495: Critical Care Considerations in Pregnancies With Short Fetal Femur: A Preeclampsia Risk Assessment

Introduction: Preeclampsia is a major health concern in Peru, causing 32% of maternal deaths. At Belén Hospital in Trujillo, severe preeclampsia affected 5.9% of pregnancies in 2012. Early risk identification remains difficult. Beyond traditional hypertension and proteinuria criteria, fetal biometric measurements show promise as predictive markers. This study examined whether short fetal femur length during second and third trimester ultrasounds can predict severe preeclampsia. Methods: This retrospective case-control study analyzed 152 pregnant women who received care at Belén Hospital of Trujillo during 2013-2014. The study population was divided into two groups: 76 women with severe preeclampsia (cases) and 76 women with non-severe preeclampsia (controls). Severe preeclampsia was defined as systolic blood pressure ≥160 mmHg or diastolic blood pressure ≥110 mmHg, with or without proteinuria, plus evidence of organ involvement. Short femur length was defined as measurements below the 5th percentile for gestational age according to the standards established by Snijders and Nicolaides. Statistical analysis included calculation of odds ratios with 95% confidence intervals to determine the association between short femur length and severe preeclampsia. Results: Among women with severe preeclampsia, 35.5% (27/76) presented with short fetal femur length, while 64.5% (49/76) did not. In the control group of women with non-severe preeclampsia, only 9.2% (7/76) exhibited short fetal femur length, compared to 90.8% (69/76) with normal measurements. Statistical analysis revealed that short femur length was significantly associated with severe preeclampsia, with an odds ratio of 5.4 (95% CI: 2.1-13.4, p=0.001). Conclusions: Short femur length during second and third trimester ultrasounds significantly predicts severe preeclampsia (OR=5.4). This accessible parameter could enhance routine prenatal screening to identify high-risk pregnancies. Early detection may improve management strategies, potentially reducing maternal and perinatal complications. While consistent with some previous research, further studies are needed to establish optimal screening protocols.