P04.18: First trimester placental volume, uterine arteries Doppler, and biochemical markers for the prediction of preeclampsia

Abstract

The aim of this study is to determine whether a combination of placental volume measurement, uterine artery Doppler assessment and biochemical markers in first trimester is able to predict pregnancies that subsequently develop preeclampsia. This is a prospective study of 115 singleton pregnancies attending our center during a 15 month period (between April 2008 to July 2009) for a routine nuchal translucency thickness screening at 11–13 + 6 weeks of gestation. All patients underwent placental volume measurement by three-dimensional ultrasound, while colour Doppler was used for the assessment of both uterine arteries providing the mean pulsatility index (PI) calculation. In addition maternal serum free β-hCG and PAPP-A levels were measured. Exclusion criteria were multiple pregnancies, pre-existent conditions like diabetes, hypertension, renal diseases. Pregnancy outcome was obtained by post-labor telephone contact. Complete outcome was obtained in 110 of the 115 pregnancies. There were 108 live births, one case of miscarriage as well as 1 case of intrauterine death. Preeclampsia occurred in 2 patients, while one patient exhibited pregnancy associated hypertension without proteinuria. The route of labor in 56% was vaginal and the rest 44% were treated by caesarean section. Placental volume varied from 18 to 211cc (mean placental volume 69.09cc). The mean uterine artery PI was 0.45–3.13 and the mean fetal crown–rump length (CRL) was 64.15 mm (39–90 mm). The findings of this preliminary study suggests that such a combination is promising, it has the potential advantage to be performed at an early stage of pregnancy, and seems more effective in predicting complications due to impaired placentation than the single use of the above parameters.