PLACENTAL GROWTH FACTOR (PlGF) – ES189
🤰 Preeclampsia & Fetal Health ScreeningReport: 7th Working Day
Sample Type: Blood (Serum)
Test Code: ES189
Overview: What is Placental Growth Factor (PlGF)?
Placental Growth Factor (PlGF) is a protein belonging to the Vascular Endothelial Growth Factor (VEGF) family. It plays a critical role in angiogenesis (the formation of new blood vessels), particularly in the placenta during pregnancy.
In a healthy pregnancy, levels of PlGF rise steadily during the first two trimesters, peaking around the 30th week. This rise ensures that the placenta develops a rich network of blood vessels to supply oxygen and nutrients to the growing baby. However, in pregnancies complicated by Preeclampsia (dangerous high blood pressure), the placenta fails to develop properly, and PlGF levels are abnormally low.
Why is this Test Critical? (Clinical Significance)
The PlGF test is primarily used for the prediction, diagnosis, and management of Preeclampsia. It is a game-changer in obstetric care for several reasons:
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1. Early Screening (11-14 Weeks):
When performed in the first trimester (usually alongside PAPP-A and Ultrasound), a low PlGF level can predict if a woman is at high risk of developing early-onset preeclampsia later in the pregnancy. This allows doctors to start preventive treatment (like low-dose Aspirin) early, which can save lives. -
2. Diagnosis in 2nd & 3rd Trimester:
If a pregnant woman develops high blood pressure or swelling after 20 weeks, doctors need to know if it is simple hypertension or severe Preeclampsia. A low PlGF level confirms placental dysfunction, indicating a higher risk of complications. -
3. The sFlt-1/PlGF Ratio:
Often, PlGF is measured alongside another marker called sFlt-1. sFlt-1 is an anti-angiogenic factor (it stops vessel growth). In Preeclampsia, sFlt-1 goes UP and PlGF goes DOWN. The ratio of these two is the gold standard for predicting impending eclampsia. -
4. Intrauterine Growth Restriction (IUGR):
Low PlGF is also associated with babies who are smaller than expected because the placenta isn't feeding them enough.
Who Should Get Tested?
Your gynecologist or fetal medicine specialist may recommend this test if you fall into any High Risk category:
- History of preeclampsia in a previous pregnancy.
- Chronic hypertension (High BP) or Diabetes before pregnancy.
- First pregnancy (Primigravida) at an older age (>35 years).
- High BMI (Obesity).
- Abnormal Uterine Artery Doppler scan results.
- Pregnant with twins or multiples.
Understanding the Results
The interpretation depends heavily on the gestational age (how many weeks pregnant you are). Always rely on your specialist for interpretation.
- Normal Levels: Indicates a healthy placenta and a very low risk of developing preeclampsia in the next 4 weeks.
- Low Levels: Suggests placental dysfunction. It indicates a high risk of Pre-term Preeclampsia or Fetal Growth Restriction.
Frequently Asked Questions (FAQ)
Preeclampsia is a serious pregnancy complication characterized by high blood pressure and damage to organ systems (like the liver and kidneys). If untreated, it can lead to seizures (Eclampsia), which is life-threatening for both mother and baby. It is a leading cause of pre-term birth.
The test result itself is not a disease, but a warning. If low PlGF is detected early (11-13 weeks), doctors often prescribe low-dose Aspirin (150mg) to be taken daily until 36 weeks. Studies show this significantly reduces the risk of developing severe preeclampsia. If detected late, doctors will monitor the baby more closely and may plan an early delivery.
No. The Dual Marker Test (Free Beta HCG + PAPP-A) mainly screens for chromosomal abnormalities like Down Syndrome. The PlGF test specifically screens for placental health and blood pressure risks. However, PlGF is often added to the Dual Marker screening (making it a Triple Screen or First Trimester Screening with PlGF) to cover both risks simultaneously.
The PlGF test is a specialized immunoassay that requires advanced analyzers (like the Roche Cobas or Kryptor systems). Because it is a specialized test and samples are often batched for accuracy and calibration controls, the turnaround time is longer than routine blood tests.
No, fasting is typically not required for the PlGF test. You can eat and drink normally before giving the sample, unless your doctor has ordered other tests (like Glucose) along with it.
Indirectly, yes. Since PlGF reflects how well the placenta is working, extremely low levels are often linked to Fetal Growth Restriction (FGR), meaning the baby may be smaller than expected (Small for Gestational Age).