Obese women are more likely to have decreased insulin sensitivity and are at increased risk for many adverse pregnancy outcomes. An early lifestyle intervention (LI) may have the potential to reduce the impact of insulin resistance (IR) on perinatal outcomes. We report post hoc analysis of an open-label randomized control trial that includes IR women with body-mass index ≥25 randomly assigned to a LI with a customized low glycemic index diet or to standard care (SC) involving generic counseling about healthy diet and physical activity. Women were evaluated at 16, 20, 28, and 36 weeks of gestation, at which times perinatal outcomes were collected and analyzed. An oral-glucose-tolerance test (OGTT) showed that women in the LI group had lower plasma glucose levels at 120 min at 16–18 weeks of gestation, and at 60 and 120 min at 24–28 weeks. More importantly, these women had a lower rate of large-for-gestational-age (LGA) infants (p = 0.04). Interestingly, the caloric restriction and low-glycemic index diet did not increase the rate of small-for-gestational-age (SGA) babies in the LI group. A lifestyle intervention started early in pregnancy on overweight and obese women had the potential to restore adequate glucose tolerance and mitigate the detrimental role of IR on neonatal outcomes, especially on fetal growth.

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Background: Cardiomyopathies account for 8%-11% of the cardiovascular diagnoses detected in utero. Case presentation: We illustrate a case of fetal dilated cardiomyopathy (DCM) diagnosed in a woman arrived at our Emergency Room for reduced fetal movements at 35+3 weeks of gestation. The patient had an abnormal fetal echocardiography with evidence of enlarged fetal hearth with a cardiothoracic ratio over 95° p.le, a dilated left and right ventricle and a reduced wall contraction. The diagnosis was of DCM was done. A Cesarean section was performed at 36 weeks of gestation for pathological pattern of cardiotocography (CTG). The female newborn had normal post-natal adaptation. Heart ultrasound showed a severe biventricular DCM with poor kinesis and a Holter electrocardiogram (ECG) showed supraventricular isolated extra systoles. The newborn infant was treated with ACE inhibitor, beta blockers and diuretics with partial improvement and the DCM was confirmed by the referral center of Cardiology and cardio surgery. The panel of Next Generation Sequencing (NGS) for CM was performed. The sequence analysis identified the heterozygous c.554C>T variant in the SCN5A gene, which at protein level determines Ala185Val variant, that is described in the literature as associated with the Brugada Syndrome (BrS). This genomic variant was inherited by the mother. Conclusion: This article illustrates that when we have a fetus with DCM associated to demonstration of a genetic background, the counselling to the couple cannot exclude the presence of BrS in the child and an unknown genetic mutation in parents.

London, UK & VirtualElectronic poster abstracts fetuses (p 25 = 143.50). The sFlt-1/PlGF ratio had a mean value of 36.51 (p75 = 55.28) compared to a mean value of 24.74 in the other arm (p75 = 29.06). In the FGR group, in 75% of cases the pulsatility of the uterine arteries was elevated, compared to 6.5% of patients in the normal weight group. Conclusions:The FGR is defined as the deficit in the weight gain of a fetus during its development. One of the major clinical problems involves discrimination between the real FGR fetuses and the healthy small ones. In our study, PlGF levels were lower in those fetuses with lower birthweights, which supports the idea that angiogenic markers can be a useful weapon in the diagnosis of FGR. EP37.30Low level of PAPP-A MoM and obstetric outcomes in SGA and AGA babies: a retrospective cohort study

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