Abstract：
Monitoring and timing of delivery in preterm preeclampsia and fetal growth restriction is one of the biggest challenges in Obstetrics. Finding the optimal time of delivery of these fetuses usually involves a trade-off between the severity of the disease and prematurity. So far, most clinical guidelines recommend the use of a combination between clinical, laboratory and ultrasound markers to guide the time of delivery. Angiogenic biomarkers, especially placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1), have gained significant attention in recent years for their potential role in the prediction and diagnosis of placenta-related disorders including preeclampsia and fetal growth restriction. Another potential clinical application of the angiogenic biomarkers is for the differential diagnosis of patients with chronic kidney disease, as this condition shares similar clinical features with preeclampsia. Consequently, angiogenic biomarkers have been advocated as tools for monitoring and deciding the optimal time of the delivery of fetuses affected by placental dysfunction. In this clinical opinion, we critically review the available literature on PlGF and sFlt-1 for the surveillance and time of the delivery in fetuses affected by preterm preeclampsia and fetal growth restriction. Moreover, we explore the use of angiogenic biomarkers for the differentiation between chronic kidney disease and superimposed preeclampsia.
摘要：
早产先兆子痫和胎儿生长受限的监测和分娩时机是产科面临的最大挑战之一。寻找这些胎儿的最佳分娩时间通常涉及疾病的严重程度和早产之间的权衡。到目前为止,大多数临床指南建议在临床，实验室和超声标记，以指导交货时间。血管生成生物标志物,尤其是胎盘生长因子（PlGF）和可溶性fms样酪氨酸激酶-1（sFlt-1），近年来，因其在预测和诊断胎盘相关疾病包括先兆子痫和胎儿生长受限方面的潜在作用而受到广泛关注。血管生成生物标志物的另一个潜在临床应用是用于慢性肾脏病患者的鉴别诊断。因为这种情况与先兆子痫具有相似的临床特征。因此,血管生成生物标志物已被提倡作为监测和决定受胎盘功能障碍影响的胎儿的最佳分娩时间的工具.在这个临床观点中，我们严格回顾了PlGF和sFlt-1在受早产先兆子痫和胎儿生长受限影响的胎儿中的监测和分娩时间方面的现有文献.此外，我们探讨了使用血管生成生物标志物来区分慢性肾脏病和叠加先兆子痫.
