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Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 2 (2012) 240–339
(1 Hypertension Unit, University Hospital Geneva, Switzerland, 2 Obstetrics, University Hospital, Geneva 4, Switzerland, 3 Nephrology, CHUV, Lausanne, Switzerland, 4 Primary Care and Emergencies, University Hospital, Geneva 4, Switzerland) Introduction: Recent data have shown that preeclampsia is not just a disease of pregnancy that resolves with delivery. Preeclampsia may be considered a ‘risk marker’ for later-life diseases, including cardiovascular and renal diseases and the metabolic syndrome. Objectives: We aimed a longitudinal prospective study to analyze the renal abnormalities in the post-partum. Methods: We studied 127 post-preeclamptic women at 6 weeks post-partum. Twenty-four hour urine collection, ambulatory blood pressure and renal function were evaluated. Results: The mean age (±SD) was 32 ± 6 years, BMI was 29.4 ± 5.7, the race distribution was Caucasian 69%, Hispanic 14%, Black 12% and Orient 5%. Ten % were active smokers, 10% have been suffering from gestational diabetes. The mean duration of the pregnancy was 36 weeks 3/7 ± 4. Our results show that the prevalence of hypertension defined by office blood pressure 140/90 mmHg or ongoing antihypertensive treatment was 35%. The daytime ambulatory blood pressure (ABPM) was 122 ± 16/85 ± 11 mmHg, heart rate 84 ± 8, and 111 ± 20/75 ± 11 mmHg at nighttime. Sixteen % had a daytime ABPM 135/85 mmHg corresponding to the definition of ambulatory hypertension. Ultrasensitive CRP was 4.9 ± 5.1 mg/ml, of them 31% had a frank elevation of the CRP >4. The glomerular filtration rate evaluated by the Gault-Cockroft equation showed a hyperfiltration with a mean value of 150 ± 42 ml/min. Eleven% had a decreased GFR < 90 ml/min. Microalbumine/creatinine ratio measured in the urine spot was 7 ±4. Mean microalbuminuria was 225 ± 529 mg/d measured on the 24 h urine collection.Urine 24 h Na excretion rate was 204 ± 48 mmol/d. Conclusion: In conclusion, after the post-partum period, women having suffered from a pre-eclampsia display many cardiovascular risk factors with a high prevalence of hypertension, microalbuminuria, renal hyperfiltration and elevated CRP. These women should be carefully screened, and sub-groups with the higher risk have to be targeted for prevention and treatment, and close follow-up.
Objectives: The aim of this case-control study is to compare the incidence and the characteristics of preeclampsia in women who conceived by oocyte donor or by homologous IVF. Methods: Data were collected from 65 consecutive women who conceived through oocyte donor IVF and 71 consecutive pregnancies from homologous IVF in women older than 35 years (control group), who attended our institution between 2009 and 2011. Data are expressed as percentage, average and standard deviation (SD). Statistical analysis was performed by chi-square test for unpaired data and the results were considered significant with p < 0.05. Results: Thirteen women from the donor oocyte group were excluded because of first trimester miscarriage, ectopic pregnancy and lack of data. After the exclusion, 52 pregnancies from oocyte donation were compared to the control group. Baseline characteristics, such as maternal age, BMI, parity and prevalence of twin pregnancies were similar in the two groups. Preexisting hypertension was present only in the oocyte donor IVF group (n = 6 cases). The risk of preeclampsia was significantly related to oocyte donor IVF (27% vs 5.6%, p = 0.0024 OR = 6.17), even when only singleton pregnancies were considered (16.7 vs 1.9%; p = 0.02, OR = 9). When women with preexisting hypertension were excluded, the incidence of severe preeclampsia remained significant (p = 0.02). This result was not confirmed when both preexisting hypertension and twin pregnancies were excluded (p = 0.09), even if the percentage of cases was higher in the oocyte donor IVF group (10.7% vs 1.85%). Three cases of life threatening severe preeclampsia occurred before the 24th week, two of which required interruption of pregnancy; one case was complicated by eclampsia. The two groups did not show significant differences in terms of prevalence of IUGR, both in multiple and singleton pregnancies, even if percentage values were higher in the donor IVF group (multiple: 21.2% vs 11.3%, p = 0.21/ singleton 10% vs 5.6%, p = 0.48). Conclusion: IVF with oocyte donation stands as an independent risk factor for preeclampsia. The risk of developing a severe and early preeclampsia may be increased when chronic hypertension occurs. Disclosure of interest: None declared.
Disclosure of Interest: None Declared doi:10.1016/j.preghy.2012.04.220 doi:10.1016/j.preghy.2012.04.219
PP109. Risk of preeclampsia in homologous and oocyte donation IVF pregnancies S. Simeone *, M.P. Rambaldi, S. Ottanelli, C. Serena, G. Mello, F. Mecacci (Centro di Riferimento Regionale per la Medicina materno–fetale e le gravidanze ad alto rischio, AOU Careggi– Università degli Studi di Firenze, Florence, Italy)
PP110. The role of doppler to predict adverse pregnancy outcome in patients with pre-eclampsia G. Pagani *, V. Gerosa, M.E. Gregorini, P.L. Rovida, F. Prefumo, A. Valcamonico, T. Frusca, L. Andrea (Maternal Fetal Medicine Unit, Dept. Obstetrics and Gynecology–University of Brescia, Brescia, Italy)
Introduction: Women who conceived by donor oocyte in vitro fertilization (IVF) are at high risk for placenta-related complications, because of advanced maternal age, nulliparity and maybe for an altered immune response.
Introduction: Recently Middle Cerebral Artery (MCA) to uterine artery (UtA) Pulsatility Index (PI) ratio and MCA to Umblical Artery (UA) PI ratio have been described to be good predictors of neonatal outcome in pre-eclamptic patients in
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 2 (2012) 240–339
(1 Hypertension Unit, University Hospital Geneva, Switzerland, 2 Obstetrics, University Hospital, Geneva 4, Switzerland, 3 Nephrology, CHUV, Lausanne, Switzerland, 4 Primary Care and Emergencies, University Hospital, Geneva 4, Switzerland) Introduction: Recent data have shown that preeclampsia is not just a disease of pregnancy that resolves with delivery. Preeclampsia may be considered a ‘risk marker’ for later-life diseases, including cardiovascular and renal diseases and the metabolic syndrome. Objectives: We aimed a longitudinal prospective study to analyze the renal abnormalities in the post-partum. Methods: We studied 127 post-preeclamptic women at 6 weeks post-partum. Twenty-four hour urine collection, ambulatory blood pressure and renal function were evaluated. Results: The mean age (±SD) was 32 ± 6 years, BMI was 29.4 ± 5.7, the race distribution was Caucasian 69%, Hispanic 14%, Black 12% and Orient 5%. Ten % were active smokers, 10% have been suffering from gestational diabetes. The mean duration of the pregnancy was 36 weeks 3/7 ± 4. Our results show that the prevalence of hypertension defined by office blood pressure 140/90 mmHg or ongoing antihypertensive treatment was 35%. The daytime ambulatory blood pressure (ABPM) was 122 ± 16/85 ± 11 mmHg, heart rate 84 ± 8, and 111 ± 20/75 ± 11 mmHg at nighttime. Sixteen % had a daytime ABPM 135/85 mmHg corresponding to the definition of ambulatory hypertension. Ultrasensitive CRP was 4.9 ± 5.1 mg/ml, of them 31% had a frank elevation of the CRP >4. The glomerular filtration rate evaluated by the Gault-Cockroft equation showed a hyperfiltration with a mean value of 150 ± 42 ml/min. Eleven% had a decreased GFR < 90 ml/min. Microalbumine/creatinine ratio measured in the urine spot was 7 ±4. Mean microalbuminuria was 225 ± 529 mg/d measured on the 24 h urine collection.Urine 24 h Na excretion rate was 204 ± 48 mmol/d. Conclusion: In conclusion, after the post-partum period, women having suffered from a pre-eclampsia display many cardiovascular risk factors with a high prevalence of hypertension, microalbuminuria, renal hyperfiltration and elevated CRP. These women should be carefully screened, and sub-groups with the higher risk have to be targeted for prevention and treatment, and close follow-up.
Objectives: The aim of this case-control study is to compare the incidence and the characteristics of preeclampsia in women who conceived by oocyte donor or by homologous IVF. Methods: Data were collected from 65 consecutive women who conceived through oocyte donor IVF and 71 consecutive pregnancies from homologous IVF in women older than 35 years (control group), who attended our institution between 2009 and 2011. Data are expressed as percentage, average and standard deviation (SD). Statistical analysis was performed by chi-square test for unpaired data and the results were considered significant with p < 0.05. Results: Thirteen women from the donor oocyte group were excluded because of first trimester miscarriage, ectopic pregnancy and lack of data. After the exclusion, 52 pregnancies from oocyte donation were compared to the control group. Baseline characteristics, such as maternal age, BMI, parity and prevalence of twin pregnancies were similar in the two groups. Preexisting hypertension was present only in the oocyte donor IVF group (n = 6 cases). The risk of preeclampsia was significantly related to oocyte donor IVF (27% vs 5.6%, p = 0.0024 OR = 6.17), even when only singleton pregnancies were considered (16.7 vs 1.9%; p = 0.02, OR = 9). When women with preexisting hypertension were excluded, the incidence of severe preeclampsia remained significant (p = 0.02). This result was not confirmed when both preexisting hypertension and twin pregnancies were excluded (p = 0.09), even if the percentage of cases was higher in the oocyte donor IVF group (10.7% vs 1.85%). Three cases of life threatening severe preeclampsia occurred before the 24th week, two of which required interruption of pregnancy; one case was complicated by eclampsia. The two groups did not show significant differences in terms of prevalence of IUGR, both in multiple and singleton pregnancies, even if percentage values were higher in the donor IVF group (multiple: 21.2% vs 11.3%, p = 0.21/ singleton 10% vs 5.6%, p = 0.48). Conclusion: IVF with oocyte donation stands as an independent risk factor for preeclampsia. The risk of developing a severe and early preeclampsia may be increased when chronic hypertension occurs. Disclosure of interest: None declared.
Disclosure of Interest: None Declared doi:10.1016/j.preghy.2012.04.220 doi:10.1016/j.preghy.2012.04.219
PP109. Risk of preeclampsia in homologous and oocyte donation IVF pregnancies S. Simeone *, M.P. Rambaldi, S. Ottanelli, C. Serena, G. Mello, F. Mecacci (Centro di Riferimento Regionale per la Medicina materno–fetale e le gravidanze ad alto rischio, AOU Careggi– Università degli Studi di Firenze, Florence, Italy)
PP110. The role of doppler to predict adverse pregnancy outcome in patients with pre-eclampsia G. Pagani *, V. Gerosa, M.E. Gregorini, P.L. Rovida, F. Prefumo, A. Valcamonico, T. Frusca, L. Andrea (Maternal Fetal Medicine Unit, Dept. Obstetrics and Gynecology–University of Brescia, Brescia, Italy)
Introduction: Women who conceived by donor oocyte in vitro fertilization (IVF) are at high risk for placenta-related complications, because of advanced maternal age, nulliparity and maybe for an altered immune response.
Introduction: Recently Middle Cerebral Artery (MCA) to uterine artery (UtA) Pulsatility Index (PI) ratio and MCA to Umblical Artery (UA) PI ratio have been described to be good predictors of neonatal outcome in pre-eclamptic patients in
