Changes of sFlt-1, PLGF and their ratios in peripheral blood of pregnant women with early missed abortion andtheir early diagnostic value Han Yanmet" , Fu Mianai, Wang Wenfang , Fu Binbin. " Department of Medical Cenetics ,HaikouHospital of Maternal and Child Health , Hainan Province , Haikou 570203 , ChinaCorresponding author: Han Yanmei , E-mail: hanyanmei669 @ 163. comFunding program ;Natural Science Foundation of Hainan Province( 821MSO847)

Abstract：

Objective To analyze the changes of soluble fms like tyrosine kinase-1(sFlt-1), placental growth factor(PLGF) and their ratios in the peripheral blood of pregnant women with early missed abortion and their diagnostic value for early missed abortion. Methods From June 2021 to June 2022, 200 early pregnant women with abnormal medical genetics or physical examination in Haikou Maternal and Child Health Care Institute were selected as the study group, and 200 healthy pregnant women with prenatal examination in the same hospital were selected as the control group. The pregnant women in the study group were continuously monitored until 12 weeks of pregnancy, and were divided into 171 non abortion subgroups and 29 abortion subgroups according to the occurrence of early missed abortion. Compare the changes of maternal serum β-HCG, progesterone, sFlt-1, PLGF, sFlt-1/PLGF. The diagnostic value of serum sFlt-1, PLGF, sFlt-1/PLGF alone or in combination for early missed abortion was analyzed by the subject's work characteristic curve(ROC). Results The levels of study group serum β-HCG, progesterone and PLGF were lower than those in the control group, and the values of sFlt-1 and sFlt-1/PLGF were higher than those in the control group(t/P=31.993/<0.001, 2.906/0.004, 21.297/<0.001, 11.444/<0.001, 22.599/<0.001). 29(14.50%) of the 200 pregnant women in the study group had early missed abortion. Serum sFlt-1 and sFlt-1/PLGF at admission and diagnosis of abortion subgroup were higher than those of non-abortion subgroup at admission and 12 weeks of pregnancy(sFlt-1: t/P=1.980/0.049, 4.487/<0.001; sFlt-1/PLGF: t/P=2.876/0.004, 6.756/<0.001), and PLGF at admission and diagnosis of abortion subgroup was lower than those of non-abortion subgroup at admission and 12 weeks of pregnancy(t/P=2.012/0.046, 7.691/<0.001). In the abortion subgroup, the serum sFlt-1 and sFlt-1/PLGF showed an upward trend at the time of admission, diagnosis and before uterine clearance, and decreased significantly 3 days after uterine clearance(F/P=21.503/<0.001, 16.400/<0.001), while the serum PLGF showed a downward trend(F/P=42.184/<0.001). ROC curve results showed that the AUC of serum sFlt-1, PLGF, sFlt-1/PLGF and their combination in diagnosing early missed abortion were 0.755, 0.858, 0.866 and 0.873, respectively. The combined diagnostic value of the three was higher, but the difference was not statistically significant(Z/P=1.593/0.111, 0.241/0.810, 0.121/0.904). Conclusion Serum sFlt-1, PLGF and their ratios showed dynamic changes before and after the diagnosis of early missed abortion and the curettage, which can be used for the early diagnosis of early missed abortion.

Missed abortion;                    Soluble fms like tyrosine kinase-1;                    Placental growth factor;                    Diagnosis;