S780 Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867

was higher than risk for cases only with hypertension, (OR=1.31;

CI95%: 0.54–3.15 vs. OR=1.16; CI95%: 0.39–3.40), respectively.

Moreover, there was noted a positive correlation between −592A

IL-10 genotype and PE with protein excretion >1g/24 hrs. (OR=1.35;

95%CI: 0.34–5.43 for C/A genotype and OR=1.84; 95%CI: 0.27–12.35

for A/A homozygote). Although insignificant association between

IL-10 592C>A and onset of the PE was assessed, a slight trend for

higher prevalence of early form (<34g.w.) was noted in A allele

carriers (OR=1.37; 95%CI: 0.14–13.02).

Conclusions: The risk of hypertensive disorders in pregnancy

may be elevated among Slovak women with IL-10 592C>A

polymorphisms, where the A allele may be associated with severe

cases of PE.

Acknowledgement: Supported by project CEPV II co-financed from

EU sources.

W231

OVERVIEW OF ECLAMPSIA AT PAROPAKAR MATERNITY AND

WOMEN’S HOSPITAL, KATHMANDU, NEPAL

B. Shakya1,2, A. Vaidya1,2. 1OB/GYN, Paropaker Maternity and

Women’s Hospital, Kathmandu, Nepal; 2National Academy of Medical

Sciences, Kathmandu, Nepal

Objectives: To study morbidity and mortality of eclampsia cases at

Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal.

Materials: This is a retrospective observational study undertaken

in Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal

on 45 eclampsia cases from April 14, 2010 to July 16, 2011.

Methods: This is a retrospective observational study undertaken

at Paropakar Maternity and Women’s Hospital, Thapathali,

Kathmandu, Nepal. In-patient numbers of eclampsia cases were

retrieved from admission room and intensive care unit registers.

The charts were collected fromMedical Record Section. The medical

records of 45 eclampsia cases were reviewed from April 14, 2010

to July 16, 2011. The frequency table has been used for analysis.

Results: Out of 31,674 obstetric admissions, 45 (0.14%) formed

eclampsia cases of which 42.2% belonged to 20-<25 years and

28.8% in 17-<20 years age group occurring mostly in primipara

(71.1%). Antepartum and postpartum eclampsia formed 77.7% and

22.2% respectively. Majority of them presented at 36–40 weeks’

(46.6%) followed by 31–35 weeks’ (24.4%), 26–30 weeks’ (4.4%)

and 41 weeks’ (2.2%) of gestation; unbooked cases being 80% and

20% had antenatal check-up at this hospital. The diastolic blood

pressure on admission recorded was 110–130mmHg (55.5%), with

convulsion of one episode (55.5%), 2 to 6 episodes (40%) and

10 episodes at home (4.4%), headache being the most common

symptom (53.3%), blurred vision (22.2%), HELLP syndrome (4.4%)

and urine albumin 3+ (46.6%) at the time of admission. Magnesium

sulphate was used as anticonvulsant, loading and maintenance dose

(40%) and only as loading dose (33.3%). The most frequently used

antihypertensive agent was Nifedipine (62.2%). Mode of delivery

included cesarean section (53.3%) and vaginal delivery (46.6%) with

fetal outcome of normal (44.4%), premature (24.4%), intrauterine

growth restriction (17.7%) and intrauterine fetal demise (13.3%).

Three (6.6%) cases were referred to multidisciplinary centre, for

renal failure in 2 cases and another to rule out central nervous

system disorder. Maternal mortality occurred in 2 (4.4%) cases, one

died of cardiopulmonary arrest and the other had presented with

atypical eclampsia, died of prolonged hypoxia.

Conclusions: Emphasizing the early and regular antenatal check-up

for all the pregnant women allows for early diagnosis and treatment

of preeclampsia. Treating preeclampsia may prevent eclampsia and

its consequences.

W232

SENSITIVITY, SPECIFICITY, POSITIVE PREDICTIVE VALUE,

NEGATIVE PREDICTIVE VALUE AND ACCURACY OF ULTRASOUND

SCREENING ON FIRST TRIMESTER (11–14WK) IN THE

PREDICTION OF PREECLAMPSIA

E.A. Figueiro-Filho1, M.V. Galhardo1, B.A. Souza1. 1Obstetrics and

Gynecology, Faculty of Medicine – Federal University of Mato Grosso

do Sul, Campo Grande, Mato Grosso do Sul, Brazil

Objectives: To assess the sensitivity, specificity, positive predictive

value, negative predictive value and accuracy of ultrasound

screening of first trimester (11–14wk) in the prediction of

preeclampsia.

Materials: This was a prospective observational study of 195

pregnant women screened with ultrasound for the first trimester

of pregnancy, with risk calculations using the Fetal Medicine

Foundation software Astraia® – ’First Trimester Screening Program’

version 2.3.2_12.

Methods: The calculated risk of developing preeclampsia in the first

trimester were compared with the final outcome of pregnancies in

women studied. It was considered high risk for developing pre-

eclampsia all pregnant women that reached a calculated risk in the

first trimester greater than or equal to 5%. This study was approved

by the Ethics Committee (CEP/UFMS), 1859 Protocol of 09.30.2010.

Results: Among the patients studied, 19% (n =37) had high risk

for developing preeclampsia calculated in the first trimester.

Development of pre-eclampsia was confirmed in 12% of the

sample (n =24). There was a statistically significant association

between first-trimester ultrasound screening and the development

of preeclampsia (p < 0.01, OR=14.28, 95%CI 5.44 to 37.45). The

sensitivity of ultrasound screening for preeclampsia in the first

trimester was 66.0%, specificity 87.0%, positive predictive value

(PPV) of 43.0%, negative predictive value (NPV) of 94.0%.

Conclusions: Screening of first trimester ultrasound between

11–14 weeks, in order to predict preeclampsia, using specific

software obtained good specificity, high NPV and accuracy of 85%.

Preeclampsia developing calculated risk in first trimester and preeclampsia

confirmed at the end of pregnancy

16 (8%) 21 (11%)

8 (4%) 150 (77%)

W233

POLYMORPHISMS IN THE ANNEXIN A5 GENE PROMOTER IN

JAPANESE WOMEN WITH PREECLAMPSIA

H. Miyamura1,2, H. Nishizawa1, S. Ota2, M. Suzuki2, A. Inagaki2,

H. Inuzuka1,2, S. Nishiyama1, H. Kurahashi2, Y. Udagawa1.1Department of Obstetrics and Gynecology, Fujita Health University

School of Medicine, Toyoake, Aichi, Japan; 2Division of Molecular

Genetics, Institute for Comprehensive Medical Science, Fujita Health

University, Toyoake, Aichi, Japan

Objectives: Annexin A5 (ANXA5) is known as placental

anticoagulant protein. Recently a common haplotype called M2

haplotype consisting of minor alleles of four SNPs (SNP1–4: g.-

467G.A, g.-448A.C, g.-422T.C, g.-373G.A) located at the promoter

region of the ANXA5 gene has been described as risk factor for

recurrent pregnancy loss (RPL). In our present study, we examined

the association between the ANXA5 gene variants and preeclampsia

(PE).

Materials: In our present study, placental DNAs from 47 Japanese

PE patients and 50 normotensive controls were genotyped for the

four ANXA5 gene promoter SNPs reported previously. Additional

two SNPs (SNP5 and 6: g-302T>G, g.-1C>T) were also examined.

Among them, 34 PE patients and 22 normotensive controls were

also genotyped using their blood samples.

Methods: We investigated the expression of ANXA5 mRNA in

placentas from PE cases and controls with qRT-PCR. These data