The presence of racial disparity in acceptance of these treatment modalities can inform clinicians about patient factors affecting treatment choice for menopausal symptoms and opportunities to explore racial differences in quality of care.

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p<0.01) were more likely to be admitted to the hospital. Of patients admitted, those on the weekend (RR .96 95% CI: .95, .97 p< .01), black patients (RR .97 95% CI: .95, .98 p< .01), younger patients (RR .92 95% CI: .89, .94 p< .01), and those with co-morbidities (RR .86 95% CI: .84, .88 p< .01) were less likely to undergo same-day surgery for ectopic pregnancy. Similarly, patients admitted on the weekend (RR .97 95% CI: .95, .97 p< .01) and those with co-morbidities (RR .88 95% CI: .86, .89 p< .01) were also less likely to receive surgery within one day. Furthermore, patients on the weekend (RR 1.49, 95% CI: 1.46, 1.53 p<0.01) and those with co-morbidities (RR 3.90, 95% CI: 3.73, 4.09, p< .01) were more likely to have a blood transfusion during admission.CONCLUSIONS: Ectopic pregnancies evaluated in the ED during the weekend are more likely to be admitted to the hospital, but less likely to undergo same day or surgery within one day of admission. Weekend admissions were independently at significantly higher risk for blood transfusions even after adjustment for timing of surgical management. Further studies are needed to understand factors such as provider staffing which may contribute to this weekend effect, and to work to mitigate this impact.

Velamentous cord insertion can be diagnosed at 8 weeks of gestation, earlier than previously reported. Fetal surveillance may be informed and prognosis may be impacted by early diagnosis once viability is reached.

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Introduction Placental pathology provides a unique insight into the intrauterine environment prior to preterm birth. Objectives To investigate correlations between maternal variables and abnormal placental pathology in a cohort of women delivering extremely preterm; to determine associations between these and the incidence of adverse short-term neonatal outcome. Method Placental histopathology reports from women who gave birth in Leeds between 22–32 weeks gestation from 2009–2011 were obtained. Relevant maternal and neonatal data were accessed. Intergroup differences and trends were sought using Mann-Whitney U and logistic/linear regression analyses where appropriate. Results 269 women were included in the study. 89% of the placentas demonstrated abnormal pathology (infection/inflammation and/or ischaemia/infarction). Smoking and socioeconomic deprivation were associated with an increased incidence of placental infection (p = 0.02) and ischaemia (p = 0.0001). Babies were born significantly earlier if their placenta demonstrated infection than those whose showed ischaemia (p = 0.0001). Neonates born with infected placentas tended to be more likely to have intraventricular haemorrhage than those with ischaemic placentas (adjusted OR 1.9; 95th CI 0.5–6.5, p = 0.3). Conclusion Intrauterine infection/inflammation is the predominant antecedent of extreme prematurity, and is associated with maternal smoking and socioeconomic deprivation. Further studies need to consider the mechanisms which link these features. (supported by Cerebra)