The evaluated score was not useful to predict the outcome of women undergoing labor induction. Our results show the necessity of validating existing scores in different settings and patient populations before widespread implementation in clinical care.

Poster abstracts small foramen into left uterine cavity. Patient delivered a healthy baby by elective cesarean section at 34 wks. No constriction band was found in umbilical cord. A thick fibrous band was discovered in uterine cavity attaching from anterior wall to the posterior wall. Conclusions: Complete amniotic sheets may be associated with intrauterine death due to cord accident. Incomplete amniotic sheets with a small foramen can be benign, but close monitoring and appropriate obstetric management is important. P14.06The significance of umbilical cord insertion in term singleton pregnancies Objectives: To determine if umbilical cord insertion (UCI) affects perinatal outcomes. Methods: A prospective cohort study of term singleton pregnancies at a large Irish maternity hospital. At delivery, the umbilical cord insertion was recorded as belonging to one of four groups: (A) central, (B) lateral, (C) marginal or (D) velamentous. Outcome measures included perinatal deaths, birthweight, placental weight, gestational age at delivery, delivery method and abnormalities of the amniotic fluid or of the CTG in labour. Results: Seven hundred and twenty seven placentas were studied. The number (%) in each of the four groups was (A) 305 (42%), (B) 327 (45%), (C) 77 (10.6%) and (D) 18 (2.5%). Birth weight was correlated significantly with placental size (r = 0.5; P < 0.001). Placental weight was significantly different between UCI groups (P < 0.001). Small for gestational age births were less common in central UCI (1.6%, 4.6%, 6.5%, and 11.1% in the four groups respectively). A remarkable finding was the very high rate (22.2%) of manual removal of placenta in the velamentous group (D), compared with only 0.3% in central insertions (A). Similarly, the insertion site had a dramatic effect on emergency cesarean section rates: (A) 11.8%, (B) 9.2%, (C) 18.2% and (D) 38.9%. Normal liquor and CTGs were associated more commonly with central cord insertion than with marginal and velamentous cord insertion. There were two neonatal deaths and one stillbirth, all in the central and lateral UCI groups. Conclusions: In this study, central umbilical cord insertion was associated with heavier placentas, bigger babies and fewer CTG abnormalities in labour, while velamentous and marginal insertion was associated with lower birth weight, more intrapartum fetal heart rate abnormalities, more deliveries by emergency cesarean sections and markedly more manual removals. Determination of UCI in early pregnancy might identify pregnancies at risk. P14.07The relationship of intrapartum amniotic fluid index and perinatal outcomes

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