Background: Thyroid disorders are common in women of childbearing age and are associated with adverse pregnancy outcomes. Physiological changes in pregnancy and the lack of pregnancy-specific reference ranges make managing thyroid disorders in pregnancy challenging. Our aim was to establish trimester-specific thyroid function reference intervals throughout pregnancy, and to examine the prevalence of thyroid autoimmunity in otherwise euthyroid women. Method: This was a prospective, cross-sectional study of thyroid function tests (TFTs) in pregnant women attending a large, tertiary referral maternity hospital. Patients with known thyroid disorders, autoimmune disease, recurrent miscarriage, hyperemesis gravidarum and pre-eclampsia were excluded. TFTs were analysed in the CUH biochemistry laboratory using Roche Modular E170 electrochemiluminescent immunoassay. Trimester-specific reference ranges (2.5th, 50th and 97.5th centiles) were calculated. Results: Three-hundred-and-fifty-one women were included into the analysis. Median maternal age was 30. Thyroidstimulating hormone concentrations showed slightly increasing median centile throughout gestation. Free thyroxine (T4) and T3 decreased throughout gestation. Table 1 demonstrates the calculated percentiles according to gestational weeks. Conclusion: We established pregnancy-specific thyroid function reference intervals for our pregnant population, for use in clinical practice.

Outpatient hysteroscopy and endometrial biopsy are increasingly being used in the investigation of abnormal uterine bleeding. In our unit, both Endocurette® and Endosampler® endometrial biopsy devices are available in the outpatient hysteroscopy clinic. Literature comparing these devices is lacking. This was a prospective, randomised trial involving women attending the outpatient hysteroscopy clinic at Cork University Maternity Hospital. Women were randomised to endometrial sampling with either Endosampler® or Endocurette® devices. A number of device insertions, pain scores, ease of handling and histological reporting of sample adequacy and tissue histology were recorded. One hundred and six women were recruited comprising 55 pre-menopausal and 51 post-menopausal women. A substantially higher rate of multiple device insertions to obtain a visually adequate sample was recorded using Endocurette® compared with Endosampler®. In the Endosampler® group, 10.7 and 12.5 % of women in pre-and post-menopausal categories had ≥2 device insertions compared to 88.8 and 58.3 %, respectively, with Endocurette® (p=0.002 and p=0.0001). There was no difference in the rate of histologically inadequate samples or difficulty with device handling between matched groups. Mean pain scores in the pre-and post-menopausal groups were 5.83 and 4.58 for Endosampler®, and 4.69 and 4.88 for Endocurette® (p=0.02). The rate of histologically inadequate samples was higher in postmenopausal compared to pre-menopausal women (27.4 vs 3.7 %, p=0.0025). A significantly lower rate of multiple device insertions for adequate histological sample was recorded with Endosampler®. No significant differences in operational difficulties, patient acceptability and sample adequacy were shown. Higher overall pain scores were reported with Endosampler® with no difference in the rate of severe pain between groups' satisfaction with the procedure or willingness to undergo the procedure again.

AbstractsObjective To construct reference intervals for umbilical artery Doppler indices from 15 to 40 weeks in a low-risk population. Study design This was a prospective, cross-sectional study involving low-risk women attending Cork University Maternity Hospital conducted concurrently with a primary study to construct normograms for fetal biometry. Women were recruited from their first trimester dating scan and randomly allocated to a single scan between 14-40 weeks gestation. Scans were performed by a sole researcher. Gestation was calculated using the estimated due date assigned by dating scan. Recruits were Irish Caucasian women with a singleton pregnancy. Women with conditions affecting placental function including hypertension, pre-eclampsia, renal disease, autoimmune disorders and diabetes mellitus were excluded as were fetuses with congenital anomalies. Umbilical artey Dopplers were sampled using the Voluson E8 ultrasound by GE Healthcare. Results Nine-hundred-and-fifteen women were recruited. Sevenhundred-and-ninety-three women met the inclusion criteria and were scanned as per protocol. Women in gestational week 14 were not included in this dataset due to technical difficulties and presence of absent end diastolic flow. Median maternal age was 32 (range 17-44). Median BMI was 24.7 (range 17.1-48.6). Nulliparous women constituted 46.5% (369/793) of recruits, 32.6% (261/793) were expecting their second child, 18.3% (145/793) were expecting their third or fourth child, while only 2.3% (18/793) were grand multiparous. Reference intervals for umbilical artery resistance index (RI), pulsatility index (PI) and systolic/diastolic (S/D) ratio were generated for this population. The following table shows the calculated percentiles for each gestational week. Conclusion We have constructed Irish Caucasian specific reference intervals for umbilical artery Doppler indices from 15 to 40 weeks in a low-risk population using up-to-date ultrasound equipment.

Objective To construct normograms for cervical length in low-risk, singleton pregnancies from 14 weeks to 40 weeks gestation. Study design This was a prospective, cross-sectional study involving low-risk women attending Cork University Maternity Hospital conducted concurrently with a primary study to construct normograms for fetal biometry. Women were recruited in the first trimester and randomly allocated to a single scan between 14–40 weeks gestation. Scans were performed by a sole researcher. Gestation was calculated using the estimated due date assigned by dating scan. Recruits were Irish Caucasian women with a singleton pregnancy. Women with a previous history of preterm labour, mid-trimester pregnancy loss, cervical sutures, cone biopsy and large loop excision of transformation zone (LLETZ) were excluded. Measurements were obtained transvaginally using the Voluson E8 ultrasound by GE Healthcare. Results Seven-hundred-and-ninety-three women were recruited into the primary study. Five-hundred-and-fifty-five women consented to cervical length measurements and were scanned as per protocol. Median maternal age was 32 (range 17–44). Median BMI was 24.7 (range 17.1–48.6). Nulliparous women constituted 46.5% (369/793) of recruits, 32.6% (261/793) were expecting their second child, 18.3% (145/793) were expecting their third or fourth child, while only 2.3% (18/793) were grand multiparous. Normograms for cervical length have been generated for this population. The following table demonstrates the calculated percentiles for each gestational week. Conclusion We have constructed normograms for cervical length from 14 to 40 weeks gestation in the low-risk Irish Caucasian population.