EP01.05: Adjusting the risk of pre‐eclampsia throughout pregnancy in a high‐risk population under aspirin prophylaxis

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We aimed to analyse the risk for Pre-eclampsia(PE) in high risk women under Aspirin, by analysing the blood pressure and uterine arteries at 20-236 weeks(w), 28-316w and 36-386w of pregnancy. This is a preliminary analysis of a cohort study that included 125 women at high risk for PE. We selected singleton pregnancies with an increased risk for PE before 37w above 1:100 at first trimester scan based on the Fetal Medicine Foundation algorithm. At enrolment maternal characteristics, biochemical and biophysical parameters were evaluated. All women initiated ≥ 100mg of aspirin (ASA) before 16 weeks and stopped at 36w. Systolic (SBP), diastolic (DBP), mean arterial blood pressure (MAP) and Z-score of the median pulsatility index of the uterine arteries were evaluated at 20-236, 28-316 and 36-386w. A ROC curve was used to evaluate the respective cutoffs and its correlation with PE development in patients who consistently screened positive for PE. Among the 125 patients under ASA, 12% (15) developed PE of which 1.6% (5) developed PE < 37w. At 20-236w by using a PAS = 119.5mmHg, PAD = 73.5mmHg, MAP = 89.17mmHg and Z-score UtArt = 1.282, 88 (70.4%) patients would be considered as screen positive and 14/15 would develop PE. At 28-316w by using a PAS = 133.5mmHg, PAD = 84.5mmHg, MAP = 90.17mmHg and Z-score UtArt = 0.653, 50/88 (56.8%) patients would be considered as screen positive and 12/14 would develop PE. At 36-386w by using a PAS = 133.5, PAD = 85.5, MAP = 98.17 and Z-score UtArt = 1.461, 25/50 (50%) patients would be considered as screen positive and 9/10 would develop PE. All the PE that were missed were term PE not associated to small for gestational age and no had no severe features of pre-eclampsia. By reassessing the risk of PE throughout pregnancy it's possible to identify patients whose ASA will be effective in prevention of PE and in those cases reduce the medical surveillance. Patients in whom ASA won't be enough can be correctly identified and benefit from a more personalised medical care. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.