ABSTRACT

Objectives: Preterm delivery is defined as a labor that occurs at less than 37 weeks' gestation. There has been a recent interest in ultrasonographic and biochemical markers designed to differentiate the truly high-risk patient. We analyzed biochemical cervical-vaginal inflammatory markers like cytokines and insulinlike growth factor binding protein's phosphorylated isoform (phIGFBP-1). Methods: We analyzed 214 symptomatic and 285 asymptomatic women. Transvaginal ultrasonography was performed at admission. We collected from cervical-vaginal secretions two samples of IL-6 and IL-8 and a sample of the decidual phIGFBP-1. Results: Characteristics of the two groups are shown in the Conclusions: Both tests have a high NPV for preterm delivery. Cervical length measurement has higher sensitivity but lower specificity than phIGFBP-1. As the two tests have a poor agreement, their combined used might enhance accuracy in the prediction of preterm delivery. OP19.06Cervical length and risk of antepartum bleeding in women with complete placenta praevia

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Oral poster abstracts statistically significant correlation between maternal serum PAPP-A, free β-hCG and uterine artery resistance indices. Conclusions: The present study demonstrates a positive correlation between first trimester uterine artery resistance, pulsatility indices and second trimester MSAFP. Uterine artery Doppler measurement during the first trimester prenatal sonography may be a prognostic screening method. The potential application of first trimester uterine artery blood flow in conjunction with maternal biochemistry such as MSAFP for prediction of adverse pregnancy outcomes will be further evaluated with increasing number of patients in the current study. OP11.03 Can the severity of the maternal anti-angiogenic state of pre-eclampsia be detected by Doppler velocimetry?

Oral poster abstractsObjectives: To explore the association of uterine arteries (UA) waveform analysis with brachial artery flow-mediated dilation (BAFMD) in the prediction of preeclampsia in high-risk pregnancies. Methods: UA waveforms were recorded using Pulsed Doppler ultrasonography in 33 women at 22-24 weeks of gestation with high risk factors for preeclampsia (PE). Mean Pulsatility Index (PI) of both UA were registered. At the same time, brachial artery diameter was evaluated in basal and after stress conditions using Color Doppler; BAFMD was expressed as percent change in diameter from baseline. The onset of PE was divided in early (before 34 weeks of gestation) or late (after 34 weeks). Logistic regression models were developed, and their predictive ability assessed using ROC curves. Results: The prevalence of PE in the studied group was 24% (8/33), 5 early and 3 late-onset. Mean UA-PI and BAFMD values of cases without PE were lower, but not significant, than those developing PE (mean difference (MD): −0.39 (95% CI: −0.90-0.13) and −4.41% (95% CI: −16.1-7.3) respectively). Area under ROC curve for mean UA-PI was of 0.70 (95% CI: 0.41-0.99%), and for BAFMD of 0.59 (95% CI: 0.37-0.80). Logistic regression analysis was only significant for mean UA-PI (P = 0.034), and adding BAFMD did not improve the prediction. For early-onset PE, there were significant higher values in mean UA-PI (MD: 0.56 (95% CI: 0.19-0.94)), and higher BAFMD results but not significant (MD: 8.8% (95% CI: −4.6-22.2%)). Area under ROC curve for mean UA-PI was of 0.79 (95% CI: 0.44-1), and for BAFMD of 0.69 (95% CI: 0.46-0.91). Logistic regression analysis was only significant for mean UA-PI (P = 0.02), multivariate regression analysis combining UA-PI and BAFMD did not get better the prediction of early-onset PE. Conclusions: Although there is a trend of higher BAFMD in pregnancies with PE, the test in the second trimester did not improve the capacity for prediction of PE that provides the UA by itself. Objectives: We evaluated changes in uterine artery score (UAS) based on presence or absence of notching and values of pulsatility index (PI) in relation to perinatal outcome in pregnancy complicated by diabetes mellitus (DM). Material and Methods: 379 diabetic pregnant women at gestational age 24-20 were investigated. 152 patients belonged to class G1/G2 DM, according to White, 92 -to class B, 71 -to class C, 43 -to class D, and 21 -to class R/F. HbA1c concentration in the study group: 5.3%-10.2%. Color Doppler flow studies in uterine and umbilical arteries were performed using Aloka alpha-10 with abdominal 3.5-5.0 probe. PI in the uterine arteries was obtained and systolic notches were recorded when present. Adverse perinatal outcome was defined as presence of the following: pH value of umbilical arterial blood < 7.20, BE value of the umbilical arterial blood < 9, Apgar score at 5 min < 5, preterm delivery (< 37 weeks of gestation), operative delivery for fetal distress (CTG, fetal skalp pH value < 7.20), preterm delivery and SGA. Results:...