Amniotic fluid-soluble vascular endothelial growth factor receptor-1 in preeclampsia

Objective: To measure the levels of the soluble receptor for the potent ang iogenic agent vascular endothelial growth factor (VEGF) in amniotic fluid ( AF) in healthy and complicated pregnancies, and compare them with levels of erythropoietin, another factor upregulated by hypoxia. Methods: We assessed amniotic fluid from the second (n = 35, gestational we eks 14-19) and third (n = 29) trimesters of healthy women, and from the thi rd trimesters of preeclamptic (n = 22) and diabetic women with (n = 11) or without preeclampsia (n = 34) and from women with fetal growth restriction (FGR) (n = 14) for soluble VEGF receptor-1 (VEGFR-1) by enzyme-linked immun osorbent assay. Results: In early normal pregnancy, AF-soluble VEGFR-1 levels were higher ( median 22 ng/mL, range 2.3-29.5 ng/mL) than in the third trimester (median 13 ng/mL, range 0.5-32 ng/mL; P < .05). In preeclamptic women during the th ird trimester, levels were higher (median 20 ng/mL, range 10.5-37 ng/mL; P < .05) than healthy controls. The lowest third-trimester levels were in dia betic women (median 11 ng/mL, range 0.5-27 ng/mL). In women with preeclamps ia and diabetes, AF-soluble VEGFR-1 levels remained lower (median 13, range 6-32 ng/mL; P < .05) than in women with preeclampsia alone. Amniotic fluid levels of soluble VEGFR-1 in women with FGR (median 19.5 ng/mL, range 5-40 ng/mL) did not statistically differ from those of controls. The AF levels of soluble VEGFR-1 did not correlate with those of erythropoietin. Soluble VEGFR-1 was clearly detectable (median 14 ng/mL, range 9-22 ng/mL) in cultu re media from placental biopsies (n = 20). Conclusion: Preeclampsia is associated with increased levels of soluble VEG FR-1, which are independent of erythropoietin, another hypoxia-inducible fa ctor. (Obstet Gynecol 2000;95:353-7. (C) 2000 by The American College of Ob stetricians and Gynecologists.).