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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
Abstract Award
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Poster Session 1

Category: Operative Obstetrics

Poster Session 1

(391) The Association Between sFlt-1/PlGF Ratio and Unplanned Cesarean Delivery in Individuals with Suspected Placental Insufficiency

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  

    Submitting Author and Presenting Author(s)

  • Uri Shemesh, MD (he/him/his)

    The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
    Tel Aviv, Tel Aviv, Israel

    • Coauthor(s)

  • Keren Zloto, MD

    sheba medical center
    Tel Hashomer, Tel Aviv, Israel

  • TD

    Tal Dadon, MD

    Doctor
    Sheba medical hospital
    Tel Aviv, HaMerkaz, Israel

  • RY

    Rakeft Yoeli Ullman, MD

    The Sheba Medical Center
    The Sheba Medical Center, HaMerkaz, Israel

  • AT

    Abraham Tsur, MBA, MD

    Director of Anterpartum High Risk Beyond, Medical Director ARC
    The Sheba Medical Center
    The Sheba Medical Center, HaMerkaz, Israel

  • SM

    Shalom Mazaki-Tovi, MD

    The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
    Ramat Gan, HaMerkaz, Israel

  • YY

    Yoav Yinon, MD

    Head of Fetal Medicine UnitChair of the Israeli Maternal Fetal Medicine Society
    Sheba Medical Center, Ramat Gan, Israel
    Ramat Gan, HaMerkaz, Israel

  • MF

    Michal Fishel Bartal, MD

    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • Noa Gonen, MD

    MFM Fellow
    Wolfson Medical Center
    Holon, HaMerkaz, Israel

Objective:

To determine the predictive value of an abnormal sFlt-1/PlGF ratio for unplanned cesarean delivery (CD) in laboring individuals with suspected placental insufficiency.

Study Design:
This retrospective cohort study included all laboring individuals ( ≥23 weeks of gestation) with suspected placental insufficiency at a tertiary care center between August 2023 and July 2025. Suspected placental insufficiency included those small for gestational age fetus (SGA) (EFW < 10th percentile), hypertensive disorders of pregnancy (HDP), or oligohydramnios (AFI< 5cm). An sFlt-1/PlGF ratio was obtained at presentation, however, the result was not used to guide clinical management. Those undergoing elective cesarean delivery were excluded. The cohort was stratified by sFlt-1/PlGF ratio (< 38 vs. ≥ 38), and rates of unplanned cesarean delivery among laboring individuals were compared. Multivariate logistic regression was used to assess the independent variables associated with sFlt-1/PlGF ratio and unplanned CD.

Results:
Among the 818 patients, 231 (28.2%) had an elevated sFlt-1/PlGF ratio ( ≥ 38). Patients with abnormal ratios were more likely to be nulliparous, older, conceived via fertility treatment, and had a higher incidence of HDP and fetal growth restriction (Table 1). The rate of unplanned CD was higher in the abnormal sFlt-1/PlGF ratio compared to those with a normal value (41.1 vs 22.5%).  Following multivariate analysis sFlt-1/PlGF ratio did not remain a significant independent predictor of unplanned cesarean delivery (adjusted OR, 95% CI, Table 2).

Conclusion:

In laboring individuals with suspected placental insufficiency, an elevated sFlt-1/PlGF ratio is not an independent predictor for increased risk of unplanned cesarean delivery.