OC13.04: sFlt1/PlGF ratio in the management of pre‐eclampsia: a multicentre, randomised controlled trial – EuroPE trial

To assess the utility of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in diagnosing and classifying PE, with a focus on improving maternal outcomes and reducing unnecessary interventions. This parallel-group, open-label, multicentre, randomised controlled trial was conducted at 17 maternity units across Spain. Singleton pregnancies between 24 and 41 weeks with suspected or diagnosed PE were included. Selective planned deliveries based on sFlt1/PlGF levels (revealed group) were compared with expectant management (concealed group) following standard care protocols. 2316 women were included between January 2018 and June 2022. Of those 1019 were assigned in the conceal group and 1297 in the reveal group. Results showed significantly higher gestational age at birth in the control group, with a 38% higher risk of maternal complications(OR: 1.38 95% CI (1.120-1.713)) and a 41% of neonatal complications (OR: 1.414 95% CI (1.184-1.184) in the control group after adjusting for gestational age at delivery. However, there was a trend towards increased neonatal pulmonary dysplasia in deliveries before 28 weeks in the intervention group. Integrating the sFlt1/PlGF ratio into clinical decision-making improves outcomes for both mothers and neonates and reduces unnecessary interventions in cases of suspected or established PE.