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for labor induction in women with gestational hypertension or mild preeclampsia at term: an exploratory analysis of the HYPITAT trial Parvin Tajik, Karin van der Tuuk, Corine Koopmans, Henk Groen, Marielle van Pampus, Paul van der Berg, Joris van der Post, Aren van Loon, Christianne de Groot, Anneke Kwee, Anjoke Huisjes, Erik van Beek, Dimitri N. M. Papatsonis, Kitty W.M. Bloemenkamp, Gijs van Unnik, Martina Porath, Robbert Rijnders, Rob Stigter, Karin de Boer, Liesbeth Scheepers, Patrick Bossuyt, Ben Mol Academic Medical Center, Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, Netherlands, University Medical Center Groningen, Obstetrics and Gynaecology, Groningen, Netherlands, University Medical Center Groningen, Epidemiology, Groningen, Netherlands, University Medical Center Groningen, Obstetrics and Gynecology, Groningen, Netherlands, Academic Medical Center, Department of Obstetrics and Gynaecology, Amsterdam, Netherlands, Martini Hospital, Obstetrics and Gynaecology, Groningen, Netherlands, VU Medical Centre, Obstetrics and Gynaecology, Amsterdam, Netherlands, Dutch consortium AMPHIA trial, Netherlands, Gelre Hospital, Department of Obstetrics and Gynaecology, Apeldoorn, Netherlands, St Antonius Hospital, Obstetrics and Gynaecology, Nieuwegein, Netherlands, Amphia Hospital, Obstetrics and Gynaecology, Breda, Netherlands, Leiden University Medical Center, Department of Obstetrics and Gynecology, Leiden, Netherlands, Diaconessen Hospital, Obstetrics and Gynaecology, Leiden, Netherlands, Maxima Medical Center, Department of Obstetrics and Gynecology, Veldhoven, Netherlands, Jeroen Bosch Hospital, Department of Obstetrics and Gynaecology, Den Bosch, Netherlands, Deventer Hospital, Obstetrics and Gynaecology, Deventer, Netherlands, Rijnstate Hospital, Obstetrics and Gynaecology, Arnhem, Netherlands, University Medical Centre Nijmegen, Obstetrics and Gynaecology, Nijmegen, Netherlands OBJECTIVE: Examining whether cervical ripeness should defer obstetricians decision regarding labor induction for women with gestational hypertension or mild preeclampsia at term. STUDY DESIGN: We used the data from the HYPITAT trial (ISRCTN08132825), a multicenter, parallel, and open-label randomized controlled trial in women with a singleton pregnancy at term who had gestational hypertension or mild preeclampsia; in this trial 756 women had been randomized to either labor induction or expectant monitoring. We examined if the presence of an unfavorable cervix (measured by cervical length and Bishop score) would affect the superiority of labor induction compared to expectant monitoring. The primary outcome was the occurrence of a high risk maternal (HR) situation. Secondary outcomes were neonatal outcome and cesarean delivery. All analyses were by intention to treat and were done by using logistic regression. RESULTS: HR situations had occurred in 117 women (31%) in the labor induction group and in 166 women (44%) in the expectant monitoring group. The superiority of labor induction over expectant monitoring in preventing HR situations varied significantly according to cervical length (test for interaction p 0.03). In women with a long cervix ( 40 mm) or a low Bishop score (5). Similarly, the effect of induction on reducing the cesarean section rate was also stronger in women with a long cervix or a low bishop score. CONCLUSION: Against the widely held opinion that labor induction should be introduced when the cervix is ripe, women with gestational hypertension or mild preeclampsia, and with an unfavorable cervix benefit more from labor induction, as compared to expectant monitoring, than women with a ripe cervix. 793 Placental oxidative stress is an important mediator of IL-17 induced hypertension during pregnancy Pushpinder Dhillon, Jeremy Scott, Kedra Wallace, Judith Heath, Janae Moseley, James Martin, Babbette LaMarca University of Mississippi Medical Center, Obstetrics and Gynecology, Jackson, MS OBJECTIVE: New onset hypertension with proteinuria during pregnancy, preeclampsia is vastly becoming is associated with chronic immune activation. Recent studies show that preeclampsia is associated with activation of autoimmune cells, TH17, secreting interleukin-17, an inflammatory cytokine strongly associated with autoimmune diseases. Reactive oxygen species (ROS) is thought to be one important pathophysiological mediator of preeclampsia as well as many chronic immune disorders. The objective of our study was to determine if chronic exposure to IL-17 during pregnancy increases blood pressure by stimulating oxidative stress. STUDY DESIGN: To answer this question four groups of rats were examined: NP (n 20), NP IL-17 (n 7), NP tempol (n 7) (a superoxide dismutase mimetic that scavenges ROS) and NP IL17 Tempol (n 12). On day 14 of gestation miniosmotic pumps infusing IL-17 (150 pg/day) were implanted into NP rats while tempol was administered via the drinking water ad libitum. On day 18 of gestation carotid catheters were inserted and mean arterial pressure (MAP) was recorded, plasma, urine, and tissue were collected for isolation of ROS and detection by chemiluminescent technique. Urinary isoprostane was measured by ELISA. RESULTS: MAP increased from 98 / 3 in NP to 123 / 3 mmHg in IL17 infused NP rats. Urinary isoprostane increased with chronic IL-17 from 1029 / 1 pg/mg/day in NP rats to 3526 / 2 pg/mg/ day in IL-17 infused, p 0.05. Placental ROS was 436 / 4 RLU/ml/ min (n 4) in NP to 702 / 5 (n 5) RLU/ml/min in IL-17 treated rats. Administration of Tempol attenuated the blood pressure increase to IL-17. MAP was 102 / 5 mmHg in Tempol controls and was unchanged in NP IL-17 tempol, 101 / 3 mmHg. Tempol attenuated placental ROS production to 459 / 5 (n 5) RLU/ml/ min in IL17 Tempol, which was no different from Tempol controls, 474 / 5 (n 3) RLU/ml/min CONCLUSION: These data indicate that chronic IL-17 causes placental oxidative stress, which plays an important role in mediating IL-17 induced hypertension during pregnancy.