title: PP057. The role of uterine artery pulsatility index for prediction of pregnancy outcome, in women affected by pre-eclampsia.
abstract: BACKGROUND
  Uterine artery (UtA) Pulsatility index assessed in the second trimester is known to be the best predictor of Pre-eclampsia (PE) in women with risk factors. The role of this index when PE occurs seems to be related with clinical outcome.
  
  
  OBJECTIVE
  To detect if there does exist a correlation between mean UtA PI, assessed at diagnosis of PE, and: (A) Gestational Age (GA) at delivery; (B) birth weight (BW) percentile. To detect the predictive value of mean UtA PI and the development of adverse pregnancy outcome (APO).
  
  
  METHODS
  Cohort study on 100 consecutive singleton pregnancies complicated with pre-eclampsia referred to our Department from January 2010 and December 2011. Doppler evaluations were performed from diagnosis to delivery. Mean UtA PI obtained at time of diagnosis of PE were analysed. PE was defined according to ISSHP criteria. Clinical and perinatal outcomes were reviewed. APO was defined as Apgar score less than 7 at five minutes, pH <7.20; birth weight <5th percentile (SGA), stillbirth or neonatal death. Receiver-operating characteristics (ROC) curve was used to determine the predictive ability for subsequent development of APO.
  
  
  RESULTS
  Maternal characteristics and main pregnancy outcomes are shown in Table 1. Fifty-six pregnancies developed APO. One case of stillbirth and four cases of neonatal death were observed. SGA occurred in 56/100 neonates; 52/95 (55%) live births were admitted to Neonatal Intensive Care Unit. Table 1. Mean UtA PI at diagnosis of PE was 1.40 (SD±0.28) in women that developed APO and 1.10 (SD±0.41) in women that did not develop APO (p=0.02). Pearson's Correlation coefficient for mean UtA PI and GA at Delivery was -0.533 (p=0.002); while for mean UtA PI and BW percentile was -0.466 (p=0.007). The prediction of subsequent development of APO, expressed as the area under ROC curve, was 61.6 (95% CI 0.44-0.79) for UtA PI at Diagnosis of PE.
  
  
  CONCLUSIONS
  Our data confirm that mean UtA PI, assessed at diagnosis of PE, represent a good independent predictor for GA at delivery end BW percentile. However the predictive value for development of APO seems to be poor.
authors.affiliation: Maternal Fetal Medicine Unit, Dept. Obstetrics and Gynecology-University of Brescia, Brescia, Italy.
authors.forename: M E
authors.initials: ME
authors.lastname: Gregorini
authors.affiliation: Maternal Fetal Medicine Unit, Dept. Obstetrics and Gynecology-University of Brescia, Brescia, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Gerosa
authors.affiliation: Maternal Fetal Medicine Unit, Dept. Obstetrics and Gynecology-University of Brescia, Brescia, Italy.
authors.forename: P L
authors.initials: PL
authors.lastname: Rovida
authors.affiliation: Maternal Fetal Medicine Unit, Dept. Obstetrics and Gynecology-University of Brescia, Brescia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Pagani
authors.affiliation: Maternal Fetal Medicine Unit, Dept. Obstetrics and Gynecology-University of Brescia, Brescia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Platto
authors.affiliation: Maternal Fetal Medicine Unit, Dept. Obstetrics and Gynecology-University of Brescia, Brescia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Valcamonico
authors.affiliation: Maternal Fetal Medicine Unit, Dept. Obstetrics and Gynecology-University of Brescia, Brescia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Lojacono
authors.affiliation: Maternal Fetal Medicine Unit, Dept. Obstetrics and Gynecology-University of Brescia, Brescia, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Frusca