skip to main content

sFlt1 PlGF Ratio Pre-eclampsia — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePregnancy & RenalsFlt1 PlGF Ratio Pre-eclampsiaESENeph

A 35-year-old woman at 22 weeks gestation with pre-existing CKD G3a is found to have an sFlt-1/PlGF ratio of 85. Her BP is 140/88. She has mild proteinuria but no other pre-eclampsia features. What does this biomarker ratio indicate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — An sFlt-1/PlGF ratio >38 suggests pre-eclampsia and has high negative predictive value when low (<38); a ratio of 85 supports a diagnosis of pre-eclampsia or imminent development

The sFlt-1/PlGF ratio is a validated biomarker for pre-eclampsia. sFlt-1 (soluble fms-like tyrosine kinase 1) is anti-angiogenic and elevated in pre-eclampsia; PlGF (placental growth factor) is pro-angiogenic and reduced. A ratio <38 has >99% negative predictive value for pre-eclampsia within 1 week. A ratio >38 supports the diagnosis and guides clinical management. NICE NG133 recommends PlGF-based testing to help rule out pre-eclampsia in women presenting between 20-36+6 weeks. Interpretation in pre-existing CKD requires caution as baseline PlGF may be altered.

Reference: NICE NG133 2019 – PlGF Testing; PROGNOSIS Study – NEJM 2016