Abstract 9: Diagnostic and Prognostic Use of sFlt-1/PlGF Ratio in Preeclampsia: Enhancing Fetomaternal Outcomes in Cases with Diagnostic Dilemma

Abstract Background: Preeclampsia affects 2–8% of pregnancies and remains a major cause of maternal and perinatal morbidity. Diagnosis is often difficult in cases where its clinical features overlap with conditions such as tropical infections, viral hepatitis, intrahepatic cholestasis of pregnancy, diabetic nephropathy, lupus nephritis, or chronic kidney disease. This may lead to unnecessary interventions or delays in appropriate treatment. The sFlt-1/PlGF ratio has emerged as an objective tool to improve diagnostic accuracy and short-term risk prediction. It helps in making timely clinical decisions and prevent iatrogenic preterm deliveries in diagnostically uncertain cases. Methods: A prospective observational study including 80 pregnant women over a period of 2 years at JN Medical College, Aligarh, who presented beyond 20 weeks of gestation with clinical features suspicious of preeclampsia. The sFlt-1/PlGF ratio was measured and interpreted using a cut-off value of 38. Final diagnosis and fetomaternal outcomes were analyzed using sensitivity, specificity, and predictive values of the test. Results: The test showed a sensitivity of 85.7%, specificity of 62.2%, PPV of 63.8%, NPV of 84.8%, and an AUC of 0.867 (95% CI: 0.788–0.946; p210 or >655) had shorter prolongation (4.9 ± 2.6 days), with 55.5% experiencing fetomaternal complications. Conclusion: The sFlt-1/PlGF ratio helps differentiate preeclampsia from overlapping conditions in resource-limited settings where exclusion of HDP may reduce unnecessary interventions. The ratio also has prognostic value that supports individualized management in severe preterm cases, contributing to improved maternal and fetal outcomes in diagnostically challenging situations.