O002 PSYCHOLOGICAL DISTRESS IN OLDER FIRST TIME MOTHERS, FROM MID-PREGNANCY TO 18 MONTHS AFTER BIRTH

s in this section appear in alphabetical order according to presenter’s name, as per September 25, 2012 O001 THE EFFECT OF PREOPERATIVE SINGLE-DOSE METHYLPREDNISOLONE ON POSTOPERATIVE REHABILITATION AFTER ABDOMINAL HYSTERECTOMY: A RANDOMIZED CONTROLLED TRIAL A.J.M. Aabakke, L.B. Holst, J.C. Jorgensen, N.J. Secher. Department of Obstetrics and Gynaecology, University of Copenhagen, Holbaek Hospital, Holbaek, Denmark; Department of Anaesthesiology, University of Copenhagen, Holbaek Hospital, Holbaek, Denmark; Department of Obstetrics and Gynaecology,University of Copenhagen, Hvidovre Hospital, Hvidovre, Denmark Objectives: To compare the effect of 125mg Methylprednisolone (MP) with placebo on the postoperative rehabilitation after abdominal hysterectomy. Materials: Elective abdominal hysterectomies (n = 62) were randomized to receive either 125mg MP (n=33) or saline (n =29) i.v. preoperatively at a Danish university hospital. Methods: Randomization was computer-generated, with allocation concealment by opaque sequentially numbered sealed envelopes. Primary outcome was pain measured on a visual analogue scale (VAS) ranging from 0.0 (no pain) to 10.0 (worst pain) and assessed at rest and during mobilization repeatedly the first 24 hours and daily 2–7 days postoperatively. Pain scores were controlled for surgeon experience and surgery type in the statistical analysis. Secondary outcomes were postoperative use of opioids and antiemetics, vomiting, C-reactive protein (CRP) concentrations and time to mobilization and discharge. Participants, surgeons and outcome assessors were blinded to group assignment. Results: 49 woman were included in the analysis (MP n=25, saline n =24). Pain scores controlled for surgeon experience and surgery type did not differ between the two groups at rest (0.60 [95%CI -0.01–1.21] p = 0.055) but during mobilization VAS-scores were significantly higher in the MP group (0.89 [95%CI 0.11–1.64] p = 0.026). Both at rest and during mobilization VAS-scores were significantly lower when the surgeon performing the hysterectomy had at least 5 years experience as a gynaecological senior surgeon (rest 0.83 [95%CI 0.18–1.47] p = 0.012; mobilization 1.00 [95%CI 0.19–1.81] p = 0.016). At mobilization VAS-scores were higher after subtotal than total hysterectomy (0.95 [95%CI 0.16–1.74] p =0.019). There was no difference between the MP and saline group regarding cumulated use of opioids (p = 0.241), antiemetics (p = 0.142) and number of vomits (p = 0.260) 24 hours postoperatively and time to mobilization (p =0.238) and discharge (p = 0.276). CRP levels were significantly higher in the placebo group (p =0.012). Conclusions: This study showed no beneficial effect of preoperative MP on postoperative pain or rehabilitation after abdominal hysterectomy. MP significantly lowered postoperative CRP concentrations. Based on this study a preoperative singledose administration of glucocorticoid seems to have no effect on postoperative pain and rehabilitation after abdominal hysterectomy. Trial Registration ClinicalTrials.gov; Identifier: NCT01106547 O002 PSYCHOLOGICAL DISTRESS IN OLDER FIRST TIME MOTHERS, FROM MID-PREGNANCY TO 18 MONTHS AFTER BIRTH V. Aasheim, A. Hjelmstedt, H.J. Pettersson, S. Rasmussen, U. Waldenstrom, E. Schytt. Karolinska Institutet, Department of Women’s and Children’s Health, Stockholm, Sweden; Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway; Institute of Clinical Medicine, Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway; Karolinska Institutet, Institutionen for klinisk forskning och utbildning, Stockholm, Sweden Objectives: Maternal age at first childbirth has increased dramatically during the last decades in most high income countries. The postponement of childbearing has been high on the research agenda because of the subsequent increase in medical complications during pregnancy and birth, and also because of its long-term consequences on the total fertility rate. However, there is a gap in knowledge about the psychological well-being of older first time mothers. The objective of this study was to investigate if advanced maternal age at first birth increases the risk of psychological distress, by means of depressive and anxiety symptoms, from mid-pregnancy to 18 months after the birth. Materials: 19,291 nulliparous, Norwegian speaking women, were reqruited between 1999 and 2009 from all hospitals and maternity units with more than 100 births annually. Methods: Selected data from the Norwegian Mother and Child Cohort Study (MoBa) was used. Data was collected by means of six questionnaires during pregnancy and postpartum. Psychological distress was measured by a short form of the Hopkins Symptom Checklist (SCL5) in pregnancy weeks 17 and 30 and 6 months and 18 months post-partum. Advanced maternal age was defined as ≥32 years and a reference group of women 25–31 years was used for comparisons. Women aged 20–24 years were also included. The prevalence of psychological distress at three time points was estimated and generalized estimation equations were used to investigate associations between advanced maternal age and psychological distress. Results: The findings will be presented at the conference. Conclusions: The conclusion will be presented at the conference O003 MACROSOMIA: A MOROCCAN TEACHING HOSPITAL STUDY ABOUT 1335 CASES S. Abakka, N. Khoummane, A. Ansari Chenguiti, S. Amrani, S. Bargach. Obstetrics and gynaecology, oncology and high risk pregnancies, Maternity hospital Souissi, Rabat, Rabat-Sale, Morocco Objectives: Our aim was to determine the prevalence of macrosomia in 2011, its risk factors and morbidity. Materials: We studied the obstetrics notes of all deliveries of newborns with a birthweight of 4000 g and above, from the 1st January 2011 to the 31st Decembre 2011, at the teaching Maternity hospital Souissi of Rabat, Morocco. We also used abstracts and 0020-7292/ $ – see front matter © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.