According to current ACOG guidance, which serum biomarker ratio is used to rule-out pre-eclampsia within the next 1 week in women presenting with hypertension between 20–35 weeks gestation?
- A Urine protein : creatinine ratio
- B sFlt-1 : PlGF ratio ✓
- C Serum uric acid level
- D Mean arterial pressure
Correct answer: B. sFlt-1 : PlGF ratio
Explanation
The soluble FMS-like tyrosine kinase-1 to placental growth factor (sFlt-1:PlGF) ratio has a high negative predictive value for ruling out pre-eclampsia within 1 week when below 38. It reflects placental angiogenic imbalance and is now used clinically in Europe and endorsed by NICE/FIGO for prediction and triage. Urine PCR, uric acid, and MAP are supportive but not sufficiently sensitive or specific for this purpose.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.