diagnostic utility of soluble fms like

Diagnostic utility of soluble fms-like tyrosine kinase 1 and soluble

endoglin in hypertensive diseases of pregnancy

Salahuddin S, Lee Y, Vadnais M, Sachs BP, Karumanchi SA, Lim KH.

Department of Obstetrics, Gynecology, and Reproductive Biology, Beth

Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,

USA.

OBJECTIVE:

The objective of this pilot study was to evaluate the clinical utility

of soluble fms-like tyrosine kinase 1 (sFlt 1) and soluble endoglin

(sEng) in the differential diagnosis of hypertension in late

pregnancy.

STUDY DESIGN:

We analyzed serum levels of sFlt 1 and sEng in women with gestational

hypertension (GHTN; n = 17), chronic hypertension (CHTN; n = 19),

preeclampsia (n = 19), and normal pregnancy (n = 20) in the third

trimester. We calculated the sensitivity, specificity, and positive

and negative likelihood ratio (LR) for each factor in diagnosing

preeclampsia.

RESULTS:

The sensitivity and specificity of sFlt 1 in differentiating

preeclampsia from normal pregnancy were 90% and 90%, respectively, and

90% and 95% for sEng. In women with GHTN, they were 79% and 88% for

sFlt 1; 84% and 88% for sEng; 90% and 63% for uric acid. In women with

CHTN, they were 84% and 95% for sFlt 1; 84% and 79% for sEng; 68%; and

78% for uric acid. The positive LR for preeclampsia was 9 for sFlt 1

and 7 for sEng in women with normal pregnancy; in women with GHTN; 6.7

for sFlt 1 and 7.2 for sEng; in CHTN, 16 for sFlt 1 and 4 for sEng.

Serum uric acid had a positive LR of only 2.4 in women with GHTN and

3.1 in women with CHTN.

CONCLUSION:

Both sFlt 1 and sEng may prove useful in differentiating preeclampsia

from other hypertensive diseases of pregnancy. A prospective cohort

study should be performed determine the clinical utility of measuring

these proteins.

Source: Am J Obstet Gynecol. 2007 Jul;197(1):28.e1-6. Related Articles