P14.23: Influence of gestational weight gain and prepregnancy body mass index on fetal growth

Abstract

Electronic poster abstractsInter-observer agreement was assessed using the Kappa statistics with bootstrapped 95% confidence intervals (CI). Results: The kappa for inter-observer agreement in presence of uterine artery Doppler notching was 0.82 [95% CI: 0.72 to 0.92], which was interpreted based on the standards of Landis & Koch to reflect excellent agreement. Conclusions: Despite the subjective nature of uterine artery Doppler notching assessment, high inter-observer variability supports its use in clinical practice in a cohort of high-risk women P14.22 Utero-placental vascularization by 3D power Doppler during first trimester: predictive value for placental vascular disease. Objectives:The aim was to evaluate the predictive value of 3D power Doppler (3DPD) quantification of placental and myometrium vascularisation at the end of the first trimester for the prediction of secondary placental vascular diseases (PVD), pre-eclampsia and IUGR. Methods: Acquisition of utero-placental volume was performed prospectively in 127 patients (67 low risk and 60 high risk women), between 11 and 14 weeks, using a standardized abdominal 3DPD procedure. Placental and myometrial vascularization were quantified separately using the VOCAL. Values obtained from patients with PVD were compared with those with favourable outcome. Results: In low risk population, PVD occurred in 6 cases (1 pre-eclampsia, 1 gestational hypertension associated to IUGR and 4 isolated IUGR). All placental 3DPD indices (VI, FI and VFI) significantly decreased in patients who developed PVD (p < 0.01) {mean VI: 1,73 vs 6,9; VFI: 0,59 vs 2,81 and FI 33,41 vs 41,49} whereas in myometrium, only VI and VFI were reduced (p < 0.05) {mean VI: 12,97 vs 20,97; VFI: 5,6 vs 10,27}. Among high risk women, PVD occurred in 15 cases (13 IUGR of which 3 with associated pre-eclampsia, 2 gestational hypertension). Any significant differences where found for placental indices or volumes. But regarding myometrium all 3D PD indices (VI, FI and VFI) significantly decreased in patients who developed PVD (p < 0.01) {mean VI: 11,09 vs 21,71; VFI: 4,39 vs 10,92 and FI 44,58 vs 49,15}. Conclusions: In PVD, utero-placental vascularization is impaired very soon in pregnancy. This technique could be a way to detect patients at high risk of PVD in general as well as in high risk population and to select patients needing preventive treatment and increased medical monitoring.