Рецептор фактора роста эндотелия сосудов первого типа (sFlt-1)

Placental Growth Factor (PlGF) testing aids the early identification of preeclampsia during pregnancy, including before sustained hypertension and proteinuria are evident. The assay is used to assess risk in pregnant patients with established risk factors and can support clinical decision-making when preeclampsia is a concern. PlGF measurement is often interpreted in conjunction with clinical findings and may be combined with other biomarkers, such as soluble fms-like tyrosine kinase-1 (sFlt-1) and pregnancy-associated plasma protein A (PAPP-A).

Preeclampsia is a hypertensive disorder of pregnancy characterized by new-onset elevated blood pressure and proteinuria after 20 weeks’ gestation, with resolution by 6 weeks postpartum. Per the International Society for the Study of Hypertension in Pregnancy (ISSHP), the diagnosis is considered when blood pressure exceeds 140/90 mm Hg on two occasions separated by more than 4 hours and protein excretion is greater than 0.3 g per 24 hours (or more than 30 mg/mmol by protein-to-creatinine ratio). It affects approximately 2%–8% of pregnancies. Clinical severity varies: outcomes are generally favorable when mild disease develops after 36 weeks, whereas early-onset disease (before 33 weeks) or preeclampsia occurring alongside comorbid conditions is associated with substantially higher maternal and fetal risk. Current models implicate impaired trophoblast differentiation and invasion early in gestation, leading to placental maldevelopment. This triggers oxidative stress and a systemic inflammatory response, along with endothelial dysfunction in the placental vasculature and resultant systemic hypertension. Risk factors include maternal age over 40 years, obesity, a personal or family history of preeclampsia, antiphospholipid syndrome, insulin-dependent diabetes mellitus, multiple gestation, nulliparity, and preexisting chronic hypertension or kidney disease. Early recognition is central to management, and laboratory markers can support detection prior to overt hypertension or proteinuria. Placental Growth Factor (PlGF) is a proangiogenic member of the vascular endothelial growth factor (VEGF) family produced by trophoblasts and is integral to placental vascular development. In uncomplicated pregnancies, PlGF concentrations rise progressively to about 30 weeks’ gestation. Preeclampsia is associated with low PlGF levels, and a decline in PlGF can precede clinical manifestations. In one study, low PlGF between 20 and 35 weeks indicated a high likelihood of preeclampsia within the subsequent 2 weeks. These changes are viewed as secondary to evolving placental insufficiency rather than causal. Interpretation requires adjustment for factors that influence measured concentrations—gestational age, maternal weight and age, ethnicity, cigarette smoking, conception by in vitro fertilization, nulliparity, and preexisting diabetes—commonly by expressing results as multiples of the mean (MoM), analogous to approaches used for alpha-fetoprotein. PlGF testing may be complemented by assays for sFlt-1 and PAPP-A when investigating suspected preeclampsia.