Interpretation
The purpose of prolonging pregnancy duration in patients with clinical
suspicion of early-onset preeclampsia is the reduction of newborn
morbidity by decreasing the number of preterm deliveries and their
severity. This potential benefit is counterbalanced by potential
life-threatening maternal complications. Despite published randomized
clinical trials (21-23), the potential benefit of prolonging pregnancy
duration is still unclear. Currently, the decision of inducing delivery
depends on clinical signs and fetal well-being markers, which may be
insufficient to prevent severe complications. The emergence of
proangiogenic and antiangiogenic markers may be a valuable opportunity
to select pregnancies that can be prolonged without major risks and to
standardize the decision-making in preeclampsia management. An
improvement in this patient selection is proposed in the present study.
A study by Verlohren et al. (24) identified the cut-off value of 655 for
the sFlt-1/PlGF ratio that was associated with early-onset preeclampsia
leading to imminent delivery (within 48h). A posterior publication (25)
did not confirm the clinical relevance of the previous described cut-off
value. When applying the sFlt-1/PlGF ratio cut-off of 655 to study
population for predicting early-onset pre-eclampsia diagnosis leading to
delivery within one week, the developed prognostic prediction tool
showed superior test performance.