Three-dimensional ultrasonography using the VOCAL technique for estimation of reference range between 7 and 11 weeks embryonic volume

ObjectiveAccurate estimation of gestational age (GA) is the basis of vital decisions in pregnancy and hence its importance in obstetric management. This study tries estimating a reference range of 3D embryonic volume using the VOCAL technique for pregnancies between 7 and 11 weeks.Materials and methodsThis cross-sectional study included 62 singleton normal uneventful pregnancies. All women were essentially sure of the date of last menstrual period. All women were submitted to 3D ultrasonographic examination with VOCAL technique to determine the embryonic volume. In addition the crown-rump length was measured. Regression analysis was performed to predict the gestational age from the fetal volume.ResultsThere was a strong positive correlation between embryonic volume and menstrual age, gestational age and crown-rump length (r = 0.919, 0.938 and 0.941, respectively). Power regression model produced R² value of 0.838 with a regression equation (y = 52.22 + 6.5 x).ConclusionThis study demonstrated that embryonic/fetal volume is a good predictor of gestational age with a power regression equation (y = 52.22 + 6.5 x) for the period from 7 to 10 weeks + 6 days. We suggest using the embryo volume as an early evidence of growth restriction in high risk pregnancy.     

Lipid concentration in small for gestational age (SGA)pregnancies and hypertensive disorders

ObjectiveLow maternal serum lipid and high maternal serum lipid have both been associated with some complications in pregnancy. The lipid profiles in pregnancies complicated by small for gestational age (SGA) or hypertension disorders have been compared with those of normal pregnancies.MethodIn a prospective study, 900 pregnant women between 13 and 23 weeks of pregnancy were studied. Primarily, serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, were measured. Ultimately, the serum lipid levels at 13–23 weeks of pregnancies were compared between the women who later suffered from hypertension disorders or SGA and the matched women with normal pregnancies.ResultsAt 13–23 weeks of pregnancy, the mean triglyceride levels were significantly higher in the women who later experienced preeclampsia when compared with normal, matched pregnancies with an appropriate weight for gestational age and women who had gestational hypertension (p = 0.001 and p = 0.014, respectively). Also, triglyceride levels were significantly higher in women with neonates with large for gestational age (LGA) in comparison with those who gave birth to neonates with SGA (p = 0.012) and with uncomplicated matched pregnant women who gave birth to neonates with weight >10th and <90th percentile for their gestational age (p = 0.007).ConclusionOnly the levels of TG and not any other lipids evaluated were found to be different in pregnancies complicated by preeclampsia when compared to pregnancies complicated by SGA.     

Plasma levels of S100B during pregnancy in women developing pre-eclampsia

ObjectiveS100B is suggested to be a peripheral biomarker of central nervous system injury with increased blood–brain barrier permeability. The aim of this study was to investigate if there is a difference in plasma levels of S100B throughout pregnancy between women developing pre-eclampsia and those who did not.Study designA nested case-control study within a longitudinal study cohort was performed. Healthy pregnant women were enrolled and plasma samples were collected at gestational weeks 10, 25, 28, 33 and 37. Levels of S100B throughout pregnancy were analyzed with an ELISA assay.ResultsThe levels of S100B did not change between gestational weeks 10 and 37 (0.047 vs. 0.052; p = 0.71) in the healthy controls, but the S100B levels increased between corresponding weeks in women who developed pre-eclampsia (0.052 vs. 0.075; p < 0.05). In gestational weeks 33 and 37 women who developed pre-eclampsia had higher levels of S100B than the controls (p = 0.047 and p = 0.010, respectively).ConclusionS100B levels increase during pregnancy in women who develop pre-eclampsia and there is an increased S100B level in women who develop pre-eclampsia compared with healthy pregnancies several weeks before clinical symptoms of the disease. The increased amount of plasma S100B in women developing pre-eclampsia might be secondary to cerebral vascular damage and S100B is a potential peripheral biomarker reflecting cerebral involvement in pre-eclampsia.     

Transient gestational hypertension: Not always a benign event

ObjectivePregnancy outcome in women with transient gestational hypertension (TGH);defined as de novo blood pressure elevation after 20 weeks gestation that normalizes by subsequent evaluation in a Day Assessment Unit.Study designRetrospective cohort analysis of hypertensive pregnancies between 2003 and 2008.Main outcome measuresFinal hypertensive delivery diagnosis and composites of adverse maternal and fetal outcome.ResultsOverall 1417 women were referred; 890 met criteria; 41% (65% of study population) had TGH. Twenty percent with TGH developed gestational hypertension and 19% preeclampsia. Women with TGH who developed preeclampsia had similar composite adverse maternal outcomes to other preeclamptic women (51% vs. 63%; p = 0.24) but fewer adverse fetal outcomes (50% vs. 71%; p < 0.01) due to less prematurity (30% vs. 45%; p = 0.02) and small for gestational age babies (33% vs. 51%; p = 0.02). Within the TGH population;developing gestational hypertension or preeclampsia was associated with referral at gestation <33 weeks (RRR 2.8; p < 0.01);initial average systolic blood pressure 130–139 mmHg (RRR 2.1; p < 0.01) and initial average diastolic blood pressure 80–89 mmHg (RRR 3.2; p < 0.01).ConclusionTGH after 20 weeks is common in pregnancy. Although initial assessment implies low risk;the risk of progression to gestational hypertension or preeclampsia is substantial and warrants appropriate clinical surveillance.     

Body mass index and hypertensive disorders of pregnancy

ObjectivesWe compared the incidence of the hypertensive disorders of pregnancy in obese women with women of a normal body mass index (BMI).Study designProspective observational study in which BMI was calculated accurately early in pregnancy. Women were enrolled after a sonographic confirmation of an ongoing pregnancy. To reduce confounding variables the study was confined to white European women with a singleton pregnancy.Main outcome measuresIncidence of pre-eclampsia and gestational hypertension.ResultsIn 2230 women, 16.8% were obese. Pre-eclampsia was diagnosed in 3.3% (n = 74) and gestational hypertension in 3.0% (n = 67). Both pre-eclampsia (p = 0.01) and gestational hypertension (p < 0.01) were common in obese women compared with normal weight women. Overall 13.1% of obese women developed a hypertensive disorder during pregnancy. When analysed by parity pre-eclampsia occurred in 2.1% of primigravidas and 0.3% of multigravidas. Pre-eclampsia was increased in obese multigravidas (p = 0.001), but not obese primigravidas, suggesting that parity is more influential than obesity in the development of pre-eclampsia.ConclusionsObese multigravidas are more likely to develop hypertensive disorders in pregnancy and obese primigravidas are more likely to develop gestational hypertension. This is important in clinical practice because maternal weight, unlike parity, is potentially modifiable before or during pregnancy.     

Interrupción del embarazo. Estudio comparativo entre diferentes pautas de inducción médica

ObjectiveTo compare the effectiveness of distinct medical induction regimens used for second trimester abortions.Materials and methodsWe performed a retrospective review of 145 pregnancies between 13 and 22 weeks that underwent an induced abortion using four different methods: 1) intraamniotic prostaglandin F2α and endocervical E2; 2) endocervical prostaglandin E2; 3) intravaginal and oral prostaglandin E1; and 4) intravaginal prostaglandin E1. All these methods were followed by oxytocin infusion.ResultsThe mean induction to abortion interval was 20.2 ± 7.6 h; 17.5 ± 8.2 h; 16.8 ± 8.7 h, and 12.6 ± 4.2 h, respectively. The differences were statistically significant when the mean interval was analyzed globally (p = 0.02, ANOVA) and in nonprimigravidas (p = 0.02, ANOVA). The rate of successful abortions within 12 hours was 5.5%, 31%, 32.5% and 50%, respectively (p = 0.002 χ² test). Surgical abortion and serious side effects (one case of disseminated intravascular coagulation) occurred only with prostaglandin E2.ConclusionsVaginal administration of prostaglandin E1 resulted in a shorter mean induction to abortion interval and a higher rate of successful abortions within 12 hours.     

The role of matrix metalloproteinase-2 in the culture media in embryo implantation rate in normogonadotrophic cases undergoing ICSI

ObjectiveThe aim of the study is to correlate the changes in the biochemical marker MMP-2 in the culture media with the outcome of normogonadotrophic cases undergoing ICSI.MethodologyA prospective study of infertile females was conducted in El-Shatby Maternity University Hospital between October 2011 and May 2012 utilizing a sample of 40 normogonadotrophic infertile women (22 females with unexplained infertility and 18 females with tubal factor infertility).ResultsClinical pregnancy was 57.5%; 15 out of the 22 females with unexplained infertility and 8 out of the 18 females with tubal factor infertility. There was no abortion, ectopic or chemical pregnancy. Ongoing pregnancy after 14 weeks of gestational age was 100%.Total (MMP-2) ranged between (4.1 and 21.1) and (3.5–37) ng/ml with the mean of (9.91 ± 5.48) and (13.91 ± 8.87) ng/ml for non pregnant and pregnant groups respectively. There were no statistical significant differences between the two groups regarding total MMP-2 (P = 0.055).The mean of MMP-2/embryo/h ranged between (0.05 ± 0.05) and (0.06 ± 0.08) ng/ml/embryo/h for non pregnant and pregnant groups respectively. There were no statistical significant differences between the two groups regarding MMP-2/embryo/h (P = 0.234).ConclusionsMMP-2 concentration in the culture media cannot be used as a biochemical marker for embryo selection or prediction of implantation in the normogonadotrophic cases undergoing ICSI.RecommendationsResults of the present study suggest searching for other markers in the culture media for better embryo selection and for prediction of implantation in the normogonadotrophic cases undergoing ICSI.     

Pre-eclampsia and gestational hypertension are less common in HIV infected women

ObjectiveTo determine whether pre-eclampsia and gestational hypertension are less common in HIV infected women.MethodsThis prospective cohort study was performed in the Western Cape province of South Africa. HIV negative and positive pregnant women without chronic renal or chronic hypertensive disease were continuously recruited. During the study period HIV positive patients received either mono- or triple (HAART) antiretroviral therapy for prevention of vertical transmission or maternal care. Only routine clinical management was performed. The development of hypertensive disease during pregnancy was recorded.Results1093 HIV positive and 1173 HIV negative cases were identified during pregnancy and evaluated again after delivery. Significantly fewer cases of pre-eclampsia n = 35 (3.2%) were recorded in the HIV positive group than in the HIV negative group, n = 57 (4.9%) (p = 0.045; OR 0.65 95% CI 0.42–0.99). There were also significantly fewer cases of gestational hypertension recorded in the HIV positive group compared to the HIV negative group (p = 0.026; OR 0.53 95% CI 0.30–0.94). Multiple logistic regression analysis confirmed the reductive effect of HIV on pre-eclampsia and gestational hypertension.ConclusionPre-eclampsia and gestational hypertension are less common in HIV infected women being managed with mono- or triple anti-retroviral therapy.     

Impact de la chirurgie bariatrique sur le pronostic obstétrical

ObjectivesAssessment of pregnancy outcomes after bariatric surgery and analysis of follow-up particularities of such pregnancies.Patients and methodsA retrospective study of 63 post-bariatric surgery pregnancies compared to 259 pregnancies of obese un-operated patients. Pregnancy outcomes, neonatal datas, delay influence between surgery and pregnancy beginning, bariatric surgery type and gastric banding (GB) loosening consequences were analysed.ResultsIn the surgical brand were developed less gestational diabetes (DG) (P = 0,05), deliveries were more often normal (P = 0,004) and births shown less macrosomias and small for gestational age newborns (P = 0,04). Neonatal state was improved among operated patients: less Apgar scores less than 7 at 1 minute (P = 0,05) and less cord blood pH less than 7,2 (P = 0,03). They gained more weight during the pregnancy (P = 0,0003) and only 53% had a nutritional management and assessment. Patients with GB loosening gained more weight (P = 0,0003). Lastly, there were no difference due to the different bariatric surgery techniques or nutritional follow-up in the pregnancy course and neonatal state.Discussion and conclusionBariatric surgery improves obstetric and neonatal prognosis. Improvements have to be developed in the multidisciplinary follow-up in order to avoid nutritional deficiencies or important weight gain pregnancy in case of GB.     

Evaluation of coagulation abnormalities among women with vaginal bleeding in the first trimester of pregnancy

ObjectiveTo compare blood coagulation parameters between pregnant women with vaginal bleeding in the first trimester of pregnancy and pregnant women with normal pregnancy in the first trimester.MethodsA prospective controlled study of 98 women in the first trimester of vital pregnancy was conducted at the University Medical Centre Maribor, Slovenia. The study group comprised women with vaginal bleeding (n = 50) while the control group women with normal pregnancy, admitted for artificial abortion (n = 48). Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen concentration, number of platelets, hemogram, coagulation factor VIII (FVIII) and von Willebrand factor (VWF) activity were compared between the 2 groups.ResultsNo significant between-group differences were detected in mean PT, fibrinogen concentration, FVIII, and VWF activity. Mean aPTT was significantly higher in the control group than the study group (32.47 versus 30.46 seconds; P < 0.05). The mean number of platelets was significantly lower in the study group than the control group (181.69 versus 203.52 × 10⁹/L; P < 0.05). All measured coagulation parameters, except VWF activity, were within normal ranges.ConclusionCoagulation abnormalities are rarely the cause of vaginal bleeding in the first trimester of pregnancy among women with no previous symptoms of bleeding disorders.     

Mifepristona (600 mg) + misoprostol (400 μg) en el aborto del primer trimestre

ObjectiveTo evaluate the safety and efficacy of mifepristone 600 mg + oral or vaginal misoprostol 400 μg for early abortionSubjectsThey were included in the study 450 women that freely requested a voluntary pregnancy interruption (IVE) up to 9 weeks gestation, from the private sector in the Clinica Mediterrània Mèdica of Valencia and CastellónResultsRate of complete abortion was 96.7% (95% CI 95–98%); there were not significant statistical differences for the abortion rates among the groups for gestacional age (p = 0.24). The total vaginal bleeding lasted 11.7 ± 5.4 days. The mean time of expulsion was of 4.1 h ± 2.1 hours. The mean time of returning menses was 37 ± 5 daysConclusionsThe association of 600 mg of mifepristone + 400 μg vaginal misoprostol doses is a valid method for abortion up to 9 weeks gestations     

High blood pressure six weeks postpartum after hypertensive pregnancy disorders at term is associated with chronic hypertension

ObjectivesHypertension in pregnancy is associated with cardiovascular disease (CVD) later in life. Blood pressure monitoring in women who experienced hypertension in pregnancy after puerperium has been suggested to be important for early detection and prevention of CVD. The aim of this study is to evaluate if hypertension six weeks postpartum is associated with chronic hypertension in women with a history of term hypertensive pregnancy disorders.Study designWomen with a history of term gestational hypertension or preeclampsia were included in a follow up study of the HYPITAT trial. Blood pressures were measured six weeks and 2.5 years postpartum according to the study protocol.Main outcome measuresHypertension was defined as a diastolic blood pressure ?90 mmHg and/or a systolic blood pressure ?140 mmHg or use of antihypertensive medication. Differences in categorical variables between groups were analyzed by Chi-Square tests. Blood pressure was analyzed using unpaired t-tests and Wilcox ranked tests.ResultsAmong 187 women who had term hypertensive pregnancy disorders, 75 (40%) had hypertension at six weeks postpartum. Of these 46 (61%) had hypertension 2.5 years postpartum. In contrast, of 112 women without hypertension at six weeks postpartum, 36 (32%) had hypertension 2.5 years (OR 3.3, 95% CI 1.8–6.2).ConclusionAmong 61% of women who had hypertensive pregnancy disorders at term, high blood pressure at six weeks postpartum indicated chronic hypertension. This warrants the importance of identification of hypertension 6 weeks postpartum for women’s future health.     

OS001. Pregnancy outcome in subsequent pregnancies after eclampsia

IntroductionEclampsia in the previous pregnancy may have impact on future reproductive performance of the women. Few studies have been conducted in recent years to review the subsequent pregnancy outcome. In this study women with previous eclampsia were followed up in subsequent pregnancy and outcome was compared with normotensive control group.ObjectivesTo study the risk of recurrence of hypertension and associated complications in subsequent pregnancies following eclampsia.MethodsFifty-three pregnant women with previous history of eclampsia were supervised and delivered in PGIMER, Chandigarh, India (2001 April–2011 March) were studied prospectively. The pregnancy outcome was compared with 106 age and gravida matched controls who had remained normotensive in previous pregnancies. The data analysis was done by Chi-square test and Student ‘t’ test.ResultsAmongst women with previous eclampsia eight women (15%) were found to have underlying chronic hypertension. The incidence of gestational hypertension and pre-eclampsia was 37.7% amongst these women, compared to 7.5% in control group (p = 0.0001). Preterm deliveries mainly due to preterm inductions were higher (32%) amongst women with previous eclampsia compared to 12% amongst controls (p = 0.0004). Incidence of intra uterine growth restriction was significantly higher amongst cases (15% vs 1.5%, p = 0.0003).ConclusionWomen with previous eclampsia have higher incidence of chronic hypertension. These women are at significant risk to develop hypertensive disorders of pregnancy and its related complications. The recurrence of eclampsia is low with aggressive and vigilant antenatal care.     

Valores extremos del IMC materno: factores determinantes de peores resultados obstétricos y perinatales

ObjectiveTo study the influence of maternal body mass index (BMI) at the beginning of pregnancy on obstetric-perinatal outcomes.Material and methodsObservational-ambispective study. We recruited 1407 patients with singleton gestations and deliveries of foetuses > 24 weeks between 01/12/2017 and 31/07/2019. The sample was stratified according to their BMI following the WHO classification. Variables on pre-pregnancy, gestational disease, obstetric care, and maternal-perinatal outcomes were analysed and compared between the studied groups. The statistical program has been R Core Team 2020, version 3.6.3. P ≤ .05 was considered significant.ResultsClass II-III (BMI 35-39 and BMI ≥ 40 respectively) obese women have a higher risk of chronic arterial hypertension (OR 53.54, 95% CI 18.21-229.02), gestational diabetes (OR 5.24, 95% CI 2.87-9.51) and preeclampsia (OR 2.38, 95% CI 0.95-5.51 with P = .049). The underweight women had more intrauterine growth restriction diagnoses (OR 3.09, 95% CI 1.46-6.17). Inductions of labour and caesarean sections increase as BMI increases (P = .006). Low weight patients also had a higher risk of caesarean section (OR 2.46, 95% CI 1.06-5.20). Neonatal admissions were more frequent in obese and underweight women (OR 2.68, 95% CI 1.39-5.00 and OR 2.56, 95% CI 1.10-5.44 respectively). Obese women had a higher risk of neonatal weight > 4000 g (OR 3.06, 95% CI 1.57-5.77) and low weight pregnant women had a higher risk of neonatal weight < 2500 g (OR 2.94, 95% CI 1.54-5.41).ConclusionExtreme values of maternal BMI at the beginning of gestation are determining factors for an adverse obstetric-perinatal outcome.     

Three-dimensional ultrasonography measurement of fetal nasal bone length during the midtrimester in Taiwanese women

ObjectiveTo evaluate the normal range of the fetal nasal bone length (NBL) in Taiwanese women using three-dimensional (3D) ultrasound, and compare the NBL of normal fetuses with Down syndrome to determine its significance in screening for trisomy 21.Materials and MethodsA total of 102 consecutive fetuses and another 7 fetuses with trisomy 21, determined by karyotyping at 15–22 weeks' gestation, were evaluated with 3D ultrasound before amniocentesis at Changhua Christian Hospital between November 2003 and April 2004.ResultsThe normal range for NBL in the second trimester in the Taiwanese population was investigated, and a linear relationship with gestational age was noted. The NBL increased with advancing gestational age (NBL in cm = 0.0264 × gestational age in weeks –0.042 (R² = 0.2416). The median of the biparietal diameter/nasal bone length ratio had a stable value which tended to change minimally between 15 and 22 weeks of gestation. Chromosomally normal fetuses had statistically longer nasal bones than fetuses with Down syndrome (p = 0.014).ConclusionWe present a reference range for 3D ultrasound measurement of the fetal NBL. A short nasal bone at 15 to 22 weeks is associated with a high risk of trisomy 21.     

Suivi pédiatrique de 30 grossesses gémellaires monochoriales consécutives traitées par fœticide sélectif

ObjectivesTo describe perinatal and pediatric outcome after selective feticide for complicated monochorionic twin pregnancy.Patients and methodsWe reviewed all consecutive cases of umbilical cord occlusion performed for complicated monochorionic twin pregnancy over a 16-year period. Pediatric follow-up was based on medical records and updated by phone calls to the parents.ResultsThirty procedures were performed. Indications were: twin-to-twin transfusion syndrome (TTTS) progressing despite serial amniodrainage (n = 12) ; twin reversed arterial perfusion (n = 9) ; selective growth restriction (n = 5) ; severe discordant structural anomalies (n = 4). Mean gestational age at procedure was 21.8 ± 3.1 gestational weeks (GW) and 31.8 ± 4.8 GW at birth. Overall survival rate was 87%, i.e. 83%, 100%, 60% and 100% for each indication, respectively. Mean pediatric follow-up was 5 years (range: 6 months to 15 years). Medical charts and parents declared normal development in 88% of surviving children, i.e. 67%, 100%, 100%, and 100% for each indication. Cross-comparison between the four groups revealed that in the TTTS group, gestational age at procedure was more advanced (P = 0.01) while delivery was slightly earlier (P = 0.1), and pediatric development was poorer (P = 0.02).Discussion and conclusionPediatric outcome after selective feticide appeared to be poorer for TTTS progressing despite serial amniodrainage than for other indications.     

Cardiac function at term in human pregnancy

ObjectivesWe have previously demonstrated deterioration in cardiac function at term in human pregnancy. To explore further, we investigated central arterial hemodynamics and association with maternal weight during gestation.Study designPrimiparous women (n = 32) were recruited in a tertiary referral obstetric hospital and a longitudinal cohort study with analyses at median 16 and 37 weeks gestation undertaken. Subgroups of normal body mass index, <25 kg/m², and overweight, ?25 kg/m², at 16 weeks were created.Main outcome measuresWe performed 2D speckle tracking echocardiography strain analysis and tonometric measures of central arterial pressures, waveforms and pulse wave velocity.ResultsA reduction in cardiac strain (2P = 0.002) from 16 to 37 weeks gestation was associated with increased systemic vascular resistance (2P = 0.008), reduced arterial compliance (2P = 0.004) and increased central arterial pressures (2P < 0.001) and augmentation index (2P = 0.001).ConclusionsBy 37 weeks, compared with values in earlier pregnancy, overweight women had higher systemic vascular resistance (2P < 0.05). Additionally, their central diastolic pressure was higher (2P < 0.05) and their ventricular strain was lower (2P < 0.05) than in normal weight pregnant women. An increase in systemic vascular resistance and central arterial pressures by term may contribute to the observed deterioration in cardiac function. This appears more prominent in overweight women.     

Correlations of selected vaginal cytokine levels with pregnancy-related traits in women with bacterial vaginosis and mycoplasmas

The aim of this study was to examine correlations between vaginal inflammatory cytokines (IL-1α, IL-1β, IL-6 and IL-8) and pregnancy-related traits (gestational age, birth-weight, BMI, weight gain during pregnancy and vaginal pH). Differences in correlation coefficients were examined among bacterial vaginosis (BV) status and the presence or absence of mycoplasmas. A total of 105 women between the 22nd and 34th week of pregnancy were enrolled in this study. There was a strong negative correlation between IL-1α and weight gain during pregnancy (r = −0.877, p < 0.001) and a strong positive correlation between IL-6 and BMI (r = 0.670, p = 0.024) in women with normal vaginal flora and mycoplasmas. These correlations were not present in women who had normal flora and no mycoplasmas. In women with BV and no mycoplasmas, there were significant correlations of gestational age with IL-6 (r = 0.727, p = 0.027) and IL-8 (r = 0.689, p = 0.040); however, these correlations were not significant in women with mycoplasmas. Our findings support the conclusion that correlations between inflammatory cytokines and pregnancy-related traits are dependent on context, suggesting that expression is labile. In particular, BMI and gestational age correlation differs depending on BV status and the presence or absence of BV-related mycoplasmas such as Mycoplasma hominis and Ureaplasma urealyticum.     

Evaluation of the value of the first and third trimester maternal mean platelet volume (MPV) for prediction of pre-eclampsia

IntroductionPre-eclampsia is one of the most serious complications of pregnancy and one of the major causes of maternal mortality. Thus its prediction is a matter for serious concern.ObjectiveThe purpose of the present study is to determine the value of mean platelet volume (MPV) measurement in the first and third trimesters of pregnancy for the prediction of pre-eclampsia.MethodA prospective nested case–control study was performed on pregnant women who were at 9–12 weeks of pregnancy. In the first trimester and again in 26–28 weeks, MPV was calculated. All eligible women were then monitored to delivery and the MPV of women who were pre-eclamptic was compared with the MPV of normotensive women.ResultsPre-eclamptic women were compared with 269 normotensive women. MPV at the first trimester of pre-eclamptic women was significantly higher than normotensive women (10.2 ± 1.06 fl VS 9.68 ± 1.09 fl, P = 0.008). Also, MPV at the third trimester of pregnancy of pre-eclamptic women was more than normotensives (10.16 ± 1.23 fl VS 9.62 ± 1.12 fl, P = 0.009).Area under the curve in receiver operating characteristics (ROC) curve was calculated as 0.64 for the predictive value of MPV at the first and third trimesters of pregnancy, which showed a low value of this test for predicting of pre-eclampsia.ConclusionMPV at the first and third trimesters of pregnancy are higher in women who eventually would be pre-eclamptic, but has low predictive value and is not a good predictor of pre-eclampsia.