Placental growth factor in predicting adverse Maternal outcomes in patients of hypertensive Disorders of pregnancy- a prospective observational Study.

Abstract

BACKGROUND: The journey of bearing a child is not easy and may be associated with multiple complications. Hypertensive disorders of pregnancy are a result of mainly angiogenic imbalance and failure of vascular remodelling which ultimately leads to constriction of spiral arterioles manifesting as higher levels of blood pressure. The consequences that follow, affect multiple organs of the mother that have already been reformed physiologically during pregnancy. Early detection and timely intervention can predict these unfortunate events and bring a halt to losing mothers and neonates to the hands of this deadly disease. This study demonstrates a significant association between an abnormal serum Placental Growth Factor before delivery and severity of Hypertensive disorders of pregnancy along with neonatal and maternal outcomes. OBJECTIVES OF THE STUDY: To establish the diagnostic efficacy of Placental growth factor as a marker for predicting the adverse maternal outcomes in patients diagnosed with hypertensive disorders of pregnancy. MATERIALS AND METHODS: It was a prospective observational study, carried out in pregnant women, who got admitted to the Department of OBSTERTICS & GYNAECOLOGY in B.L.D.E. (DEEMED TO BE UNIVERSITY) Shri B.M. Patil Medical College Hospital and Research Centre, Vijayapura. Women who fulfilled the inclusion criteria were enrolled in the study after taking informed consent. A sample of peripheral venous blood was taken on admission and submitted for serum PLGF testing with ELISA kit. Series of events following admission are monitored mainly for maternal and perinatal sequalae. The test results are corelated with all parameters and severity of the disease. RESULTS: Of the 164 Hypertensive women Normal PLGF values were observed in 91(55.5%) and low PLGF in 73(45.5%). Significant associations (p<0.05) were observed between serum PLGF and mode of delivery, presence of imminent signs, interval between admission and delivery, urine albumin,

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12 | P a g e amniotic fluid volume, category of hypertensive disorder, antepartum and intrapartum complications, NICU admission at birth with reasons for stay, neonatal death, mean birth weight of infants born and period of gestation at the time of birth. Negative correlation as well as negative linear relation was observed while comparing PLGF with Systolic blood pressure and Diastolic blood pressure. The validity of history of hypertension prior admission gave us values of sensitivity 83.5%, specificity 34.1%, positive predictive value of 50.4% and negative predictive value of 72.1%. CONCLUSION: Serum PLGF levels can provide valuable information for the prediction of hypertensive disorders of pregnancy and abnormal PLGF values showed a significant association with adverse obstetrical as well as perinatal outcomes.