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Q&A

Hypertension

Poster Session 1

(263) The utility of PlGF as a “rule-out” test: examining outcomes after triage testing

Tuesday, February 13, 2024

10:30 AM – 12:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Natalie Neff, MD

MFM Fellow
University of Texas Health Science Center at Houston
Houston, TX, United States

Coauthor(s)

HC

Han-Yang Chen, PhD

Department of Obstetrics, Gynecology and Reproductive Sciences
The University of Texas Health Science Center at Houston
Houston, TX, United States
Baha M. Sibai, MD

Professor
Hermann Memorial Hospital
Houston, TX, United States
Jacqueline G. Parchem, MD (she/her/hers)

Assistant Professor
University of Texas Health Science Center at Houston
Houston, TX, United States

Objective: Despite the release of a new preeclampsia biomarker test in the United States, the clinical application of PlGF-based testing is unclear as few have examined adverse outcomes or assessed the test’s ability for timely risk stratification in the triage setting. Therefore, we sought to evaluate the outcomes of patients with suspected preeclampsia according to PlGF value, stratified by inpatient vs. outpatient status to evaluate PlGF as a “rule-out” test.

Study Design: This is a secondary analysis of the Preeclampsia Triage by Rapid Assay Trial, a prospective, multicenter, observational study that enrolled patients with suspected preeclampsia aged 18-45 with a singleton pregnancy between 20-35 weeks gestation. Plasma PlGF was measured at enrollment and defined as normal > 100 pg/mL, indeterminate 12-100 pg/mL and abnormal < 12 pg/mL. Our primary outcome was a composite adverse outcome (maternal or neonatal) and delivery within 7 days. A secondary outcome was a diagnosis of severe preeclampsia and delivery within 7 days. Data were analyzed within two disposition groups, inpatient and outpatient. Analysis was performed with use of Fisher’s exact or chi-square tests as appropriate.

Results: Of 601 patients who met inclusion criteria, 260 were managed as inpatient and 341 as outpatient. Demographic characteristics were similar between groups. A normal PlGF was identified in 59 (22%) of the inpatient group and 190 (55%) of the outpatient group. Among patients with a normal PlGF, the primary adverse composite neonatal outcome was only identified in 1 (1.7%) inpatient, and was not observed in the outpatient group. The primary adverse composite maternal outcome was not observed in either disposition group. The secondary outcome did not occur in the outpatient group with a normal PlGF.

Conclusion: A normal PlGF may provide reassurance and allow for outpatient surveillance within an interval of 7 days. Our findings suggest PlGF as a “rule-out” test and could strengthen clinical decision making and potentially limit unnecessary hospitalizations.