Measurable variations in the IVC diameter occur in response to volume changes in normal term pregnancy and postpartum.

INTRODUCTION: Objective: To analyze pregnancy outcomes between two different methods of insulin delivery in an obstetrical type I diabetic patient population. METHODS: Study Design: A retrospective chart review of an obstetrical type I diabetic was analyzed from a single institution. These patients were separated into those utilizing a continuous subcutaneous insulin pump (CSI) and those receiving multiple daily injections of insulin (MDDI). Subsequently, the data pertinent to the different antenatal and postnatal outcomes was collected. Statistical analysis with student t-test and Chi square test was done as applicable. RESULTS: There were no statistical differences in the outcomes between these two groups when comparing age, parity, gestational age, BMI, starting weight, weight at delivery, number of years since diagnosis, weight gain during pregnancy., neonatal birthweight, neonatal hypoglycemia, shoulder dystocia, macrosomia, and primary C-section rate. The HgA1C of the CSI was statistical significant lower when compared to MDDI in first trimester(p<.003), second (p<.03) and third trimester (p<.01).The total number of insulin units needed to treat patients in the CSI was statistically significant lower when compared to MDDI in the first(p<.04), second(p<.004) and third trimester(p<.006).The weight retention at 1 year postpartum was statistically significant lower in the CSI when compared to the MDDI (p<.04). CONCLUSION: Pregnancy outcomes were comparable between these two methods for many variables. However, CSI appears to offer an advantage in minimizing the insulin quantity needed during pregnancy and reducing weight retention postpartum in the setting of optimal blood sugar control.

No abstract

introduction course. Fellows have continued assessments quarterly as the new algorithm is validated. Results: Eleven outgoing and 30 incoming fellows (Surgical and Medical) comprised the study group (n541). 59% were surgeons. Preidentified training gaps included image interpretation, advanced cardiac imaging, and lung ultrasound. Knowledge and skills scores were significantly less in both incoming fellows groups than the OF group. Image interpretation was not different amongst the groups. After a one day course, incoming fellows skills significantly increased from initial testing (p50.007, 0.0001 respectively), and approached skills of the OF group. Notably, after the one day course there continued to be a significant difference in the post scores between the ISF and IMF (p50.0029). Conclusions: Knowledge gaps in our current curriculum prompted a change in training, which remains to be validated. Preliminary results reveal that the one day and one month courses led to equivalent skills and knowledge for Critical Care fellows. A significant difference existed amongst those from a medical background regarding the FAST exams. The prior training led to improved confidence and self-reported competence in all other categories amongst OF group. Long term retention of knowledge and skills remains to be seen, and we have ongoing data collection directed at answering this question.

At least one of 11 FHR patterns examined occurred in 82% (4331) of 5305 analyzed (Table). Median time from randomization to delivery was 5.5 hrs. Compared with those with none of the 11 FHR patterns, the NN outcome was increased when one or more FHR pattern was identified (OR 2.5; 95%CI 1.5-4.1). Except for increased variability and sinusoidal pattern, each FHR pattern (AEothers) was associated with a 2-to 7-times increase in the odds of the NN composite (Table). Furthermore, relative to those with none of the 11 FHR patterns (n¼974), the association with the NN composite increased as the number of identified FHR patterns increased. CONCLUSION: Nine of 11 FHR patterns later in labor were each significantly associated with a low but increased risk of adverse NN outcome that varied by type of FHR. The odds of adverse outcome increased with increasing number of FHR patterns.