The sFlt-1 to PlGF ratio is used in predicting pre-eclampsia. Which of the following best describes its role in clinical practice?
- A A ratio >38 reliably rules out pre-eclampsia within the next 7 days
- B It is used only after 37 weeks gestation
- C A ratio ≤38 rules out pre-eclampsia onset within the next 7 days with high negative predictive value ✓
- D A ratio >200 is required before initiating antihypertensives
Correct answer: C. A ratio ≤38 rules out pre-eclampsia onset within the next 7 days with high negative predictive value
Explanation
The sFlt-1:PlGF ratio ≤38 has a very high negative predictive value (>99%) for ruling out pre-eclampsia in the subsequent 7 days, useful in women presenting with suspected pre-eclampsia before 37 weeks. A ratio >38 supports the diagnosis but does not independently trigger treatment thresholds. Antihypertensive initiation is based on BP thresholds, not angiogenic markers.
Reference: Williams Obstetrics, 26th ed.
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