Obtaining the knowledge of the "omics" and therefore of the metallomics of gestational diabetes mellitus (GDM) appears to be a necessary task to obtain information about the molecular causes of this disease. In this study, the metallome of GDM and of other types of diabetes mellitus was first reviewed. The comparative analysis of the published data revealed that no GDM elemental markers could be identified with sufficient reliability in blood or in the other considered samples, with the partial exception of selenium. The placenta was chosen as an alternative target organ for the analysis of the GDM metallome. The full elemental average composition of 19 healthy placentas was obtained by ICP-MS. Analyses were then performed on 28 placentas from women affected by GDM. The statistical tests and the principal component analysis evidenced that cadmium was found in lower concentrations and selenium was found in higher concentrations in GDM placentas than in those of the control group. These results were interpreted in light of literature data, and they attract attention on two key elements for understanding the molecular pathways of GDM.

Electronic poster abstractsConclusions: Prenatal diagnosed placenta percreta using ultrasound with bladder invasion and new surgical technique of bilateral hypogateric arteries ligation is considered an effective method before hysterectomy especially in cases of placenta percreta aiming to decrease all maternal morbidities of such cases. Objectives:To determine the sensitivity of ultrasound for the diagnosis of invasive placentation and examine pregnancy outcomes in cases of invasive placentation. Methods: Retrospective cohort of placenta accreta at the Foothills Medical Centre. 35 cases were identified. Ultrasound findings, gestational age at delivery and surgical outcomes were examined. The sensitivity and positive predictive value of ultrasound were calculated. Results: There were 21 cases of possible placenta accreta identified by ultrasound findings or at the time of surgery. 9 cases of placenta accreta were diagnosed correctly by ultrasound. The median GA at delivery was 30.43 weeks, average blood loss was 3,700 mls and 33% had a postoperative complication. 7 cases were missed by ultrasound and diagnosed at surgery. The median GA at delivery was 37 weeks, average blood loss was 4,571 mls and 14% had a postoperative complication. 5 cases were identified by ultrasound as suspicious for placenta accreta and were found at surgery to not have invasive placentation. The median GA at delivery was 34.86 weeks, average blood loss was 1740 mls and there were no postoperative complications. There were no maternal deaths.The sensitivity of ultrasound for the diagnosis of invasive placentation was 56% and the positive predictive value was 64%. There were 14 cases in which a pathological diagnosis of placenta accreta could not be confirmed but a clinical diagnosis was made by the surgeon and there was a significant postpartum hemorrhage. None of these cases were detected by ultrasound. Conclusions: Ultrasound is a useful tool, but does not detect all cases of invasive placentation. Improvements in the detection rate should be strived for. The management of pregnancy may be altered with earlier delivery and maternal anxiety increases with false positive diagnosis. False negative diagnosis can lead in inadequate preparation for massive blood loss. EP02.07The metallome of human placenta in gestational diabetes mellitus