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Background <p>Early-onset fetal growth restriction (FGR) may result from genetic abnormalities, uteroplacental insufficiency, or constitutional smallness, with differentiation often difficult in the absence of maternal hypertension or abnormal genetic findings. The sFlt-1/PlGF ratio has emerged as a potential marker of placental dysfunction.</p> Methods <p>This single-center case series evaluated the clinical utility of the sFlt-1/PlGF ratio in pregnancies with early-onset FGR. Maternal characteristics, hypertensive disorders, and perinatal outcomes were analyzed.</p> Results <p>All patients had elevated sFlt-1/PlGF ratios (129.31–817.39). One patient had chronic hypertension, four developed gestational hypertension at least two weeks after FGR diagnosis, and four remained normotensive. Four pregnancies resulted in intrauterine demise. Among five live births, one neonate died, two required ongoing neonatal intensive care, and two were discharged after prolonged NICU stays. Elevated ratios were associated with placental insufficiency and adverse perinatal outcomes.</p> Conclusion <p>The sFlt-1/PlGF ratio may help identify uteroplacental dysfunction in early-onset FGR and reduce reliance on costly genetic testing when aneuploidy screening is normal. Larger studies are needed to defi ne thresholds, optimal timing,and clinical utility.</p>

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Can the sFlt-1/PlGF Ratio be Incorporated into Routine Testing Protocols for Early-Onset Fetal Growth Restriction?

  • 期刊论文

  • 发表日期：

    2026年6月1日

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  • K. Aparna Sharma,
  • Tanisha Gupta,
  • Vatsla Dadhwal,
  • Anubhuti Rana

摘要

Background

Early-onset fetal growth restriction (FGR) may result from genetic abnormalities, uteroplacental insufficiency, or constitutional smallness, with differentiation often difficult in the absence of maternal hypertension or abnormal genetic findings. The sFlt-1/PlGF ratio has emerged as a potential marker of placental dysfunction.

Methods

This single-center case series evaluated the clinical utility of the sFlt-1/PlGF ratio in pregnancies with early-onset FGR. Maternal characteristics, hypertensive disorders, and perinatal outcomes were analyzed.

Results

All patients had elevated sFlt-1/PlGF ratios (129.31–817.39). One patient had chronic hypertension, four developed gestational hypertension at least two weeks after FGR diagnosis, and four remained normotensive. Four pregnancies resulted in intrauterine demise. Among five live births, one neonate died, two required ongoing neonatal intensive care, and two were discharged after prolonged NICU stays. Elevated ratios were associated with placental insufficiency and adverse perinatal outcomes.

Conclusion

The sFlt-1/PlGF ratio may help identify uteroplacental dysfunction in early-onset FGR and reduce reliance on costly genetic testing when aneuploidy screening is normal. Larger studies are needed to defi ne thresholds, optimal timing,and clinical utility.