P211. The sFlt-1/PlGF ratio and its predictive value concerning time to delivery in patients with preeclampsia- Preliminary Data

Sabine Enengl (AT), Georg Grüßenberger (AT), Philip Trautner (AT), Omar Shebl (AT), Pol-Edern Le Renard (AT), Peter Oppelt (AT), Richard Mayer (AT)

[Enengl] Kepler University Hospital, Linz, [Grüßenberger] Kepler University Hospital, Linz, [Trautner] Kepler University Hospital, Linz, [Shebl] Kepler University Hospital, Linz, [Le Renard] Kepler University Hospital, Linz, [Oppelt] Kepler University Hospital, Linz, [Mayer] Kepler University Hospital, Linz

Context The outcome of preeclampsia can’t easily be predicted, its severity varies from patient to patient. Laboratory markers like the soluble fms-like tyrosine kinase (sFlt-1) and the placental growth factor (PlGF) are said to be predictive markers. A study of Verlohren et al. evaluated cutoffs determining the predictive value for time to delivery in patients with elevated sFlt-1/PlGF ratio. Objective This study compares the above findings in patients with elevated sFlt-1/PlGF ratio delivering at Kepler University Hospital, Linz. The aim of the study was to find out if the described cutoffs are also an indicator for women at risk for imminent delivery in our patients. Methods A retrospective study of all patients with preeclampsia delivering at the Kepler University Hospital in Linz/Austria from 1.1.2014 to 31.10.2017 with an elevated sFlt-1/PlGF ratio was performed. We focused on patients showing an sFlt-1/PlGF ratio higher than 655 before 34 weeks of pregnancy (group 1) and higher than 201 between 34 and 37 weeks of pregnancy (group 2). Above all we investigated the time to delivery but also characteristics like mode of birth, induction of labor, former history of preeclampsia and complications like HELLP syndrome or eclampsia. Participants Patients of all age and race with preeclampsia delivering at the Kepler University Hospital in Linz/Austria from 1.1.2014 to 31.10.2017 with an elevated sFlt-1/PlGF ratio were included. Only patients showing an incomplete data record were excluded. Interventions None Main Outcome Measure(s) Time to delivery with sFlt-1/PlGF ratio over 655 (group 1) or 201 (group 2). Result(s) In our patient collective we found 31 patients with an elevated sFlt-1/PlGF ratio over 655 before 34 weeks of pregnancy (group 1) and 29 patients with an elevated sFlt-1/PlGF ratio over 201 between 34 und 37 weeks of pregnancy (group 2). In the first group 16 patients delivered their baby within 48h (51,6%), but 15 patients remained pregnant (48,4%). In the second group 12 patients delivered within 48h (41,4%), whereas 17 patients were still pregnant (58,6%). Conclusions The sFlt-1/PlGF ratio does seem to be a predictive tool for assessing the risk of imminent delivery in patients with preeclampsia, however we could not confirm the former evaluated cutoffs. The low number of patients investigated in this study is of course a limitation. Further studies will be needed to assess the predictive value of the sFlt-1/PlGF ratio.