How is the ratio of soluble fms-like tyrosine kinase I (sFlt-1) to placental growth factor (PlGF) used in the diagnosis of HELLP syndrome in preeclampsia?

Updated: Nov 29, 2018
  • Author: Kee-Hak Lim, MD; Chief Editor: Ronald M Ramus, MD  more...
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Answer

A multicenter, prospective observational study of the ratio of sFlt-1 to PlGF in women with a clinical suspicion of preeclampsia or HELLP syndrome, who were between 24 and 37 weeks' gestational age, has demonstrated that an sFlt-1 to PlGF ratio of 38 or lower to have important predictive value [58] : An sFlt-1:PlGF ratio of 38 or lower had a negative predictive value of 99.3% (95% confidence interval [CI], 97.9 to 99.9), suggesting an extremely unlikely development of preeclampsia or HELLP within 1 week. However, the positive predictive value of an sFlt-1:PlGF ratio above 38 for a diagnosis of preeclampsia within 4 weeks was 36.7% (95% CI, 28.4 to 45.7). The authors concluded that an sFlt-1:PlGF ratio of 38 or lower can be used to predict the short-term absence of preeclampsia in women in whom the syndrome is suspected clinically. [58]


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