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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Heidi Tiller, UiT - The Arctic University of Norway
- Second opponent: Professor II Malin Holzmann, Karolinska University Hospital, Sweden
- Third member and chair of the evaluation committee: Professor II Per Steinar Halvorsen, University of Oslo
Chair of the Defence
Professor Kirsten Bjørklund Holven, University of Oslo
Principal Supervisor
Associate Professor Meryam Sugulle, University of Oslo
Summary
Good placental health is an essential precondition for the placental and fetal capacity to support a normal labor and birth. Today there is a lack of optimal clinical tools to help identify a fetus at risk of fetal distress and adverse delivery outcome. The placenta-associated proteins placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) are present in maternal circulation during pregnancy and are proposed to represent general placental health markers. Changes in their concentrations are associated with adverse pregnancy outcomes such as preeclampsia and fetal growth restriction.
The aim of this thesis was to examine whether predelivery circulating PlGF and sFlt-1 are associated with fetal distress and composite adverse delivery outcome, both in clinically uncomplicated as well as complicated term and late-term pregnancies.
Women with complicated and uncomplicated singleton pregnancies between gestational age 37+0 and 42+2 weeks were recruited to the prospective, observational study. Placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured in the maternal circulation at inclusion and, if possible, daily until labor onset.
We demonstrate that PlGF and sFlt-1 are likely to be helpful in the prediction of fetal distress and adverse delivery outcome in term and late-term pregnancies. The predelivery maternal circulating imbalance between PlGF and sFlt-1 most likely reflects placental dysfunction. This thesis underlines the importance of differentiating between likely placental cause or other causes for the adverse delivery outcome. In the future, placenta-associated biomarkers could advance the prediction of adverse delivery outcome and hopefully contribute to the improvement of pregnancy monitoring and to help estimating the ideal timing and mode of delivery.
Additional information
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