PlGF triage To improve detection later in pregnancy, the soluble Fms-like tyrosine kinase 1 (sFlt-1)/PIGF ratio has been evaluated as a diagnostic and screening test, and has been found to have high specificity and sensitivity for pre-eclampsia, particularly for early onset disease (Verlohren et al, 2010). Subsequent investigations have shown that it may be possible to discriminate between the hypertensive disorders of pregnancy using this ratio (Engels et al, 2013). This approach provides the possibility of rapid testing to predict or clarify a diagnosis of pre-eclampsia once clinical suspicion is present, and such a test is now commercially available. PlGF in isolation has been shown to predict among those presenting with suspected pre-eclampsia at less than 35 weeks’ gestation those women who are likely to require delivery within the next 14 days (Chappell et al, 2008). These strategies could help direct hospital and outpatient management of pre-eclampsia in the future, but do not afford the opportunity to identify high-risk women at a time when pre-eclampsia could potentially be prevented.
Screening