[MATERNAL SERUM ANGIOGENIC FACTORS AS AN AIDING TOOL FOR SCREENING WOMEN WITH SUSPECTED PREECLAMPSIA NEAR DELIVERY - INITIAL DATA AND AN ESTIMATED COST-BENEFIT].

Harefuah Pub Date : 2022-11-01
Uriel Katz, Ron Maymon, Anna Tsviban, Adi Sharabi-Nov, Ramzia Abu Hamid, Hamutal Meiri, Yifat Wiener
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引用次数: 0

Abstract

Introduction: Preeclampsia (PE) is a major pregnancy complication, posing considerable morbidity and mortality. The maternal serum angiogenic factors - PlGF and sFlt-1, and their ratio appear to be promising markers to predict PE. Aims: To assess whether the evaluation of PlGF and sFlt-1 adds to the clinical workup of women with suspected PE, and to estimate the cost/benefit.

Methods: We prospectively enrolled pregnant women with suspected PE who were admitted to the Maternal-Fetal Medicine Unit (MFM) at Shamir Medical Center. Pregnancy and delivery records were collected from their computerized electronic medical records. PlGF<150pg/ml and sFlt-1/PlGF>38 measured prospectively were used to predict PE.

Results: Of 105 women included, 28 were in the control group with unrelated complications and none developed PE. Among 66 women with suspected PE, 27(41%) developed the syndrome, with a positive predictive value (PPV) of 90.3% for PlGF<150 pg/ml and 88.9% for sFlt-1/PlGFabove 38. Out of 11 women with suspected intrauterine growth restriction (IUGR), six developed the syndrome, and among them, the negative predictive value (NPV) was ~ 90%.

Conclusions: Angiogenic factors are reliable in predicting PE near delivery. Of 8355 annual deliveries, 584 were admitted for suspected PE. The annual test cost was NIS 66,576 (NIS 140 per single test). Cost-saving was NIS 2.18 million, the ratio of cost saved vs. test cost was 32.7.

Discussion: The angiogenic factors are efficient and cost-saving in PE prediction near delivery. A larger study is necessary to determine the inclusion of angiogenic factors in the workup for suspected PE.

[产妇血清血管生成因子作为产前筛查疑似子痫前期妇女的辅助工具-初步数据和估计的成本效益]。
子痫前期(PE)是一种主要的妊娠并发症,具有相当高的发病率和死亡率。母体血清血管生成因子- PlGF和sFlt-1及其比值似乎是预测PE的有希望的标志物。目的:评估PlGF和sFlt-1的评估是否增加了疑似PE妇女的临床检查,并估计成本/收益。方法:我们前瞻性地招募了沙米尔医学中心母胎医学单元(MFM)收治的疑似PE的孕妇。怀孕和分娩记录从他们的计算机电子医疗记录中收集。前瞻性测量PlGF38用于预测PE。结果:纳入的105例女性中,对照组28例无相关并发症,无PE发生。在66名疑似PE的女性中,27名(41%)出现了该综合征,plgf阳性预测值(PPV)为90.3%。结论:血管生成因子在预测分娩前后PE方面是可靠的。在每年8355例分娩中,584例因疑似PE入院。每年的检测费用为66,576谢克尔(每次检测140谢克尔)。节约成本218万新谢克尔,节约成本与检测成本之比为32.7。讨论:血管生成因子在产前PE预测中是有效且节省成本的。有必要进行更大规模的研究,以确定在疑似PE的检查中是否包括血管生成因子。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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