A 29-year-old primigravida at 28 weeks presents with BP 155/105 mmHg. sFlt-1:PlGF ratio is requested. Which ratio value best identifies a woman who is UNLIKELY to develop pre-eclampsia within 4 weeks according to current evidence?

• A sFlt-1:PlGF ratio 38–85
• B sFlt-1:PlGF ratio > 85
• C sFlt-1:PlGF ratio > 110
• D sFlt-1:PlGF ratio < 38 ✓

Explanation

The PROGNOSIS trial established that an sFlt-1:PlGF ratio < 38 has a high negative predictive value (99.3%) for ruling out pre-eclampsia within 1 week, and values ≤ 38 are generally associated with very low risk over 4 weeks. Ratios between 38 and 85 indicate intermediate risk, and > 85 predicts high short-term risk. This biomarker helps clinicians safely discharge women with suspected pre-eclampsia.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.