on the problem list similar to obstetriciangynecologists
(29.2% compared with 27.7%, P5.80) but had depression
screening more often (67% compared with 49%, P5.01).
CONCLUSIONS: Overall adherence to American Col-
lege of Obstetricians and Gynecologists guidelines for
obesity management in pregnancy was low (less than
20%) for both health care provider types. Health care
provider education and training may be necessary to
improve their adherence. Further research is necessary to
determine whether these guidelines improve outcomes
for obese women.
Financial Disclosure: Ashley Elizabeth Scott, MD, and Michelle A.
Kominiarek, MDThese authors have no conflicts of interest to disclose
relative to the contents of this presentation.
Postnatal Exercise Can Reverse
Diastasis Recti
Geeta Sharma, MD
Weill Cornell Medical College, New York, NY
Tricia Lobo, BS, and Leah Keller
INTRODUCTION: Prenatal training has been shown to
prevent diastasis recti. The purpose of this study was to
see if women who started an exercise program after delivery
had a comparable reduction in diastasis recti as those who
started the program during their pregnancy.
METHODS: A retrospective analysis was done of 63
women who trained prenatally or postnatally, engaging in
isometric contractions of the transverse abdominis, resis-
tance training, and cardiovascular exercise, with the same
certified prenatal trainer. Diastasis recti measurements were
obtained prospectively in a standard fashion by the trainer
at the start and completion of the training.
RESULTS: Both prenatal (n534) and postnatal groups
(n529) were similar in ethnicity, socioeconomic status,
full-term deliveries (82% compared with 93%), height
(160 cm, interquartile range [IQR] 157.5167.5; 160 cm,
IQR 155165) and maternal age (34 years, IQR 3237; 36
years, IQR 3238; P5nonsignificant). Both the prenatal and
postnatal groups showed significant improvement (P,.05) in
the reduction of postnatal rectus abdominis muscle separation.
There was no significant difference in the final absolute sepa-
ration measurement of the two groups (1 cm; IQR prenatal
11.5; IQR postnatal 11.25 cm; P5nonsignificant).
CONCLUSIONS: Women who started after delivery an
exercise program aimed at reducing diastasis recti achieved
the same reduction in diastasis recti as those who started the
program during pregnancy.
VOL. 123, NO. 5 (SUPPLEMENT), MAY 2014
Financial Disclosure: Geeta Sharma, MD, and Tricia Lobo, BSThese
authors have no conflicts of interest to disclose relative to the contents of this
presentation. Leah KellerThis author has a relevant financial relationship with
the following commercial interest: Part owner: Keller Provost Media, LLC.
Universal Compared With
Selective Anticoagulation
RiskBenefit Analysis
Vidya Sharma, MD
Lincoln Medical & Mental Health Center, Bronx, NY
Tia Welsh, MD, MPH, Minakshi Ramchand, BS,
and Ray Mercado, DO
INTRODUCTION: Although there is consensus about deep
vein thrombosis (DVT) prophylaxis in the pregnant pop-
ulation, the decision about the same in postpartum women
is left to the physicians preference. This study was under-
taken to compare the incidence of wound complications in
selective compared with universal administration of antico-
agulation in postcesarean delivery women. Secondary out-
comes were any episode of DVT or pulmonary embolism
(PE) during 2-week period.
METHODS: Women who had cesarean delivery as the
method of delivery between March 1, 2009, and February
28, 2011, of were included in the study. All the participants
were divided into two groups: 1) selective anticoagulation:
anticoagulation depending on their DVT score; and 2)
universal anticoagulation: anticoagulation irrespective of
their DVT score.
RESULTS: Of 434 women in selective group, five had
immediate wound complications and 45 women had de-
layed wound complications. Of 367 women in the universal
group, eight had immediate wound complications and 37
had delayed wound complications. The two-sided P value
was .744, considered not significant (odds ratio 1.073).
There were two cases of diagnosed PE, one case of DVT,
and one case of maternal mortality attributed to PE in the
selective group, whereas there was none in the universal
anticoagulation group.
CONCLUSION: Our data point to no difference in the rate of
wound complications resulting from universal and selective
anticoagulation, whereas there was a case of PE and one
maternal mortality in the selective anticoagulation group.
Hence, we strongly encourage universal pharmacological anti-
coagulation for all puerperal women after cesarean delivery.
Financial Disclosure: Vidya Sharma, MD, Tia Welsh, MD, MPH,
Minakshi Ramchand, BS, and Ray Mercado, DOThese authors have no
conflicts of interest to disclose relative to the contents of this presentation.
TUESDAY POSTERS 171S