Gynecology, Obstetrics and Perinatology

The role of angiogenic growth factors in predicting placental insufficiency

The authors made a prospective analysis of the course of pregnancy and labor outcomes in 150 women with non-complicated pregnancy and with placental insufficiency (PI). The study has found that in patients with PI marked changes in the production of angiogenic growth factors take place. In subcompensated PI, VEGF levels increase threefold. Detection of VEGF in women with PI might be an early marker of the hypoxic state of the fetus. In pregnant women with PI a decreased production of PGF is noted during the whole period of gestation studied. As soon as in the 2nd trimester, the average level of PGF is reliably lower in compensated PI than in non-complicated pregnancy, in contrast to the VEGF level. Therefore, the PGF level is an early prognostic marker appearing before the clinical manifestation of PI. PGF has a  high affinity for the VEGF-R1 receptors. An increased concentration of the plasma soluble receptor VEGF-R1 is one of the mechanisms of regulation of the PGF level: the receptor binds PGF and the concentration of the latter in blood serum decreases. Excessive VEGF-R1 expression in the placenta, and also increasing concentrations on the mother’s blood precede a clinical development of the picture of PI.