24th World Congress on Ultrasound in Obstetrics and Gynecology Electronic poster abstracts

found in the control group (median47.0% vs.41.4%,p = 0.03).In the placental insufficiency group, total polyunsaturated FAwere reduced in fetal plasma when compared to the mother(median21.1% vs.30.0%,p = 0.005) and the same occurred in thecontrol group (median27.5% vs.32.9%,p = 0.01). In the placentalinsufficiency group the n-6 polyunsaturated FA were reduced inthe fetal plasma when compared to the mother (median18.6%vs.27.4%,p = 0.004) whereas no difference was found in the controlgroup (median25.2% vs.28.7%,p = 0.27).There were no differencesin the total monounsaturated and n-3 polyunsaturated fatty acidsbetween maternal and fetal circulations.Conclusions: In an apparently well-nourished population with pla-cental insufficiency we found alterations in maternal fetal transfer ofFA. We speculate that the reduced fetal concentrations of n-6 FA maybe due to the consumption, as precursors of inflammatory cytokines.

P13.15Maternal plasma fatty acid composition in pregnanciescomplicated by placental insufficiency

R.M. Nomura, R.F. Saffioti

University of Sao Paulo, Sao Paulo, Brazil

Objectives: To analyze the fatty acids (FA) concentrations in thematernal plasma of pregnant women with placental insufficiency,and to compare with high risk pregnancies with normal placentalfunction.Methods: A prospective cross-sectional study with following inclu-sion criteria: singleton pregnancy, fetus alive; above 26 weeks gesta-tion; diagnosis of placental insufficiency characterized by abnormalumbilical artery Doppler (PI > 95p); absence of fetal abnormalitiesor diabetes, without omega n-3 supplementation. Maternal bloodsamples were collected at the day of delivery. Total FA weredetermined in maternal and fetal plasma. Samples were processedusing direct esterification and their composition was determined bygas chromatography. Results were expressed as % of total FA.Results: We included 21 pregnant women in the study groupwith placental insufficiency and 21 pregnant women in the con-trol group. No difference was found in the median BMI (studygroup = 26.5kg/m2,control group = 28.0kg/m2,p = 0.563). Percent-age values of saturated FA among mothers from the placentalinsufficiency group were significantly higher than controls (median44.9% vs.41.4%,p = 0.02), whereas total polyunsaturated FA weresignificantly reduced (median29.5% vs.32.9%,p = 0.02). There wasno difference in the total monounsaturated FA between the groups(median24.4% vs.24.2%,p = 0.55). The analysis of n-3 and n-6polyunsaturated FA in the maternal circulation, we found lower con-centrations of n-3 in the group with placental insufficiency than con-trols (median0.88% vs.1.07%,p = 0.04), and no differences betweengroups regarding n-6 levels (median 27.9% vs. 28.7%,p = 0.62).Conclusions: In an apparently well-nourished population withplacental insufficiency we found alterations in maternal plasmacontent of FA. Growth restricted fetuses are at high risk to haveneurodevelopmental impairment and reduced concentrations of n-3in maternal circulation may contribute to adverse perinatal outcome.

P13.16Does the prenatal multi vessel Doppler ultrasound andcomputerised fetal heart tracing in early-onset IUGR predictthe neonatal mortality and long-term neurodevelopment?

C. Bamberg1, A.L. Faensen1, H. Lehmann1, M. Berns2,B. Metze2, C. Buehrer2, W. Henrich1

1Obstetrics, Charite University Hospital, Berlin, Germany;2Neonatology, Charite University Hospital, Berlin, Germany

Objectives: To describe the predictive value of prenatal Dopplervelocities and computerised fetal heart rate analysis (cCTG) for short

and long term outcome of intrauterine growth restricted (IUGR)infants.Methods: A retrospective cohort study of 176 liveborn withbirthweight <10th percentile and abnormal Doppler ultrasoundof the umbilical artery (UA). The singletons were born preterm at24-34 weeks of gestation.Within 48 hours before birth the antenatalassessment of blood flow in the UA (n = 156), middle cerebralartery (MCA, n = 146), ductus venosus (DV, n = 93) as well as theshort-term variation (STV, n = 85) of cCTG were correlated to themortality and morbidity. Neurodevelopment was evaluated after twoyears of corrected age (n = 122) using the Bayley and Griffith’s scales.Results: Mean gestational age at delivery was 29+/-3 weeks,and mean birthweight was 827+/-300 g. 98% were deliveredby Caesarean section and 89% received prenatal steroids. Oneyear mortality (n = 21, 12%) was predicted by absent or reversedenddiastolic flow (n = 58) in the UA, zero or negative a-Wave(n = 10) in the DV and lower STV (n = 4) in cCTG. Death (n = 21)or abnormal neurodevelopment (n = 17, 2 SD below the mean)occured in 38 infants and were significantly associated with elevatedUA flow (n = 12) and absent (n = 6) or reversed enddiastolic flow(n = 12). Furthermore the PI of the MCA but not brain sparing (PIMCA < 5th percentile) as well as STV in cCTG were associatedwith death and or abnormal neurodevelopment. After multiplelogistic regression analysis gestational age, birthweight and headcircumference at delivery remained the only independent variablesfor death and or abnormal neurodevelopment.Conclusions: Our data show that abnormal Doppler of UA,MCA, DV and cCTG abnormalities in interaction with gestationalage, birthweight and head circumference predict death and orneurodevelopmental impairment in IUGR fetuses < 34 weeks. Itremains to be determined which parameters are the best for timingof delivery.

P13.17The outcome of severe growth-restricted infants at 28 daysafter birth and prognostic factors

A. Yoshida1, N. Umehara1, K. Ozawa2, K. Ichizuka3,K. Tanaka4, T. Tanemoto5, H. Ishikawa6, T. Murakoshi7,J. Sasahara8, K. Ishii8, K. Kiyoshi9, H. Sago1

1National Center for Child Health and Development, Tokyo,Japan; 2Miyagi Children Hospital, Miyagi, Japan; 3ShowaUniversity, Tokyo, Japan; 4Kyorin University, Tokyo, Japan;5The Jikei University School of Medicine, Tokyo, Japan;6Kanagawa Children’s Medical Center, Kanagawa, Japan;7Seirei Hamamatsu General Hospital, Hamamatsu, Japan;8Osaka Medical Center and Research Institute for Maternaland Child Health, Osaka, Japan; 9Hyogo Prefecture KobeChildren’s Hospital, Hyogo, Japan

Objectives: Small for gestational age (SGA) infants are associatedwith neonatal mortality and morbidity such as cerebral palsy.However, critical prenatal factors to predict them have not beendetermined. We conducted the retrospective cohort study of severeSGA infants (birthweight < 3%tile) to identify the prenatal riskfactors associated with the outcomes of severe SGA infants.Methods: The subjects were severe SGA singleton infants withoutcongenital abnormality delivered from 22 weeks to 34 weeks ofgestation between January 1, 2006 and December 31, 2010. Thisstudy was conducted in nine tertiary perinatal centers in Japan.

We enrolled 366 infants met our inclusion criteria and 3 infantswere excluded from analysis because of lost to follow up. Weanalyzed 363 infants in the present study.

Infants with poor outcomes were defined when infants weredead or complicated with severe morbidity at 28 days after birth.Severe morbidity was also defined when severe brain damage suchas intraventricular hemorrhage Grades 3-4 and/or periventricularleukomalacia was detected.

258 Ultrasound in Obstetrics & Gynecology 2014; 44 (Suppl. 1): 181–369.