Our study demonstrates that DHEA has no toxic effect on chondrocytes up to 100 micro M of concentration and has an ability to modulate the imbalance between MMPs and TIMP-1 during OA at the transcription level, which suggest that it has a protective role against articular cartilage loss.

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Staphylococcal superantigens (SAg) could play an important role in sepsis by activating numerous T cells. We investigated whether serum capacity to neutralize SAgs can be a prognostic factor in Staphylococcus aureus bacteremia (SAB). In a university hospital, 105 consecutive SAB patients were enrolled during a 12-month period. The earliest serum samples prior to SAB onset were stored for a later T cell proliferation assay. Multiplex polymerase chain reaction (PCR) for 19 SAg genes was performed for S. aureus blood isolates. To determine the serum capacity to neutralize SAgs, T cell proliferation by the culture supernatant of each S. aureus isolate was measured in the presence and absence of the corresponding patient's serum. Twenty-six (24.8%) patients died within 4 weeks from SAB onset. Vascular catheter-related infection was associated with survival for ≥4 weeks. Unknown primary focus, Simplified Acute Physiology Score-II (SAPS-II), and specific SAg genes (tst, sec, sel, or sep) were associated with the 4-week mortality. No variables related to T cell proliferation assay showed statistical significance. In the multivariate analysis, SAPS-II ≥33 and tst were independently associated with the 4-week mortality. Serum capacity to neutralize SAg does not significantly affect SAB outcome. SAPS-II ≥33 and tst are independent predictors of the 4-week mortality.

Oral poster abstracts flow (ml/min) reduced with UtA PI growth, even not significantly. UtA flow per EFW did show a significant inverse correlation to gestational age, dropping from 780.6 ml/min/kg at 15 weeks to 138.1 at 35 weeks (5.6 fold) (p < 0.001). Conclusions: 1) UtA flow (ml/min) and mean velocity significantly increased across gestation in normal pregnancies, while UtA diameter showed a slight not significant increment; 2) UtA flow volume (ml/min) did not show a significant reduction in relation to UA PI increase; UtA flow per EFW significantly reduced along gestation. OP13.12Predicting adverse neonatal outcome in fetuses with severe placental insufficiency: a pivotal role for birth weight Z-scores Objective: To identify significant predictors for adverse neonatal outcome in pregnancies compromised by severe placental insufficiency. Methods: Consecutive premature fetuses at between 25 and 32 weeks' with severe placental insufficiency were examined prospectively. Inclusion criteria were: (i) singletons (ii) normal anatomy; (iii) abnormal umbilical artery Doppler pulsatility index (PI); (iv) middle cerebral artery (MCA) PI < − 2SD; (v) last Doppler examination performed within 24 hours prior to delivery. We considered as independent potential predicting variables: absent or reversed end diastolic flow in umbilical artery, abnormal ductus venosus S/A ratio, absent or reversed flow during atrial contraction in the ductus venosus and birth weight Z-score. Outcome parameters were: neonatal mortality and severe neonatal morbidity. Results: Backward stepwise logistic regression analysis was used to determine the optimal model for the prediction of neonatal mortality and severe neonatal morbidity. In this analyses birth weigh Z-score index showed the strongest association OR = 1.87 [1.17-2.99] with all neonatal outcome. There was no mortality for the group with normal birth weight Z-score. Conclusion: Our study suggests that birth weight Z-score is the strongest predictor of adverse neonatal outcome in severe placental insufficiencies. Z-scores are independant of gestational age or sex covariates could be extended to estimated fetal weight and might help in making important decision in the management of compromised pregnancies. OP13.13 Customized centiles and perinatal morbidity

Objectives: To determine accuracy of ultrasound (US) in classifying placental cord insertion (PCI) site in multiple gestations at a tertiary care center. Methods: A retrospective study of multiple gestations delivered from 2/2003 to 7/2009 was performed. Data included gestational age (GA) at PCI identification, use of in-vitro fertilization (IVF), and PCI characterization by both US and pathology. The distance from PCI to placental edge was measured. To correlate US with pathology data, PCI was classified as central/eccentric, marginal (≤ 1 cm from placental edge), or velamentous (into membranes). Statistical analysis was performed with Chi-square comparison amongst categorical variables. US images were reviewed in discordant cases to determine causality. Results: Twins and triplets were analyzed. 638 fetuses (302 pregnancies) met criteria. Mean GA at PCI evaluation was 20.9 wks, median 19.0. Using pathology results as gold standard, US correctly identified PCI as central/eccentric, marginal, or velamentous in 69.3% (P < 0.01). US was more accurate for diamniotic-dichorionic twins (73.8% of 382) than diamniotic-monochorionic (59.4% of 155, P = 0.002). US correctly classified 97.5% of central/eccentric, 8.5% of marginal, and 6.1% of velamentous PCIs (438, 118, and 82 cases). Conversely, pathology confirmed US diagnosis of central/eccentric in 71.4%, marginal in 32.3%, and velamentous in 11.1% (of 598, 31, and 9). Comparing normal (central/eccentric) to abnormal (marginal/velamentous), US was less accurate in identifying abnormal (7.5% of 200) than normal (97.5% of 438) PCIs (P < 0.01); no difference was seen for twins (71.9% of 549) vs. triplets (73.5% of 89, P > 0.05). No difference was found in occurrence of velamentous PCI in IVF vs. non-IVF cases (12.5% for both). Conclusions: US classification of PCI was often inconsistent with pathological results in multiple gestations. Discrepant cases were evaluated and suggest evolution/peripheral infarction of the placenta with apparent evolution of the PCI in many instances.

Oral poster abstractscompared between patients who delivered preterm with those who delivered at term. Statistical analysis was performed with SPSS package. Multiple logistic regression analysis was performed in order to identify the independent risk factors for preterm delivery. Results: A total of 87 women were enrolled in the study group; 26 patients (30.2%) had preterm delivery. When comparing patients who delivered preterm with those delivered at term, no differences were found in maternal characteristics (maternal age, parity, BMI and smoking) between the groups. The cerclage rate was not statistically significant between the groups (3.3% vs.3.8%, p = 0.905). Cesarean section rate was statistically significant higher among the PTD group (20.8% vs. 73.9%, p < 0.001). Cervical length ≤ 25 mm was to be independent risk factors for preterm delivery with OR-9.7, 95% CI 1.57-60, P = 0.014 (Table). Conclusion: Cervical length ≤ 25 mm among patients with vaginal bleeding at 22-34 weeks, is an independent risk factor for preterm delivery. Objectives: To assess the utility of ultrasound cervical length in the prediction of spontaneous onset of labor Methods: 125 women were attended a dedicated post-dates clinic at 41 + 3 weeks of pregnancy and agreed to the assessment of cervical length using transvaginal ultrasound. Those women who had not delivered at 42 weeks, were offered induction of labor. The labor details were prospectively recorded and the mode of delivery was correlated with the ultrasound cervical length data. Results: Women who went into spontaneous labor (n = 75) had a significantly shorter cervical length (p < 0.001) as compared to women whose labor had to be induced (n = 50). Logistic regression analysis showed that cervical length was an independent predictor for the likelihood of spontaneous labor (p = 0.008) and vaginal delivery (p = 0.018). Conclusion:Ultrasound cervical length is a significant independent predictor of likelihood of onset of spontaneous labor and successful vaginal delivery in prolonged pregnancy. OP11.12The clinical implications of uterine myomas in preterm delivery; analysis based on antenatal ultrasonographic parameters group of women without uterine myomas was selected at random for the same period. Excluding preterm delivery prompted by obstetric indications, only the spontaneous preterm delivery (less than 37 weeks of gestation) was included for analysis. Uterine myomas were evaluated for the location, size (largest diameter) and number. The incidence of spontaneous preterm delivery in the study group was compared with that in the control group. Results: The incidence of preterm delivery was significantly higher in patients with uterine myomas compared with in controls (10/102 (9.8%) vs. 13/435 (3.0%), P < 0.05). Regarding the location of uterine myomas, patients with myomas in fundus or corpus of the uterus showed a significantly higher incidence of preterm delivery (10/89 (11.2%) vs. 13/435 (3.0%), P < 0.05). All patients with myomas in the lower segment of the uterus deli...

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