tracings with a baseline 90 - 100 bpm and apparent early decelerations could be maternal in origin. 2nd stage tracings that show repetitive accelerations with contractions (especially with  20 bpm) should be considered MHR until proven otherwise. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.245 231 The effect of low dose oxytocin infusion on cerebral hemodynamics in pregnant women Teelkien R. Van Veen 1 , Michael A Belfort 2 , Gerda G. Zeeman 1 1 University Medical Center, Groningen, Netherlands, 2 HCA, St. Mark‘s Hospital, and University of Utah School of Medicine, Salt Lake City, Utah OBJECTIVE: Oxytocin is known to have a vasodilator effect on porcine cerebral blood vessels. If true in humans, oxytocin may increase cere- bral perfusion pressure (CPP), potentially endangering women in whom increased CPP is contraindicated. Our aim was to investigate the cerebrovascular effects of a continuous infusion of low dose oxy- tocin in normal pregnant women undergoing induction of labor. STUDY DESIGN: Prospective observational study. Middle cerebral ar- tery (MCA) velocity was measured with transcranial Doppler (TCD) ultrasound in 25 healthy, normotensive, non-smoking patients un- dergoing induction of labor. No vasoactive drugs were used before or during the study period. Measurements were made at baseline, 15, 30, 60 and 120 minutes after oxytocin initiation. Mean arterial pressure (MAP), CPP, resistance index, resistance area product and cerebral flow index at the different time points were analyzed. CPP was esti- mated as: MeanVelocity/(MeanVelocity-DiastolicVelocity) x (MAP- DiastolicBP). Statistics: 1-way ANOVA for repeated measures or Friedman Repeated Measures ANOVA as appropriate. P 0.05 sig- nificant. RESULTS: Mean cumulative dose at 120 minutes was 467133 mU. No systemic or cerebrovascular changes were noted after oxytocin initiation and there was no correlation between the dosage adminis- tered and any hemodynamic parameter. Oxytocin did not increase the CPP (CPP baseline: 52 7; CPP 120 minutes: 52 9; P=0.83). CONCLUSION: Induction dose oxytocin does not significantly effect se- lected cerebral hemodynamic parameters in the first two hours after initiation. Specifically oxytocin infusion, at least at these low doses, does not increase CPP in normal pregnant women and is unlikely to endanger parturients at risk from high cerebral perfusion pressure (preeclamptics, women with an AVM or aneurysm). 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.246 232 The influence of maternal obesity and diabetes on placental fatty acid transporters Christina Scifres 1 , Baosheng Chen 2 , D. Michael Nelson 3 , Yoel Sadovsky 4 1 University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Pittsburgh, Pennsylvania, 2 Washington University in St. Louis, St. Louis, Missouri, 3 Washington University in St. Louis, OBGYN and Cell Biology & Physiology, St. Louis, Missouri, 4 University of Pittsburgh, Pittsburgh, Pennsylvania OBJECTIVE: Maternal diabetes is associated with increased placental free fatty acid content. Exposure of cultured primary human tropho- blasts to fatty acids in the presence or absence of insulin enhances neutral lipid droplet formation. We hypothesized that hyperinsulin- emia, hyperlipidemia, or both regulate the expression of fatty acid transport proteins (FATP) responsible for uptake of fatty acids in cells. STUDY DESIGN: Placental villi samples were collected from healthy, normal weight controls (BMI 25, n=10), obese women (BMI 30, n=10), or obese women with gestational or type-2 diabetes mellitus (n=10) who underwent term elective cesarean delivery without labor. Primary human trophoblasts were exposed to insulin (10 nM), 1200 microM fatty acids, both or vehicle control. Expression of the FATPs in villi and cells was assessed by RT-qPCR and total neutral lipids in cultured human trophoblasts were visualized by microscopy and quantified using BODIPY immunofluorescence. RESULTS: Obesity plus diabetes was associated with a significant in- crease in the expression of FAT/CD36 (2.2-fold, p 0.05, ANOVA with Bonferroni correction), but no differences in the expression of FATP 1,2,3,4, and 6 when compared to placental villi samples from normal or obese women. Using cultured primary trophoblasts we found that FAT/CD36 expression was increased in cells exposed to fatty acids (4-fold, p0.05) or fatty acids plus insulin (6.4-fold, p0.05) compared to vehicle control. There were no differences in expression of FATP 1,2,3,4, and 6 in cultured human trophoblasts. Exposure of the cells to fatty acids or fatty acids plus insulin resulted in increased intracellular lipid accumulation as assessed using BODIPY immunofluorescense (p0.05). CONCLUSION: Placentas from women with diabetes and obesity exhibit higher expression of FAT/CD36 compared to control or obese women. Our data suggest that fatty acids play a central role in tropho- blast up regulation of FAT/CD36 expression. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.247 233 Hexosamine biosynthetic pathway: does it contribute to insulin resistance of pregnancy? Hye Heo 1 , Roopali Donepudi 2 , Reshmi Madankumar 3 , Derek M. Huffman 4 , Radhika Muzumdar 5 , Nir Barzilai 4 , Francine H. Einstein 1 1 Albert Einstein College of Medicine/Montefiore Medical Center, Obstetrics & Gynecology and Women’s Health, Bronx, New York, 2 University of Tennessee Health Science Center, Obstetrics & Gynecology and Women’s Health, Tennessee, 3 North Western University, Illinois, 4 Albert Einstein College of Medicine, Department of Medicine, Bronx, New York, 5 Albert EInstein College of Medicine, Department of Pediatrics, Bronx, New York OBJECTIVE: With positive energy balance, intrinsic nutrient-sensing pathways can limit cellular uptake of nutrients by rapid induction of insulin resistance via hexosamine biosynthetic pathway (HBP). Co- valent modification of the transcription factor, Sp1 by GlcNAc, has been implicated as the link between HBP activation and insulin sig- naling regulation. Because pregnancy is associated with insulin resis- tance and positive energy balance, we sought to determine if alteration of glucose flux through the HPB contributes to the insulin resistance of normal pregnancy. STUDY DESIGN: Three groups of age-matched SD rats were studied: 1)Non-pregnant (NP; n=6), 2)Pregnant (day 19) non-obese, glucose tolerant (P; n=6), and 3) Pregnant (day 19) after surgical removal of visceral fat 1 month prior to mating(PVF-;n=6). We used pre-con- ception removal of visceral fat as a tool to improve insulin sensitivity. Western blot was performed using rabbit polyclonal anti-Sp1 anti- body and used to measure protein concentration in hind limb muscle as a representative marker for GlcNAc modifications dependent on increased glucose flux through HPB. Skeletal muscle glucose uptake was measured after 2-[U-14C]deoxyglucose (20 Ci) was adminis- tered over the final 30 minutes of 3mU/kg/min hyperinsulinemic- euglycemic clamp. RESULTS: Glucose uptake in muscle was greater in NP compared to P (27.64 v 13.53.4 ug/g/min, p0.05) and intermediate in PVF- (23.86.3 ug/g/min, p=NS compared to other groups) demonstrat- ing the predicted variation in peripheral insulin action in the 3 groups. However, Sp1 glycosylation was similar in all groups (P 27,646 3408, NP 35,337 5064, PVF- 34846 6070 AU, p=NS compared to oth- ers) and was not consistent with the degree of insulin resistance. CONCLUSION: Cellular nutrient-sensing with HBP in maternal skeletal muscles does not contribute greatly to pregnancy-related insulin re- sistance. Future studies will need to determine if the placental/pup unit diverts glucose from the mother during transient periods of rel- ative hyperglycemia, minimizing flux through the HPB. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.248 www.AJOG.org Clinical Obstetrics, Neonatology, Physiology-Endocrinology Poster Session I Supplement to DECEMBER 2009 American Journal of Obstetrics & Gynecology S97