Corresponding author*: Dr. Revathi Soundararajan,

Maternal-Fetal Medicine, Associate Fellow, Milann Hospital, Bengaluru, India;

Email: drrevathi.smfmi@gmail.com

Objective

To evaluate the effectiveness of PlGF-POC (Triage®) testing in predicting preeclampsia in high-risk pregnant women (20-24 weeks gestation) and compare outcomes with historical controls.

Background

Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity and mortality worldwide, affecting approximately 3% to 5% of all pregnancies and representing the most prevalent medical complication during gestation. It is associated with a combined maternal and perinatal mortality rate of around 10%.1 PE often presents with atypical features and can progress rapidly, necessitating prompt recognition and intervention. Potential complications include eclampsia, HELLP syndrome, fetal growth restriction, and intrauterine fetal demise. Identified risk factors include primiparity, multifetal gestation, and preexisting conditions such as obesity, chronic hypertension, renal disease, and autoimmune disorders.1 The International Society for the Study of Hypertension in Pregnancy (ISSHP) recommends incorporating angiogenic biomarkers, such as placental growth factor (PlGF), into clinical assessments to enhance diagnostic accuracy. Nevertheless, further research is required to validate the routine implementation of these biomarkers, with the overarching goal of reducing adverse outcomes through timely and accurate diagnosis and management.

2 Pathophysiology of PE PE

arises from abnormal placentation, including:

•  Incomplete spiral artery remodelling
• Oxidative and hydrostatic injury
•  Endothelial dysfunction

This leads to systemic maternal inflammation and vascular pathology. Role of PlGF in early prediction of PE

Placental Growth Factor (PlGF) is a biomarker of placental dysfunction, with reduced levels in early-onset severe preeclampsia and fetal growth restriction. Between 20 and 34+6 weeks of 

gestation, PlGF enhances diagnostic accuracy, demonstrating high sensitivity (94.5%) and specificity (95%) for early-onset pre-eclampsia3. PlGF testing guides decisions on surveillance and referral, improving outcomes. The Triage PlGF assay on POC shows superior performance, enabling earlier detection and targeted surveillance.4

Integrating PlGF testing into antenatal care enables the earlier detection of complications and improved outcomes in preeclamptic mothers through targeted surveillance.