J. Miranda

Performance of a third trimester combined screening model for the prediction of adverse perinatal outcome

To explore the potential value of third‐trimester combined screening for the prediction of adverse perinatal outcome (APO) in the general population and among small‐for‐gestational‐age (SGA) fetuses.

Prediction of fetal growth restriction using estimated fetal weight vs a combined screening model in the third trimester

To compare the performance of third‐trimester screening, based on estimated fetal weight centile (EFWc) vs a combined model including maternal baseline characteristics, fetoplacental ultrasound and maternal biochemical markers, for the prediction of small‐for‐gestational‐age (SGA) neonates and late‐onset fetal growth restriction (FGR).

OP19.07: Fetoplacental Doppler association with placental pathology in pre-eclampsia and fetal growth restriction: Short oral presentation abstracts

L. Youssef1, J. Miranda2, C. Paules2, F. Crovetto2, F. Figueras2, E. Eixarch2, A. Nadal1, C. Rovira3, F. Crispi2, E. Gratacós2 1Pathology, Hospital Clinic-IDIBAPS, Barcelona, Spain; 2BC Natal, Barcelona, Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clı́nic and Hospital Sant Joan de Deu) and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain; 3Pathology, Hospital Sant Joan de Deu, Barcelona, Spain

OC09.06: Placental ageing in term small‐for‐gestational age and growth‐restricted fetuses

maternal maldevelopment (%) 2.2 16.2* 2.5 maternal perfusión (%) 28.4 73.8* 33.1 maternal loss of integrity (%) 3.7 6.2 6.4 maternal lesions (%) 32.1 76.2* 36.9 fetal maldevelopment (%) 3 0 8.3* fetal malperfusion (%) 11.2 13.8 11.5 fetal loss of integrity (%) 21.6 13.8 15.3 fetal lesions (%) 33.6 27.5 33.5 vascular lesions (%) 53.7 83.8* 56.7 infectious lesions (%) 13.4 2.5* 6.4 immune lesions (%) 9.7 16.2 8.3 inflammatory lesions (%) 21.6 18.8 14.6

OP01.08: Prenatal stress modifies RNA expression of HSD11β2 and the hypothalamic‐pituitary‐adrenocortical axis in fetal growth restriction

criteria was single cut of point method found by ROC curve. The second classification criteria was CPR value under <5th centile using Barcelona Calculator. The two methods of classifications criteria were applied on AGA and SGA groups independently. These two methods were compared and analysed for each study group. For statistical analysis T test and Chi square test were used as appropriate. Results: Over all, 481 pregnant women were eligible for the study, 170 in SGA group and 311 in AGA group. In the SGA group, Barcelona Calculator classification method was found better predictor over single cut off point method with Odds Ratio 5.2 and 3.01 respectively and Likelihood Ratio 19.3 and 10 p<0.0001, p 0.00151, respectively. In AGA group, CPR was not found predictor of mode of delivery in both methods. Conclusions: Classification criteria based on CPR value <5th centile to classify CPR as pathologic value, has been found a better predictor for mode of delivery in SGA fetuses group. In AGA fetuses, CPR was not found predictor with any of the methods of classification criteria.

OC09.03: *Pattern of placental stromal‐vascular lesions in small fetuses with and without pre‐eclampsia

Objectives: To evaluate the effect of the treatment with nitric oxide (NO) donors in pregnant women with small-for-gestational age fetuses. Methods: 48 pregnant women referred for small for gestational age (SGA) fetus underwent a non-invasive hemodynamic measurement and an ultrasonic assessment of fetal growth. We obtained three subgroups according to total vascular resistance (TVR): Group A (high TVR treated, n=13), Group B (high TVR untreated, n=15) and Group C (low TVR untreated, n=20). After 4 weeks, we repeated fetal biometry and maternal cardiovascular assessment. Furthermore our aim was to identify those fetuses which turned their conditions to pathological intrauterine growth restriction (IUGR). Results: In table 1, we reported maternal main hemodynamic parameters in the three groups after 4 weeks of treatment/no treatment. Our data demonstrated that SGA fetuses with high TVR under treatment showed an improvement of maternal hemodynamic parameters after 4 weeks (see graph). Group B patients showed an impaired hemodynamic pattern, having an increased risk to develop IUGR and other complications. Conclusions: Maternal hemodynamic assessment at diagnosis of a SGA fetus might identify patients at risk to turn to pathological growth restriction. The preventive use of NO donors has shown to improve the impaired cardiovascular pattern and fetal outcomes.

OP01.02: Placenta‐derived exosomes in pregnancies complicated with fetal growth restriction at term

Objectives: Evaluation of the fetus at risk for uteroplacental insufficiency and growth restriction applies spectral Doppler measurements of the fetal circulation. Our objective is to determine if fetuses with abdominal circumference (AC) below the 5th or weight (EFW) below the 10th percentile will have lower values for the cerebroplacental ratio or the cerebrorenal ratio. Methods: We evaluated 2900 unselected women with multiple associated fetal and maternal co morbidities in whom we measured both the CPR and the CRR using previously standardised methodology. Results: No discernible differences were found between fetuses with low AC <5 or 10 percentile and fetuses with EFW <10% and the CRR or CPR of the appropriately grown fetuses. We plotted the values of each on previously created reference curves (figure). Conclusions: The measurement of the CPR or the CRR among fetuses with AC <10th percentile was not better than EFW <10th percentile to identify fetuses that would ultimately have a lower value consistent with centralisation of fetal blood flow.

OP13.07: Targeted lipidomics of maternal and cord blood in term gestations with suboptimal fetal growth

J. Miranda1, R.V. Simoes1, C. Paules1, N. Amigó2, M. Pardo2, M.L. Garcı́a-Martı́n3, F. Figueras1, E. Eixarch1, F. Crispi1, E. Gratacós1 1Maternal Fetal Medicine, BCNatal–Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clı́nic and Hospital Sant Joan de Déu) and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain; 2Biosfer Teslab, Reus, Spain; 3Nano-Imaging Facility, Andalusian Centre for Nanomedicine and Biotechnology (BIONAND), Malaga, Spain

OP07.10: Neurosonographic evaluation of corpus callosum and cortical development in small-for-gestational-age and growth-restricted fetuses

J. Miranda1, C. Paules1, C. Policiano2, N.M. Hahner1, F. Crispi1, E. Eixarch1, E. Gratacós1 1Maternal Fetal Medicine, BCNatal–Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clı́nic and Hospital Sant Joan de Déu) and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain; 2Department of Obstetrics and Gynecology, University Hospital of Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal