RESULTS: During the study period, 88 diabetics underwent screening during pregnancy. The mean age was 32.66.5 years, 56% were Latina, and mean BMI was 359.1. Of those screened, 26%(23/88) were type 1 diabetics, 66% (58/66) had type 2 diabetes and 8%(7/88) had gestational diabetes. 35% of patients had one or more abnormal- ities on echocardiogram, including increased left atrial diameter in 30% (26/88), LV diastolic dysfunction in 13% (11/88), and moderate left ventricular hypertrophy in 4.5%(4/88). No patients had severe valvular or functional echocardiographic abnormalities. One patient was diagnosed with a myocardial infarction in pregnancy with an ejection fraction of less than 50%. Obesity, years of diabetes, advanced maternal age, and poor glycemic control were not associated with abnormal echocardiographic findings. The only significant factor as- sociated with abnormal echocardiogram was medicated hyperten- sion, which identified 17 of 31 patients with abnormalities (p=.001); OR 5.71(2.14-15.25), adjusted OR 9.83 (2.3-41.9). CONCLUSION: Echocardiographic screening for cardiovascular disease in pregnancy based on risk factors including years of diabetes, hyper- tension, obesity, advanced maternal age and level of glycemic control identifies a low percentage of abnormalities. The majority of abnor- malities detected were mild. Treated hypertension was the only single risk factor associated with abnormal echocardiographic findings. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.268 254 Early glucose testing in the obese gravida Danielle Durie 1 , Amanda Victory 1 , Kristin Knight 1 , Brittany Walker 1 , Katie Somers 1 , Eva Pressman 1 , Loralei Thornburg 1 1 University of Rochester, Rochester, New York OBJECTIVE: Gestational diabetes mellitus (GDM) complicates 2-14% of pregnancies in the US. Recommendations from 2004 advised early glucose evaluation in obese women. We sought to evaluate the rate and results of early glucose screening in morbidly obese women and the overall rate of gestational diabetes in this population. STUDY DESIGN: Electronic records were reviewed for all women with body mass index 35 without preexisting diabetes from 1/2004 through 12/2008 who delivered at our institution. Women were di- vided into three groups: class II (BMI 35-39.9), class IIIa (BMI 40- 44.9) and class IIIb obesity (BMI 45). Rates and results of early glucose screening (20-24 weeks), routine glucose screening (24 weeks), three hour testing and GDM were compared among groups. RESULTS: Of 1350 women, 359 women were excluded for no available glucose screening results. Of the remaining 991 women (567 class II, 274 IIIa, 150 IIIb), 45 (4.5%) underwent early glucose testing which was not different between groups (3.7%, 4.7%, 7.3%), and 27% had a positive screen (28.6%, 30.8%, 22.2%). 960 women underwent rou- tine screening, with 320 (33%) screening positive (33% each group). Of the 257 who underwent three hour testing, 107 (42%) of patients tested positive with no differences between groups (39%, 40%, 54%). Overall, 172 (17%) of morbidly obese women were diagnosed with diabetes at any point in pregnancy, with no differences between groups (15%, 16%, 19%). CONCLUSION: Few morbidly obese women are undergoing early glu- cose screening despite recommendations, even though 25% will test positive at early screening. At routine screening, 33% of morbidly obese women screened positive and 40% of those had positive 3 hour testing. Consistent with prior guidelines, early screening for ges- tational diabetes in the morbidly obese gravida is warranted but is not routinely done in practice. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.269 255 Two low dose oxytocin induction protocols: effects on tachysystole, fetal heart rate patterns and mode of delivery Danielle Durie 1 , Nigel Campbell 1 , Holly Sato 1 , Joanne Wienschreider 1 , Ken Edell 1 , Eva Pressman 1 1 University of Rochester Medical Center, Rochester, New York OBJECTIVE: To evaluate the effects of a change in oxytocin administra- tion practice on maternal and fetal outcomes. STUDY DESIGN: We performed a retrospective cohort study of women who underwent term labor induction from 10/07 through 9/08. One physician group adopted an oxytocin protocol of 1 mU/min increases every 45 minutes (1q45) while remaining groups used increases of 2 mU/min every 30 minutes (2q30). Uterine contractility and fetal heart rate patterns were assessed using CALM Patterns (LMS Medical Mon- treal, Canada). Mode of delivery, average and maximal oxytocin dose, and duration of oxytocin administration were assessed. Data were analyzed with Mann-Whitney U test for continuous variables and Chi square for categorical variables. Power analysis indicated 500 subjects would detect a 0.10 difference in the incidence of tachysystole with 80% power. RESULTS: 850 patients were identified, and after exclusion for twins, prior cesarean, fetal anomalies, and incomplete data, 539 records were available for analysis (214 in the 1q45 group and 325 in the 2q30 group). There were no differences in incidence of tachysystole (0.15 for 1q45 and 0.20 for 2q30, p=0.14) or median episodes of late or variable decelerations between the two groups. The 1q45 group had a longer duration of oxytocin (median 803 vs. 575 minutes, p=0.000), but lower average dose (median 5.05 vs. 5.93 mU/min, p=0.000) and maximal dose (median 8 vs. 9 mU/min, p=0.01). There were no dif- ferences between the two groups in rates of overall cesarean delivery or cesarean delivery for fetal indications. CONCLUSION: Increases of oxytocin by 1 mU every 45 rather than 2 mU every 30 minutes did not affect rates of uterine tachysystole, fetal heart rate abnormalities or mode of delivery but did lead to longer inductions. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.270 256 Outcomes of group diabetic care in a hispanic population: the DULCE program Anna Gonzalez 1 , Michael Gardner 2 , Nora Doyle 1 1 University of Oklahoma School of Community Medicine, Obstetrics and Gynecology, Tulsa, Oklahoma, 2 University Of Oklahoma School of Community Medicine, Department of Obstetrics and Gynecology, Tulsa, Oklahoma OBJECTIVE: The DULCE Program provides comprehensive prenatal care to diabetic gravidas in a group setting using a multidisciplinary team of physicians, nutritionist, and certified diabetic eductors in a relaxed culturally sensitive setting. We compared the obstetrical out- comes in Hispanic Diabetic (HDM) patients receiving conventional care versus group care that consisted of appropriate medical therapy including diet, oral hypoglycemics and insulin as indicated; as well as nutrition and lifestyle counseling and group social bonding. STUDY DESIGN: Pregnant Diabetic patients at our university hospital diagnosed prenatally were identified. Information on maternal demo- graphics, pregnancy complications, antenatal interventions, and peri- natal outcomes were obtained by reviewing the medical records and our perinatal database. Uni and multivariate analyses were performed where appropriate with p  0.05 considered significant. RESULTS: In the 2-year period from July 2007 - June 2009, 67 HDM cases were identified. Maternal demographics included age range from 17 – 44, mean parity of 3, Mean EGA 37.6 weeks, birth weight 3270 grams, Median Apgar score 9 (7-10). There were no significant differences between the groups in these variables. Maternal pregnancy complications identified included 0 intrauterine fetal demises, pre- eclampsia (5). There was a significant difference in mean HgA1C val- ues (5.6% - group care vs. 7.6% - conventional). Moreover, the num- ber of visits in the DULCE program patients was greater vs. conventional care.(12.6 vs. 7.3 p  0.001). CONCLUSION: Women in the DULCE program had improved HgA1C values. Furthermore, the DULCE patients attended more prenatal vis- its than conventional care, perhaps due to higher patient satisfaction Comprehensive care in a group setting including education and fre- quent visits may translate into better maternal and fetal outcomes particularly in the Hispanic population. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.271 Poster Session II Diabetes, Doppler, Labor, Ultrasound-Imaging www.AJOG.org S106 American Journal of Obstetrics & Gynecology Supplement to DECEMBER 2009