Markedly Elevated sFlt-1/PlGF Ratios in Atypical Superimposed Preeclampsia Before 20 Weeks of Gestation: A Three-Case Series.
Chisa Ito, Manabu Ogoyama, Akihide Ohkuchi et al.
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Case in brief
Three women with chronic hypertension or IgA nephropathy developed atypical superimposed preeclampsia before 20 weeks of gestation, presenting with severe hypertension, worsening proteinuria, and fetal growth restriction or fetal death. Markedly elevated sFlt-1/PlGF ratios were observed, and placental pathology indicated maternal vascular malperfusion. Following pregnancy termination, maternal conditions improved, and all women later achieved successful pregnancies.
What made this case unusual
The occurrence of atypical superimposed preeclampsia before 20 weeks of gestation is extremely rare, highlighting a unique presentation in patients with underlying chronic conditions.
Diagnostic / clinical pearl
Clinicians should consider atypical superimposed preeclampsia in patients with chronic hypertension or renal issues presenting with early severe hypertension and proteinuria.
Why it matters
This case series underscores the potential role of angiogenic biomarkers in assessing placental dysfunction in atypical preeclampsia, contributing to understanding its pathophysiology.