1. Serum soluble fms like tyrosine kinase-1(sflt-1)
16-009
Serum soluble fms like tyrosine kinase-1(sflt-1)
level at third trimester of pregnancy and after one month following delivery in patients with preeclampsia
Professor Dr. Najat Abdul Razzaq Hasan (MB ChB,MSC,PhD); Assistant Professor Dr. Bushra Jaber AL – Rubayae (MB ChB,IFCMG) and Radhwan Mohammed Hussein (BSC, MSC ,PhD) .* Dept. of Chemistry & Biochemistry, College of Medicine- Al-Nahrain University:**Dept. of Gynecology,College of Medicine- Babylon University: ***Ministry of Health, Baghdad-Iraq:
Introduction: Preeclampsia (PE) is a life-threatening complication of human pregnancy that is characterized by abnormal vascular response to placentation that is associated with increased systemic vascular resistance, enhanced platelet aggregation, activation of the coagulation system, and endothelial cell dysfunction (1,2).
Objective: To investigate the third trimester level of anti
angiogenic factor soluble fms-like tyrosine kinase-1 (sFlt-1) in the sera of PE pregnant in relation to the Doppler ultrasonography indices.
Methods
35 pregnants with mild PE
35 pregnants with severe PE
35 normotensive
Postdelivery
Predelivery
The study was approved by the Higher Scientific and Ethical Committee at Al-Nahrain College of Medicine Five milliliters of venous blood samples were withdrawn from all pregnant women.
sFlt-1 was determined the
(ELISA)
Other tests
BMI
Spot urine protein/
Creatinine ratio
pulsatility index resistance index sFlt-1 concentration
total protein
Diastolic Bp
Systolic Bp
pulsatility index resistance index sFlt-1 concentration
total protein
Diastolic Bp
Systolic Bp
70 pregnants
Results:
Table 1. The mean ±SEM of maternal age, gestational age at delivery, BMI, neonatal weight, spot urinary protein / creatinine ratio and Doppler findings (PI and RI) for control and patients with mild and severe preeclampsiagroups at third trimester.
In PE, the sflt-1 is positively correlated with BP, protein: creatinine ratio, BMI, resistance and pulsatility indices, total serum protein, and negatively correlated with neonatal weight and gestational age at delivery.
Control
Pregnant
No.=35
Mild
Preeclampsia
Severe
maternal age(year)
25.6 ±0.84
27.43 ±0.99
26.8 ±0.84
gestational age
38.00 ±0.2
36.92±0.26a▼***
36.17 ±0.19 a▼***
BMI(Kg/m2)
27.92±0.55
31.23 ±0.5 a▲**
34.3 ±0.86 a▲***, ▲b**
neonatal weight(Kg)
2.66 ±0.05
2.45 ± a▼**
2.34 ±0.4 a▼***
urinary protein /creatinine
0.1 ±0.003
1.04 ±0.05 a▲***
3.55 ±0.23 a▲***,b▲***
Table 2. Comparison of the mean ±SEM of systolic blood pressure (sBP), diastolic blood pressure (dBP), total serum protein (TSP) and serum soluble fms like tyrosine kinase -1, sflt-1 (ng/ml) of pregnant control women and patients with mild and severe preeclampsia at third trimester of pregnancy and after one month following delivery.
Control
Pregnant
No.=35
Mild
Preeclampsia
(mmHg/hr.)
sBP
Before delivery
10.92 ±0.1
13.52±0.18a▲***
After delivery
11.31±0.11c▲***
11.48±0.12c▼***
dBP
7.3 ±0.11
9.4 ±0.15 a▲***
7.51 ±0.09 ▲***
7.64 ±0.13 c▼***
(TSP)
(g/dl)
6.02 ±0.11
5.61 ±.09 a▼**
6.72±0.09 c▲***
6.43±0.07a▼*c▲***
Conclusion: The changes in anti angiogenic factor sFlt-1 during pregnancy and in post-delivery period stress its role in the pathogenesis of PE and could be used to predict the disease progression and impact on the outcome of pregnancy as effects on liver and heart.
aANOVA test between mild, severe preeclampsia group versus control pregnant group:bANOVA test between mild and severe preeclampsia ;c paired t-test for control, mild, severe, mean concentration at third trimester versus one month following delivery mean values P˂0.01 ; *** P˂0.001
References:(1) Chappell C, Bramham K, and Shennan A. (2014): Short-term prediction of preeclampsia: how close are we? Biomarkers Med, 8: 455–458. (2) Mary L, and Nadine T. (2013): Preeclampsia. An obstetrician’s prspective. Ad Chr Kidney Dis, 20: