281-POS

Abstract

Objectives To determine the utility of early-pregnancy vascular compliance measurements for the prediction of medically-indicated preterm delivery ( Methods High-risk women were recruited to the Manchester Antenatal Vascular (MAViS) clinic. Pulse wave velocity (PWV) and central BP were measured at 14–18 and 18–24 weeks gestation using a Tensioclinic arteriograph. Uterine artery Doppler (UAD) was performed at 22–24 weeks and plasma placental growth factor (PlGF) was quantified using Alere Triage at 14–18 weeks. Results Data were available for 127 pregnancies (chronic hypertension = 82, diabetes (with vasculopathy) = 12, renal hypertension = 21, previous PE = 11) of whom 31 (24%) had a medically-indicated preterm delivery. Maternal age, BMI, ethnicity and PlGF (14–18 weeks) were not different between the preterm delivery and the comparison group ( n = 96). Peripheral and central mean arterial pressure (MAP) were different at 14–18 weeks, peripheral 103.4 [95th CI 100.4–106.5) vs 99.2 [97.2–101.2] mmHg; p = 0.02 and central 100.0 [95.4–104.6] vs 94.4 [92.1–96.7] mmHg; p = 0.03). Only central MAP was different between the groups at 18–24 weeks ( p PWV was significantly different between groups at both gestations (9.5 [8.7–10.3] vs 8.5 [8.2–8.7] m/s; p = 0.002 and 8.9 [8.2–9.6] vs 8.2 [7.9–8.4] m/s; p = 0.01). UAD revealed bilateral notching in 18/27(67.7%) of the iatrogenic preterm delivery group compared with 16/82(19.5%) in the comparison group ( p p = 0.01 (14–18) and 1.6 (1.00–2.5); p = 0.05 (18–24), the other covariates were not significant in the models. Conclusions PWV is a marker of vascular compliance and is a likely indicator of the degree of maternal vascular adaptation to pregnancy. Higher PWV in this cohort was associated with a significantly increased risk of preterm delivery indicated by maternal and/or fetal disease. Disclosures R. Cockerill: None. E. Shawkat: None. J. Horn: None. C. Chmiel: None. G. Bernatavicius: None. E. Jonhstone: None. I. Crocker: None. J.E. Myers: None.