9–12 September 2012, Copenhagen, Denmark Short oral presentation abstracts during delivery. Antenatal sonography is potentially effective in the prediction of the risk of uterine defect during labor. OP25.07 Ultrasound evaluation of the cesarean scar: comparison between one and two layer uterotomy closure J. Glavind , L. D. Madsen, N. Uldbjerg, M. Dueholm Obstetrics and Gynecology, Aarhus University Hospital, Aarhus N, Denmark Objectives: To compare the residual myometrial thickness and the size of the cesarean scar defect after one- and two layer uterotomy closure. Methods: From July 2010 a continuous two-layer uterotomy closure technique replaced a continuous one-layer technique after cesarean delivery at the Department of Obstetrics and Gynecology at Aarhus University Hospital. A total of 149 consecutively invited women (68 women with one-layer and 81 women with two-layer closure) had their cesarean scar examined with 2D transvaginal sonography (TVS) 6–16 months post partum. Inclusion criteria were non-pregnant women with one previous elective cesarean, no post-partum uterine infection or uterine re-operation, and no type 1 diabetes. Scar defect width, depth, and residual myometrial thickness were measured on the sagittal plane, and scar defect length was measured on the transverse plane. Results: The median residual myometrial thickness was 4.6 mm (interquartile range (iqr) ± 3.1) after one-layer closure and 5.8 mm (iqr ± 3.7) after two-layer closure (P = 0.04). A scar defect was visible in 66/68 women (97%) with one-layer closure, and 78/81 women (96%) with two-layer closure, respectively. Median defect width was 6.8 mm (iqr ± 4.1) after one-layer compared to 5.6 mm (iqr ± 2.9) after two-layer closure (P = 0.01). No significant differences were found in defect height and length between women with one- and two-layer closure. Conclusions: Two-layer closure of the uterotomy significantly increases residual myometrial thickness and decreases defect width. Results do not prove but imply increased scar strength after two-layer closure. OP25.08 Ultrasonic evaluation of a scar on uterus in primiparous women 6 weeks and 6 months after Caesarean section J. Hanacek , L. Krofta Institute for the Care of Mother and Child, Prague, Czech Republic Objectives: Quality of a scar after Caesarean section is important particularly with regard to possible complications during the following pregnancy. Methods: In this prospective cohort study 6 weeks and 6 months after Caesarean section patients undergo 3D ultrasound examination of the uterus. We evaluate the type of the scar and its relation to the external orifice and internal orifice of the uterus and the fundus of the uterus. We analyse obstetric data related to the Caesarean section. Results: We have evaluated 158 women; the average age was 31.4; SD ± 4.15; BMI 23.3; SD ± 4.5; pregnancy week 40.17; SD ± 1.26. Hysterotomy suture was closed in a single layer in 41.4% of the cases and in two layers in 58.6% of the cases. A wall defect was found in 78.5% of the cases. This mostly involved inclusive cysts and fissures out of contact with the uterine cavity (73.8%). On the average, the scar was situated 30.2 mm from the external orifice; SD ± 6.6 mm; 10.13 mm from the internal orifice; SD ± 2.5 mm; 38.5 mm from the apex of the uterine cavity; SD ± 7.5 mm; and 50.3 mm from the fundus of the uterus; SD ± 8.3 mm. The myometrium above the scar is 12.16 mm high; SD ± 2.8 mm. The myometrium is 12.16 mm high above the scar; SD ± 2.8 mm and 11.2 mm high under the scar; SD ± 2.6 mm. During the period from the 6 th week to the 6 th month, the position of the uterus changed from retroversion to anteversion in 8.4% of the cases. When we compared Caesarean sections performed on a fully dilated orifice and other findings, we did not find any significant correlation, except for the parameters of the location of the scar from the external orifice of the uterus and the fundus of the uterus and the height of myometrium above the defect (independent sample t-Test). Conclusions: 6 weeks after the Caesarean section marked wall defects are apparent. We have not found any significant difference between a uterine wall defect and hysterotomy suture in a single layer or two layers. OP25.09 The impact of obstetric ultrasound in reducing maternal mortality in rural communities of Africa: an OBGYN resident’s experience B. O. Oluborode Obstetrics & Gynaecology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria Objectives: Ultrasound imaging is unequally distributed in develop- ing countries where maternal mortality is very high. With the pecu- liarities of the environment, the development of portable ultrasound machines provides a broader use of ultrasound. This motivated the need to assess the impact of its use in improving maternal health in the rural communities devoid of basic infrastructure. Methods: Obstetric ultrasounds done and the outcome of resultant clinical decisions over a 10 year period of several medical outreaches using ultrasound machines in several rural communities in Nigeria was reviewed. Existing literature on ultrasound, maternal mortality and issues relating to the use of medical technology in a low-resource setting was reviewed. The authors’ decade of field-experience in medical outreach programs in several rural communities in Nigeria was evaluated as a platform for wider use. Results: There were 15 medical mission outreaches during a 10 year period, 3254 patients were enrolled for ultrasound scan. The most frequent indications were pregnancy-related (97.9%), followed by gynecological conditions (2.1%). 90% of the obstetric scans were in patients receiving care from traditional birth attendants. In 361 patients (11.1%), increased risks of hemorrhage and prolonged labor were first detected on scanning and none had had an earlier scan. Three patients with transverse lie in labor were referred for surgery. A threefold turnout of pregnant women observed on days ultrasound scanning was done gave an enhanced opportunity for health education. Conclusions: Without proper tools in widespread use, maternal mortality will not reduce. Medical technology, such as ultrasound, is worthless unless the people who need it have adequate access. It provides an effective means of reducing maternal mortality and also serves as a vehicle for simultaneous dissemination of efforts required to address several causes of maternal mortality, thus, heightening the potential for improving clinical outcomes in a cost effective manner. OP25.10 Assessment of maternal cardiac dysfunction following doxorubicin exposure: is any level of exposure during pregnancy cardiotoxic? A. Patil, A. James, M. Small Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA Objectives: Strategies to prevent doxorubicin-dependent cardiomy- opathy include an empiric dose limit of 500 mg/m 2 of body surface area. Doxorubicin is known to cause a dose-dependent cardiomy- opathy due to oxidative stress and cellular injury. The cardiovascular adaptations of pregnancy include transient left ventricular remodel- ing in response to hemodynamic changes. We evaluated the impact of doxorubicin-containing chemotherapeutic regimens on maternal cardiac function. Ultrasound in Obstetrics & Gynecology 2012; 40 (Suppl. 1): 55–170 131