SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - 173A

Scientific Abstracts

Maternal Plasma G-CSF Concentrations in Preeclampsia Cases and
Controls. Stephen A McCartney†, Hilary S Gammill, Ellen A Schur,
Hayley W Hunt, Suchitra Chandrasekaran*. University of Washington,
Seattle, WA, United States.
INTRODUCTION: Preeclampsia (PE) is associated with an increased
maternal inflammatory response systemically and focally within the
maternal-fetal interface. One aspect of this response is recruitment
of neutrophils to the placenta during PE, which has previously been
demonstrated by human pathologic studies. Granulocyte colony
stimulating factor (G-CSF) stimulates the production and mobilization
of neutrophils from the bone marrow, and is known to be produced
during inflammation. Previous studies have demonstrated progressively
increased G-CSF concentrations in patients during pregnancy, but there
is limited data on G-CSF in PE. We hypothesized that serum G-CSF
concentrations would be higher in women with PE compared with
uncomplicated pregnancies.
METHODS: We analyzed data from a case control study of women with
and without PE. Cases and controls were frequency matched for maternal
age and BMI. Plasma G-CSF concentrations were measured by Luminex
multiplex assay among the two groups, from maternal peripheral blood
samples collected at the time of PE diagnosis (n=61) or during a third
trimester outpatient visit for controls (n=58). All samples were collected
prior to onset of labor. Appropriate transformation for data analysis was
performed. Student T-tests were performed to analyze differences in
concentrations between the two groups.
RESULTS: Of women with PE (n=61), 41 (67%) women had severe
features (sPE), 15 (25%) lacked severe features (mPE), and 4 (7%) had
HELLP syndrome. There was no significant difference in maternal plasma
G-CSF concentration in patients with PE compared to controls (38.9 ng/
ml +/- 1.6 vs 40.0 ng/ml +/- 20.1, p=0.77). Complete data for subjects,
including subgroups, is shown in Figure 1. Though maternal plasma
G-CSF was also similar in sPE (41.9 ng/ml +/- 23.6) versus mPE (36.8
ng/ml +/- 7.4, p=0.68) there appeared to be a subset of sPE subjects with
high levels of G-CSF, possibly representing a unique subset.
CONCLUSION: In our cross-sectional cohort, we found similar maternal
plasma G-CSF concentrations in women at the time of PE diagnosis and
controls. Exploratory evaluation suggested that subsets of PE, including
sPE and HELLP, may warrant further investigation. Future longitudinal
studies would allow for evaluation of G-CSF concentrations preceding
clinical manifestations of PE.
*Figure(s) will be available online.

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Identifying Fetal Growth Disorders Using Ultrasound in Women with
Obesity. Annie Dude†, Berkley Davis†, Katie Delaney†, Lynn M Yee*.
Northwestern University, Chicago, IL, United States.
INTRODUCTION: Performance of third trimester ultrasound for
estimate of fetal weight is common, yet the test characteristics of
ultrasound in obese women are not well established. We evaluated the
diagnostic performance of third trimester ultrasound to diagnose disorders
of fetal growth among women with class II and III obesity.
METHODS: This is a retrospective cohort of nulliparous women with a
body mass index (BMI) at the time of delivery of at least 35 kg/m2 who
delivered term, singleton gestations at a single academic institution (201015). Clinical, demographic, and sonographic data were abstracted for
women who had an ultrasound for fetal growth assessment within 5 weeks
of delivery. Large-for-gestational age (LGA) or small-for-gestational age
(SGA) were defined as an ultrasound estimated fetal weight > 90% or <
10%, respectively. We characterized the sensitivity, specificity, positive
predictive value (PPV) and negative predictive value (NPV) of ultrasound
to detect LGA and SGA infants for the entire cohort, as well as by class
of obesity (BMI 35-39.9 and 40 and above, corresponding to class II
and class III obesity). Finally, we compared the areas under the curve
(AUC) for receiver - operating characteristic (ROC) curves for different
classes of obesity.
RESULTS: Of 1,206 obese women, 299 (24.8%) had an ultrasound
within 5 weeks of delivery and were eligible for study inclusion. In this

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population, 7 (2.3%) screened positive for SGA and 9 (3.0%) delivered an
SGA neonate. In contrast, 69 (23.1%) screened positive for LGA and 40
(13.4%) delivered an LGA neonate. The sensitivities, specificities, PPVs,
and NPVs of ultrasound to detect SGA and LGA are shown below (Table).
The ROC curves for detection of LGA and SGA did not differ significantly
for different degrees of obesity (p = 0.18 for LGA; p = 0.78 for SGA).
CONCLUSION: Ultrasound in women with obesity at term has a high
specificity but poor sensitivity for SGA, and a low PPV for LGA as well.
The classification capability of ultrasound to correctly classify fetuses
with regard to growth abnormalities did not differ by class of obesity.
*Figure(s) will be available online.

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Uterine Electromyography (EMG) in the Expectant Management
of Placenta Previa. Jinying Yang†, Xiuyu Pan, Pin Li, Huishu Liu.
Guangzhou Women and Children Medical Center, Guangzhou, China.
INTRODUCTION: In case of placenta previa, there are only two options
in late pregnancy, one is the emergency cesarean section due to the
antepartum bleeding, the alternative is to expect until term if the patients
have no antepartum bleeding. The core is uterine contraction which causes
antepartum bleeding, In this study, noninvasive uterine electromyography
(EMG)is used to evaluate uterine contraction and further guide the optimal
timing for termination of pregnancy in placenta previa.
METHODS: This was a prospective study of patients with placenta
previa between January 2017 and October 2017 in Guangzhou Women
and Children Medical Center. All women were monitored uterine
electromyography from32 weeks until delivery. According to our previous
study, the uterine EMG parameters of the threatened labor, including
number of burst (30minutes), root mean square (RMS), power density
spectrum of peak frequency (PDS), and total power were chosen as
reference parameters to evaluate whether to terminate the gestation or
continue the pregnancy in the course of expectant management. The
clinical characteristics, perinatal outcomes and uterine electromyography
were compared between the patients with active uterine EMG pattern and
silent uterine EMG pattern.
RESULTS: A total of 40 patients with placenta previa were monitored
uterine EMG during the study period. Twenty three patients with silent
uterine EMG until term received elective cesarean section. In the active
uterine EMG group, the number of burst (30minutes) was 3-5, root mean
square (RMS) was 0.018-0.030mV, power density of spectrum (PDS) was
0.51-0.62Hz, total power was 10.20-21.32pV2.Sixteen patients showed
active uterine EMG and agree cesarean section which resulted in favorable
perinatal outcome, with one patients refused the operation, which received
emergency cesarean section due to massive vaginal bleeding 30 hours later.
CONCLUSION: The noninvasive uterine EMG may be applied in the
expectant management of placenta preivia, it could help clinicians find
an appropriate timing of pregnancy termination in placenta previa and
improve perinatal outcome.

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Effect of Endocrine Disruptors in mtDNA Content of Cumulus
Granulosa Cells (CGCs). Almena Luna†,2 Elena Herrera-Cogco†,1 Bruno
López-Bayghen,1 Dinorah Hernandez-Melchor,1 Esther López Bayghen*.1
1
Cinvestav-IPN, CDMX, Mexico; 2Cinvestav-IPN, Mexico City, Mexico.
INTRODUCTION: CGCs play an important energetic role in oocyte
growth and maturation, therefore, understanding how different compounds
can affect their mitochondrial activity is important to identify possible
toxic effects. The extensive use of parabens as preservatives in cosmetic
and pharmaceutical products has led to the evaluation of their safety
profiles. Studies have identified negative mitochondrial effects at the
ATP-production level and at the membrane potential level caused by
parabens and bisphenol A (BPA). However, the effect of parabens and BPA
at the mtDNA level has yet to be determined. Here, we hypothesize that
these endocrine disruptors will affect mtDNA concentrations in CGCs.
Our objective was to evaluate the effect of environmentally relevant
concentrations (levels found in follicular fluid, serum, and plasma) of
methylparaben (MPB), butylparaben (BPB), and BPA on mtDNA content
in CGCs.

Thursday Posters

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Reproductive Sciences Vol. 25, Supplement 1, March 2018

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