Regarding the sFlt-1/PlGF ratio in pre-eclampsia prediction, a ratio > 38 before 34 weeks gestation has which clinical utility according to PROGNOSIS study data?
- A Confirms pre-eclampsia diagnosis with 100% specificity
- B Rules out development of pre-eclampsia within 1 week with negative predictive value ~99% ✓
- C Predicts need for caesarean section
- D Guides timing of corticosteroid administration only
Correct answer: B. Rules out development of pre-eclampsia within 1 week with negative predictive value ~99%
Explanation
The PROGNOSIS study demonstrated that an sFlt-1/PlGF ratio ≤ 38 has a negative predictive value of ~99.3% for ruling out pre-eclampsia within the subsequent 1 week in women with suspected pre-eclampsia at 24–36+6 weeks. Conversely, a ratio > 38 has a positive predictive value of ~36.7% for developing pre-eclampsia within 4 weeks. It aids triage rather than confirming diagnosis or guiding steroid timing.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.