O128. Placental vascularization indices and uterine artery peak systolic velocity in pregnancy hypertension

Abstract

Introduction Hypertension during pregnancy affects about 6–9% of pregnant women, it is a leading cause of maternal and fetal morbidity and mortality, and remarkable portion of pregnancy hypertension cases are accompanied by gestational diabetes (GDM). There is a great effort worldwide on reaching greater effectiveness in prediction and prevention in these pathological pregnancies. Objectives The aim of the study was to analyze placental vascularization, uterine artery peak systolic velocity (PSV), placental volume and pre-gestational BMI for the better prediction rate of adverse pregnancy outcomes in pregnant women with essential hypertension (EH), EH associated with gestational diabetes (EH + GDM), pregnancy induced hypertension (PIH), and PIH associated with gestational diabetes (PIH + GDM) compared to a normal blood pressure (NBP) group. Methods We measured placental 3-dimensional power Doppler indices, such as vascularization index (VI), flow index (FI) and vascularization flow index (VFI), and uterine artery PSV in pregnancies complicated with EH ( N = 51), EH + GDM ( N = 13) PIH ( N = 57) and PIH + GDM ( N = 23), and compared these to pregnancies with NBP ( N = 146) with the help of 3-dimensional analysing VOCAL program. We analyzed the correlation between the above mentioned indices, volume of the placenta, pre-gestational BMI, and gestational age. Results VI and VFI were significantly higher in pregnancies with EH (VI:13.27% ±9.77; VFI:5.94 ± 4.99 (mean ± SD)) and significantly lower in pregnancies with PIH (VI:7.75% ±6.50; VFI:3.00 ± 2.3(mean ± SD)) than in pregnancies with NBP (VI:10.18% ±6.16; VFI:5 ± 3.49 (mean ± SD)) ( p p p > 0.01). FI (31.35 ± 12.48) and VFI (1.87 ± 1.20) were significantly ( p p > 0.01). VI(4.13 ± 2.77) and VFI (1.70 ± 1.31) were significantly ( p p > 0.01) PSV was significantly higher in PIH + GDM (66.01 cm/s ±26.03) compared to PIH (56.27 cm/s ±26.56) ( p p The placental volume was smaller ( z -score:-1.5) in EH and PIH than in NBP and higher in EH + GDM and PIH + GDM than in NBP ( z -score:+0.8). Pre-gestational BMI was significantly higher ( p Conclusion The 3-DPD indices combined with PSV in pregnancies complicated with EH + GDM and PIH + GDM showed that GDM aggravates EH and PIH cases significantly. Although our study proved that pre-gestational BMI and placental volume do have effect on placental vascularization, it seems that adverse pregnancy outcomes can be predicted more effectively with the help of 3-DPD indices and PSV measurements during the entire pregnancy compared to conventional uterine artery findings.