Effect of Terminated Fetal Circulation on Maternal Angiogenic Factors in Severe Early Preeclampsia

Background. Although intrauterine presence of the placenta is essential in the etiology of preeclampsia (PE), case reports showed that the viability of the fetus influences the clinical course of PE and the intensity of the clinical symptoms. Aim. We examined the course of angiogenic factors soluble fms-like tyrosine kinase-1 receptors (sFlt-1) and placental growth factor (PlGF) in a case of severe early PE in week 22 + 1 of gestation, when fetal termination was required to stabilize maternal condition. Results. The cessation of the feto-placental perfusion via fetocide led to a reduction of the maternal sFlt-1 concentration of 8.3% which was associated with a decline of the sFlt-1/PlGF ratio from 405 to 334. Nevertheless, the highest change of the angiogenic factors was detected after ejection of the fetus and placenta. Conclusions. Our observations implicate that neither a vital fetus nor an intact feto-placental component is an obligatory prerequisite for the angiogenic imbalance that is associated with the preeclamptic phenotype.