Copyright ªby The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. RESULTS: There was no statistical significant difference between the groups on the basis of age, gestational week, or plasma level of eicosapentaenoic acid, docosahexaenoic acid, or archidonic acid. There was a statistically significant difference between the groups on the basis of plasma level of C20 (arachidic acid) and C22 (behenic acid). C20 reduced, but the level of C22 behenic acid increased in the hyperemesis gravidarum group. CONCLUSION: Hyperemesis gravidarum did not affect the plasma levels of eicosapentaenoic acid, docosahexaenoic acid, or archidonic acid, which contribute to placental and fetal neurologic development. We detected that hyperemesis gravidarum affects the plasma levels of C20 (arachidic acid) and C22 (behenic acid). To supply energy needs, plasma levels of C20 may be decreased. C22 behenic acid is a cholesterol-raising saturated fatty acid in humans. The reason for the increase of C22 in the hyperemesis group should be investigated. Financial Disclosure: The authors did not report any potential conflicts of interest. Contraception in the Postpartum Care of Patients With Gestational Diabetes [319] Emily Rosenthal, MD Brigham & Women’s Hospital, Boston, MA Sarah Rae Easter, MD, Emma Morton-Eggleston, MD, Caryn Dutton, MD, and Chloe Amelia Zera, MD INTRODUCTION: Effective contraception allows women with ges- tational diabetes mellitus (GDM) time to optimize their health before future pregnancies. We therefore sought to evaluate use of long-acting reversible contraception (LARC) in women with GDM compared with women with preexisting DM. METHODS: We identified 404 pregnancies with GDM and 232 with preexisting DM cared for at Brigham and Women’s Hospital between 2006 and 2011. We compared the likelihood of receiving LARC in women with GDM compared with women with preexisting DM with bivariate analyses using Fisher’s exact test or t tests as appropriate. We performed multivariate logistic regression to identify factors associated with LARC uptake. RESULTS: Women with GDM were less likely to have had a planned pregnancy than women with preexisting DM (P5.04). Of 404 pregnancies with GDM, 21.5% with A1GDM and 21.6% with A2GDM received LARC. Of 232 pregnancies with preexisting DM, 24.4% with type 1 DM and 18.5% with type 2 DM received LARC. There was no significant difference among the groups (P5.79). Women who had received contra- ception during their postpartum hospitalization were less likely to attend their postpartum visit (odds ratio 0.58, 95% confidence interval 0.39–0.86). CONCLUSION: Although women with GDM were as likely as women with preexisting DM to receive LARC postpartum, they were more likely to have an unplanned pregnancy, highlighting the need for effective contraception in this population. Our findings suggest that further study is needed to understand how best to provide contracep- tion while still engaging women in postpartum care. Financial Disclosure: The authors did not report any potential conflicts of interest. Editor’s Note: Poster no. 320 was withdrawn during production. 11:30 AM–12:30 PM OBSTETRICS Gestational Weight Gain Below the 2009 Institute of Medicine Guidelines Modifies Preterm Birth in Obese Pregnant Women [321] Alexander A. Berger, MD, MPH Thomas Jefferson University Hospital, Philadelphia, PA Gila Levitan, MPH, Jason K. Baxter, MD, MSCP, and Liat Lerner-Geva, MD, PhD INTRODUCTION: Obesity and excessive gestational weight gain present significant challenges during pregnancy to the mother and neonate, including an increased rate of preterm birth, the leading direct cause of neonatal death. The Institute of Medicine (IOM) refined guidelines for appropriate gestational weight gain in 2009 to improve outcomes for all mothers. Recent research suggests the gestational weight gain recommendations for obese mothers may be too high, leading to increased preterm birth. We conducted a systematic review to evaluate the effect of gestational weight gain below the IOM guidelines on preterm birth for obese pregnant women. METHODS: PubMed, Cochrane, CINAHL, and EMBASE were systematically searched from inception to 2014 for relevant articles; previous reference lists were reviewed and authors and experts were queried to find other relevant studies. Two reviewers independently reviewed 116 abstracts and 38 full-text articles to identify seven studies that reported for obese pregnant women, gestational weight gain, and its effect on the rate of preterm birth. RESULTS: Overall, the included evidence was of fair to good quality. There is low certainty in the evidence for overall preterm birth, insufficient evidence for preterm birth subtypes, and moderate certainty for both teenagers and African Americans for gestational weight gain below the 2009 IOM recommendations increasing preterm birth rates for obese pregnant women. There is low certainty in the evidence that obesity class modulates this effect. CONCLUSION AND IMPLICATION: Gestational weight gain below the 2009 IOM recommendations may increase preterm birth rates for obese pregnant women. Evidence with moderate strength suggests that teenagers and African Americans show this effect. Financial Disclosure: The authors did not report any potential conflicts of interest. Rating Pregnancy Wheel Applications Using the APPLICATIONS Scoring System [322] Kathy Chyjek, MD Mount Sinai Hospital, New York, NY Sara Farag, MD, and Katherine Tsia-Huey Chen, MD INTRODUCTION: Mobile applications (apps) are becoming increas- ingly popular in medicine. However, there is no systematic way to rate apps that are useful to obstetrics and gynecology providers. This study aims to identify the top-rated pregnancy wheel apps using a newly developed APPLICATIONS scoring system. METHODS: A list of pregnancy wheel apps was identified. Consumer-based and inaccurate apps were excluded. The APPLICA- TIONS scoring system was developed to rate the remaining apps. App comprehensiveness was evaluated. Objective rating components included price, paid subscription, literature used, in-app purchases, connectivity to Internet, advertisements, text search field, inter-device compatibility, and other components such as images or figures, videos, and special features. Subjective rating components were ease of navigation and subjective presentation. RESULTS: A complete list of 55 pregnancy wheel apps was created from three sources. Thirty-nine (71%) were consumer-based, inaccu- rate, or both, leaving 16 (29%) for analysis using the APPLICATIONS scoring system. CONCLUSION AND IMPLICATION: More than two thirds of pregnancy wheel apps were excluded from our study secondary to being consumer-based, inaccurate, or both. This highlights the importance of identifying systematically, reviewing critically, and rating the thousands of available apps to health care providers to ensure accuracy and applicability. We propose that our APPLICATIONS scoring system be used to rate apps in all specialties with the goal of improving health care provider performance and thereby patient outcomes. Financial Disclosure: The authors did not report any potential conflicts of interest. The Cost-Effectiveness of Operative Delivery in the Management of Obstructed Labor [323] Sonia Dutta, MD Johns Hopkins Hospital, Baltimore, MD Karin J. Blakemore, MD, and Clark Timothy Johnson, MD 102S TUESDAY POSTERS OBSTETRICS & GYNECOLOGY