Objective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations.Design Prospective cohort study.Setting 28 hospitals in the Netherlands and Belgium.Participants 1920 consecutive women treated with tocolytics for threatened preterm labour.Main outcome measures Maternal adverse events (those suspected of being causally related to treatment were considered adverse drug reactions) leading to cessation of treatment.Results An independent panel evaluated the recorded adverse events, without knowledge of the type of tocolytic used. Of the 1920 women treated with tocolytics, 1327 received a single course of treatment (69.1%), 282 sequential courses (14.7%), and 311 combined courses (16.2%). Adverse drug reactions were categorised as serious or mild in 14 cases each. The overall incidence of serious adverse drug reaction was 0.7%. Compared with atosiban, the relative risk of an adverse drug reaction for single treatment with a β adrenoceptor agonist was 22.0 (95% confidence interval 3.6 to 138.0) and for single treatment with a calcium antagonist was 12 (1.9 to 69). Multiple drug tocolysis led to five serious adverse drug reactions (1.6%). Multiple gestation, preterm rupture of membranes, and comorbidity were not independent risk factors for adverse drug reactions.Conclusions The use of β adrenoceptor agonists or multiple tocolytics for preventing preterm birth is associated with a high incidence of serious adverse drug reactions. Indometacin and atosiban were the only drugs not associated with serious adverse drug reactions. A direct comparison of the effectiveness of nifedipine and atosiban in postponing preterm delivery is needed.

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introduction of medical management. These groups were further divided into incomplete (ICM) or missed miscarriage (MM). Within these groups the choice of miscarriage, success rates and any subsequent surgical management were measured. Results: Medical management led to a 17% (95% CI:11-22%, p < 0.001) reduction in the proportion of women undergoing surgical management from 79% to 62%. The availability of medical management had no effect on the proportion of women choosing surgical management for ICM, 27% vs 26%. However, there was a 21% (69 to 48%) reduction in women with MM choosing surgical management. 89/108(82%) women had successful medical management. The remaining 19 underwent surgical management. The association between management type and success was highly statistically significant. Table 1 is a summary of the management outcomes for women who chose conservative or medical management in both groups combined. Conclusions: Medical management of miscarriage is effective, is chosen by 18% of miscarrying women and reduces the number of primary surgical procedures. OP03.03 Does the presence of subchorionic haematoma increase the risk of miscarriage?

Objectives: Positive CMV IgM in the first trimester of pregnancy mandates IgG avidity assays to exclude or confirm primary infection in pregnancy. Methods: To correlate IgG avidity index actual values and trends with the risk of fetal infection. Sera were obtained from women in the first trimester of pregnancy. CMV serology was performed with the LIAISON CMV IgG kit and the LIAISON CMV IgM. Kit. Positive IgG (> 0.6 UI/mL) and equivocal IgM (≥ 15 UA/mL and < 30 UA/mL) or positive IgM (≥ 30 UA/mL) prompted CMV IgG avidity test. LIAISON CMV IgG Avidity assay and VIDAS CMV IgG Avidity assay were used in parallel and results were interpreted as recommended by the manufacturer (PI less than 3 months, PI more than 3 months, Intermediate). When at least one of the 2 avidity results was in favour of a PI dating back more than 3 months, the patient was reassured, in all other cases amniocentesis was recommended for prenatal diagnosis after 20 weeks. Results: 187 women (256 sera) had positive or equivocal IgM. Avidity index values were correlated (r 2 = 0.646) but there was only 48% concordance in avidity test interpretations. 61 women (77 sera) had an avidity index low or intermediate in LIAISON or VIDAS CMV IgG Avidity assays. 15 of these 61 women (24.5%) had a positive CMV PCR in amniotic fluid retrieved between 19 and 25 weeks. Logistic regression of IgM levels and LIAISON avidity index values did not show any significant association with fetal infection but VIDAS avidity index values were inversely statistically associated with fetal infection (P = 0.002). Based on this logistic regression model the risk of fetal transmission was 70, 40% and 20% for VIDAS avidity index below 0.10, at 0.2, and at 0.4 respectively. Conclusions: These results could be useful for more accurate counselling of women presenting with positive CMV IgM in the first trimester to help them choose between amniocentesis at 20 weeks or ultrasound follow-up alone. Objectives: To estimate the rate of malignancy in adnexal lesions described as unilocular cysts at transvaginal scan (TVS), and to investigate if there are differences in clinical and ultrasound characteristics between benign and malignant unilocular cysts. Methods: We used the information on the 3511 adnexal masses examined with TVS in the International Ovarian Tumor Analysis (IOTA) database. The gold standard was the histopathological diagnosis of the surgically removed mass. Results: 1148 masses were classified as unilocular cysts at TVS. 11 of these, i.e. 0.96% (95% CI 0.48% to 1.71%) were malignant (5 borderline, 6 invasive). Patients with malignant unilocular cysts were older (median 60 years versus 36, P = 0.002) and more were postmenopausal (55% versus 19%, P = 0.009) and had a personal history of breast cancer (18% versus 2%, P = 0.02) or ovary cancer (18% versus 0.6%, P = 0.003) than patients with benign unilocular cysts. Haemorrhagic cyst contents was more common in malignant than benign unilocular cysts (18% versus 2%, P = 0.03). In 7 of the 11 malignancies judged to be...