Utilidad del ratio sFlt-1/PIGF en el cribado de preeclampsia precoz en la población gestante de La Rioja

Resumen

Aim. To evaluate the usefulness of the sFlt-1/PIGF ratio at 36 week of pregnancy to dismiss early preeclampsia. Material and methods. Monocentric cohort study carried out between September 2018 and September 2019. The reference population of our study were all pregnant women in the Autonomous Community of La Rioja whose healthcare is centralized in San Pedro’s Hospital. The target population were all pregnant women with a single gestation who were asymptomatic at the time of screening (morphologic ultrasound at 21st week) and in whom the mean of IP AUt was pathological (> 95th percentile for low-risk pregnant women repeatedly at 21st and 26th week or > 75th percentile for high-risk pregnant women at 21st week). Results. 27 women met the inclusion criteria of our reference population (1896 pregnant women). From these 27 women, 22 of them presented a value of the ratio sFlt-1 / PIGF less than 38, showing a specificity and a negative predictive value of 88% and 100% respectively to dismiss preeclampsia, continuing a low-risk gestational control. Two pregnant women presented a ratio greater than 85 and both presented adverse events related to the placental insufficiency they suffered, premature detachment of the normal placenta and HELLP syndrome after fetal death. The risk factors for preeclampsia in the first trimester screening and the epidemiological characteristics of the patients with this condition were compared with those who did not develop the disease without finding statistically significant differences. Conclusion. The implementation of a screening based on epidemiological factors in the first trimester together with the Doppler determination mean of IP AUt and the sFlt-1 / PIGF ratio in our population seems to be useful to dismiss early preeclampsia, since it has a high specificity and a negative predictive value, similar to those reported in the literature.