{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:19:05Z","timestamp":1791559145088,"version":"4.3.4"},"reference-count":67,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T00:00:00Z","timestamp":1692662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Regarding the hypertensive disorders of pregnancy, pre-eclampsia (PE) remains one of the leading causes of severe and life-threatening maternal and fetal complications. Screening of early-onset PE (&lt;34 weeks of pregnancy), as well as late-onset PE (\u226534 weeks), shows poor performance if based solely on clinical features. In recent years, biochemical markers from maternal blood\u2014the pro-angiogenic protein placental growth factor (PlGF) and the antiangiogenic protein soluble FMS-like tyrosine kinase 1 (sFlt-1)\u2014and Doppler velocimetry indices\u2014primarily the mean uterine pulsatility index (PI), but also the uterine resistivity index (RI), the uterine systolic\/diastolic ratio (S\/D), uterine and umbilical peak systolic velocity (PSV), end-diastolic velocity (EDV), and uterine notching\u2014have all shown improved screening performance. In this review, we summarize the current status of knowledge regarding the role of biochemical markers and Doppler velocimetry indices in early prediction of the onset and severity of PE and other placenta-related disorders, as well as their role in monitoring established PE and facilitating improved obstetrical surveillance of patients categorized as high-risk in order to prevent adverse outcomes. A sFlt-1\/PlGF ratio \u2264 33 ruled out early-onset PE with 95% sensitivity and 94% specificity, whereas a sFlt-1\/PlGF \u226588 predicted early-onset PE with 88.0% sensitivity and 99.5% specificity. Concerning the condition\u2019s late-onset form, sFlt-1\/PlGF \u2264 33 displayed 89.6% sensitivity and 73.1% specificity in ruling out the condition, whereas sFlt-1\/PlGF \u2265 110 predicted the condition with 58.2% sensitivity and 95.5% specificity. The cut-off values of the sFlt-1\/PlGF ratio for the screening of PE were established in the PROGNOSIS study: a sFlt-1\/PlGF ratio equal to or lower than 38 ruled out the onset of PE within one week, regardless of the pregnancy\u2019s gestational age. The negative predictive value in this study was 99.3%. In addition, sFlt-1\/PlGF &gt; 38 showed 66.2% sensitivity and 83.1% specificity in predicting the occurrence of PE within 4 weeks. Furthermore, 2018 ISUOG Practice Guidelines stated that a second-trimester mean uterine artery PI \u2265 1.44 increases the risk of later PE development. The implementation of a standard screening procedure based on the sFlt-1\/PlGF ratio and uterine Doppler velocimetry may improve early detection of pre-eclampsia and other placenta-related disorders.<\/jats:p>","DOI":"10.3390\/children10091430","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T08:58:54Z","timestamp":1692694734000},"page":"1430","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Current Role of the sFlt-1\/PlGF Ratio and the Uterine\u2013Umbilical\u2013Cerebral Doppler Ultrasound in Predicting and Monitoring Hypertensive Disorders of Pregnancy: An Update with a Review of the Literature"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5454-9117","authenticated-orcid":false,"given":"Cristian Nicolae","family":"Chiril\u0103","sequence":"first","affiliation":[{"name":"Department of Internal Medicine-Nephrology, Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540142 T\u00e2rgu Mure\u0219, Romania"},{"name":"Department of Nephrology, Mures Clinical County Hospital, 540103 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudiu","family":"M\u0103rginean","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology 2, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540142 T\u00e2rgu Mure\u0219, Romania"},{"name":"Department of Obstetrics and Gynecology, Mures Clinical County Hospital, 540057 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Maria","family":"Chiril\u0103","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Mures Clinical County Hospital, 540142 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirela Liana","family":"Gliga","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine-Nephrology, Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540142 T\u00e2rgu Mure\u0219, Romania"},{"name":"Department of Nephrology, Mures Clinical County Hospital, 540103 T\u00e2rgu Mure\u0219, Romania"},{"name":"Diaverum Dialysis Centre, 540487 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,22]]},"reference":[{"key":"ref_1","unstructured":"Cunningham, F.G., Leveno, K.J., Bloom, S.L., Spong, C.Y., Dashe, J.S., Hoffman, B.L., Casey, B.M., and Sheffield, J.S. 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