Endothelial dysfunction of the maternal vasculature induced by pro-oxidants may contribute to the development of preeclampsia. Obesity results in vascular inflammation and oxidative stress and is therefore a risk factor for preeclampsia. Regular exercise is known to induce antioxidants. We recently demonstrated that stretchers (subjects who performed low-intensity exercises) had a lower incidence of preeclampsia as opposed to walkers (moderate-intensity exercise; 2.6% versus 14.6%). We now seek to determine the possible protective mechanisms. We hypothesized that stretchers will have higher vascular levels of the antioxidant superoxide dismutase (SOD) and plasma transferrin levels, an antioxidant marker. We conducted immunohistochemical analyses of blood vessels embedded in fat biopsy samples obtained during cesarean sections from women who were randomized to either stretching ( N = 6) or walking ( N = 5) exercises. In addition, levels of plasma transferrin were measured. SOD expression was increased ( P < 0.05) in stretchers [106.3 (interquartile range 84.2 to 127.8 arbitrary units (AU)] when compared with that of walkers [56.92 (interquartile range 46.35 to 82.32 AU)]. Transferrin levels continued to increase throughout gestation only among the stretchers. There appears to be a higher antioxidant protective effect in subjects who performed low-intensity exercise during pregnancy.

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Background: Although moderate intensity maternal exercise is recommended during pregnancy, most women do not achieve this level. Objective: This study aimed to determine the effects of supervised maternal light-intensity exercise on fetal cardiovascular measures in the 3rd trimester. Materials and Methods: We compared women participating in light-intensity (LI) stretching/breathing or no exercise (CON) across 24+ weeks of pregnancy Women with singleton pregnancies (<16 weeks), between 18-40 years, 18.5-34.99 kg/m2 BMI, and having no chronic health conditions were eligible. LI did 150 minutes light-intensity weekly exercise; CON did normal daily activities, but no exercise. Maternal measures included resting heart rate (HR) and blood pressure (BP). Fetal measures included estimated fetal weight (EFW), ponderal index (PI), HR, along with right and left ventricular measures (e.g., stroke volume, cardiac output, ejection fraction) at 36 weeks’ gestation. T-tests compared differences between groups; partial spearman rank correlations and regressions were performed to find relationships and predict fetal echocardiographic outcomes, controlling for fetal activity state. Results: Of 50 pregnant women (n=26 in LI, n=24 in CON), we found maternal exercise intensity influences fetal left ventricular heart flow, while maternal exercise duration influences fetal right ventricular outcomes. There were no differences (p>0.05) in fetal cardiac anatomical measures. Lastly, light intensity exercise and duration of exercise lower maternal blood pressure in late pregnancy. Conclusions:Light-intensity exercise is associated with improved fetal cardiac measures. Women benefit from light intensity exercise during pregnancy. Cardiovascular benefits from exercise for mother and child are dose dependent.

. Women were included with a singleton pregnancy from 24-34 wks, who were deemed at high risk for PTD based on symptoms of premature contractions or a history of previous PTD.The ultrasound examination was done using a mid-sagittal transvaginal view of the cervix, without applying pressure. Elastogram of the internal os was measured along with cervical length and presence of sludge or funnelling. Elastogram was graded according to colour intensity into high risk (level 3-4) or low risk (level 1-2).The correlation between sonographic cervical factors and PTD were calculated using Pearson chi square test, as well as a multifactorial regression analysis to exclude confounding factors. Results: The study included 127 women. PTD occurred in 15 cases (11.8%). A statistically significant correlation was found between PTD with elastogram of the cervix and funnelling. Women in the high risk group had a PTD risk of 3.2x (23% vs 7%, p=0.037). Women with cervical funnelling delivered early in 55% of cases versus 9.7% (p=0.003). Conclusions: In women at high risk for PTD, positive elastogram of the internal os of the cervix (level 3-4) was found to correlate to birth before 37 weeks. EP18.03The evolution of cervical length during pregnancy in singletons and twins and analysis of influencing factors Objectives: Preterm birth (birth before 37 weeks of completed gestation) is the leading cause of neonatal death, and has an incidence of 5-13% which is believed to be on the rise. The objective of this study was to determine the rate of spontaneous preterm birth and investigate the relationship between preterm birth and cervical length in a pregnant Asian population. Methods: 1000 women with single viable pregnancies at less than 14 weeks of gestation were recruited between September 2010 and November 2013. Cervical length was measured using ultrasound at each of the 4 antenatal visits (Visit 1: > 14 weeks, Visit 2: 18-22 weeks, Visit 3: 28-32 weeks and Visit 4: > 34 weeks) using the Fetal Medicine Foundation protocol.Results: There was a significantly shorter cervical length both in the 2nd trimester (18 to 22 weeks) and the 3rd trimester (28 to 32 weeks) in the preterm birth group compared to the term birth group (p = 0.028 and p < 0.001 respectively). In the first trimester (11 to 14 weeks), there was no statistically significant difference in cervical length between the two groups (p = 0.425). ROC curve analysis for cervical length in the preterm birth group for Visit 2 and 3 showed an AUC of 0.605 and 0.725 respectively. At Visit 3, a cut-off level at 2.49 cm has a sensitivity of 54.8%, specificity of 82.5%, negative predictive value of 97.9% and positive predictive value of 11.1%. Conclusions:There is a significantly shorter cervical length in the 2nd and 3rd trimester in the preterm birth group. Cervical length is a moderate predictor of preterm birth with good negative predictive value and a relatively good specificity. Ultrasound cervical length screening between 28 and 32 weeks of gestation with a cut-off of ≥ 2.5cm can ...