Poster Session I
org
OBJECTIVE: eovascularization along the bladder-serosal interface is
often observed in cases of placenta accreta spectrum (PAS) requiring
hysterectomy. We sought to determine the relationship between 3-
dimensional power Doppler (3D PD) quantification of vascular
indices along the bladder-serosal interface e a potential surrogate
marker of vascularization e and the outcome of hysterectomy in
women with concern for PAS in the first trimester.
STUDY DESIGN: Women with a prior cesarean and low implantation
in the first trimester underwent 3D PD as part of standardized ul-
trasound assessment for PAS. The ultrasound imaging device used
was a GE Voluson E10. An investigator blinded to clinical infor-
mation employed a standardized reading protocol to select the 3D
PD study with the best visualization of the bladder-serosal interface
and minimal aliasing. 3D volumes were constructed from the entire
placental mass along the bladder serosal interface. Vascular indices
were then extracted from this volume and compared based on the
outcome of hysterectomy. The Wilcoxon Rank Sum Test was used for
statistical analysis. Each 3D PD study was analyzed independently on
two different days to assess intra-observer reliability.
RESULTS: Between March 2021 to June 2022, 16 women had first
trimester 3D PD studies and delivery data available for analysis. Six
women required hysterectomy. The vascularization index, vascular-
ization flow index, and flow index were significantly higher in those
women requiring hysterectomy (P < 0.01, Table). The intra-observer
reliability was 0.94, 0.95, and 0.95 for vascularization index, vascu-
larization flow index, and flow index respectively.
CONCLUSION: Vascular indices based on 3D PD in the first trimester
are significantly higher in women requiring hysterectomy. Intra-
observer reliability was excellent. Further assessment to validate
these findings and assess for predictive capability will enhance
clinical management of these complicated cases.
148 Social Determinants of Health Associated with
Intimate Partner Violence in an Urban Obstetric
Population
Christina Kuhrau1, Elizabeth Kelly1, Emily A. DeFranco2
1
Department of Obstetrics and Gynecology, University of Cincinnati College
of Medicine, Cincinnati, OH, 2University of Cincinnati College of Medicine,
Cincinnati, OH
OBJECTIVE: Intimate partner violence (IPV) is pervasive and can lead
to severe health consequences. In the US, 25% of women have
experienced sexual violence, physical violence, and/or stalking by an
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intimate partner. However, less is known about the frequency and
risk factors for IPV in the obstetric population.
STUDY DESIGN: Nested case-control study from a prospective cohort
survey study of 606 parturients at a single academic medical center
from 2011-2022. Structured surveys were administered to consented
patients during their postpartum hospital stay to gather information
on social determinants of health (SDoH) and birth outcomes. The
case group included participants who reported forced sex causing
pregnancy, verbal abuse before or during pregnancy, or physical
abuse during pregnancy. The control group reported none of these.
Odds ratios were used to quantify the relationship between IPV and
maternal sociodemographic characteristics, pregnancy factors, and
levels of perceived support and discrimination.
RESULTS: Of 606 study participants, 568 (94%) had data on IPV. Of
those, 20.4% reported IPV (case) and 80.6% reported no IPV
(control). 74.6% of the study population was enrolled pre-pandemic.
Unmarried status, low income, food insecurity, housing insecurity,
substance use during pregnancy, higher gravidity, unintended
pregnancy, low social support, and racial and gender discrimination
were all significantly associated with IPV; maternal race and preg-
nancy during the COVID-19 pandemic were not.
CONCLUSION: IPV is common, reported by 1 in 5 parturients in our
population. Although maternal race was not associated with IPV in
this perinatal cohort, experiencing racism was. Initiatives aimed to
address SDoH such as substance use, family planning, and access to
food and housing remain key opportunities to support pregnant
patients experiencing IPV. The connection between perceived
discrimination and IPV found here highlight the importance of
addressing the influence of racism and gender-based violence on
adverse birth outcomes in the US.
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149 Symptoms of perinatal mood disorders in
expectant parents with a diagnosis of a congenital
anomaly
Christina Paidas Teefey1, Alexandria Budney1,
Juliana S. Gebb1, Nahla Khalek2, Shelly Soni3,
Julie S. Moldenhauer1, Joanna Cole1
1
Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Children’s
Hospital of Philadelphia, Philadelphia, PA, 2Richard D. Wood Jr. Center for
Fetal Diagnosis and Treatment at CHOP, Philadelphia, PA, 3The Children’s
Hospital of Philadelphia, Philadelphia, PA
OBJECTIVE: To assess frequency of depressive and traumatic stress
symptoms in parents following a fetal diagnosis. To evaluate whether
diagnosis type, demographics or prematurity were associated with
heightened psychological distress.
STUDY DESIGN: Postpartum Depression Screening Scale (PDSS) and
Center for Epidemiological Studies-Depression (CES-D) were used
to identify clinically significant symptoms of depressive risk (  60
and  21) and The Impact of Events Scale-Revised (IES-R) was used
to determine traumatic stress risk (  33) in a cohort of pregnant
patients and their partners at a single center with onsite psychosocial
services from 2013-2022. Expectant parents completed screens
following diagnosis of a fetal anomaly (Time 1) and immediately
postpartum (Time 2). Change over time was defined by improve-
ment from positive to negative screen between Time 1 and Time 2.
Supplement to JANUARY 2023 American Journal of Obstetrics & Gynecology
Poster Session I
Sociodemographic variables, type of fetal anomaly and gestational
age at delivery were assessed. Statistical analysis was performed using
Fisher’s exact test and chi-square test for categorical variables and
Mann-Whitney U test for continuous variables.
RESULTS: Rates of clinically significant depressive and traumatic
stress risk for patients and partners are presented in the Table. Risk
decreased significantly in all groups over time. Demographics
including age, race/ethnicity, education level, and insurance did not
significantly impact change in symptoms between screens. Anomaly
type did not impact change over time for depressive or traumatic
stress symptoms. Prematurity was not associated with significant
change in symptoms at time 2.
CONCLUSION: Diagnosis of a fetal anomaly is associated with
heightened parental psychological distress. Clinically significant
decline in symptoms was demonstrated at birth. Findings support
the importance of implementing mental health screening and
availability of psychosocial support services in maternal-fetal care
settings to address anticipatory concerns and normalize the
emotional distress during the perinatal period among expectant
parents.
150 Hematopoietic Stem Cell Mobilization in
Pregnancy
Christine Nkemeh1, Shontreal M. Cooper2,
Charissa Okang2, ChiaLing Kuo3, Andrea Shields2,
Winston Campbell4, Hideyuki Oguro3
1
Eastern Virginia Medical School , Norfolk, VA, 2University of Connecticut,
Farmington, CT, 3UConn Health, Farmington, CT, 4University of
Connecticut Health Center, Farmington, CT
OBJECTIVE: The primary objective of this study was to investigate
hematopoietic stem cells (HSC) mobilization into peripheral blood
throughout pregnancy, and postpartum, compared to non-pregnant
controls.
STUDY DESIGN: This observational, prospective, longitudinal study
was approved by the UCONN Health institutional review board.
Participants were recruited between October 2020 and February
2022. Participants were female, 18-40 years old, and receiving care at
the study site. Patients with major medical problems were excluded.
Pregnant participants were permitted a collection of five blood
samples over the course of pregnancy and postpartum. Non-preg-
nant controls consented to a single blood collection. Flow cytometry
was used to measure mobilized HSC concentration in peripheral
blood. Baseline demographics, pregnancy, and neonatal information
were abstracted from study participants’ medical charts. ANOVA was
used for data analysis; P < 0.05 was significant.
RESULTS: 54 participants were enrolled (47 pregnant, 7 non-preg-
nant). At baseline, the non-pregnant controls had a higher BMI
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