{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T20:00:10Z","timestamp":1773691210851,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,7,18]],"date-time":"2021-07-18T00:00:00Z","timestamp":1626566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Acute fatty liver of pregnancy (AFLP) substantially contributes to maternal and neonatal morbidity and mortality. Other liver\u2010associated pregnancy complications such as preeclampsia\u2010associated HELLP (hemolysis, elevated liver enzyme, low platelet) syndrome may be difficult to differentiate from AFLP as these diseases overlap with regard to multiple clinical and laboratory features. The aim of this study was to investigate angiogenic profiles by measuring soluble fms\u2010like tyrosine kinase\u20101 (sFlt\u20101) and placental growth factor (PlGF) in pregnancies compromised by AFLP and to compare them with those complicated by HELLP syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Pregnant women affected by AFLP or HELLP syndrome were enrolled. The study population of women with HELLP syndrome was part of a larger data collection obtained in our clinic that has been used for previous work. Patients\u2019 angiogenic profiles were assessed by measuring sFlt\u20101 and PlGF serum levels. To assess the diagnostic potential of these angiogenic markers in AFLP, as well as discriminating it from HELLP syndrome, non\u2010parametric tests were used and receiver operating curves were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six women with AFLP and 48 women with HELLP syndrome were included in the study. Patients with AFLP showed significantly higher sFlt\u20101 levels (median: 57\u00a0570\u00a0pg\/mL; range 31\u00a0609\u2013147\u00a0170\u00a0pg\/mL) than patients with HELLP syndrome (9713\u00a0pg\/mL; 1348\u201330\u00a0781\u00a0pg\/mL; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). PlGF serum levels were higher in patients with AFLP compared with those with HELLP syndrome (197\u00a0pg\/mL; 127\u2013487\u00a0pg\/mL vs. 40\u00a0pg\/mL; 9\u2013644\u00a0pg\/mL, respectively; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). sFlt\u20101\/PlGF ratios were not significantly different between AFLP and HELLP syndrome patients (192; 157\u20131159 vs. 232; 3\u2013948, respectively; NS). In our study population, an sFlt\u20101 cut\u2010off value of 31\u00a0100\u00a0pg\/mL allowed differentiation between these two diseases with a sensitivity and specificity of 100%. A linear correlation was found between the cumulative numbers of Swansea criteria and sFlt\u20101 serum levels (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.97; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>AFLP is associated with very high sFlt\u20101 serum levels in particular in women fulfilling eight or more Swansea criteria. Besides the suggested Swansea criteria to diagnose AFLP, an sFlt\u20101 value above 31\u00a0100\u00a0pg\/mL may be an additional biochemical feature improving discrimination between AFLP and HELLP syndrome. However, because of the small number of pregnancies affected by AFLP included in this work further studies are needed to corroborate our findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14218","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T18:34:59Z","timestamp":1624386899000},"page":"1876-1884","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Soluble fms\u2010like tyrosine kinase 1 (sFlt\u20101): A novel biochemical marker for acute fatty liver of pregnancy"],"prefix":"10.1111","volume":"100","author":[{"given":"Fabienne","family":"Trottmann","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Inselspital University Hospital and University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Raio","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Inselspital University Hospital and University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Amylidi\u2010Mohr","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Inselspital University Hospital and University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Mosimann","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Inselspital University Hospital and University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Araceli","family":"Jarquin Campos","sequence":"additional","affiliation":[{"name":"Center of Laboratory Medicine Dr. Risch Vaduz Liechtenstein"},{"name":"Private University of the Principality of Liechtenstein Triesen Liechtenstein"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franz H.","family":"Messerli","sequence":"additional","affiliation":[{"name":"Department of Cardiology Inselspital Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenz","family":"Risch","sequence":"additional","affiliation":[{"name":"Division of Clinical Chemistry Labormedizinisches Zentrum Dr. Risch Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4696-5700","authenticated-orcid":false,"given":"Marc U.","family":"Baumann","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Inselspital University Hospital and University of Bern Bern 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