The Feasibility of a Patient-Centered Medical Home to Treat Pregnant Women With Opioid Use Disorder: A Pilot Study [19Q] Neggin Mokhtari, MD Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA Stephanie Bobby, RN, Judy C. Chang, MD, MPH, Robert Gedekoh, MD, Michael England, MD, and Elizabeth E. Krans, MD, MSc INTRODUCTION: The patient-centered medical home (PCMH) is a healthcare model intended to improve healthcare quality while reducing costs. Pregnant women with opioid use disorder (OUD) require intensive healthcare resources. Therefore, a pilot study was conducted to establish the feasibility of a buprenorphine PCMH for pregnant women with OUD. METHODS: The Pregnancy Recovery Center (PRC) was created by five buprenorphine-licensed obstetricians and one addiction certified nurse in 2014. The PRC provides co-located buprenorphine, prenatal care, counseling, and social services support through a PCMH approach. Feasibility was measured by the ability to enroll, treat and retain patients. Successful completion (retention) was defined by negative drug screens, compliance with prenatal care, buprenorphine and counseling appointments. Additional outcomes were also com- pared between PRC vs non-PRC buprenorphine patients. RESULTS: Of 50 pregnant women enrolled from July 2014 to July 2015, 32 (64%) women successfully completed the program. The mean age was 28.1 years and 95.5% of women were white. Among 32 PRC and 78 non-PRC patients, buprenorphine dose at delivery was significantly higher for PRC vs non-PRC patients (18.4 vs 14.7 mg; P , .01), but neonatal abstinence syndrome (NAS) treatment rates were similar between the groups (46.2% vs 43.8%, P5.82). Fewer hos- pital charges for antepartum and delivery hospitalizations ($23,554.00 vs $183,703.00) were found for PRC vs non-PRC patients. CONCLUSION: A buprenorphine PCMH is feasible and may improve maternal and neonatal outcomes for pregnant women with OUD. Future large-scale clinical trials are needed to compare out- comes associated with alternative healthcare delivery models such as PCMHs for this population. Financial Disclosure: The authors did not report any potential conflicts of interest. A Reminder System for Postpartum DM Screening in GDM Patients: A Randomized Controlled Trial (RCT) [20Q] Adeeb Khalifeh, MD Thomas Jefferson University Hospitals, Philadelphia, PA Jayasree Iyer, MD, Eva Cantor, MD, Johanna Quist-Nelson, MD, Jordyn Tumas, and Vincenzo Berghella, MD INTRODUCTION: The postpartum period is an opportunity to screen for diabetes mellitus (DM) in pregnancies complicated by gestational diabetes mellitus (GDM). We evaluated whether a reminder system increases DM screening in the postpartum period. METHODS: This was a multicenter RCT of women who had pregnancies complicated by GDM and whom we anticipated would undergo postpartum screening for DM. Our intervention was a reminder system comprising of providing the patient with a screening test laboratory requisition prior to discharge from the hospital and of a phone reminder 6 weeks postpartum. Our control group included patients undergoing routine DM screening during their 6 week postpartum visits. The primary outcome was DM screening uptake in the postpartum period. Data was analyzed using Chi squared and Fisher exact tests. RESULTS: A total of 75 patients were randomized. 38 were assigned to the reminder system and 37 to the control group. Maternal age, race, insurance and parity were similar between both groups. From the intervention group, 31.6% (n512) performed postpartum DM screen- ing compared to 24.1% (n510) in the control group (p50.1). This increase was significant in patients with public insurance (p50.04) but not in patients with private insurance (p50.19). 31.8% (7/22) of patients who completed the screening test were diagnosed with pre- diabetes but none with DM. CONCLUSION: A reminder system for postpartum DM screening in GDM patients did not increase testing uptake. However, a reminder system may be beneficial in patients with lower socioeconomic status. Financial Disclosure: The authors did not report any potential conflicts of interest. The Effects of Tocolysis on Neonatal Septic Death in Women With PPROM: A Retrospective Cohort Study [21Q] Ariel Chackowicz Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada Andrea R. Spence, PhD, and Haim A. Abenhaim, MD, MPH INTRODUCTION: The use of tocolysis in women with preterm premature rupture of membranes (PPROM) remains uncertain, particularly in suspected chorioamnionitis. The purpose of our study was to evaluate the effect of tocolysis on neonatal septic death in women with PPROM +/- chorioamnionitis. METHODS: Using the Linked Birth and Infant Death data files (2009-2013) from the National Center for Health Statistics, we conducted a retrospective cohort study on all registered live births between 24-32 weeks’ of pregnancy in order to evaluate the effect of tocolysis on neonatal septic death at 7 and at 28 days among women with PPROM between 24 and 32 weeks’ gestation. Logistic regression models were used to evaluate the effect of tocolysis on neonatal septic death at 7 and at 28 days in births with and without chorioamnionitis. RESULTS: There were 46,968 births that met study criteria, and of which 6,264 (13.3%) received tocolysis. Tocolysis was more commonly administered to women who were Caucasians, smokers, and with multiple birth pregnancies and previous preterm births. There was no significant association between tocolysis and neonatal septic death at 7 days (OR 0.66, 95% CI 0.39-1.13) and at 28 days (OR 0.85, 95% CI 0.60-1.19). This was consistent in pregnancies complicated by cho- rioamnionitis and those without chorioamnionitis. CONCLUSION: In the setting of PPROM, tocolysis does not appear to increase the risk of neonatal septic death. Therefore, consideration can be given to its administration if clinically indicated. Financial Disclosure: The authors did not report any potential conflicts of interest. The Effects of Continuous Local Anesthetic After Cesarean Delivery on Pain and Narcotic Use [22Q] Jerome Yaklic, MD, MBA Wright State University Boonshoft School of Medicine, Dayton, OH Rose Maxwell, PhD, Kiera Urschel, MD, Steven Lindheim, MD, MMM, and Kara Griffiths, MD INTRODUCTION: Studies of the effectiveness of continuous local anesthetic administration for pain reduction after Cesarean delivery have provided inconsistent results. This study evaluated the effectiveness of this mode of administration on post-surgical pain and narcotic use. METHODS: Fifty women who had a Cesarean delivery were enrolled into a randomized double-blind, placebo controlled trial. The On-Q continuous abdominal wall and intraperitoneal wound irrigation system for local anesthetic administration was placed at the time of closure. Total post-operative narcotic use and patient reported pain scale scores were used to evaluate efficacy of treatment at 6, 12, 24 and 48 hours postoperatively. RESULTS: Forty patients completed the study. Repeated measures ANOVA revealed no significant difference in narcotic use or reported pain scores between the control group and those receiving local anesthetic for all time points. There was a trend towards reduced pain and narcotic use in the study group at the 6, 12, and 48-hour time points (group*time interaction p , 0.09). Regardless of group assignment, women who had a prior Cesarean section, versus primigravid women, had an increased total narcotic use (58.06 mg vs. 38.28 mg, respectively; p , 0.03). CONCLUSION: Dual catheter placement and infusion of bupiva- caine has potential to decrease the use of narcotics and pain following 178S TUESDAY POSTERS OBSTETRICS & GYNECOLOGY Copyright ª by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.