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319 Altered vaginal cytokine expression in patients receiving pessary treatment for short cervix Jennifer M. Goldkamp, Alexandra M. Edwards, Daivd M. Kraus, William M. Perez, Gilad A. Gross, Rajeev Aurora Saint Louis University School of Medicine, Division of Maternal Fetal Medicine, St. Louis, MO, Saint Louis University School of Medicine, St. Louis, MO, Saint Louis University School of Medicine, Molecular Microbiology and Immunology, St. Louis, MO OBJECTIVE: Vaginal pessaries are a treatment for gravid patients with short cervix. Increased discharge has been a consistent finding in multiple prior investigations and it’s etiology has not been elucidated. We aimed to explore variation in cytokine expression following placement of a vaginal pessary in patients with short funneled cervix. We hypothesize that the cytokine expression profile is altered as a consequence of pessary use. STUDY DESIGN: This is a prospective cohort study of patients who received Milex Inflatoball pessaries for shortened cervix. Gestational age-matched controls without cervical shortening served as the control group. Following consent, pessary and control patients underwent collection of sterile vaginal lavage for baseline specimen. Both arms were followed longitudinally and underwent vaginal lavage collection a week later and then monthly. Multiplexed ELISA analyzed 38 cytokines with a broad survey panel. Cytokine levels were compared longitudinally within each arm, between baseline experimental subjects and controls and longitudinal cytokine concentration was compared between the two arms. Pair-wise comparisons were performed using Mann-Whitney U test. RESULTS: Most of the 38 cytokines were below the level of detection. Granulocyte-colony stimulating factor (G-CSF) demonstrated significant differences between preand post-pessary arm and post-pessary arm (p<.0001) and baseline pessary arm and baseline control arm (p1⁄4.0003). Interleukin-4 (IL-4) likewise was significantly different between baseline specimens in each arm (p1⁄4.003) and preand post-pessary arms (<.0001). Interleukin-6was expressed differently in preand post-pessary arms (p<.0001), baseline pessary and baseline control arms (p1⁄4.0101), and longitudinal pessary and control arms (p<.0001). Interleukin-1-a (IL1-a) was variably expressed between baseline arms (p<.0001). CONCLUSION: Significant variation in cytokine expression of G-CSF, IL-4, IL-6, and IL-1-a was noted in pessary patients compared with controls. Reduced cytokine expression of IL-1 alpha and G-CSF are noted in patients who underwent pessary placement. However, IL-6