{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T17:55:48Z","timestamp":1782755748910,"version":"3.54.5"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,4,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              There is little knowledge about the significance of extremely high values (&gt;655) for the ratio of\n              <jats:styled-content style=\"fixed-case\">sF<\/jats:styled-content>\n              lt\u20101 (soluble fms\u2010like tyrosine kinase 1) to Pl\n              <jats:styled-content style=\"fixed-case\">GF<\/jats:styled-content>\n              (placental growth factor). We aim to describe the time\u2010to\u2010delivery interval and maternal and perinatal outcomes when such values are demonstrated while assessing suspected or confirmed placental dysfunction based on clinical or sonographic criteria.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A multicenter retrospective cohort study was performed on 237 singleton gestations between 20+0 and 37+0\u00a0weeks included at the time of first demonstrating a\n              <jats:styled-content style=\"fixed-case\">sF<\/jats:styled-content>\n              lt\u20101\/Pl\n              <jats:styled-content style=\"fixed-case\">GF<\/jats:styled-content>\n              ratio &gt;655. Clinicians were aware of this result, but standard protocols were followed for delivery indication. Main outcomes were compared for women with and without preeclampsia at inclusion. In those with preeclampsia (n=185, of whom 77.3% had fetal growth restriction), severe preeclampsia features and fetal growth restriction in stages\n              <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\n              or\n              <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>\n              were present in 49.2% and 13.5% cases, respectively, at inclusion and in 77.3% and 28.6% cases, respectively, at delivery. In the group without preeclampsia (n=52, 82.7% had fetal growth restriction), these figures were 0% and 30.8%, respectively, at inclusion and 21.2% and 50%, respectively, at delivery. Interestingly, 28% of women without initial preeclampsia developed it later. The median time to delivery was 4\u00a0days (interquartile range: 1\u20136 days) and 7\u00a0days (interquartile range: 3\u201312 days), respectively (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). Overall, perinatal mortality was 62.1% before 24\u00a0weeks; severe morbidity surpassed 50% before 29\u00a0weeks but became absent from 34\u00a0weeks. Maternal serious morbidity was high at any gestational age.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              An\n              <jats:styled-content style=\"fixed-case\">sF<\/jats:styled-content>\n              lt\u20101\/Pl\n              <jats:styled-content style=\"fixed-case\">GF<\/jats:styled-content>\n              ratio &gt;655 is almost invariably associated with preeclampsia or fetal growth restriction that progresses rapidly. In our tertiary care settings, we observed that maternal adverse outcomes were high throughout gestation, whereas perinatal adverse outcomes diminished as pregnancy advanced.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.015548","type":"journal-article","created":{"date-parts":[[2020,4,4]],"date-time":"2020-04-04T09:00:47Z","timestamp":1585990847000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt\u20101 (Soluble fms\u2010Like Tyrosine Kinase 1)\/PlGF (Placental Growth Factor) Ratio"],"prefix":"10.1161","volume":"9","author":[{"given":"Cecilia","family":"Villala\u00edn","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit\u2010SAMID Department of Obstetrics and Gynaecology Hospital Universitario 12 de Octubre Instituto de Investigaci\u00f3n Hospital 12 de Octubre (imas12) Universidad Complutense de Madrid Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6807-4944","authenticated-orcid":false,"given":"Ignacio","family":"Herraiz","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit\u2010SAMID Department of Obstetrics and Gynaecology Hospital Universitario 12 de Octubre Instituto de Investigaci\u00f3n Hospital 12 de Octubre (imas12) Universidad Complutense de Madrid Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonor","family":"Valle","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Hospital Universitario Materno\u2010Infantil de Las Palmas de Gran Canaria Las Palmas de Gran Canaria Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manel","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Maternal\u2010Foetal Medicine Unit\u2010SAMID Vall d\u2019Hebron University Hospital Universitat Aut\u00f2noma de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Luis","family":"Delgado","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario Virgen de la Arrixaca Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"V\u00e1zquez\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Hospital Universitario Central de Asturias Asturias Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Mart\u00ednez\u2010Uriarte","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital General Universitario Santa Luc\u00eda Cartagena Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00cd\u00f1igo","family":"Melchor","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department Biocruces Bizkaia 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