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O156 Gestational diabetes mellitus: an independent risk factor for hyaline membrane disease in neonates delivered after 34 weeks
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
or tacrolimus (p = 0.036). Mean graft survival rates since BL were similar in both groups (9.5 vs. 10.6 years), but in adjusted models we found that the association between pregnancy and CNI treatment increases the risk of long-term graft loss, with a HR = 2.6 95%CI (1.15–6.04). Conclusion: Globally, pregnancy in kidney transplant recipients does not significantly affect survival rates. However the use of CNI regimens during pregnancy significantly increases the risk of longterm graft loss. At our knowledge this observation has not been described until now. O156 Gestational diabetes mellitus: an independent risk factor for hyaline membrane disease in neonates delivered after 34 weeks P. Vignoles1 , X. Carcopino1 , J. Mancini2 , F. Bretelle1 , L. Boubli1 , E. Janky3 . 1 Service de Gyn´ecologie Obst´etrique, Hˆ opital Nord, Chemin des Bourrely, 13915 Cedex 20, Marseille, France, 2 Service Sant´e Publique, Hˆ opital de la Timone, 264, Rue Saint-Pierre 13385 Marseille Cedex 5, France, 3 Service de Gyn´ecologie Obst´etrique, Hˆ opital de Pointe-` a-Pitre Abymes, 97159 Pointe a ` Pitre Cedex, Guadeloupe Objective: To evaluate if gestational diabetes mellitus (GDM) exposes neonates delivered after 34 weeks to an increased risk of hyaline membrane disease. Materials and Methods: Data from 3237 women, of whom 198 women were diagnosed with GDM, who delivered after 34 weeks of pregnancy between January 2006 and August 2007 were retrospectively analyzed. Premature delivery (<37 weeks), fetal sex, low birth weight (<2500 g), mode of delivery (vaginal or c-section) and the occurrence of hyaline membrane disease were recorded for analysis. Results: Hyaline membrane disease was diagnosed in 21 cases. GDM was significantly more frequent in cases of hyaline membrane disease than in others: 38.1% vs. 5.9% (p < 0.001), respectively. We also observed higher proportion of premature delivery: 76.2% vs. 12.3% (p < 0.001), low birth weight: 66.7% vs. 11.5% (p < 0.001), and c-section delivery: 47.6% vs. 20.5% (p = 0.005). After adjustement for these variables, GDM was identified as an independant risk factor for hyaline membrane disease: adjusted odds ratio 18.7, 95% confidence interval 3.31–24.89 (p < 0.001). Conclusion: GDM should be considered as an independent risk factor for hyaline membrane disease in neonates delivered after 34 weeks. Such result raises the question of the benefit of the use of corticosteroids after 34 weeks in that specific targeted population. O157 The membrane bound G-protein coupled receptor, GPR30, mediates the anti-invasive effect of estradiol in ovarian cancer cells B. Casslen, E. Henic. Dep Gynecology & Obstetrics, University Hospital, 221 85 Lund, Sweden The objective was to study the impact of estradiol on invasive behavior in ovarian cancer cells, and subsequently to identify the mediating receptor. Seven ovarian cancer cell lines were studied for cell migration, invasion, and urokinase receptor expression. These cells as well as 44 primary ovarian tumors were analyzed for expression of GPR30 mRNA and protein using real-time PCR and Western blot. EGF stimulated migration and invasion of ovarian cancer cells, and estradiol attenuated this response. This effect of estradiol was secondary to reduction of EGF induced mobilization of occupied urokinase receptor from cryptic domains in the cells. Tamoxifen and ICI 182780, which are antagonists to nuclear estrogen receptors, had agonistic effects in this model, which is a well-known property of GPR30. Furthermore, a specifically designed GPR30 agonist, G-1, also mimicked the effect of estradiol. These results lead us to conclude that this effect of estradiol is mediated by GPR30. The estrogen responsive membrane receptor GPR30 is expressed in ovarian cancer cell lines and in primary ovarian tumors. It mediates
S137
the anti-invasive effect of estradiol by inhibiting mobilization of urokinase receptor in response to EGF. This is important since high expression of EGF and its receptor associates with tumor aggressiveness. Thus, our finding is relevant to any discussion of the role of estrogen in development and progression of ovarian cancer. O158 Thickness of the epithelium of the uterine cervix and its association with AIDS C. Cavellani, L. Rocha, R. Silva, C. Guimar˜aes, R. Corrˆea, H. Oliveira, V. Teixeira. Triˆ angulo Mineiro Federal University Epidemiological data have shown a progressive incidence of HIV infection, observing trends of heterosexualization and feminization. It was demonstrated that HIV infection is associated with changes in the immune status of mucosal surfaces, as in the intestine and lung, and that such changes may also occur in the genital tract. Objective: The aim of this study was to evaluate the thickness of the epithelium of the uterine cervix and its association with AIDS, with the nutritional status and the number of Langerhans cells. Methods: Were used fragments of the uterine cervix from 25 women autopsied at the Triˆangulo Mineiro Federal University, Brazil, between 1980 and 2008, which were divided into two groups: without AIDS (n = 14) and with AIDS (n = 11). The measurement of the whole cervical epithelium was performed through the system Image J and to immunohistochemical marking of Langerhans cells was used anti-S100. Results: Patients with AIDS presented mean age and BMI lower than women without AIDS. The cervical epithelium was significantly thinner in women with AIDS and women considered undernourished, independently of AIDS. The number of Langerhans cells observed in the epithelium of the uterine cervix was significantly lower in the group of women with AIDS, and these women presented a higher frequency of immature or morphologically changed Langerhans cells, suggesting a decreased function of these cells. Conclusion: Thus, from histochemical, morphometric and immunohistochemical studies in autopsied patients with or without AIDS, we conclude that probably AIDS and undernutrition cause a reduction in the thickness of esophageal epithelium and in the number and functions of Langerhans cells, contributing to changes in local immunity, which favors the onset of symptoms and opportunistic infections in the uterine cervix. The local deficient immunity associated with a thinner epithelium and more severe morphological changes could promote co-infection, reinfection and spread of the virus in patients with AIDS. Grants: FAPEMIG, CAPES, CNPq, FUNEPU. O159 Umbilical artery, middle cerebral artery and uterine artery Doppler indices in pregnant women with hypertensive disorders and correlation with perinatal outcome V. Chaddha, S. Kala, Y. Juneja, K. Bannerjee, P. Pahwa. Moolchand Womens Hospital, Moolchand Medcity, New Delhi, India Objective: To evaluate the role of umbilical artery, middle cerebral artery and uterine artery Doppler indices in pregnant women with hypertensive disorders [PIH] and correlation with perinatal outcome. Materials and Methods: A total of 50 cases of PIH between 28–40 wks of gestation were studied over a period of one year. Doppler study of umbilical artery, uterine arteries and middle cerebral artery was done. Pulsatility index (PI) of these vessels was documented. Middle cerebral artery PI < 1.5, umbilical artery PI > 1.5 and uterine artery PI > 1.45 was considered abnormal. Fetal outcome parameters were gestational age at delivery, mode of delivery, APGAR score at 5 minutes, NICU stay >7 days, requirement of ventilator support, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH),
or tacrolimus (p = 0.036). Mean graft survival rates since BL were similar in both groups (9.5 vs. 10.6 years), but in adjusted models we found that the association between pregnancy and CNI treatment increases the risk of long-term graft loss, with a HR = 2.6 95%CI (1.15–6.04). Conclusion: Globally, pregnancy in kidney transplant recipients does not significantly affect survival rates. However the use of CNI regimens during pregnancy significantly increases the risk of longterm graft loss. At our knowledge this observation has not been described until now. O156 Gestational diabetes mellitus: an independent risk factor for hyaline membrane disease in neonates delivered after 34 weeks P. Vignoles1 , X. Carcopino1 , J. Mancini2 , F. Bretelle1 , L. Boubli1 , E. Janky3 . 1 Service de Gyn´ecologie Obst´etrique, Hˆ opital Nord, Chemin des Bourrely, 13915 Cedex 20, Marseille, France, 2 Service Sant´e Publique, Hˆ opital de la Timone, 264, Rue Saint-Pierre 13385 Marseille Cedex 5, France, 3 Service de Gyn´ecologie Obst´etrique, Hˆ opital de Pointe-` a-Pitre Abymes, 97159 Pointe a ` Pitre Cedex, Guadeloupe Objective: To evaluate if gestational diabetes mellitus (GDM) exposes neonates delivered after 34 weeks to an increased risk of hyaline membrane disease. Materials and Methods: Data from 3237 women, of whom 198 women were diagnosed with GDM, who delivered after 34 weeks of pregnancy between January 2006 and August 2007 were retrospectively analyzed. Premature delivery (<37 weeks), fetal sex, low birth weight (<2500 g), mode of delivery (vaginal or c-section) and the occurrence of hyaline membrane disease were recorded for analysis. Results: Hyaline membrane disease was diagnosed in 21 cases. GDM was significantly more frequent in cases of hyaline membrane disease than in others: 38.1% vs. 5.9% (p < 0.001), respectively. We also observed higher proportion of premature delivery: 76.2% vs. 12.3% (p < 0.001), low birth weight: 66.7% vs. 11.5% (p < 0.001), and c-section delivery: 47.6% vs. 20.5% (p = 0.005). After adjustement for these variables, GDM was identified as an independant risk factor for hyaline membrane disease: adjusted odds ratio 18.7, 95% confidence interval 3.31–24.89 (p < 0.001). Conclusion: GDM should be considered as an independent risk factor for hyaline membrane disease in neonates delivered after 34 weeks. Such result raises the question of the benefit of the use of corticosteroids after 34 weeks in that specific targeted population. O157 The membrane bound G-protein coupled receptor, GPR30, mediates the anti-invasive effect of estradiol in ovarian cancer cells B. Casslen, E. Henic. Dep Gynecology & Obstetrics, University Hospital, 221 85 Lund, Sweden The objective was to study the impact of estradiol on invasive behavior in ovarian cancer cells, and subsequently to identify the mediating receptor. Seven ovarian cancer cell lines were studied for cell migration, invasion, and urokinase receptor expression. These cells as well as 44 primary ovarian tumors were analyzed for expression of GPR30 mRNA and protein using real-time PCR and Western blot. EGF stimulated migration and invasion of ovarian cancer cells, and estradiol attenuated this response. This effect of estradiol was secondary to reduction of EGF induced mobilization of occupied urokinase receptor from cryptic domains in the cells. Tamoxifen and ICI 182780, which are antagonists to nuclear estrogen receptors, had agonistic effects in this model, which is a well-known property of GPR30. Furthermore, a specifically designed GPR30 agonist, G-1, also mimicked the effect of estradiol. These results lead us to conclude that this effect of estradiol is mediated by GPR30. The estrogen responsive membrane receptor GPR30 is expressed in ovarian cancer cell lines and in primary ovarian tumors. It mediates
S137
the anti-invasive effect of estradiol by inhibiting mobilization of urokinase receptor in response to EGF. This is important since high expression of EGF and its receptor associates with tumor aggressiveness. Thus, our finding is relevant to any discussion of the role of estrogen in development and progression of ovarian cancer. O158 Thickness of the epithelium of the uterine cervix and its association with AIDS C. Cavellani, L. Rocha, R. Silva, C. Guimar˜aes, R. Corrˆea, H. Oliveira, V. Teixeira. Triˆ angulo Mineiro Federal University Epidemiological data have shown a progressive incidence of HIV infection, observing trends of heterosexualization and feminization. It was demonstrated that HIV infection is associated with changes in the immune status of mucosal surfaces, as in the intestine and lung, and that such changes may also occur in the genital tract. Objective: The aim of this study was to evaluate the thickness of the epithelium of the uterine cervix and its association with AIDS, with the nutritional status and the number of Langerhans cells. Methods: Were used fragments of the uterine cervix from 25 women autopsied at the Triˆangulo Mineiro Federal University, Brazil, between 1980 and 2008, which were divided into two groups: without AIDS (n = 14) and with AIDS (n = 11). The measurement of the whole cervical epithelium was performed through the system Image J and to immunohistochemical marking of Langerhans cells was used anti-S100. Results: Patients with AIDS presented mean age and BMI lower than women without AIDS. The cervical epithelium was significantly thinner in women with AIDS and women considered undernourished, independently of AIDS. The number of Langerhans cells observed in the epithelium of the uterine cervix was significantly lower in the group of women with AIDS, and these women presented a higher frequency of immature or morphologically changed Langerhans cells, suggesting a decreased function of these cells. Conclusion: Thus, from histochemical, morphometric and immunohistochemical studies in autopsied patients with or without AIDS, we conclude that probably AIDS and undernutrition cause a reduction in the thickness of esophageal epithelium and in the number and functions of Langerhans cells, contributing to changes in local immunity, which favors the onset of symptoms and opportunistic infections in the uterine cervix. The local deficient immunity associated with a thinner epithelium and more severe morphological changes could promote co-infection, reinfection and spread of the virus in patients with AIDS. Grants: FAPEMIG, CAPES, CNPq, FUNEPU. O159 Umbilical artery, middle cerebral artery and uterine artery Doppler indices in pregnant women with hypertensive disorders and correlation with perinatal outcome V. Chaddha, S. Kala, Y. Juneja, K. Bannerjee, P. Pahwa. Moolchand Womens Hospital, Moolchand Medcity, New Delhi, India Objective: To evaluate the role of umbilical artery, middle cerebral artery and uterine artery Doppler indices in pregnant women with hypertensive disorders [PIH] and correlation with perinatal outcome. Materials and Methods: A total of 50 cases of PIH between 28–40 wks of gestation were studied over a period of one year. Doppler study of umbilical artery, uterine arteries and middle cerebral artery was done. Pulsatility index (PI) of these vessels was documented. Middle cerebral artery PI < 1.5, umbilical artery PI > 1.5 and uterine artery PI > 1.45 was considered abnormal. Fetal outcome parameters were gestational age at delivery, mode of delivery, APGAR score at 5 minutes, NICU stay >7 days, requirement of ventilator support, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH),