P51. Screening for preeclampsia in the first trimester: A reduced fat mass increases the risk in normo BMI patients.

Introduction Maternal cardiovascular system adapts to pregnancy thanks to complex physiological mechanisms that involve cardiac output, total vascular resistance (TVR) and water body distribution. Abnormalities of this adaptive mechanism are connected with hypertensive disorders and foetal growth restriction. Moreover, maternal serum PAPP-A is considered a biochemical marker extensively used for the first trimester screening of PE. Objective To identify patients at high risk of developing hypertensive complications of pregnancy during the first trimester through the use of non-invasive methods such as USCOM (Ultrasonic Cardiac Output Monitor), bioimpedance and biochemical marker. Materials and Methods We enrolled 96 healthy normotensive women with normal Body Mass Index during the first trimester of pregnancy (from 11 + 0 to 13 + 6 weeks of gestation) obtaining all measurements with the USCOM system, Bioimpedance and collecting MoM values of PAPP-A Results Patients were divided into two groups: Group A ( n = 54) with TVR < 1200 dynes.sec.cm-5, Group B ( n = 42) with TVR >1200 dynes sec cm −5 . 10% ( n = 10) of our study population developed pregnancy complications as IUGR and hypertensive disorders. In this group 81% of patients presented high TVR values and 37% PAPP-A<0.4 MoM. Higher values of the Cardiac Output and Stroke Volume have been highlighted in the group A ( p < 0.05). No statistically significant difference was identified in terms of water distribution, mean arterial pressure (MAP), heart rate, inotropy index and flow time corrected between the two groups (Table 1). Moreover, as shown in Table 2, we found a statistically significant lower Fat Mass percentage in complicated pregnancies with higher TVR values with respect uncomplicated pregnancies in Group B (23% vs 26% of Fat Mass). Conclusions High TVR and lower Fat Mass during the first weeks of gestation may be an early marker of cardiovascular maladaptation more than the evaluation of PAPP-A values and blood pressure assessment. [ABSTRACT FROM AUTHOR]