Urinary Placental Growth Factor in Pregnancies Complicated by Preeclampsia

Introduction: Preeclampsia is associated with alterations in the maternal serum levels of the vascular endothelial growth factor (VEGF), the placental growth factor (PlGF) and the soluble fms-like tyrosine kinase-1 (sFlt-1). The serial measurement of these angiogenic factors in the serum may be used to pre-empt the diagnosis of preeclampsia, but obtaining such measurements during the routine antenatal care needs a cost-effective analysis. A promising tool is a non-invasive, alternative screening method for measuring the urinary placental growth factor (PlGF). Objective: To estimate the levels of urinary PlGF in preeclamptic and normotensive, non proteinuric pregnant women in the Indian population and also to analyze the association of this factor with the onset of the disease. Methods: A case control-study was planned in 80 patients, among which 40 were preeclamptic patients and 40 were nor-motensive, non proteinuric pregnant women who served as the controls. Urine samples were obtained both from the preeclamptic women and the control women and they were analyzed for the levels of urinary PlGF by using ELISA. Results: The levels of urinary PlGF were significantly reduced in the preeclamptic patients as compared to those in the normotensive, non-proteinuric pregnant women (30.08 +/- 9.42 pg/ml Vs 77.70 +/- 24.70 pg/ml, p<0.0001). Further, the levels were also significantly reduced in early-onset preeclampsia compared to those in late-onset preeclampsia (25.44 +/- 6.35 pg/ml Vs 40.92 +/- 5.71 pg/ml, p< 0.0001). Conclusion: A significant reduction in the levels of urinary PlGF was found in the preeclamptic patients and this reduced level of urinary PlGF may be used to pre-empt the onset of preeclampsia and to institute the appropriate therapeutic measures.