SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - 149A

Scientific Abstracts

Reproductive Sciences Vol. 25, Supplement 1, March 2018

T-119
Uterine Leiomyomas Do Not Appear to Be a Risk Factor for a Short
Cervical Length. Melissa T Chu Lam†,1 Aaron Herrera†,2 Jonathan
Hunt†,2 James Anasti*,2 Christopher Wayock*.2 1Mount Sinai West, New
York, NY, United States; 2St Luke's University Health Network, Bethlehem,
PA, United States.
INTRODUCTION: A mid-trimester short cervix is a known risk factor
for preterm birth (PTD). Studies report an increase incidence of a short
cervix with uterine leiomyomas (UL) which may contribute to higher
rates of PTD in these patients. However, studies of mid-trimester cervical
length in women with UL are limited by small sample size and lack
of transvaginal cervical length measurements (TVS-CL).We therefore
reviewed our data on TVS-CL and pregnancy outcomes in women with
UL.
METHODS: We performed a retrospective cohort review of all UL
patients that underwent routine second trimester anatomic ultrasounds
between July 2012-July 2015. These patients were compared to a
randomly selected control group without UL. Patient demographics, UL
measurements (number and size), cervical length measurements, and
pregnancy outcomes were collected.
RESULTS: We obtained data on 224 patients with UL and compared
them to 220 controls. All values are reported as mean ± standard deviation.
UL patients were older (34.9 ± 4.9, vs 29.5 ± 6.6y, p=0.001) and had a
higher BMI (29.1±6.6 vs 27.8 ± 6.8, p=0.02). Parity and prior spontaneous
preterm birth were comparable between groups. The numbers of ULs were
1.6 ± 1.1 per patient, and the largest UL diameter was 4.5 ± 2.6 cm with a
UL volume of 142 ± 373 cm3. TV-CLs were performed at an average of
20 weeks EGA for both groups. Mean TVS-CL measurements were 3.9 ±
0.8 cm in UL group and 3.7 ± 0.81 cm in controls (p=0.11). TVS-CLs less
than 2.5 cm occurred more frequently in the control group vs UL group
(4.5% vs 0.9%; p= 0.040). Mean Gestational age at time of delivery was
38.1 ± 3.3 wks for UL and 38.9 ± 2.0 for controls (p=0.001). Cesarean
delivery did not differ between groups. Singleton preterm births less than
37 weeks (13.4 vs 6.7%, p=0.040) and before 35 weeks (7.8 vs 2.8%,
p=0.038) were more common in UL patients.
CONCLUSION: TVS-CL in pregnancies complicated by UL do not
appear to differ significantly from those patients without UL. Despite an
increased risk for PTB with UL, a short cervical length does not appear
to be a potentially modifiable risk factor.
Comparison of outcomes in Uterine Leiomyoma (UL) patients and controls.
Values are means ± SD.
Outcome measure

Controls
(n=220)

UL (n=224)

p
value

Gestation age Delivery (wks)

38.9 ± 2.0

38.1 ± 3.3

0.001

Twin pregnancy

10 (4.5%)

8 (3.6%)

0.78

Cesarean delivery

71 (32.3%)

85 (37.9%)

0.25

Gestational age of CL (wks)

20.6 ± 1.9

20.7 ± 3.2

0.82

Multiple Fibroids

NA

67 (29.9%)

NA

Largest Fibroid (cm)

NA

4.5 ± 2.6

NA

Cervical Length (cm)

3.7 ± 0.81

3.9 ± 0.80

0.11

CL < 2.5 cm

10 (4.5%)

2 (0.9%)

0.040

Singleton Preterm Birth < 37 wks

14/210 (6.7%)

29/216
(13.4%)

0.031

Singelton Preterm Birth < 35 wks

6/210 (2.8%)

17/216 (7.8%)

0.038

T-120
Ulipristal Acetate Inhibits Wnt and mTOR Signaling Pathways in
Human Uterine Fibroid. Mohamed Ali†,1,2 Sara M Shahin,2 Nagwa A
Sabri,2 Ayman Al-Hendy*.1 1Augusta University, Augusta, GA, United
States; 2Clinical Pharmacy Department, Faculty of Pharmacy, ASU,
Cairo, Egypt.
INTRODUCTION: Uterine fibroids (UFs) are the most common benign
neoplastic threat to women's health with cost of billions of health care
dollars. Current evidences support the key role of progesterone in UFs
pathogenesis via multiple actions including WNT signaling pathways.
Selective progesterone receptor modulators (SPRMs) family offer novel
and unique oral treatment options. Ulipristal acetate (UPA) has shown
superior efficiency in controlling UF associated bleeding and inducing
fibroid shrinkage which can be sustained up to 6 months after treatment
cessation. Studies showed many functional markers expression changes
due to UPA in UFs but its exact mechanism of action is still unknown.
Objective: To examine the ability of UPA to modulate WNT and mTOR
signaling in human UF cells
METHODS: Immortalized human fibroid cells (HuLM) were treated
by 100 nM UPA (equivalent to clinically relevant doses) for either 1 or 4
days, extracted RNA from untreated and treated cells were evaluated using
a WNT signaling pathway prime PCR array. Expression of 9 Wnt genes
was validated using RT-qPCR. Protein lysate was extracted from same
samples and expressions of Wnt4, Phospho-mTOR, mTOR, TSC1, TSC2,
Wnt induced signaling protein 1 (Wisp1), Sox17 and Wnt inhibitory factor
1 (WIF1) were measured by Western blot and by immunofluorescence.
Furthermore, protein was extracted from primary cells of UF and adjacent
myometrium (MM) tissue sample, collected at time of hysterectomy
as approved by Augusta University (AU) IRB No. 644354-6, and the
expression of naked cuticle homolog 1 (NKD1) and WIF1 were examined
using Western blot and RT-PCR analyses respectively. (P < 0.05) was
considered significant
RESULTS: UPA treated human UF cells (4 days) showed downregulation
of 52 genes and upregulation of 29 genes related to WNT pathway.
RT-PCR analysis confirmed a statistical significant decrease in mRNA
expression of several Wnt signaling genes including Wnt4, Wnt5B,
Wnt7B, Wnt9A, Wisp1, NKD1 and increase in WIF1 as compared to
untreated control. UPA treated cell lysate showed significant decrease in
protein expression of Wnt4, NKD1 and Wisp1 while increase in Sox17 and
WIF1 which both known to inhibit Wnt signaling. Immunofluorescence
intensity measurement confirmed the reduction in Wisp1 level. Baseline
comparison of Wnt related tumor marker NKD1 showed increase in
expression level in UF as compared to MM for both protein and mRNA
expression level. Protein extract from 1 day UPA treated cells showed
decreased p-mTOR and increased TSC1 and TSC 2 expression levels
CONCLUSION: Ulipristal acetate exert its robust anti-UF impact, at
least partially, through inhibition of Wnt and mTOR signaling in human
UF cells. Support: in part by the National Institutes of Health grants:
R01 HD089553-01, R01 ES 028615-01 and Egyptian governmental fund

T-121
Temporal and Spatial Variation in Microbial Community Membership
in Preterm and Term Placentas. Yin Yin†, Lindsay A Parnell, Indira U
Mysorekar*. Washington University SOM, St. Louis, MO, United States.
INTRODUCTION: The placenta is the principal organ nurturing the
fetus during pregnancy and comprises maternal and fetal compartments
including the maternal basal plate (BP); feto-placental villi (PV), and fetal
membranes (FM), each with distinct biology, physiology, and functions.
The human placenta has previously been considered to be sterile, but
recent work has identified that the term placenta harbors distinct microbial
communities depending on placental location. In fact, these distinct
bacterial communities are not altered by mode of delivery and share
greater homology with the same geographical niche across the sample
cohort than with a different region from the same placenta. However,
whether the spatial organization of the microbiome is altered temporally
by gestational age has not been evaluated.
METHODS: A case and control study of pregnant women (n=54)
who delivered preterm (29.19±3.12weeks) versus at term (n=57)

Thursday Posters

regulated (n=10) genes in the endometrial cell line compared to vehicle (8
genes were downregulated and 2 were upregulated). None of the regulated
genes were share between cell lines.
CONCLUSION: These preliminary observations suggest that the immune
component of endometriosis is epigenetically regulated and that the
effects of this HMTi are specific for ectopic endometrium. Funded by a
grant from the PR Science, Technology & Research Trust, RISE Program
(R25GM082406), the Puerto Rico Clinical and Translational Research
Consortium- Technology, Resources, Core Lab (U54MD007587) and
PR-INBRE NIH/NIGMS (P20GM103475).

149A
Table of Contents for the Digital Edition of SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018
