Interpretation
The purpose of prolonging pregnancy duration in patients with clinical suspicion of early-onset preeclampsia is the reduction of newborn morbidity by decreasing the number of preterm deliveries and their severity. This potential benefit is counterbalanced by potential life-threatening maternal complications. Despite published randomized clinical trials (21-23), the potential benefit of prolonging pregnancy duration is still unclear. Currently, the decision of inducing delivery depends on clinical signs and fetal well-being markers, which may be insufficient to prevent severe complications. The emergence of proangiogenic and antiangiogenic markers may be a valuable opportunity to select pregnancies that can be prolonged without major risks and to standardize the decision-making in preeclampsia management. An improvement in this patient selection is proposed in the present study.
A study by Verlohren et al. (24) identified the cut-off value of 655 for the sFlt-1/PlGF ratio that was associated with early-onset preeclampsia leading to imminent delivery (within 48h). A posterior publication (25) did not confirm the clinical relevance of the previous described cut-off value. When applying the sFlt-1/PlGF ratio cut-off of 655 to study population for predicting early-onset pre-eclampsia diagnosis leading to delivery within one week, the developed prognostic prediction tool showed superior test performance.