indicates the need for immediate delivery
Correct answer: A. Rules out development of pre-eclampsia within the next 1 week with high negative predictive value (>99%)
Explanation
The sFlt-1 (soluble fms-like tyrosine kinase-1) to PlGF (placental growth factor) ratio is an angiogenic biomarker. An sFlt-1/PlGF ratio ≤38 between 24 and 37 weeks has a very high negative predictive value (>99%) for ruling out development of pre-eclampsia within the next 7 days (PROGNOSIS study, 2016). Ratios >85 (or >110 after 34 weeks by some cutoffs) are associated with imminent severe pre-eclampsia. This test helps triage which women can be safely managed outpatient.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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