الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Preeclampsia is a multisystem progressive disorder characterized by the new onset of hypertension and proteinuria or the new onset of hypertension and significant end-organ dysfunction with or without proteinuria after 20 weeks of gestation or postpartum in previously normotensive women. It is develops due to placental and maternal vascular dysfunction and disappears after delivery gradually by time. The incidence is estimated to be between 3 and 10% of all pregnancies.
Maternal endothelial dysfunction which leads to pre-eclamptic signs and symptoms is induced by high levels of the antiangiogenic factor sFLT1, which is produced in the placenta and released into the maternal circulation. sFLT1 is a soluble splice variant of the membrane-bound receptor VEGFR1 that binds to the proangiogenic proteins VEGF and placental growth factor (PlGF); therefore, sFLT1 acts as a ligand trap and antagonizes ligand-mediated angiogenic signalling via the cell surface receptors.
The current work was designed to to evaluate serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1) in cases of severe preeclampsia and eclamptic fits,and to correlate serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1) in these cases to outcome of fetus and mother and incidence of complication.
The patients were recruited from El-Shatby Maternity University Hospital, The study was conducted on 70 pregnant women with gestational age ≥ 28 weeks, they were categorized into two groups; group I: 35 severe preeclamptic pregnant women. group II: 35 pregnant women who had eclamptic fits. All cases were subjected to detailed history taking, general and local abdominal examination, obstetric ultrasound, Doppler ultrasound, laboratory investigations; treatment received (antihypertensive medications, magnesium sulphate (MgSO4) and steroids) and finally follow up till delivery.
The result of our study showed that serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1) levels were significantly increased in severe preeclampsia group and in eclpamtic group but was higher in eclamptic group.
We also investigated the diagnostic performance of sflt-1in the detection of eclampsia and severe preeclampsia by using the ROC plot.
Sflt-1 level is a statistically significant discriminator of occurrence of severe preeclampsia with Area under the ROC curve (AUC) =0.876 (95% CI 0,788 –0,963) (p<0.001). The diagnostic criterion using Youden index is the level of <11425.15pg/dl with a sensitivity of 88.57%, specificity of 82.86 %.
Sflt-1 level is a statistically significant discriminator of occurrence of eclampsia with Area under the ROC curve (AUC) =0.876 (95% CI 0,788 –0,963) (p<0.001). The diagnostic criterion using Youden index is the level of >11588.74pg/dl with a sensitivity of 85.71%, specificity of 82.86 %.so sflt-1 consider as significant biomarker for detection of the severity of occurrence of preeclampsia and eclamptic fits.