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Screening of preeclampsia (PE) in the first trimester: high Total Vascular Resistance (TVR) with a reduced fat mass increase the risk in normo BMI patients

G Gagliardi, GM Tiralongo, D Lo Presti, I Pisani, D Farsetti, B Vasapollo, GP Novelli, A Andreoli

Presented: Second International Congress on Maternal Haemodynamics

Published: Second International Congress on Maternal Haemodynamics, 2016 Workbook

Introduction: Abnormlities of cardiac output, TVR and water body distribution are connected with PE and foetal growth restriction (FGR).

Targets: To identify patients at risk of PE in the first trimester through USCOM system, bioimpedance and combined screening (maternal history, biophysical and biochemical markers). We enrolled 150 healthy nulliparous women with normal BMI.

Results: Patients were divided into 2 groups: A (TVR <1200 dynes.sec.cm-5), Group B ((TVR >1200 dynes.sec.cm-5). Lower values of the Cardiac Output (CO), Cardiac Index (CI), Inotropy Index (INO), Heart Rate (HR) and higher values of Flow Time correct (TFC) have been highlighted in the group B (p<0,01) compared to group A. 8% of study population developed PE or PE+FGR . In this group 75% of patients presented high TVR values and 50% is at high risk on the basis of combined screening. We found lower Fat Mass in complicated pregnancies with high TVR values compared to uncomplicated pregnancies with high TVR (Table 1).

Conclusions: High TVR and lower Fat Mass in the first trimester may be an early marker of PE more than the combined screening. Moreover lower fat mass increases the positive predictive value of isolated high TVR from 18% to 50%.