{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T18:03:26Z","timestamp":1768241006483,"version":"3.49.0"},"reference-count":7,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The ability to measure pro\u2010angiogenic (PlGF) and anti\u2010angiogenic (sFlt\u20101) factors, specifically the sFlt\u20101\/PlGF ratio, allows obstetricians to assess syncytiotrophoblast stress, a key mechanism in preeclampsia. In Australia, the introduction of this ratio to clinical practice, particularly its high negative predictive value, was led by Professor Brennecke (Melbourne). At our tertiary centre, adapted Victorian guidelines were introduced in October 2021. Despite multiple educational sessions, the transition from assessing \u2018end organ damage\u2019 to the \u2018placental syndrome\u2019 presented challenges for clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This retrospective audit examined 431 women over 20\u2009months to assess the implementation of the sFlt\u20101\/PlGF ratio. The primary objective was to identify key educational points to improve clinical decision\u2010making and the accurate use of the ratio in a tertiary centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 750 tests, 79% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009596) were ordered according to guidelines. Among 154 tests ordered outside the guidelines, 57% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200988) were performed within a reassuring time frame from the previous test, 41% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200963) outside validated gestational windows, 1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092) with an unknown indication and 1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091) following a \u2018severe risk\u2019 result.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Common errors included repeating tests too frequently (despite the high negative predictive value over 3\u20134\u2009weeks), testing prior to 20\u2009weeks or after 37\u2009weeks, and underestimating the prognostic value of very high sFlt\u20101\/PlGF ratios.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajo.70046","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T13:09:18Z","timestamp":1752844158000},"page":"860-866","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Experience and Major Learning Points Following the Implementation of the\n                    <scp>sFlt<\/scp>\n                    \u20101\/\n                    <scp>PlGF<\/scp>\n                    Ratio in the Management of Suspected Preeclampsia in a South Australian Tertiary Hospital"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3794-7287","authenticated-orcid":false,"given":"Annabel","family":"Lane","sequence":"first","affiliation":[{"name":"Central Adelaide Local Health Network  Adelaide Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. U.","family":"Amy","sequence":"additional","affiliation":[{"name":"Northern Adelaide Local Health Network  Adelaide Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anupam","family":"Parange","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Northern Adelaide Local Health Network  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustaaf","family":"Dekker","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Northern Adelaide Local Health Network  Adelaide South Australia Australia"},{"name":"Discipline of Obstetrics and Gynaecology, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-019-0119-6"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414838"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19178"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00131-2"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024395"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2021.12.003"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14760"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.70046","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.70046","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.70046","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T14:56:29Z","timestamp":1768229789000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.70046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,18]]},"references-count":7,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/ajo.70046"],"URL":"https:\/\/doi.org\/10.1111\/ajo.70046","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,18]]},"assertion":[{"value":"2024-12-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}