Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729 S635

measures in the form of all grains fortification and preconception

care and folic acid supplementation are needed.

Conclusion: National Flour fortification in Saudi Arabia did not

have the expected impact on reducing the incident of SB in Riyadh

area. Addition measures are needed.

P781

New directions in the provision of acute gynaecology services

for non-pregnant women in the UK

Y. Wan1, E. Edi-Osagie2. 1University of Manchester, 2St Mary’s

Hospital for Women & Children, Manchester

Background: Great strides have been made in the provision

of dedicated early pregnancy care, however acute gynaecology

services for non-pregnant women still suffer from a lack of

recognition.

Objectives: To explore the level of provision of acute gynaecological

care for non pregnant women in hospital trusts throughout the UK

and to identify effective care models.

Materials and Methods: A cross-sectional postal survey of health

care trusts providing pregnancy and gynaecological care in the UK

in 2008. A response rate of 38% (88/230) was achieved.

Results: 89% (78/88) of trusts provided acute gynaecology

services for non-pregnant women. 64% (50/78) of these

identified themselves as having dedicated acute gynaecological

assessment and/or treatment facilities. Early pregnancy and acute

gynaecological care was provided as joint units in 44% (22/50) and

separate units in 56% (28/50) of trusts.

Where there were separate premises, more out of hours care was

provided; 71% (17/24) versus 35% (8/23) provided 24 hour access

(p = 0.0199). 37% (29/78) of all trusts offering gynaecological care

had no dedicated ultrasound service compared with 1% of early

pregnancy units. 58% (45/78) of operating in acute gynaecology

occurs on emergency lists shared with other specialties whereas

36% (32/88) of early pregnancy lists are shared (p =0.0079).

Conclusions: There is a disparity in the provision of imaging and

theatre services for pregnant and non-pregnant patients despite

differing care models. This may lead to delays in diagnosis and

treatment for the non-pregnant patient. Opportunities for resource

sharing within acute gynaecology and early pregnancy services

need to be further explored in order to develop comprehensive and

accessible facilities.

P782

Evaluation of Sure Start Project – Providing specialised health

services to urban slums in Navi Mumbai

R. Wani1, U. Thanawala. 1FOGSI

Introduction: Navi Mumbai is a new township on the outskirts of

Mumbai having a population of 11 lakhs. As with any other city it

has its share of slums which houses 20% of the population.

This population generally, presents late for antenatal registrations,

has irregular follow ups & 10% of these women give birth at

home. This significantly contributes to morbidity and mortality

both maternal and neonatal.

Sure Start Project aims at targeting this population by way of

outreach antenatal clinics at Urban Health Post (UHP). 20 UHPs have

been selected where high risk patients are called for consultation

and examination by a senior specialist. This project aims at

providing regular antenatal care & immunization and thus creating

awareness of the importance of medical care among this population.

This hopes to bring about a behavioral change in the population

in terms of early ANC registrations, institutional deliveries which

would help in reducing maternal & neonatal mortality.

This public private partnership with Navi Mumbai Municipal

Corporation (NMMC), PATH International, Navi Mumbai Obstetric

and Gynecological Society (NMOGS), Indian Pediatric Association,

Sathi (NGO) and Yoga Niketan (For Yoga in ANC) was started in

February 2007.

Aim of our study: Analyse the Project to evaluate if the desired

impact has been made by the intervention in the last 12 months:

1. Induction of behavioral change in the population –

a. Awareness of health facility available

b. Early ANC registration and regular follow-up

c. Yoga exercises in ANC

d. No Home births

2. Health services provided –

a. Efficiency of link workers & UHP medical Officer in identifying

high risk cases in the population

b. Working and facilities at the High risk ANC clinic

c. Coordination with Mother and Child Health Centres (MCH) or

FRU (First Refferal Unit) to deal with high risk cases.

3. Parameters of health care in population

a. Maternal Mortality

b. Perinatal Mortality

c. Home deliveries

Results: It was observed that the recruitment of high risk cases

was not satisfactory in the first three months. This was because the

Link workers and the health officers were not used to the concept

of managing high risk antenatal at the UHP and all were sent to

MCH. But in the following months more cases were retained for

the clinics.

Awareness spread rapidly among the population and the women

were happy to receive specialist consultation at their doorstep.

Facilities available at the UHP (like a Doppler or basic ANC blood

investigations), which have now been sanctioned and we hope that

they will be available soon, so that the UHP is upgraded.

Analysis of the health parameters is pending on the collection of

population data from the registry.

Remarks of the Specialists – Obstetricians, Pediatricians, Yoga

trainers and NGO workers were also noted.

P783

Effect of aspirin on endometrial receptivity and success of IUI

A. Agarwal1, V. Das2, A. Pandey2, V. Jain2, S. Agarwal2, A. Ara2.1Dept. of Obs & Gynae, CSM Medical University (Former KGMC)

Lucknow, India, 2Dept. of Obs & Gynae, CSM Medical University

(Former KGMC), Lucknow, India

Objectives: To evaluate the effect of low dose aspirin on

endometrial receptivity and success of IUI.

Material and Methods: A double blind randomised controlled trial

was carried out in Deptt of Obs & Gynae, CSM Medical University

(former KGMC), Lucknow, India. 101 couple having undergone

intrauterine insemination without conception in at least 2 cycles

were enrolled after informed consent. They were randomised to

take either 150mg aspirin or placebo orally from Day 21 of cycle

prior to IUI cycle, for 2 months. All women underwent ovulation

induction with clomiphene citrate 100mg from day 2 to day 6. They

were followed for 2 cycles of IUI with aspirin/placebo. Pulsatility

index of uterine artery & endometrial thickness on Day 21 of IUI

cycles & conception rates of the two groups were compared using

SPSS software.

Results: There was statistically significant decrease in pulsatility

index and increase in endometrial thickness & folliculogenesis in

aspirin group as compared to placebo group.(p = 0.001, 0.001 &

0.023 respectively) The conception rate was 15.7% in aspirin group

as compared to 8% in placebo group.

Conclusion: Aspirin being a antiplatelet agent enhances uterine

and ovarian blood flow leading to better folliculogenesis and

improved endometrial receptivity thereby increasing conception

rates in patients having IUI failures.