Update on the diagnosis and prognosis of pre-eclampsia in singleton pregnancies based on the sFlt-1/PLGF ratio

© 2018, Sociedad Espanola de Ginecologia y Obstetricia. All rights reserved. Pre-eclampsia belongs to a group of obstetric complications that are closely related through placental insufficiency, which also includes intrauterine growth restriction and placental abruption. Timely and accurate detection and treatment of pre-eclampsia is usually difficult, since diagnostic criteria are still based on nonspecific signs and symptoms and there is no clear association between the usual criteria for severity and unfavorable outcomes for mother and fetus. The discovery of the role of angiogenic factors (sFlt-1 y PlGF) in the pathophysiology of placental insufficiency is a key step toward improving early diagnosis and establishing a prognosis in cases occurring before week 34 of pregnancy. At present, ≤ 38 is widely accepted to be threshold value of the sFlt-1/PlGF ratio that rules out suspected pre-eclampsia. The use of the ratio is considered cost-effective. However, current data on the treatment and prognosis of women with an abnormally high sFlt1/PlGF ratio are more limited. The present article summarizes current knowledge on the clinical application of the sFlt-1/PlGF for the diagnosis and prognosis of pre-eclampsia and highlights those areas that should be addressed with respect to biomarkers, for example, their role as targets in the development and follow-up of new treatments.