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Results: From 72 pregnancies identified, the outcomes were known for 69; there were 48 (70%) live births, 22 (46%) premature, 14 (20%) therapeutic abortions and 7 (loo/) D miscarriages, but no stillbirths, neonatal or early maternal deaths. Three major fetal anomalies were seen. Conclusions: Pregnancy occurs in women with cystic fibrosis of all degrees of severity. Outcomes for the infant are generally good but variable for the mother. Pregnancy may be normal in women with normal lung function (%FEV,>EO%). It may adversely affect mild and moderate lung disease and should be avoided when FEV,<.50% is predicted.

FC2.36.04 ANTENATAL CARE AND WITHDRAWAL TREATMENT OF PREGNANT DRUG-ABUSERS: EFFECT ON PERINATAL OUTCOME E. Halmesmaki, H. Kukko, Dept. OB/GYN, Helsinki University Hospital, Helsinki, Finland.

Objectives: The aim of the study was to evaluate the effect of a specific counseling and withdrawn program for drug-abusing pregnant women, and its effect on perinatal outcome. Study Methods: Personnel responsible for local maternity care in the Helsinki area were trained to identify drug-abusers and to refer them to our hospital for clinical antenatal care and counseling with psychological and social support. 111 drug-abusing women having a total of 120 pregnancies were referred for treatment during the years 1985-95. Substance abuse during pregnancy was monitored by self- report and serial urine screenings. Obstetric and perinatal outcome were compared between those who succeeded to quit there abuse or reduce their drug use significantly, and those who continued their drug abuse throughout pregnancy. The significance of the difference was tested by Student’s unpaired t-test and binomial t-test. Results: Of the women, 62% were registered before the 20th week of pregnancy and 32% during the 20’h-29’h week of pregnancy (mean 18.4k6.6 wks.). Twelve women were admitted to an obstetric ward for withdrawal. In 73 of the 120 (61%) p re g nancies, the woman succeeded either in quitting totally or reducing of their drug abuse. Among this group, incidence of preterm birth (4.1%) was smaller (p<O.OOl), and gestational age (39.8k2.2 wks.) and birth weight (33936058) higher (~~0.05) than those (19.6%, 38.3k3.4 wks and 3049*728g) in the group continuing their drug abuse. Additionally, the percentage of normal delivery (81%) was higher (p<O.O5), and incidence of withdrawal symptoms (19%), lower (p<O.OOl) than for those who continued drug abuse (65% and 48%, respectively). Conclusions: Carefully monitored counseling program for pregnant drug abusers is effective in reducing the amount of drugs and improves perinatal outcome.

FC2.36.05 HYPEREMESIS GRAVIDARUM IN A CONTEMPORARY POPULATION IN OSLO, NORWAY B.-I. Nesheim, Dept. of Obstetrics, Ulleval University Hospital, N-0407 Oslo, Norway. B. Vilming, Dept. of Internal Medicine, Rogaland Central Hospital.

Objectives: Sociodemograhic studies of hyperemesis gravidarum are conflicting. During the last years, there has been a clinical impression in Norway that immigrants are more afflicted than ethnic Norwegians. Study Methods: Of 175 patients hospitalized with the diagnosis hyperemesis gravidarum 1993 1997, 120 had complete records and were compared to a control group of 115 patients without hyperemesis gravidarum, drawn at random from the labor ward protocol. Variables: Ethnicity, age, height, weight at beginning and at end of pregnancy, body mass index, gravidity, parity, smoking, gestational age at labor, birth weight, placental weight. The patient’s first name was used as an indication of ethnicity. Having a non-Norwegian name means, in the majority of cases, being a first generation immigrant from a developing country. Statistics: SPSS statistical package for regression analyses, the chi-square test with Yates correction and the Mann-Whitney U-test. Results: Risk factors for hyperemesis: non-Norwegian name (OR 3.4, 95% CI 1.5.7.6), female sex of the infant (OR 2.6, 95% CI 1.3.5.3), gravidity number (OR 1.4, 95% CI 1.1-1.9). These two last variables

were of significance only in patients with a Norwegian name. The hyperemesis group had a lower weight gain and birth weight. In a stepwise multiple regression birth weight (g) was dependent on weight increase (kg) (B=19.0, p=O.OOl), weight in early pregnancy (kg) (B=E.O, p=O.O2) and parity (B=107.1, p=O.O2). Hyperemesis, when corrected for weight increase, did not influence birth weight. Conclusions: Risk factors vary between different populations. Hyperemesis patients are at risk of having infants with reduced growth.

FC2.36.06 A MILD CASE OF AMNIOTIC FLUID EMBOLISM? M. Benson (l), H. Oi (2), R. Silver (1) (1) Dept. OB/GYN, Northwestern University, Evanston, IL, USA. (2) Dept. OB/GYN, Hamamatsu University School of Medicine,

Hamamatsu, Japan.

Objective: We sought laboratory evidence of amniotic fluid embolism (AFE) in laboring patients not clinically ill. Study Methods: In a series of 9 peri-partum patients seriously ill with AFE we found depressed complement, elevated STN and DIC requiring transfusion (study in submission). A 10th laboring patient was initially studied because of sudden, transient chest pressure and vertigo. However, as she did not require medical intervention, she did not have a case of amniotic fluid embolism as it has been traditionally viewed though she had some similar changes in her laboratory parameters. Results: On admission, the patients complement and STN levels, and platelet counts were all normal. One hour after her transient symptoms, her platelet count fell to 114 K, her C3 and C4 dropped to just below the lower limit of normal and her STN level, while still normal, had doubled. 11 hours later, her complement, STN, and platelets started returning to normal though her D-Dimer and fibrin degradation products became more normal. Conclusions: The patient had laboratory changes consistent with trends found in critically ill women with AFE, but to a lesser degree. This may suggest that the mechanism underlying AFE is a continuum with only the most extreme derangement coming to clinical attention.

FC2.36.07 DRUG ABUSE IN PREGNANCY - MATERNAL AND PERINATAL OUTCOME R.B.P. Thangauuah, Dept. OB/GYN, District Hospital, Nigris, Tamil Nadu, India.

Objectives: The aim of the study was to evaluate the maternal and perinatal outcome in women using drugs. Study Method: Thirty-five women who used drugs during pregnancy and delivered between January 1994 and August 1997 at Birch Hill Hospital, UK were studied in this retrospective case-controlled study. Results: The mean age in this study group was 25.8 years. Heroin was the most commonly used drug. Previous miscarriage, stillbirth, IUGR and pre- term delivery were seen in 62.8% of cases. Three women were positive for serum hepatitis and venereal disease was seen in 42.8% of cases. The major antenatal complications were IUGR (25.7%), prematurity (14.2%), antepartum hemorrhage (8.5%) and pre-eclamptic toxemia (11.4%). The average birth weight was 2964 grams which was 265 grams lighter than the control group. The average head circumference was 33.8 cm and body length was 51.4 cm; these measurements were similar to those for the control group, which were 34.2 cm and 52.7 cm, respectively. Neonatal withdrawal symptom were seen in 41.1% of cases and the perinatal mortality rate was 28.5/1000 total births. Conclusion: As the antenatal complications and perinatal mortality rate are high among drug abusers, it is imperative that these women should be counseled, educated and encouraged adequate antenatal care. There should be a multi-disciplinary approach in treating these women which should involve obstetricians, drug rehabilitation units, community nursing and social services.