The Role of Soluble fms-Like Tyrosine Kinase-1 Markers and Vascular Endothelial Growth Factor in Comparison with Color Doppler Sonography for Detecting Plasenta Accreta

Regarding the relatively high prevalence of placenta accreta in pregnancy, and the lack of suitable methods for predicting this complication, this study aimed to determine the role of soluble fms-like tyrosine kinase-1 (SFLT-1) markers and vascular endothelial growth factor (VEGF) in comparison with color Doppler sonography in diagnosis of placenta accreta. In a cross-sectional study, 78 pregnant women who were referred to Alzahra and Shahid Beheshti hospitals in Isfahan, Iran, in 2017 and 2018 were studied. SFLT-1 and VEGF levels were measured, and embryo sonography was also performed. After surgery, the results of surgery were compared with the results of sonography, and the level of SFLT-1 and VEGF and the agreement of these markers with ultrasound were determined. There was no significant difference in mean VEGF level in terms of pregnancy outcomes (P = 0.90), but SFLT-1 level was significantly lower in Eckert group (P = 0.02). Meanwhile, SFLT-1/VEGT ratio was not different between the two groups (P = 0.66). Comparison of ultrasound findings and surgical results showed that surgical outcomes and ultrasonography were normal in 38 cases (48.7%). Moreover, in 16 cases (20.5%), the results of surgery and ultrasound showed the presence of plementa acrata. The agreement between ultrasonography and surgery was 0.36 (P < 0.001). According to the results of our study, the two markers SFLT-1 and VEGF, compared with ultrasound, were not suitable criteria for predicting placenta accreta. At the same time, according to the limitations of this study, further studies are suggested.