Correlation between angiogenetic biomarkers, urinary protein values and ascites in women with hypertensive disorders of pregnancy

Objective. To investigate the correlation between sFlt-1/PlGF ratio, the 24-h urinary protein and the presence of maternal as­cites in a population of women with new-onset hypertensive disorders of pregnancy (HPD).
Materials and Methods. Retrospective study including a co­hort of women with new-onset HDP carrying a singleton via­ble pregnancy between 22 and 36 gestational weeks. At diag­nosis, sFlt-1 and PlGF were assessed using Brahams Kryptor and the ratio was calculated. The amount of proteins on the 24 h urine was also investigated and a value > 5 g/24 h was used to define massive proteinuria. The presence of ascites was defined in if abdominal free fluid was detected at ultrasound examination.
Results. A total of 80 patients were included for the study purpose. A linear correlation was found between the sFlt-1/ PlGF ratio and the 24 h urinary-protein values (R2 = 0.21; p < 0.001). A massive proteinuria was detected in 17 women; Sflt- 1/PlGF ratio had an AUC of 0.86 for predicting the presence of massive proteinuria with a cut-off value of 310.9 (sensitivity 88.2%, specificity 71.0%). Ascites was detected in 6 women; significantly higher values of sFlt-1/PlGF ratios were found in this group of women compared with those without ascites (1,322.0 ± 1,083.0 vs 423.0 ± 734.0).
Conclusions. Higher values of sFlt-1/PlGF ratios are associat­ed with higher levels of urinary protein and higher incidence of maternal ascites.