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Periodic assessment of plasma sFlt-1 and PlGF concentrations and its association with placental morphometry in gestational hypertension (GH) - a prospective follow-up study.

Jeevaratnam K, Nadarajah VD, Judson JP, Nalliah S, Abdullah MF - BMC Pregnancy Childbirth (2010)

Bottom Line: We suggest the development of GH in women is related to defective capillarization.In demonstrating periodic changes, this study suggest the possibility of developing GH and other long term health complications as a result of prolonged exposure to sFlt-1.The correlation between PlGF levels and morphometric findings also support possible capillarization defect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Human Biology, Faculty of Medicine, International Medical University, No,126, Jalan 19/155B Bukit Jalil, 57000 Kuala Lumpur, Malaysia.

ABSTRACT

Background: Hypertensive disorders in pregnancy contributes to about 12% of maternal deaths in Malaysia and similarly worldwide. Early detection and adequate management are preventable strategies. Biochemical markers of abnormal angiogenesis would be more specific in early detection than routine blood pressure and proteinuria measurements. The aim of this study was to estimate maternal plasma PlGF and sFlt-1 levels in pregnant women with gestational hypertension at three intervals of pregnancy and correlate these biomarker levels with placental morphometry.

Methods: Venous blood samples (antepartum, intrapartum and post partum periods) were drawn to estimate for sFlt-1 and PlGF levels while placental tissue samples were examined for placental morphometry.

Results: PlGF levels were lower in gestational hypertension (GH) compared to normotensive during antepartum and intrapartum period, whereas sFlt-1 levels were elevated in GH at antepartum, intrapartum and postpartum intervals during pregnancy. An inverse relationship between these two biomarkers was observed through correlation analysis. PlGF levels were inversely correlated with total villous surface area of the placental periphery (TCsa-C) and villous capillarization (VC-C) of the placental periphery.

Conclusion: We established periodic values of for sFlt-1 and PlGF levels for the first time in an ethnically diverse Malaysian setting. We suggest the development of GH in women is related to defective capillarization. In demonstrating periodic changes, this study suggest the possibility of developing GH and other long term health complications as a result of prolonged exposure to sFlt-1. The correlation between PlGF levels and morphometric findings also support possible capillarization defect.

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Related in: MedlinePlus

Baseline levels of plasma sFlt-1 in women based on period of sampling. Baseline levels of plasma sFlt-1 were determined using ELISA. Values displayed are mean ± standard error (SE) of the three intervals (antepartum, intrapartum and postpartum), obtained from normotensive and GH women. Means with similar superscript differ significantly at P < 0.05.
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Figure 3: Baseline levels of plasma sFlt-1 in women based on period of sampling. Baseline levels of plasma sFlt-1 were determined using ELISA. Values displayed are mean ± standard error (SE) of the three intervals (antepartum, intrapartum and postpartum), obtained from normotensive and GH women. Means with similar superscript differ significantly at P < 0.05.

Mentions: The mean plasma concentration as outlined in Figure 3 showed that sFlt-1 during the antepartum interval, for GH women (n = 23) at 6731.22 ± 1440.14 pg/mL was significantly higher than normotensive women (n = 63) at 1805.98 ± 120.59 pg/mL; P = 0.000. During the intrapartum period, GH women (n = 33) also showed significantly higher, plasma sFlt-1 concentration of 10666.30 ± 1587.90 pg/mL compared to normotensive women (n = 65) at 5798.24 ± 522.99 pg/mL, (P = 0.000). Postpartum plasma sFlt-1 concentration were significantly higher in GH women (n = 18) compared to normotensive women (n = 27) (GH - 2965.39 ± 969.68 pg/mL; Normotensive - 341.44 ± 107.83 pg/mL, P = 0.002).


Periodic assessment of plasma sFlt-1 and PlGF concentrations and its association with placental morphometry in gestational hypertension (GH) - a prospective follow-up study.

Jeevaratnam K, Nadarajah VD, Judson JP, Nalliah S, Abdullah MF - BMC Pregnancy Childbirth (2010)

Baseline levels of plasma sFlt-1 in women based on period of sampling. Baseline levels of plasma sFlt-1 were determined using ELISA. Values displayed are mean ± standard error (SE) of the three intervals (antepartum, intrapartum and postpartum), obtained from normotensive and GH women. Means with similar superscript differ significantly at P < 0.05.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2958153&req=5

Figure 3: Baseline levels of plasma sFlt-1 in women based on period of sampling. Baseline levels of plasma sFlt-1 were determined using ELISA. Values displayed are mean ± standard error (SE) of the three intervals (antepartum, intrapartum and postpartum), obtained from normotensive and GH women. Means with similar superscript differ significantly at P < 0.05.
Mentions: The mean plasma concentration as outlined in Figure 3 showed that sFlt-1 during the antepartum interval, for GH women (n = 23) at 6731.22 ± 1440.14 pg/mL was significantly higher than normotensive women (n = 63) at 1805.98 ± 120.59 pg/mL; P = 0.000. During the intrapartum period, GH women (n = 33) also showed significantly higher, plasma sFlt-1 concentration of 10666.30 ± 1587.90 pg/mL compared to normotensive women (n = 65) at 5798.24 ± 522.99 pg/mL, (P = 0.000). Postpartum plasma sFlt-1 concentration were significantly higher in GH women (n = 18) compared to normotensive women (n = 27) (GH - 2965.39 ± 969.68 pg/mL; Normotensive - 341.44 ± 107.83 pg/mL, P = 0.002).

Bottom Line: We suggest the development of GH in women is related to defective capillarization.In demonstrating periodic changes, this study suggest the possibility of developing GH and other long term health complications as a result of prolonged exposure to sFlt-1.The correlation between PlGF levels and morphometric findings also support possible capillarization defect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Human Biology, Faculty of Medicine, International Medical University, No,126, Jalan 19/155B Bukit Jalil, 57000 Kuala Lumpur, Malaysia.

ABSTRACT

Background: Hypertensive disorders in pregnancy contributes to about 12% of maternal deaths in Malaysia and similarly worldwide. Early detection and adequate management are preventable strategies. Biochemical markers of abnormal angiogenesis would be more specific in early detection than routine blood pressure and proteinuria measurements. The aim of this study was to estimate maternal plasma PlGF and sFlt-1 levels in pregnant women with gestational hypertension at three intervals of pregnancy and correlate these biomarker levels with placental morphometry.

Methods: Venous blood samples (antepartum, intrapartum and post partum periods) were drawn to estimate for sFlt-1 and PlGF levels while placental tissue samples were examined for placental morphometry.

Results: PlGF levels were lower in gestational hypertension (GH) compared to normotensive during antepartum and intrapartum period, whereas sFlt-1 levels were elevated in GH at antepartum, intrapartum and postpartum intervals during pregnancy. An inverse relationship between these two biomarkers was observed through correlation analysis. PlGF levels were inversely correlated with total villous surface area of the placental periphery (TCsa-C) and villous capillarization (VC-C) of the placental periphery.

Conclusion: We established periodic values of for sFlt-1 and PlGF levels for the first time in an ethnically diverse Malaysian setting. We suggest the development of GH in women is related to defective capillarization. In demonstrating periodic changes, this study suggest the possibility of developing GH and other long term health complications as a result of prolonged exposure to sFlt-1. The correlation between PlGF levels and morphometric findings also support possible capillarization defect.

Show MeSH
Related in: MedlinePlus