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O070 THE RELATIONSHIP BETWEEN OPIUM-ADDICTED PARENTS AND THEIR CHILDREN'S CONGENITAL HEART DISEASES
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S261–S530
Results: The results of our study showed that average blood loss in group I and II were 218.67±130.4 and 228.77±87.62 correspondently (p = 0.363). Frequency of postpartum hemorrhage (blood loss >500 ml) in group I was 1.0%, in group II was 1.5% (p = 0.645). Blood transfusion had only 1 women of group I. Manual removal of placenta had 2.5% women of I group and 1.5% women of II group (p = 0.476). The percent of women which hematocrit indicator descended more than 10% in CCT group consisted 23.5% and in group without CCT – 20.5% (p = 0.464). The use of additional uterotonics to treat PPH had 12.0% and 16.5% (p = 0.156). Additional surgical procedures (intrauterine ballon) used in 1 women in each group. The average hemoglobin and hematocrit levels were similar in both groups. In group I there was a statistically significant decrease only postpartum hematocrit level in comparison of antepartum level. In group II we found out evident descendents of hemoglobin and hematocrit. Conclusions: Thus, the results of our study showed that patients who had undergone a full package of the active management of the third stage of labor, including controlled cord traction, had less reduction in hemoglobin levels. Controlled cord traction efficiency should be evaluated in more numerous studies. Table: The primary and secondary outcomes of AMTSL outcome
Group I n = 200 Group II n = 200 p
Blood loss of 500 ml or more (%) Blood loss (ml) Blood transfusion (%) Manual removal of placenta (%) Use of additional uterotonics (%) Ballon (%) Hemoglobin, g/l
1.0 218.67±30.4 0.5 2.5 12.0 0.5 112.49±14.06
1.5 228.77±87.62 0 1.5 16.5 0.5 113.04±10.17
0.645 0.363 0.654 0.476 0.156 0.645 0.654
O068 STILLBIRTHS: RISK FACTORS AND MAIN PROBLEMS OF OBSTETRIC CARE N.V. Artymuk1 , A.G. Trishkin1 , E.S. Bikmetova1 , I.N. Noskova1 . 1 OB/GYN, Kemerovo State Medical Academy, Kemerovo, Russian Federation Objectives: To identify risk factors for stillbirth and reveal the main problems of obstetric care in the stillbirth. Materials: Group I consisted of 167 women with stillbirth (the main group), group II (comparison group) – 501 women with a favorable perinatal outcome. The main causes of stillbirth were antenatal and intrapartum asphyxia: 79% and 13% respectively. Methods: Multisite population-based case-control study conducted between December 2008 and December 2009 in the Kemerovo region. Statistical analysis was conducted using the software package StatSoft Statistica 6.1. Table: Main risk factors for stillbirth Risk factors
Still birth (n = 167)
Live-born (n = 501)
p
OR [95% CI]
Multiple pregnancy Placental abruption Stillbirth in history Asymptomatic bacteriuria Syphilis Trichomoniasis Severe preeclampsia Gestational diabetes
9 14 6 5 6 10 10 6
0 0 0 0 0 5 8 5
<0.001 <0.001 <0.001 <0.001 <0.001 0.001 0.009 0.020
4.2 [4.1–32.4] 4.3 [4.55–47.7] 4.1 [3.7–23.1] 4.0 [3.5–19.9] 4.1 [3.7–23.1] 2.8 [1.8–4.59] 2.3 [1.4–3.2] 2.2 [1.29–2.99]
Results: The main risk factors for stillbirth are multiple pregnancy, placental abruption, stillbirth in previous pregnancy, syphilis, trichomoniasis, asymptomatic bacteriuria, severe preeclampsia, gestational diabetes. The main problems of obstetric care in women with intrauterine fetal death were inadequate antenatal care, lack of risk management, delay in diagnosis of intrauterine growth restriction and delay of delivery. The main problems in women with intrapartum fetal death were the absence of continuous intrapartum fetal monitoring – 88.2%, delay in delivery of the fetus
S285
threatening condition, lack of regionalization, polypharmacy and the use of drugs with unproven efficacy in all patients. Conclusions: Thus, timely identification of risk factors, management decisions to eliminate organizational problems in providing obstetric care would reduce the rate of regional stillbirth. O069 PREGNANCY OUTCOME IN WOMEN WITH REPAIRED VERSUS UNREPAIRED CONGENITAL CARDIAC SHUNT LESIONS K. Arunachalam1 , K. Mariappan1 , J. Rosy1 . 1 Obstetrics and Gynaecology, Madha Medical College and Hospital, Chennai, Tamil Nadu, India, Chennai, Tamil Nadu, India Introduction: Globally the incidence of Congenital Heart disease is 0.7% of newborns. More than 85% can expect to survive into adulthood due to recent advances in Paediatric cardiology and Cardiac Surgery. As a consequence, most patients reach child bearing age and wish to become pregnant. The circulatory burden in pregnancy may have deleterious effects for those with congenital shunt lesions of heart either corrected or uncorrected. Hence cardiac, obstetric and neonatal complications all appear to be prevalent during pregnancy. Objective: To evaluate pregnancy outcome in women with repaired and unrepaired simple and complex cardiac shunt lesions. Materials: A prospective study was conducted in 32 antenatal women with congenital shunt lesions of heart in Govt. RSRM hospital, Chennai from Jan 2009-Dec 2010. Among them 16 had repaired lesions and 16 had unrepaired lesions. Methods: Simple lesions recruited for the study were ASD (four repaired and eight unrepaired), VSD (seven repaired and eight unrepaired). Complex lesions in the study TOF (two) and TGA (two) and PDA(one) all were surgically corrected. INCLUSION CRITERIA: Antenatal women with shunt lesions of heart-repaired /unrepaired EXCLUSION CRITERIA: MVP, valvular lesions, Cardiomyopathies, Primary Arrhythmias and Antenatal women with shunt lesions of heart associated with other co-morbidities. Results: Majority of women were aged 21–25 years (68.75%) and primi parous (59.37%). Preterm births (16.67%) were more in patients with ASD. Normal labour was high with repaired simple shunt lesions ASD (75%), VSD (85.7%). LBW babies more in patients with repaired VSD (57.14%). No adverse cardiac events were observed with complex shunt lesions of heart. Pre eclampsia and preterm labour were more in patients with unrepaired ASD. Pulmonary hypertension & CCF observed in patients with uncorrected ASD. All patients with corrected complex lesions delivered through cesarean section. One baby of uncorrected ASD mother had congenital anomaly (Holt Oram syndrome). Significant difference was observed in birth weight of babies born to mothers with repaired and unrepaired congenital cardiac lesions (p = 0.029). Conclusions: The outcome of pregnancy is favourable in women with repaired shunt lesions (Simple & Complex). O070 THE RELATIONSHIP BETWEEN OPIUM-ADDICTED PARENTS AND THEIR CHILDREN’S CONGENITAL HEART DISEASES F. Forghani1 , N. Ashrafi1 . 1 Science and Research Branch, Islamic Azad University, Tehran, Iran, Islamic Republic of Objectives: The effect of opium addiction of mother or both parents on the congenital heart diseases of their children is brought to attention. Materials: One hundred cases of children of addicted parent(s) suffering from congenital heart diseases were examined and compared with the healthy ones. Methods: Opioids and most specifically morphine, the most effective component of opium, is mainly transferred through placenta to the fetus and is accumulated in the tissues of fetus especially in the heart. Subjects were interviewed for the study and relevant information were collected and tabulated.
S286
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S261–S530
Results: It was observed that, at least one parent of 27.1% of patients was addicted, compared to the children of not addicted parents. The Teratogenic effect of opium and its derivatives on cell proliferation were observed in the first phase of pregnancy and it is suggested the possibility of similar effects on other systems in fetus. Conclusions: Findings of the study showed that there is a statistically significant correlation between parent’s opium addiction and congenital heart problems of their children. O071 AN AUDIT OF ONE STOP POST MENOPAUSAL BLEEDING (PMB) CLINIC, DO WE NEED TO CHANGE THE ENDOMETRIAL THICKNESS (ET) CUT-OFF OF 4 MM? N. Aslam1 , M. Oniah1 , M. Gaber1 , J. Hollingworth1 . 1 Obstetrics & Gynaecology, queen ’s hospital, Burton, Birmingham, United Kingdom Objectives: Post-menopausal bleeding (PMB) represents one of the most common reasons for referral to gynaecological services, largely due to suspicion of an underlying endometrial malignancy. Endometrial cancer is present in approximately 10% of patients referred with PMB To improve the service provided in PMB clinic and to see whether we adhere to national guidelines. We also wanted to see whether cut off 4mm endometrial thickness needs to be changed. Materials: Standards SIGN Publication No. 6, INVESTIGATION OF POST-MENOPAUSAL BLEEDING NICE, Clinical guideline 27, referral guidelines for suspected cancer. Methods: A retrospective analysis of case notes of 180 patients, who were referred with PMB between January 2011– June 2011. Results: Total 180 patients were included in the audit. Mean age was 62.3% were nulliparous. 99% patients were seen within 2 weeks of referral, 2% were using HRT. None of the patients was on tamoxifen, 0.5% had recurrent PMB.6% had endometrial thickness (ET) less than 5mm on TVS, 5% had ET of 4–10mm and 2% had >10mm. All patients gave verbal consent. 60% had hysteroscopy, 40% were discharged with ET <4mm after cervical examination without hysteroscopy. 35% had endometrial polyps, 88% patients with ET >5mm had pipelle biopsy. Failure rate was 1%, with vasovagal reaction <3% with no cases of uterine perforation or infection. 65% had normal histology, 5% inadequate, 8% simple hyperplasia and 3% complex hyperplasia, 2% endometrial cancer. Conclusions: We need to improve the local guideline and referral criteria re need for referral if ET < than 4mm. Further larger studies with update and review of national guideline is needed before any changes in referral criteria are made. Diagnostic and therapeutic hysteroscopy is feasible and highly successful in an outpatient setting One stop PMB clinic provides early diagnosis, reduces the number of hospital visits and enhance patient satisfaction. O072 HPV TESTING AS A TRIAGE IN WOMEN OF DIFFERENT AGE GROUPS REFERRED WITH LOW GRADE SMEARS. CAN IT PREDICT HIGH GRADE DISEASE? P. Athanasias1 , C. Chambers1 , S. Barreto2,1 , N. Pisal1 . 1 Whittington Hospital, London, United Kingdom; 2 Maternidade Dr Alfredo Da Costa, Lisboa, Portugal Objectives: Human Papillomavirus testing was introduced in our colposcopy department as a triage for women referred with a smear test indicating borderline changes or mild dyskaryosis. The aim of this study was to assess the incidence of HPV infection in various age groups and its significance in predicting high grade disease (CIN 2 or worse). Materials: The HPV status of 2406 women with a Low Grade smear test was determined using the HC2 assay. Methods: This was a retrospective study from January 2005 to October 2011. Data was collected from the medical notes and the computer database for colposcopy (Mediscan).
Results: Human Papillomavirus positive rates were 37% (953 patients) with a great variation between the different age groups: 52% between 20–24 years of age, 50% 25–29 years, 41% 30–34 years, 30% 35–39 years, 22% 40–44 years, 22% 45–49 years and 15% >50 years. Between the 1453 women that tested negative for HPV infection only 5 had a subsequent diagnosis of high grade disease. The sensitivity of HPV testing in predicting high grade cervical disease was 86 % and showed a decreasing trend with increasing age. The overall specificity was 64% and gradually increased in the older age groups. The negative predictive value was very high among patients of all ages (99.4 to 100%). Conclusions: We conclude that in women with Low Grade smears, HPV testing can be used to rule out presence of HG disease across all age groups. We therefore feel that the implementation of HPV testing in triaging women with borderline cytological abnormalities and mild dyskaryosis is a safe strategy. O073 1H NMR SPECTROSCOPY BASED METABOLOMIC PROFILING OF WOMEN WITH POLYCYSTIC OVARY SYNDROME (PCOS) W. Atiomo1 , C. Daykin1 . 1 University of Nottingham, Nottingham, United Kingdom Objectives: The current clinical challenges in the management of PCOS include a need to better characterise the syndrome, the prediction of response to therapy and the prediction of which women develop the long term health risks such as type 2 diabetes and cardiovascular disease. Metabolomic biomarkers could help address these challenges. The aim of this study was as a first step to investigate whether women with PCOS had a unique 1H NMR Spectroscopy based metabolomic profile that was different from controls and assess the feasibility of a definitive study. Materials: Nine women with PCOS and 5 healthy women acting as controls had measurement of demographic and anthropometric data and venepunctures. Methods: Assays on plasma samples for metabolomic profiles using 1H NMR Spectroscopy. Results: There were no differences between the metabolomic profiles of women with PCOS compared with controls when the NMR spectra were visually inspected and on multivariate analysis. However when NMR spectra from a subset of 5 age and BMI matched pairs of women with PCOS and controls were evaluated, phenylalanine, arginine, lysine, lipid (CH2-CH2-C=C), citrulline, acetate, glycoprotein, acetoacetate and glutamate levels were statistically significantly different in women with PCOS compared with controls. Conclusions: Women with PCOS may have a unique 1H NMR Spectroscopy metabolomic finger print and a definitive study is feasible. These findings may enable sample size calculations for confirmatory studies and stimulate further research to improve the understanding and management of PCOS. O074 RISKY SEXUAL PRACTICES TO ACHIEVE CONCEPTION AMONG PEOPLE LIVING WITH HIV: STILL A COMMON FINDING IN DEVELOPING COUNTRIES O.A. Awolude1,2 , T.I. Akinola2 , O. Adesina1,2 , I. Adewole1,2 . 1 Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; 2 University College Hospital, Ibadan, Oyo, Nigeria Objectives: To assess the sexual practices in achieving conception by PLWHIV and the implications of these on the principle of safer sexual practice. Materials: Interviewer administered, 20-stem questionnaire. Methods: A cross sectional survey of 301 female PLWHIV attending PMTCT clinic of an Antiretroviral Treatment, care and support programme at the University College Hospital, Ibadan over a 6month period was conducted. The inclusion criterion, among others,
Results: The results of our study showed that average blood loss in group I and II were 218.67±130.4 and 228.77±87.62 correspondently (p = 0.363). Frequency of postpartum hemorrhage (blood loss >500 ml) in group I was 1.0%, in group II was 1.5% (p = 0.645). Blood transfusion had only 1 women of group I. Manual removal of placenta had 2.5% women of I group and 1.5% women of II group (p = 0.476). The percent of women which hematocrit indicator descended more than 10% in CCT group consisted 23.5% and in group without CCT – 20.5% (p = 0.464). The use of additional uterotonics to treat PPH had 12.0% and 16.5% (p = 0.156). Additional surgical procedures (intrauterine ballon) used in 1 women in each group. The average hemoglobin and hematocrit levels were similar in both groups. In group I there was a statistically significant decrease only postpartum hematocrit level in comparison of antepartum level. In group II we found out evident descendents of hemoglobin and hematocrit. Conclusions: Thus, the results of our study showed that patients who had undergone a full package of the active management of the third stage of labor, including controlled cord traction, had less reduction in hemoglobin levels. Controlled cord traction efficiency should be evaluated in more numerous studies. Table: The primary and secondary outcomes of AMTSL outcome
Group I n = 200 Group II n = 200 p
Blood loss of 500 ml or more (%) Blood loss (ml) Blood transfusion (%) Manual removal of placenta (%) Use of additional uterotonics (%) Ballon (%) Hemoglobin, g/l
1.0 218.67±30.4 0.5 2.5 12.0 0.5 112.49±14.06
1.5 228.77±87.62 0 1.5 16.5 0.5 113.04±10.17
0.645 0.363 0.654 0.476 0.156 0.645 0.654
O068 STILLBIRTHS: RISK FACTORS AND MAIN PROBLEMS OF OBSTETRIC CARE N.V. Artymuk1 , A.G. Trishkin1 , E.S. Bikmetova1 , I.N. Noskova1 . 1 OB/GYN, Kemerovo State Medical Academy, Kemerovo, Russian Federation Objectives: To identify risk factors for stillbirth and reveal the main problems of obstetric care in the stillbirth. Materials: Group I consisted of 167 women with stillbirth (the main group), group II (comparison group) – 501 women with a favorable perinatal outcome. The main causes of stillbirth were antenatal and intrapartum asphyxia: 79% and 13% respectively. Methods: Multisite population-based case-control study conducted between December 2008 and December 2009 in the Kemerovo region. Statistical analysis was conducted using the software package StatSoft Statistica 6.1. Table: Main risk factors for stillbirth Risk factors
Still birth (n = 167)
Live-born (n = 501)
p
OR [95% CI]
Multiple pregnancy Placental abruption Stillbirth in history Asymptomatic bacteriuria Syphilis Trichomoniasis Severe preeclampsia Gestational diabetes
9 14 6 5 6 10 10 6
0 0 0 0 0 5 8 5
<0.001 <0.001 <0.001 <0.001 <0.001 0.001 0.009 0.020
4.2 [4.1–32.4] 4.3 [4.55–47.7] 4.1 [3.7–23.1] 4.0 [3.5–19.9] 4.1 [3.7–23.1] 2.8 [1.8–4.59] 2.3 [1.4–3.2] 2.2 [1.29–2.99]
Results: The main risk factors for stillbirth are multiple pregnancy, placental abruption, stillbirth in previous pregnancy, syphilis, trichomoniasis, asymptomatic bacteriuria, severe preeclampsia, gestational diabetes. The main problems of obstetric care in women with intrauterine fetal death were inadequate antenatal care, lack of risk management, delay in diagnosis of intrauterine growth restriction and delay of delivery. The main problems in women with intrapartum fetal death were the absence of continuous intrapartum fetal monitoring – 88.2%, delay in delivery of the fetus
S285
threatening condition, lack of regionalization, polypharmacy and the use of drugs with unproven efficacy in all patients. Conclusions: Thus, timely identification of risk factors, management decisions to eliminate organizational problems in providing obstetric care would reduce the rate of regional stillbirth. O069 PREGNANCY OUTCOME IN WOMEN WITH REPAIRED VERSUS UNREPAIRED CONGENITAL CARDIAC SHUNT LESIONS K. Arunachalam1 , K. Mariappan1 , J. Rosy1 . 1 Obstetrics and Gynaecology, Madha Medical College and Hospital, Chennai, Tamil Nadu, India, Chennai, Tamil Nadu, India Introduction: Globally the incidence of Congenital Heart disease is 0.7% of newborns. More than 85% can expect to survive into adulthood due to recent advances in Paediatric cardiology and Cardiac Surgery. As a consequence, most patients reach child bearing age and wish to become pregnant. The circulatory burden in pregnancy may have deleterious effects for those with congenital shunt lesions of heart either corrected or uncorrected. Hence cardiac, obstetric and neonatal complications all appear to be prevalent during pregnancy. Objective: To evaluate pregnancy outcome in women with repaired and unrepaired simple and complex cardiac shunt lesions. Materials: A prospective study was conducted in 32 antenatal women with congenital shunt lesions of heart in Govt. RSRM hospital, Chennai from Jan 2009-Dec 2010. Among them 16 had repaired lesions and 16 had unrepaired lesions. Methods: Simple lesions recruited for the study were ASD (four repaired and eight unrepaired), VSD (seven repaired and eight unrepaired). Complex lesions in the study TOF (two) and TGA (two) and PDA(one) all were surgically corrected. INCLUSION CRITERIA: Antenatal women with shunt lesions of heart-repaired /unrepaired EXCLUSION CRITERIA: MVP, valvular lesions, Cardiomyopathies, Primary Arrhythmias and Antenatal women with shunt lesions of heart associated with other co-morbidities. Results: Majority of women were aged 21–25 years (68.75%) and primi parous (59.37%). Preterm births (16.67%) were more in patients with ASD. Normal labour was high with repaired simple shunt lesions ASD (75%), VSD (85.7%). LBW babies more in patients with repaired VSD (57.14%). No adverse cardiac events were observed with complex shunt lesions of heart. Pre eclampsia and preterm labour were more in patients with unrepaired ASD. Pulmonary hypertension & CCF observed in patients with uncorrected ASD. All patients with corrected complex lesions delivered through cesarean section. One baby of uncorrected ASD mother had congenital anomaly (Holt Oram syndrome). Significant difference was observed in birth weight of babies born to mothers with repaired and unrepaired congenital cardiac lesions (p = 0.029). Conclusions: The outcome of pregnancy is favourable in women with repaired shunt lesions (Simple & Complex). O070 THE RELATIONSHIP BETWEEN OPIUM-ADDICTED PARENTS AND THEIR CHILDREN’S CONGENITAL HEART DISEASES F. Forghani1 , N. Ashrafi1 . 1 Science and Research Branch, Islamic Azad University, Tehran, Iran, Islamic Republic of Objectives: The effect of opium addiction of mother or both parents on the congenital heart diseases of their children is brought to attention. Materials: One hundred cases of children of addicted parent(s) suffering from congenital heart diseases were examined and compared with the healthy ones. Methods: Opioids and most specifically morphine, the most effective component of opium, is mainly transferred through placenta to the fetus and is accumulated in the tissues of fetus especially in the heart. Subjects were interviewed for the study and relevant information were collected and tabulated.
S286
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S261–S530
Results: It was observed that, at least one parent of 27.1% of patients was addicted, compared to the children of not addicted parents. The Teratogenic effect of opium and its derivatives on cell proliferation were observed in the first phase of pregnancy and it is suggested the possibility of similar effects on other systems in fetus. Conclusions: Findings of the study showed that there is a statistically significant correlation between parent’s opium addiction and congenital heart problems of their children. O071 AN AUDIT OF ONE STOP POST MENOPAUSAL BLEEDING (PMB) CLINIC, DO WE NEED TO CHANGE THE ENDOMETRIAL THICKNESS (ET) CUT-OFF OF 4 MM? N. Aslam1 , M. Oniah1 , M. Gaber1 , J. Hollingworth1 . 1 Obstetrics & Gynaecology, queen ’s hospital, Burton, Birmingham, United Kingdom Objectives: Post-menopausal bleeding (PMB) represents one of the most common reasons for referral to gynaecological services, largely due to suspicion of an underlying endometrial malignancy. Endometrial cancer is present in approximately 10% of patients referred with PMB To improve the service provided in PMB clinic and to see whether we adhere to national guidelines. We also wanted to see whether cut off 4mm endometrial thickness needs to be changed. Materials: Standards SIGN Publication No. 6, INVESTIGATION OF POST-MENOPAUSAL BLEEDING NICE, Clinical guideline 27, referral guidelines for suspected cancer. Methods: A retrospective analysis of case notes of 180 patients, who were referred with PMB between January 2011– June 2011. Results: Total 180 patients were included in the audit. Mean age was 62.3% were nulliparous. 99% patients were seen within 2 weeks of referral, 2% were using HRT. None of the patients was on tamoxifen, 0.5% had recurrent PMB.6% had endometrial thickness (ET) less than 5mm on TVS, 5% had ET of 4–10mm and 2% had >10mm. All patients gave verbal consent. 60% had hysteroscopy, 40% were discharged with ET <4mm after cervical examination without hysteroscopy. 35% had endometrial polyps, 88% patients with ET >5mm had pipelle biopsy. Failure rate was 1%, with vasovagal reaction <3% with no cases of uterine perforation or infection. 65% had normal histology, 5% inadequate, 8% simple hyperplasia and 3% complex hyperplasia, 2% endometrial cancer. Conclusions: We need to improve the local guideline and referral criteria re need for referral if ET < than 4mm. Further larger studies with update and review of national guideline is needed before any changes in referral criteria are made. Diagnostic and therapeutic hysteroscopy is feasible and highly successful in an outpatient setting One stop PMB clinic provides early diagnosis, reduces the number of hospital visits and enhance patient satisfaction. O072 HPV TESTING AS A TRIAGE IN WOMEN OF DIFFERENT AGE GROUPS REFERRED WITH LOW GRADE SMEARS. CAN IT PREDICT HIGH GRADE DISEASE? P. Athanasias1 , C. Chambers1 , S. Barreto2,1 , N. Pisal1 . 1 Whittington Hospital, London, United Kingdom; 2 Maternidade Dr Alfredo Da Costa, Lisboa, Portugal Objectives: Human Papillomavirus testing was introduced in our colposcopy department as a triage for women referred with a smear test indicating borderline changes or mild dyskaryosis. The aim of this study was to assess the incidence of HPV infection in various age groups and its significance in predicting high grade disease (CIN 2 or worse). Materials: The HPV status of 2406 women with a Low Grade smear test was determined using the HC2 assay. Methods: This was a retrospective study from January 2005 to October 2011. Data was collected from the medical notes and the computer database for colposcopy (Mediscan).
Results: Human Papillomavirus positive rates were 37% (953 patients) with a great variation between the different age groups: 52% between 20–24 years of age, 50% 25–29 years, 41% 30–34 years, 30% 35–39 years, 22% 40–44 years, 22% 45–49 years and 15% >50 years. Between the 1453 women that tested negative for HPV infection only 5 had a subsequent diagnosis of high grade disease. The sensitivity of HPV testing in predicting high grade cervical disease was 86 % and showed a decreasing trend with increasing age. The overall specificity was 64% and gradually increased in the older age groups. The negative predictive value was very high among patients of all ages (99.4 to 100%). Conclusions: We conclude that in women with Low Grade smears, HPV testing can be used to rule out presence of HG disease across all age groups. We therefore feel that the implementation of HPV testing in triaging women with borderline cytological abnormalities and mild dyskaryosis is a safe strategy. O073 1H NMR SPECTROSCOPY BASED METABOLOMIC PROFILING OF WOMEN WITH POLYCYSTIC OVARY SYNDROME (PCOS) W. Atiomo1 , C. Daykin1 . 1 University of Nottingham, Nottingham, United Kingdom Objectives: The current clinical challenges in the management of PCOS include a need to better characterise the syndrome, the prediction of response to therapy and the prediction of which women develop the long term health risks such as type 2 diabetes and cardiovascular disease. Metabolomic biomarkers could help address these challenges. The aim of this study was as a first step to investigate whether women with PCOS had a unique 1H NMR Spectroscopy based metabolomic profile that was different from controls and assess the feasibility of a definitive study. Materials: Nine women with PCOS and 5 healthy women acting as controls had measurement of demographic and anthropometric data and venepunctures. Methods: Assays on plasma samples for metabolomic profiles using 1H NMR Spectroscopy. Results: There were no differences between the metabolomic profiles of women with PCOS compared with controls when the NMR spectra were visually inspected and on multivariate analysis. However when NMR spectra from a subset of 5 age and BMI matched pairs of women with PCOS and controls were evaluated, phenylalanine, arginine, lysine, lipid (CH2-CH2-C=C), citrulline, acetate, glycoprotein, acetoacetate and glutamate levels were statistically significantly different in women with PCOS compared with controls. Conclusions: Women with PCOS may have a unique 1H NMR Spectroscopy metabolomic finger print and a definitive study is feasible. These findings may enable sample size calculations for confirmatory studies and stimulate further research to improve the understanding and management of PCOS. O074 RISKY SEXUAL PRACTICES TO ACHIEVE CONCEPTION AMONG PEOPLE LIVING WITH HIV: STILL A COMMON FINDING IN DEVELOPING COUNTRIES O.A. Awolude1,2 , T.I. Akinola2 , O. Adesina1,2 , I. Adewole1,2 . 1 Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; 2 University College Hospital, Ibadan, Oyo, Nigeria Objectives: To assess the sexual practices in achieving conception by PLWHIV and the implications of these on the principle of safer sexual practice. Materials: Interviewer administered, 20-stem questionnaire. Methods: A cross sectional survey of 301 female PLWHIV attending PMTCT clinic of an Antiretroviral Treatment, care and support programme at the University College Hospital, Ibadan over a 6month period was conducted. The inclusion criterion, among others,