Objective To examine the association between gestational age (GA) at the time of treatment initiation for gestational diabetes (GDM) and maternal and perinatal outcomes. Study Design A secondary analysis of a multicenter randomized treatment trial of mild GDM in which women with mild GDM were randomized to treatment versus usual care. The primary outcome of the original trial, as well as this analysis, was a composite perinatal adverse outcome that included neonatal hypoglycemia, hyperbilirubinemia, hyperinsulinemia, and perinatal mortality. Other outcomes examined included the frequency of large for gestational age (LGA), birth weight, neonatal intensive care unit admission (NICU), gestational hypertension / preeclampsia and cesarean delivery. The interaction between GA at treatment initiation (stratified as 24-26 weeks, 27 weeks, 28 weeks, 29 weeks, ≥30 weeks) and treatment group (treated vs. routine care), with the outcomes of interest, was used to determine whether GA at treatment initiation was associated with outcome differences. Results Of 958 women analyzed, those who initiated treatment at an earlier GA did not gain an additional treatment benefit compared to those who initiated treatment at a later GA (p-value for interaction with the primary outcome is 0.44). Similarly, there was no evidence that other outcomes were significantly improved by earlier initiation of GDM treatment (LGA p=0.76; NICU admission p=0.8; cesarean delivery p=0.82). The only outcome that had a significant interaction between GA and treatment was gestational hypertension/preeclampsia (p=0.04), although there was not a clear cut GA trend where this outcome improved with treatment. Conclusion Earlier initiation of treatment of mild GDM was not associated with stronger effect of treatment on perinatal outcomes.

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Objectives:In collaboration with the Rwanda Society of Obstetricians and Gynecologists (RSOG), ISUOG organised a live webcast for OB/GYN residents and junior OB/GYN faculty in Rwanda in training on basic ultrasound (US) which took place in South Africa on 18 March 2017. We aim to evaluate the effectiveness of this course. Methods: Participants of the ISUOG webcast were given questionnaires to evaluate the program. Basic demographic data was obtained as well as prior ultrasound experience and satisfaction scales. Data was entered in epidata and analysed with Stata 14. IRB approval was obtained. Results: Twenty-four participants, including 19 residents and 5 junior faculty, took the basic course in obstetric and gynecologic US in Rwanda while the onsite course was taking place in Cape Town. All participants consented to be part of the evaluation survey. Over 60% of participants had experience performing obstetric and gynecologic US for more than 2 years. The prior source of US skills was from more experienced colleagues, formal training during their residency and their own efforts with self-learning. The most common reasons for attending the course were exposure to ISUOG speakers, the opportunity to become members of ISUOG and the innovative aspect of the course. After completion of the course, participants completed the post course questionnaire about their level of satisfaction; all the participants appreciated the content of the course and agreed that they gained new knowledge and teaching methodologies. Half of the group felt that the knowledge they gained did not differ because of the webcast format. All the participants would recommend the webcast to their colleagues and other residents and recommended that the RSOG continue the current program in the future as well as more specialised programs. Conclusions: Distance learning through online technology is a method to combat the difficulties disseminating knowledge in developing countries. EP23.04Integration of 3D/4D ultrasound technology into undergraduate medical education: student perception Objectives: The goal of the study was to assess medical student level of comfort using 3D/4D ultrasound technology after participating in an obstetrical ultrasound educational activity, and student perception of incorporation of 3D/4D ultrasound technology into their medical education. Methods: Participants in the study included second-year medical students (N=147), who used the Fetus Ultrasound Examination Phantom for the obstetrical ultrasound exercise. The phantom provided training for routine second trimester screening and contained a 23-week fetus (26 cm) in utero. Medical students learned 2D, 3D, and 4D ultrasound technology using an obstetrical model and completed a survey about their perception of ultrasound technology and value in their future practice.Results: Students felt favourably about using 3D/4D ultrasound in their medical education. Specifically, 94% felt capable operating an ultrasound machine with 3D/4D technology, 99% of students felt ultrasound was...