EP08.05: What is the role of advance maternal age in pregnancy related complications?

Abstract

Objectives: To investigate the maternal characteristics and obstetric outcomes in pregnancies with abnormal 50 g oral glucose challenge test (50gOGCT) and normal 100 g oral glucose tolerance test (100gOGTT) results. Methods: Antenatal follow-up and delivery records were retrospectively evaluated in 379 pregnancies with normal 50gOGCT results (group1), 107 pregnancies with abnormal 50gOGCT but normal 100gOGTT (group 2) and 75 pregnancies diagnosed and treated as gestational diabetes mellitus (GDM) (group 3), excluding the cases with pre-gestational diabetes mellitus and multiple pregnancies. Results: Maternal age was significantly higher in group 2 compared to group 1 and higher in group 3 compared to group 2 (p < 0.05). Gestational age at birth was significantly lower in groups 2 and 3 compared to group 1 (p < 0.05). Idiopathic polihidramnios was present in 0.3%, 2.8% and 2.7% of the cases in group 1, 2 and 3 respectively (p < 0.05). Fetal anomaly was observed in 2.4%, 4.7% and 5.3% of the cases (p < 0.05) and perinatal mortality was observed in 0.5%, 1.9% and 1.3% of the cases (p > 0.05), respectively. Conclusions: Insulin resistance in pregnancy may be more frequently encountered as maternal age increases. Poor outcome cannot be fully eliminated in pregnancies with GDM despite treatment. In cases with abnormal 50gOGCT but normal 100gOGTT results, poor outcome may be observed more frequently than in those with normal 50gOGCT results, perhaps due to the presence of a moderate degree of insulin resistance. Further studies must be performed to clarify these facts. EP08.04Early second trimester screening in high risk pregnancy at tertiary referral ultrasound centre Objectives: To assess the utility of transvaginal ultrasound examination in early second trimester in order to recognise fetal anomalies and potential maternal complications in high risk pregnancies. Methods: Women with one previous Caesarean section underwent transvaginal ultrasound at 13 + 4-15 + 5 gestational weeks at the National tertiary referral ultrasound centre in Russia. The following ultrasound features were noted: cervical length, uterine scar appearance, location of placenta, signs of placenta accreta (PA) and fetal anatomy including face, intracranial structures, spine, lungs, heart, diaphragm, extremities, fingers, stomach, bowel, kidneys, urinary bladder, umbilical cord. All women had an additional scan at 19-21 gestational weeks and scan results were compared. Results: An uterine scar was visible in 49/52 (94%) of cases at 13-15 gestational weeks, versus 41/52 (79%) at 19-21 weeks (p = 0.02). At 13-15 weeks 1 case of cervical insufficiency was disclosed (successfully treated with cerclage). Four cases with placenta overlapping the uterine scar were identified; 3 had signs of PA and 1 was not suspicious. Two fetal anomalies were identified (one fetus had multiple anomalies and one had a ventricular septal defect). At the 19-21 weeks scan PA was confirmed in all 3 suspicious cases. The two cases with fetal anomalies were confirmed at 19-21 ...