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Background <p>Preeclampsia (PE) is a hypertensive disorder affecting up to 8% of pregnancies and a major cause of maternal and neonatal morbidity, especially in low- and middle-income countries. Its pathogenesis involves abnormal placentation, inflammation, and angiogenic imbalance. Traditional risk assessments have limited predictive value. Emerging biomarkers—soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PLGF), and their ratio—along with uterine artery Doppler indices, offer promising early prediction tools.</p> Objective <p>To evaluate first-trimester sFlt-1, PLGF, sFlt-1/PLGF ratio, and uterine artery Doppler parameters for predicting preeclampsia and associated maternal and neonatal outcomes.</p> Methods <p>In this prospective study, 274 high-risk singleton pregnancies (10–14 weeks) were screened from September 2022 to May 2024 at S.N. Medical College, Agra. Serum sFlt-1 and PLGF were measured, and uterine artery Doppler assessed mean pulsatility index (PI) and bilateral notching. Participants were followed until delivery. Statistical analyses included ROC, chi-square, and logistic regression.</p> Results <p>An sFlt-1/PLGF ratio &gt; 20 occurred in 39.4% and correlated with early-onset and severe PE (<i>p</i> &lt; 0.001). Elevated uterine artery PI ≥ 1.5 and bilateral notching were found in 27.7% and 23.4% of cases, respectively. Combined biomarker and Doppler abnormalities were linked to higher risks of fetal growth restriction (28.5%), stillbirth (4.6%), and NICU admission (28.7%), with a combined predictive AUC of 0.95. Early aspirin use reduced severe PE and NICU admissions.</p> Conclusion <p>Integrating angiogenic biomarkers with uterine artery Doppler in the first trimester markedly improves early prediction of preeclampsia, enabling timely intervention and better maternal–neonatal outcomes.</p>

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Evaluating sFlt-1/PLGF Ratio and Uterine Artery Doppler Indices for Early Detection and Prevention of Preeclampsia in High-Risk Women: A Prospective Cohort Study in a Tertiary Teaching Hospital of Uttar Pradesh

  • 期刊论文

  • 发表日期：

    2026年1月28日

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  • Nidhi Gupta,
  • Akrishti Gupta

摘要

Background

Preeclampsia (PE) is a hypertensive disorder affecting up to 8% of pregnancies and a major cause of maternal and neonatal morbidity, especially in low- and middle-income countries. Its pathogenesis involves abnormal placentation, inflammation, and angiogenic imbalance. Traditional risk assessments have limited predictive value. Emerging biomarkers—soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PLGF), and their ratio—along with uterine artery Doppler indices, offer promising early prediction tools.

Objective

To evaluate first-trimester sFlt-1, PLGF, sFlt-1/PLGF ratio, and uterine artery Doppler parameters for predicting preeclampsia and associated maternal and neonatal outcomes.

Methods

In this prospective study, 274 high-risk singleton pregnancies (10–14 weeks) were screened from September 2022 to May 2024 at S.N. Medical College, Agra. Serum sFlt-1 and PLGF were measured, and uterine artery Doppler assessed mean pulsatility index (PI) and bilateral notching. Participants were followed until delivery. Statistical analyses included ROC, chi-square, and logistic regression.

Results

An sFlt-1/PLGF ratio > 20 occurred in 39.4% and correlated with early-onset and severe PE (p < 0.001). Elevated uterine artery PI ≥ 1.5 and bilateral notching were found in 27.7% and 23.4% of cases, respectively. Combined biomarker and Doppler abnormalities were linked to higher risks of fetal growth restriction (28.5%), stillbirth (4.6%), and NICU admission (28.7%), with a combined predictive AUC of 0.95. Early aspirin use reduced severe PE and NICU admissions.

Conclusion

Integrating angiogenic biomarkers with uterine artery Doppler in the first trimester markedly improves early prediction of preeclampsia, enabling timely intervention and better maternal–neonatal outcomes.