PlGF is a protein that is produced mainly by the trophoblasts in placental tissue. This protein is considered an angiogenic factor (it causes increase blood vessels formation), as opposed to anti-angiogenic factors (fms-like tyrosine kinase 1) that are increased also in pregnancy. The balance of both factors is the one that determines whether the patient is going to develop pre-eclampsia or not. During normal pregnancy, urinary and serum PlGF increases during the first and second trimesters, peaks at 29 to 32 weeks, and subsequently decreases. In Pre-eclampsia, the pattern shows increased PlGF in the first trimester but decreases significantly in the 2nd trimester compared to normal pregnant patients. The presence of low PlGF in serum or urinary specimen of pregnant women carries an increased chance by 23 times, of developing pre-eclampsia before 37 weeks of gestation. In cases of pre-eclampsia, there is a drop of �Placental Growth factor� 2-3 months prior to onset of hypertension and proteinuria. This drop gives a warning signals. The patient can be advised and treated before pre-eclampsia develops Decreased urinary PlGF at mid gestation isstrongly associated with subsequent early development of pre-eclampsia
In Summary: �Placental Growth Factor� serum or urinary samples, at the mid-trimester of pregnancy, is the best predictor of pre-eclampsia. This test helps to screen women for high risk of pre-eclampsia. Special care is needed in such women to prevent progression or to keep the most dangerous complications from occurring
Dr. Hussam Abu-Farsakh
First Medical Lab Director
:References
Richard et all; Urinary Placental Growth Factor and Risk of Preeclampsia; JAMA. 2005;293:77-85
Redman C et all; Latest Advances in Understanding Preeclampsia , Science 10 June 2005; Vol. 308. no. 5728, pp. 1592 – 1594