Soluble FMS-like tyrosine kinase-1/Pro- angiogenic placental growth factor (sFlt- 1/PlGF) ratio as an early predictor for oxygenation impairment in preeclampsia

Preeclampsia is a major cause of maternal mortality worldwide, with angiogenic imbalance playing a central role in its pathophysiology. This study aimed to investigate the relationship between the soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1/PlGF) ratio and oxygenation impairment in preeclamptic patients. A cross-sectional observational study was conducted on 47 women with singleton pregnancies diagnosed with preeclampsia at a gestational age beyond 34 weeks who underwent cesarean delivery. Data were obtained from medical records, including sFlt-1 and PlGF serum levels, sFlt-1/PlGF ratio, and arterial blood gas analysis for calculating PaO₂/FiO₂ (P/F) ratios. A significant negative correlation was found between the sFlt-1/PlGF ratio and the P/F ratio (r = -0.514, p < 0.001), indicating that a higher angiogenic imbalance is associated with poorer oxygenation status. Receiver operating characteristic (ROC) curve analysis revealed a cut-off value of 138.58 for the sFlt-1/PlGF ratio, with 83.33% sensitivity and 80% specificity for predicting oxygenation impairment. These findings suggest that the sFlt-1/PlGF ratio may serve as an early biomarker for detecting oxygenation disturbances in preeclampsia, supporting timely clinical interventions.