The incidence of a coexistent normal fetus is quoted in literature as 1 in 22,000 to 100,000 pregnancies and may be associated with multiple complications including persistent trophoblastic neoplasia.
Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) contribute in the development of preeclampsia and are suggested as prediction markers in healthy pregnant women but limited data is available in women with major preeclampsia risk factors. This study aimed to determine the role of sFlt-1 and PlGF in predicting preeclampsia among high risk pregnant women. This was a prospective study and samples were collected for a period of ten months. Blood samples were obtained from 84 pregnant women who had at least one risk factor for preeclampsia at 25 to 28 weeks and at 29 to 36 weeks of gestation. SFlt-1 and PlGF concentrations were determined by immunoassay method. There were significantly higher median sFlt-1 and sFlt-1:PlGF ratio at gestational interval 25 to 28 weeks and sFlt-1:PlGF ratio at 29 to 36 weeks in high risk women who developed preeclampsia. Significant lower median serum PlGF levels at 25 to 28 weeks and 29 to 36 weeks were observed in this group of women. In conclusion, the concentrations of these markers were altered in high risk preeclamptic women, a similar pattern seen in low risk preeclamptic women. However the predictive value of these markers could not be established clearly.
Determinations of total calcium, total magnesium, calcium ion, parathyroid hormone and 6-keto-prostaglandin-F1 alpha levels were carried out on 84 blood samples from 4 groups of women categorised as non-pregnant normotensive (NNP), pregnant normotensive (NP), pregnancy-induced hypertension (PIH) and pre-eclampsia (PE). PIH was clinically diagnosed when the diastolic pressure was more than 90 mmHg and was only hypertensive during pregnancy while PE was with additional proteinuria after 20 weeks of gestation. Compared to NNP women, total calcium and parathyroid hormone levels were of lower levels (p < 0.05) in NP women while in PIH women, total calcium and 6-keto-prostaglandin-F1 alpha levels were also lowered (p < 0.05). Compared to NNP women, PE women's levels of total calcium, calcium ion and 6-keto-prostaglandin-F1 alpha decreased (p < 0.05) while parathyroid hormone level increased (p < 0.05). When compared to the NP women, PE women had decreased levels (p < 0.05) of total calcium as well as calcium ion and increased level (p < 0.05) of parathyroid hormone. Calcium ion was found to be negatively correlated (NNP : r = -0.883, p = 0.008/NP : r = -0.931, p = 0.000) while parathyroid hormone was positively correlated (NNP : r = 0.904, p = 0.013/NP : r = 0.913, p = 0.000) with mean arterial pressure.