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Reproductive Sciences Vol. 25, Supplement 1, March 2018

relevant food effect, peak exposures were reduced by 20% and AUCs
remained bioequivalent. Single and multiple administrations of OBE022
were well tolerated at all doses. There were no serious adverse events and
no clinically relevant changes in safety parameters.
CONCLUSION: OBE022 at single and multiple doses up to 1300mg
and 1000mg/d, respectively, is safe and has favorable pharmacokinetic
characteristics allowing for once or twice daily dosing and no clinically
relevant food effect. Our results suggest that OBE022 fulfills all
pharmacokinetic and safety prerequisites for further clinical testing in
preterm labor patients.
*Figure(s) will be available online.

S-039
Prediction of the Optimal Time for Late Preterm Antenatal Steroid
Administration. Elizabeth A Thom, George Washington University,
Rockville, MD, United States.
INTRODUCTION: Antenatal corticosteroids (ACS) should be
administered so that delivery occurs at least 24 hours and ≤ 7 days after
the first dose, which is difficult to predict. Our objective was to identify
predictive factors associated with delivery in this optimal interval in
women at risk for late preterm birth.
METHODS: Secondary analysis of a multicenter RCT of ACS vs.
placebo for women at 34-36 weeks at high risk for preterm birth. Baseline
demographic and obstetric variables were evaluated in women with 1)
pPROM and 2) preterm labor with intact membranes (PTL) defined as ≥
6 regular contractions in 1 hour and cervix ≥3cm dilated or ≥75% effaced.
For this analysis, the primary outcome is delivery from 24hrs to 7 days
after randomization and a secondary outcome is 2 doses received. For each
group and outcome, logistic regression adjusted for treatment group was
performed for each baseline variable. A minimum set of variables were
chosen by backwards elimination. Logistic regressions including these
variables and treatment group were tested with the remaining variables
and the best performing models chosen based on the score statistic. All
analyses were adjusted by treatment. 10-fold cross validation was used to
validate the models. Models with area under the curve (AUC)>0.7 were
considered acceptable.
RESULTS: Of 792 women in the PTL group, 2 were lost to follow-up,
182 (23%) delivered 24h-7days, 260(33%) before 24h and 348(44%)>7
days. The best prediction model included BMI, gestational age, nulliparity
and breech; AUC was 0.64. For 2 doses vs 1, the best prediction model
included hypertension/preeclampsia, cervical dilation and effacement;
AUC=0.71. Of 620 women in the pPROM group, 155 (25%) delivered
24h-7days; 463 delivered before 24h and 2 > 7days. The best prediction
model included cervical dilation, number of contractions per hour at
presentation, and effacement; AUC= 0.68. For 2 doses vs 1, the best
prediction model included ctx/hr and effacement; AUC=0.65.
CONCLUSION: The only model with acceptable predictive value was
for 2 doses versus 1 among women with PTL and intact membranes.
Higher cervical dilation and effacement and the presence of preeclampsia
or hypertension are strongly negatively associated with a full course.
*Figure(s) will be available online.

S-040
Evaluation of Kielland Forceps on Fetal Malrotation. Jun Takeda*,
Shintaro Makino*, Yasuko Sano†, Chihiro Hirai*, Atsuo Itakura*, Satoru
Takeda*. Juntendo University Faculty of Medicine, Tokyo, Japan.
INTRODUCTION: Malrotation of the fetal head is the most common
indication for second-stage caesarean section. Kielland forceps (KF) are
used for rotational assisted vaginal delivery, but remain controversial
having undergone a significant reduction of caesarean section without
increasing the complications. As the number of transverse arrest increases
with the painless delivery, we have been using KF after simulation training
of KF. To evaluate the feasibility of introducing KF in obstetrical practice,
we retrospectively analyzed medical records in a single teaching hospital.
METHODS: Parturient attempted KF at term with singleton cephalic
position were obtained from February to September of 2016. As a control
group, cases of occiput transverse position delivered using Naegele
forceps (NF) from 2014 to 2015 were identified. The outcomes analyzed

Scientific Abstracts

as operational features, and maternal and neonatal morbidity. Statistical
analysis was performed by chi square and Student t test. Statistical
significance was defined when p<0.05.
RESULTS: Fifteen women were eligible during the study period, and no
differences were found in maternal characteristics. All the cases attempted
KF resulted in successful vaginal delivery. The types of the forceps did
not show influence on bleeding, counts of extraction, Apgar scores, and
umbilical cord pH. Forceps marks on eyes and central of the faces were
significantly higher in NF groups (p<0.05). No case of severe perineal
lacerations was recognized in KF group.
CONCLUSION: Newly introduction of KF for transverse position with
careful consideration may be associated with high successful delivery rate
without increasing the morbidity.

S-041
Maternal and Neonatal Outcomes in Prolonged Inductions of
Labor. Masaru Negi†, Chrstina Ackerman†, Audrey Merriam, Jessica
Greenberg†, Sarah Meller†, Sophie Chung†, Anna Sfakianaki*. Yale
University, New Haven, CT, United States.
INTRODUCTION: While induction of labor is a common obstetrical
practice, there is a paucity of data published on safety of longer lengths of
induction. Allowing longer duration of inductions of labor could reduce
the incidence of cesarean delivery. This study aims to evaluate the safety
of prolonged inductions of labor.
METHODS: Women for whom an induction of labor was requested
at Yale-New Haven Hospital from February 1, 2013 to August 1, 2014
were identified. Information was obtained from the Yale-New Haven
Hospital Labor and Birth Record and Epic Hyperspace. Demographic
data included age, race, insurance type, BMI, maternal parity, history of
cesarean delivery, and maternal morbidities. Primary outcome was mode
of delivery. Secondary outcomes were composite maternal (shoulder
dystocia, blood transfusion, ICU transfer, antibiotic administration, or
death) and neonatal (APGAR < 4 at 5 minutes, neonatal injury, NICU
stay > 24 hours, antibiotic administration, or death) morbidity measures.
Unadjusted and adjusted logistic regression analyses were run to determine
the association between the above outcomes and length of induction of
labor.
RESULTS: 1002 patient records were reviewed, and 826 patients were
included. The length of inductions ranged from 0.68 to 66.08 hours
(median 10.37). Overall cesarean rate was 24.2%. There was a significant
association with increasing length of induction and delivery by cesarean
(OR 1.04, CI 1.03-1.06). However, this association was decreased when
adjusted for race, indication for induction, maternal parity, history of
cesarean delivery, Bishop score, and obesity (OR 1.02, CI 1.00-1.04).
Composite maternal morbidity was significantly associated with length of
induction after adjusting for the same variables (OR 1.04, CI 1.01-1.06).
Composite neonatal morbidity was also significantly associated with
length of induction also (OR 1.04, CI 1.02-1.06) but lost significance with
adjusting for the above variables (OR 1.02, CI 1.00-1.05).
CONCLUSION: Longer inductions are associated with cesarean delivery,
maternal morbidity, and neonatal morbidity. However, the associations
are small and may allow for continuation of a longer induction based on
a patient's individual clinical status. Further investigation is necessary to
determine a safe duration of inductions of labor.



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

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SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - Cover3
SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - Cover4
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2020
https://www.nxtbook.com/nxtbooks/sage/psychologicalscience_demo
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2020
https://www.nxtbook.com/nxtbooks/sage/fai_202009
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_august2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2019
https://www.nxtbook.com/nxtbooks/sage/fai_201909
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_july2019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2019
https://www.nxtbook.com/nxtbooks/sage/canadianpharmacistsjournal_05062019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2019
https://www.nxtbook.com/nxtbooks/sage/sri_supplement_201903
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2018
https://www.nxtbook.com/nxtbooks/sage/tec_20180810
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_julyaugust2018
https://www.nxtbook.com/nxtbooks/sage/fai_201807
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2018
https://www.nxtbook.com/nxtbooks/sage/sri_supplement_201803
https://www.nxtbook.com/nxtbooks/sage/slas_discovery_201712
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_november2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_september2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_julyaugust2017
https://www.nxtbook.com/nxtbooks/sage/fai_supplement_201709
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_may2017
https://www.nxtbook.com/nxtbooks/sage/fai_201706
https://www.nxtbook.com/nxtbooks/sage/fai_201607
https://www.nxtbookmedia.com