PP048. Carotid intima-media-thickness in the first trimester as a predictor of preeclampsia.

Introduction: Carotid intima media thickness (IMT) is an established marker for endothelial dysfunction and cardiovascular risk. The aim of this study was to assess IMT in the first trimester and it's predictive value for preeclampsia.

Method: We measured IMT on 51 non-pregnant controls (29±4 years) and 601 pregnant women (30±6 years) in the 1. (12.1±2.5 wks; T1), 2. (22.6±2.3 wks; T2), 3. (33.1±3.8 wks; T3) trimester, and postpartum (19.1±15.3 wks; pp) with high-resolution ultrasound.

Results: 38 pregnant women developed gestational hypertension (GH) and 143 preeclampsia (PE). IMT [mean (mm)±SD] of women who later developed PE (28±6 years) was significantly greater (p<0,03) at all visits compared to 420 women who remained normotensive during pregnancy (T1: 0.58±0.1 vs. 0.34±0.16; T2: 0,.3±0.1 vs. 0.34±0.1; T3: 0.49±0.09 vs. 0.34±0.13; pp: 0.56±0.31 vs. 0.39±0.14) and non-pregnant controls (0.44±0.08). IMT of women who later developed GH was not different compared to normotensive pregnant and non-pregnant controls (T1: 0.42±0.20; T2: 0.35±0.18; T3: 0.49±0.09; pp: 0.44±0.19). Using a cut-off value of >0.5 mm we would be able to predict PE already in the first trimester with a positive predictive value of 45.5 % and a sensitivity of 76.9 %.

Conclusion: IMT is increased starting from first trimester onwards in women who later developed preeclampsia but not in women developing gestational hypertension. In high risk pregnancies measurement of IMT could represent an easy to use early detection method to predict preeclampsia noninvasively.