Abstracts Ursodeoxycholic acid improves feto-placental and offspring metabolic outcomes in intrahepatic cholestasis of pregnancy and in a mouse model of hypercholanaemic pregnancy Abstracts 740The correlation between epigenetic change and neonatal plasma glucose level in maternal gestational diabetes offspring

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th World Congress on Ultrasound in Obstetrics and GynecologyPoster abstracts height, maternal age, and birth weight, but not cervical length and Bishop score, were significantly associated with cesarean delivery for failure to progress. Conclusions: Transvaginal sonographic measurement of cervical length is a useful and independent predictor of failed labor induction in term pregnancy and appears to be a better predictor than the Bishop score. Both ultrasonographically measured cervical length and Bishop score appear to be of poor predictive value for the likelihood of caesarean delivery for failure to progress in women undergoing induction of labor. P11.08Mifepristone is an effective ripening agent in postdates primips with cervical length ≥ 2.5 cm, but mode of delivery correlates with birthweight: a randomised, placebo controlled double blind study Homerton University Hospital, UKObjective: To determine the efficacy of Mifepristone as a cervical ripening or inducing agent in postdates primiparous pregnancies with an unfavorable cervix (≥ 2.5 cm length), as defined by transvaginal ultrasound measurement. Design: Double blind randomised trial. Setting: Homerton University Hospital, London. Methods: Fifty postdate primips (gestational age ≥ 41 weeks) who were found to have transvaginal cervical length ≥ 2.5 cm at the time of postdates pre-induction ultrasound assessment, were randomly assigned to mifepristone arm (n = 25) and Placebo arm (n = 25). These women were given two tablets (400 mg) of mifepristone or two tablets of placebo 48 hrs prior to the induction of labour. Main outcome measures were onset of spontaneous labour, favorable cervix, time from tablet to delivery, time from induction to labour and to delivery, mode of delivery. Results: Thirteen women in the mifepristone group and 5 in the placebo group had a favorable cervix within 48 hrs of treatment. (×2 = 0.038; P = 0.017). Twelve women (48%) who received placebo and fifteen women (60%) who received mifepristone delivered vaginally. (P = 0.395). In women who had a vaginal delivery the interval between tablets to delivery was significantly shorter in those who had mifepristone. (59 hrs 32 min vs. 76 hrs 30 min, P = 0.002). The women who underwent Caesarean Section had heavier babies than the women having vaginal deliveries. (P < 0.05). Conclusion: Mifepristone is an effective ripening agent for postdates primips with an unfavourable cervix. However, it does not reduce Caesarean section rates. Women with larger babies are more likely to end up with a Caesarean section. P11.09Nuchal cord -is it a sonographic dilema? Objective: Detection of nuchal cord by ultrasound might lead to anxiety and frustration in both parturient and caregiver. The present study was aimed at evaluating the outcome of pregnancies with nuchal cord. Methods: A retrospective population-based study of all deliveries during the years 1988-2003 in a tertiary medical center was conducted. Immediate perinatal outcomes of patients with and without nuchal cord were compared. Results: Of 1...

The transition from paediatric to adult neurodisability services can be a challenging time for young people and their families. This vulnerable group have complex needs encompassing healthcare, social care and education sectors. A new transition clinic for young people with complex neurodisability was established in 2015. Our aim was to ensure a patient-centred approach in developing and improving the current transition service in accordance with NICE guidelines on transition (2016) and cerebral palsy (2017).The patient cohort was derived from young people referred from the paediatric neurodisability service to the transition ‘spasticity’ clinic since its establishment in 2015. We used a two pronged apporach in the form of audit and telephone interviews. The audit criteria were derived from NICE guidelines and involved reviewing patients‘ notes and clinic letters. The structured telephone interviews with patients and parents enabled us to get qualitative feedback on the existing service.Our cohort of 8 patients were transitioned from paediatric to adult services at a mean age of 17.2 years. As well as the adult neurologist, a paediatrician was present in the transition clinic in 7 of 8 cases. An adult physiotherapist was present in 6, but a paediatric physiotherapist was only present in 2. Strengths demonstrated during the clinic included discussing communication and learning needs (7 out of 8). Weaknesses included discussing emotional health and planning future involvement of parents/carers. Communication with GPs was present in 5 out of 8 (formal transition letter with GP CC’d). 6 families gave us qualitative feedback.Based on our results and responses, we co-produced a leaflet with young people and their families on what to expect from the transition process including information about the transition clinic and possible discussion topics, practical information such as new contact details and where to seek emergency care. We also produced a matching ‘Patient Passport’ to be used as a checklist in the transition clinic to ensure that all aspects of care are covered in the discussion. We hope these interventions will encourage autonomy and informed decision making in the transition process.

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