fish analysis prior to multifetal reduction (MFPR) Mara Rosner, Eugene Pergament, Stephanie Andriole, Pe’er Dar, Rachel Greenbaum, Mark Evans Montefiore Medical Center/Albert Einstein College of Medicine, Obstetrics & Gynecology and Women’s Health, Bronx, NY, Northwestern Reproductive Genetics PC, Genetics, Chicago, IL, Comprehensive Genetics, Genetic Counseling, New York, NY, Albert Einstein College of Medicine/ Montefiore Medical Center, Obstetrics & Gynecology and Women’s Health, Bronx, NY, Comprehensive Genetics, Ultrasound, New York, NY, Comprehensive Genetics & Mt. Sinai School of Medicine, Obstetrics & Gynecology, New York, NY OBJECTIVE: Over 50% of patients undergoing IVF in the USA are 35 years of age. When multiples, PGD, and ICSI are added, over 70% are at increased risk, yet most patients are not offered CVS prior to MFPR. We routinely offer CVS prior to MFPR. STUDY DESIGN: We retrospectively reviewed our last 470 CVS/MFPR patients. Abnormalities were categorized as structural, FISH, and abnormal karyotype. Our approach is generally not to test fetuses that are clearly abnormal and reduced such that the overall cytogenetic abnormality rate is artificially lowered. RESULTS: 94/470(20%) pregnancies and 96/1339(7.2%) fetuses had anomalies. 62/94(66%) were referred in the 1st trimester of which 24/62(39%) were identified or suggested by ultrasound(US). 27/ 62(43.5%) had an abnormal FISH that dictated MFPR. 21/27(77.7%) of the cytogenetic abnormalities had normal US. 5/21(24%) were T21, 2/21(10%) were T18/13, 13/21(62%) were sex chromosome mosaics, and one was a trisomy 13 mosaic. When final karyotype was available, FISH agreed with the karyotype in 702/728(96.4%) fetuses. Of the 26 discrepancies between FISH and karyotype, 18/26(69%) were sex chromosomes suggesting cross contamination or known innocuous findings such as tetraploidy or inherited inversions. Ultimately, there were 8/728(1%) potentially concerning karyotypic abnormalities discordant from FISH which included mosaic trisomies, one trisomy 8 and one chromosome 15p 7/8 of which were confined placental mosaicisms. Final karyotype and subsequent amniocentesis confirmed one 46XX/46XY mosaic not seen on FISH. CONCLUSION: In our cohort, US alone identified only 39% of 1st trimester anomalies before MFPR. FISH identified another 32.8% and added value beyond US for 15/351 (4.3%) patients. 8/728(1%) required follow up amniocentesis for discrepancies. Given the risks of carrying multiples and published mistakes in reducing the wrong fetus by waiting for karyotype, our data suggest CVS, next day FISH and then MFPR as the optimal strategy. As a by-product, patients can then consider fetal sex when there are no other abnormalities. 426 Adolescent cognitive and anxiety behavior in offspring following in utero exposure to increased trans unsaturated fatty acids through maternal diet Mark Alanis, Claudia Umphlet, Heather Boger, Ann-Charlotte Granholm Medical University of South Carolina, Obstetrics and Gynecology, Charleston, SC, MUSC, Neurosciences, Charleston, SC OBJECTIVE: The developing brain is potentially susceptible to inflammatory diets, such as trans unsaturated fatty acids (TFA). STUDY DESIGN: Fisher 344 virgin rats were randomized to isocaloric experimental (TFA) or study (AIN93) diets for 4 weeks, mated, and then maintained on their study diets until weaning. On postnatal day 23 (P23) offspring were further randomized into 1 of 4 prenatal/postnatal dietary arms (N 16 litters): TFA/TFA, TFA/AIN, AIN/AIN, and AIN/TFA. Adolescent male and female rats (P36-38) underwent anxiety assessment using the elevated plus maze paradigm. Decreased % time and entry into open arms indicate increased anxiety. Adolescent male rats (P40-45) underwent cognitive behavioral performance testing using the water radial arm maze (WRAM) over 12 consecutive days. Spatial working and reference memory errors were averaged across litters during learning (days 1-3) and asymptotic phases (days 4-7, 6-9, and 10-12). Group comparisons were performed using 2-way analysis of variance (ANOVA) with repeated measures. Equality of variance was assessed by the F-test. Two-tailed p values .05 were considered significant. RESULTS: Females demonstrated greater anxiety than males based on the number of entries into open arms (10.5 0.9 versus 16.9 1.6, p .001), but not % open time (40% versus 53% open time, respectively, p .05). Diet did not demonstrate a significant relationship with anxiety (p .52). Rats in all 4 diet arms showed similar improvement over the 12 day WRAM test (Figure). When collapsing the analysis to 2 groups (prenatal TFA versus AIN), prenatal TFA rats committed more total working memory errors compared to prenatal AIN rats during the day 10-12 phase (6.1 .6 vs. 3.3 1.2 errors, respectively; p .03). Variance was not significantly different between the 4 groups (p .05 for all F-tests). CONCLUSION: Prenatal and postnatal dietary exposure of TFA did not demonstrate a major impact on either anxiety or hippocampal-dependent cognitive behavior, which may be explained by a true absence of effect or variance in the sample set (Type II error).
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