{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T16:10:05Z","timestamp":1781885405560,"version":"3.54.5"},"reference-count":23,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"09","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003It is a challenge to consider preeclampsia (PE) diagnosis and management in low and middle-income settings, where it represents a major public health concern. The placenta is the underlying cause of disease, and the plasma concentrations of proangiogenic and antiangiogenic factors released by the placenta can reflect the risks of disease progression. Antiangiogenic proteins, such as soluble fms-like tyrosine kinase 1 (sFlt-1), and proangiogenic, like placental growth factors (PlGF), are directly and inversely correlated with the disease onset, respectively.<\/jats:p><jats:p>\n          Methods\u2003Narrative review on the use of biomarkers (sFlt-1 to PlGF ratio) with a suggested guidance protocol.<\/jats:p><jats:p>\n          Results\u2003Key considerations on the use of biomarkers: the sFlt-1\/PlGF ratio is mainly relevant to rule out PE between 20 and 36 6\/7 weeks in cases of suspected PE; however, it should not replace the routine exams for the diagnosis of PE. The sFlt-1\/PlGF ratio should not be performed after confirmed PE diagnosis (only in research settings). In women with suspected PE, sFlt-1\/PlGF ratio\u2009&lt;\u200938 can rule out the diagnosis of PE for 1 week (VPN\u2009=\u200999.3) and up to 4 weeks (VPN= 94.3); sFlt-1\/PlGF ratio\u2009&gt;\u200938 does not confirm the diagnosis of PE; however, it can assist clinical management. In cases of severe hypertension and\/or symptoms (imminent eclampsia), hospitalization is imperative, regardless of the result of the sFlt-1\/PlGF ratio.<\/jats:p><jats:p>\n          Conclusion\u2003The use of biomarkers can help support clinical decisions on the management of suspected PE cases, especially to rule out PE diagnosis, thus avoiding unnecessary interventions, especially hospitalizations and elective prematurity<\/jats:p>","DOI":"10.1055\/s-0042-1744286","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T23:39:56Z","timestamp":1650929996000},"page":"878-883","source":"Crossref","is-referenced-by-count":17,"title":["Diagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers"],"prefix":"10.61622","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8280-3234","authenticated-orcid":false,"given":"Maria Laura","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Gynecology and 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Filho","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Hospital Moinhos de Vento-HMV, Porto Alegre, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3273-3001","authenticated-orcid":false,"given":"Jos\u00e9 Carlos","family":"Pera\u00e7oli","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista J\u00falio de Mesquita Filho, Botucatu, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"47794","published-online":{"date-parts":[[2022,4,25]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ejogrb.2013.05.005","article-title":"Global and regional estimates of preeclampsia and eclampsia: a systematic review","volume":"170","author":"E Abalos","year":"2013","journal-title":"Eur J Obstet Gynecol Reprod 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