5^th Asia Pacific Gynecology and Obstetrics Congress August 22-23, 2018 Tokyo, Japan

Biography:

Dr. Olson’s is a former OB hospitalist who practiced in a community hospital in Bellingham, Washington. After 28 years in a successful solo OBGYN practice, Rob was drawn to the hospitalist model because it allowed him to focus on labor and delivery. Dr. Olson moved to the OBGYN Hospitalist sub-specialty as he could see the positive impact this model provided to medical institutions, especially related to improved patient care and safety.

Dr. Olson received his medical degree from Rutgers Medical School and completed his residency at Los Angeles County Hospital/University of Southern California.  He is board-certified and a fellow in the American Congress of Obstetrics and Gynecology, a member of the Society of Hospital Medicine, and was the founding president of the Society of OB/GYN Hospitalists (SOGH).

Abstract:

Women admitted into labor and delivery in the United States are traditionally attended by registered nurses while the physician is located either in their offices or at home. The physician is called in only when complications have presented themselves on the pregnant mother and unborn child at the time of delivery.  Frequently, complications happen unpredictably and quickly and it is difficult for the nurse to judge when the physician should arrive for the actual delivery. Predictably, the safety and quality of care provided to the mother and unborn baby is compromised unnecessarily.  OBGYN Hospitalists are Board Certified physicians who physically stay in labor and delivery on 24/7 rotating shifts. OBGYN Hospitalists are able to immediately begin treatment for health complications such as postpartum hemorrhage as well as to be present for the delivery if the attending physician does not arrive in time.  Statistics have proven the markedly improved safety and quality of care provided to women in labor.  This lecture will illustrate the short history and present conditions of OBGYN hospitalists in the United States and predict the future.  Conclusion & Significance: In the United States alone, there are on average 4,000,000 births per year.  While the United States is considered a developed country, the United States has one of the developed world’s highest maternal morbidity and mortality rates. This presentation will provide facts and data on why and how OBGYN hospitalists are able to lower maternal mortality rates, reduce morbidity, improve fetal outcomes, and the overall safety and quality in women’s healthcare.

Biography:

Dr. Lei Jin has her expertise in improving the health and wellbeing on maternal and child health. Maternal folic acid supplementation can effectively prevent the fetal occurrence of neural tube defects. Mandatory or non-mandatory dietary folic acid supplement policy conducted in 87 countries in the world till 2016. Chinese government provide 400 μg folic acid tablet free to women planning to get pregnancy since 2009. The adverse effects of folic acid supplementation were found in a few studies, including gestational diabetes mellitus (GDM). She and her colleague explored association of peri-conceptional folic acid supplementation and risk of GDM in a large cohort of Chinese women in this study

Abstract:

The adverse effects of folic acid supplementation were mentioned in a few studies, including gestational diabetes mellitus (GDM). The objective of this study was to explore the association peri-conceptional folic acid supplementation and risk of GDM in Chinese women. The subjects were the singleton pregnant women who gave birth in Maternal and Child Hospital of Tongzhou District. The data were selected from the Prenatal Health Care Database of Tongzhou District, Beijing. A total of 15691 pregnancies are included in the study. All of the pregnant women underwent 75g oral glucose tolerance test (OGTT) at 24-28 gestational weeks in the maternal and Child hospital. The GDM diagnosis was verified by the inpatient medical records. Multivariate logistic regression model was used to adjust the confounders. The prevalence of GDM was 22.7%, and the proportion of folic acid or multiple micronutrients with folic acid supplementation was 89.0%, among the women. Compared to the women who didn’t take the tablets before or in pregnancy (reference group), the adjusted ORs of taking folic acid, taking folic acid regularly, and taking folic acid from pre-pregnancy and risk of GDM were 1.24 (95%CI: 1.07-1. 3), 1.20 (95%CI: 1.10-1.31), and 1.15 (95%CI: 1.05-1.26), respectively. Compared to the reference group, regularly use of folic acid tablets or multivitamin tablets from pre-pregnancy had a higher incidence of GDM [adjusted ORs were 1.31 (95%CI:1.11-1.55) and 1.44 (95%CI:1.21-1.71)], regularly or irregularly use multivitamin tablets during pregnancy also had a higher incidence of GDM [adjusted ORs were 2.03 (95%CI:1.36-3.04) and 1.18 (95%CI:1.01-1.39)]. Compare to the reference group, regularly taking folic acid supplementation before or after pregnancy both increased the risk of GDM [adjusted ORs were 1.36 (95%CI: 1.17-1.60) and 1.62 (95%CI: 1.13-2.33)]. Conclusion: Folic acid supplementation before or during pregnant period, especially when consuming regularly, may increase the risk of gestational diabetes mellitus.

Biography:

Renda Al-habib,medical student at Unziah Collage of Medicine, Saudi Arabia .

Abstract:

Haemorrhage is defined as 10% or greater decrease in hematocrit. It is considered as a major complication of surgeries and is one of the most common causes of death during surgical settings (1). Despite the low mortality and morbidity of Caesarean Sections (CS), hemorrhage is still considered as a threat to the patients and surgeons (2). Knowing the accurate blood loss is very helpful for resuscitation process and reducing in plenty of hemorrhagic shocks (3).

The objectives of this study :

1- To define the estimation of blood loss made by the obstetricians.

2- To correlate the exact amount of blood loss measured by the difference of hemoglobin level based on complete blood count (CBC) test done before and after the surgery.

3- To determine the accuracy of estimated blood loss made by the obstetricians during Caesarean Sections based on drop of hemoglobin level.  

Biography:

Dr. Magda Helmi is an Obstetrics and Gynecology consultant who lives and works in Cairo, since her birth 1951. She graduated in Medicine from Cairo University in 1975, specialized in Ob.Gyn. from 1979, fulfilled the MD in the same specialization in 1991. She conducted research work of many years in the field of Ob.Gyn., specially in reproductive biology, where she collaborated with international entities. After a long period of responsibilities at Al Azhar University in Cairo she devoted herself to the dissemination of medical culture and helping poor people.

She has three books in Arabic with a fourth under publication, her books cover topics about Ancient Egyptian Medicine, Antenatal care, Infertility and Menopause. She participated in many international meetings with clinical application papers, as well as social and scientific activates in urban rural areas all over the world in Egypt, Italy, Saudi Arabia and Kuwait.

Abstract:

It has been reported that excessive weight gain in pregnancy is associated with adverse maternal and fetal outcomes. Trying to reduce weight gain during pregnancy have the potential to reduce adverse outcomes, Interventions based on diet and physical activity, or metformin, in pregnancy could influence maternal and fetal weight and obstetric outcomes.

 The purpose is to evaluate different methods used during antenatal care to reduce weight gain during pregnancy diet, exercise and metformin.

 Methodology & Theoretical Orientation:

All 139 women in this study had a confirmed diagnosis of obesity with pregnancy (body mass index >30 kg/m2), these women were followed up during their course of pregnancy; data forms were completed once they had delivered. Cases were divided into three groups (A,B and C): (A) 54 on healthy meal; and (B) 47 on exercise and DASH diet, and (C) 20 on metformin 500mg twice daily. All groups were matched by age, height and weight. Comparison was in terms of early and late pregnancy complications. In A, B and C the rate of pregnancy-induced hypertension/pre-eclampsia was 43.7%, 23.3% and 13.9% respectively (P<0.020). Rates of gestational diabetes requiring insulin treatment in A and B, were 33.3% and 18.7% compared to 2.5% in group C, (P<0.004). The rate of intrauterine growth restriction was significantly low in C, 2.5% compared to 19.2% and 16.6% in A and B respectively, (P<0.046). Frequency of preterm labor and live birth rate was significantly better in C compared to A and B. Overall rate of miscarriages was 7.2%.

CONCLUSION:

In obese pregnant women, continuous use of metformin during pregnancy significantly reduced the rate of complication and improves outcome.

Biography:

Dr Ho Yau Bong is an Associate Consultant and Team Leader of Assisted Reproductive Technology Unit in United Christian Hospital in  Hong Kong. He  has performed a wide range of fertility surgeries, advanced laparoscopic surgeries and advanced hysteroscopic surgeries including laparoscopic myomectomy and total laparoscopic hysterectomy for complex cases

Abstract:

This case illustrates the importance of having active gynaecological intervention for patients with sudden onset of anti-NMDA receptor encephalitis with the presence of ovarian dermoid cysts.  A 18-year-old Chinese lady was presented with acute onset of confusion, development of unsteady gait, slurring of speech and gradual deterioration of Glasgow Coma Scale. Lumbar puncture was performed and cerebrospinal fluid revealed mild leukocytosis and a slight elevation in protein. CT and MRI brain, septic workup and toxicology screening were all normal. Patient was treated as viral meningoencephalitis with Acyclovir and Antibiotics. Nevertheless, she developed episodes of tonic-clonic seizures requiring intubation and admission to Intensive Care Unit. Serum auto-antibody titre was checked and anti-NMDA receptor antibody was positive. Diagnosis of anti-NMDA receptor antibody encephalitis was made. She was treated with Prednisolone, plasmapheresis, IVIG and Rituximab. CT abdomen and pelvis scan revealed a 4x3x2cm right ovarian teratoma. Emergency laparoscopic right ovarian cystectomy was done and histology confirmed the presence of mature cystic teratoma. Her conscious level gradually improved 5 weeks after the operation and she was discharged 13 weeks afterwards.  Subsequent follow-up showed she has a full recovery with no seizure nor other functional deficits. Anti-NMDA receptor antibody encephalitis was first discovered in 2007 and around half of the cases were associated with ovarian teratoma. It is thought that this condition can be caused by auto-antibodies produced by cross-reactivity with NMDA receptors in teratomas. Ovarian cystectomy can improve this condition as it can eradicate the source of auto-antibodies.

Biography:

Ma. Paula Rhove R. Ortega, MD is a resident physician at the University of the Philippines – Philippine General Hospital Department of Obstetrics and Gynecology. Ireene Cacas-David practices Obstetrics & Gynecology and specializes in Perinatology

Abstract:

Tuberculosis, a disease highly prevalent in developing countries, masquerades itself in various forms. Amidst the availability of treatment spearheaded by the government, there remains in the Philippines a great burden of morbidity and mortality from this illness. It most usually affects the lungs, but extrapulmonary forms also exist.

This case focuses on a patient with abdominopelvic tuberculosis with a chief complaint of constipation, who presented on physical examination with vaginal synechiae, and was revealed on ultrasound to have hematopyotrachelometra. Initially, there was a dilemma in the diagnosis of the 79-year-old patient. Is the cause of the synechiae infectious or is it malignant? After which, comes the dilemma in the management. Is the hematometra best treated conservatively or surgically? The history, physical examination, diagnostics and course of this patient who was admitted twice for the same clinical presentation was explored in this case report.

Biography:

Stefani D. Dela Cruz, MD-MBA has completed her Doctor of Medicine and Masters in Business Administration at the age of 25 from The Ateneo School of Medicine and Public Health in the Philippines. She is currently a resident in training from the Department of Obstetrics and Gynecology, The Medical City, Ortigas, Pasig City.

Abstract:

The rate of cesarean section (CS) has been increasing worldwide, and many countries exceed estimated ideal-population CS rate of the WHO of 15%. The most common indication for a repeat cesarean section (RCS) was a previous CS. The recommended optimal timing for RCS is 39 weeks, yet, 10-12% undergo spontaneous labor prior to 39 weeks. Due to these, they are at an increased risk of maternal and neonatal complications. The primary objective of this study was to determine the rate of spontaneous onset of labor prior to scheduled RCS at 39 weeks age of gestation (AOG) among low-risk women in a tertiary hospital. A retrospective, cohort study was done to determine the rate of spontaneous onset of labor prior to 39 weeks AOG among low-risk (no medical condition) women admitted in a tertiary hospital from January 2012 to December 2016. Information regarding prenatal/antenatal care, delivery, maternal and neonatal outcomes were obtained from chart review. Descriptive analysis was done to summarize demographic profile; and STATA 12.0 was used to further data analysis. Of 2618 women who underwent RCS from 2012 to 2016, 834 (31.8%) were classified as low-risk. Among the 834 pregnancies, deliveries occurred at 39 (53%), 38 (26%) and 37 (21%) weeks AOG. Spontaneous labor occurred prior to 39 weeks in 47% (n=396). More patients had history of infection (5%, P=.015), threatened/preterm labor (5% vs 3%), premature rupture of membranes (7%, P<.0001) and uterine contractions (94%, P <.0001); and three neonates had Transient tachypnea of the newborn (TTNB) among those who underwent spontaneous labor. Over-all, maternal and neonatal outcomes did not vary significantly between patient groups. The rate of spontaneous labor among low-risk women was greater than the estimate of the WHO. Maternal and neonatal outcomes were not statistically significant among gestational age. To note, the risk of TTNB among patients who underwent spontaneous labor validates the delivery at 39 weeks AOG. Information obtained from this study may contribute to the patients’ and doctors’ awareness of the possibility to undergo spontaneous labor prior to scheduled RCS, for them to be prepared during pregnancy.

Biography:

Dr. Denise Elaine A. Reyes received the Doctor of Medicine degree in Far Eastern University- Dr. Nicanor Reyes Medical Foundation, Philippines. She graduated with the honor of cum laude and is currently having her Obstetrics and Gynecology residency training on the same institute. She is a strong advocate of women’s health and aims to help achieve the World Health Organization’s fifth millenium developmental goal which is to improve maternal health

Abstract:

Biography:

Dr.Hongwen Zhang ，Professor，from The Second  Xiangya Hospital of Central South University，Chief of the Gynecology and Obstetrics Department.Nearly 40 years of clinical experience. Skilled in gynecologic inflammation, female diseases, gynecological oncology, uteroscope and laparoscopy surgery. First to perform research on cesarean scar pregnancy in China, then, concluded the Clinical classification and treatment of cesarean scar pregnancy. 1 SCI paper, Multiple journal articles published. Treated  CIN III with cold knife conization without suture under uteroscope assist for over two years and achieved great prognosis

Abstract:

Aim: Embryo implantation in a cesarean scar resulting in a cesarean scar pregnancy (CSP) is a special form of ectopic pregnancy. The aim of this article is to present our clinical classification and therapeutic strategy for CSP and to assess the efficacy, safety, and social benefits.

Methods: We categorized CSP as either risky or stable. Risky CSP have a high risk of severe hemorrhage and should be treated immediately, while stable CSP patients have neither obvious vaginal bleeding nor significantly elevated serum β-human chorionic gonadotrophin (β-hCG). According to the thickness of the myometrial wall between the sac and the bladder and the location of the gestational sac, risky CSP were classified into three types and the thinner myometrial wall type (type I) was divided into three subtypes. Four treatment categories were applied to the corresponding types and subtypes of CSP. A total of 331 patients with CSP in our hospital were studied. The study group (n = 81) was treated based on our classification and optimized treatment system, while the control group (n = 250) underwent the conventional methods. We assessed the efficacy, safety, and social benefits of our classification and optimized treatment system.

Results: The values of intraoperative blood loss, operative time, hospital stay, and hospital cost in the study group were significantly lower than those in the control group (P < 0.05). Suction curettage was more frequently used in the study group (P < 0.005).

Conclusion: Our clinical classification system and therapeutic strategy provide an effective and safe way to treat CSP patients resulting in reduced intraoperative bleeding, operative time, hospital days, and hospital cost.

Biography:

Obstetrics and Gynaecology doctor Olarik is currently working for Chaophya Abhaibhubejhr Hospital in Prachinburi, Thailand, Born in a rural province, Prachinburi, Thailand. Dr.Olarik Musigavong has graduated from Faculty of Medicine, Khon Kaen University majoring in Obstetrics and Gynaecology. He also attended professional classes from Reproductive medicine of Ramathibodi Hospital in coordination with Mahidol University and Reproductive surgery training course in Belgium. Furthermore, he received a master degree in the Biotechnology of Human Assisted Reproduction and Embryology from University of Valencia in Spain, and lately became a graduate of doctor’s degree in philology and clinical epidemiology of faculty of medicine from Thammasart University.

With regard to his extraordinary achievements, he has been appointed in honorary positions : Vice

President of Complementary and Alternative medicine Special interest group of American Society of

Reproductive Medicine in USA, Social Media Team Leader of American Association of Gynecologic Laparascopist in USA, 

Abstract:

Integrative medicine is a combination of conventional medicine and alternative medicine for patient treatment. Its use has increased worldwide in recent years. Endometriosis is one of the most common disorders among infertile patients seeking medical advice. Etiology of the association is still unclear, but a number of studies suggest endometriosis alteration of hormonal cells and mediated functions, reduction of oocyte and embryo quality, endocrine and ovulatory abnormality, alteration of peritoneal functions, pelvic distortion, and dyspareunia that decreases sexual activities. Nowadays, the medical treatment of conventional medicine does not improve the rate of pregnancy in patients with endometriosis-associated infertility.

Chaophya Abhaibhubejhr Hospital has experiences in using Thai integrative medicine in endometriosis-associated infertility patients. Our experiences include the use of the following: curcumin capsules for post laparoscopic ovarian cystectomy, Plasaplai formula for endometriosis-associated pain, massage therapies for uterine repositioning, and herbal diets for lifestyle modification.

Biography:

Eunice has been an Embryologist in Singapore General Hospital since 2013 till date. She has received the letter of authorisation from the Ministry of Health to authorize her to perform procedures in the clinic.

Abstract:

Intra-cytoplasmic sperm injection (ICSI) is used in assisted reproductive technology to overcome male factor infertility. Ejaculated sperm is usually used for ICSI. In our Centre, surgically retrieved sperm is an option for patients who are Azoospermic, patients with high DNA fragmentation index and patients who are unable to give a fresh ejaculate sperm sample on the day of oocyte retrieval (OR). The techniques used in the surgical retrieval of sperm include Percutaneous epididymal sperm aspiration (PESA), Microsurgical epididymal sperm aspiration (MESA) and Testicular sperm extraction (TESE). This retrospective study compares the outcomes of ICSI using surgically removed sperm versus ICSI using ejaculated sperm in our Centre. From January 2016 to June 2017, a total of 308 couples underwent IVF treatment with ICSI using fresh sperm ejaculate. The sperm was selected for ICSI based on the morphology and viability. 19 couples underwent IVF treatment with ICSI using surgically retrieved sperm. The immotile testicular sperm was first activated using GM501 Sperm Mobil before selection for ICSI. For the group of patients using ejaculate sperm, the fertilization rate was 67.9%, embryo cleavage rate was 99.1%, and pregnancy rate was 40.9%. The fertilization rate for the group of patients using surgically retrieved sperm was 56.4%, embryo cleavage rate was 97.4% and pregnancy rate was 33.3%. In conclusion, the use of surgically retrieved sperm for ICSI gives comparable outcomes to the use of ejaculate sperm. This further alleviates the problem of male factor infertility in IVF and improves the success rate of IVF treatments.

Biography:

DR G K TRIPATHI

•       Founder Hon President :-

1.     Delhi State Chapter of ISAR

2.     Delhi State Chapter of ISPAT

•       Founder Hon Secretary  Azamgarh Obgy Society

•       Pioneer to start HANDS ON TRAINING MODULE FOR :-

-          Ovum pick up & Embryo Transfer Simulator

-          USG PHANTOM

-          Hysteroscopy Simulator/Phantom

-          PESA/MESA/TESA Hands on Goat Testis

Abstract:

Male infertility, a global concern issue & now a days lot of newer medical & surgical entities evolved to cure it.

Medically Clomiphene, CoQ, HCG inj and other micronutrients are in fashion to use.

Varicocele correction had effects on sperm count morphology and motality.

Micro surgical procedure -PESA /MESA /TESA /MICRO TESE for sperm retrieval.

Non-Surgical PRP has promising impact on Erectile Dysfunction.

Other surgical process ie Epididinostomy quite effective in correction of Andrology issues.

IUI/IVF.ICSI, an effective way to conceive.

New Modalities like SPERM ROBOT promising in non-motile sperm.

STEM CELL - great hope to correct Azoospermia in future.

Biography:

Dr Dalida Badla MD at the age of 27 years from faculty of medicine in Damascus and Alepo universities .D.MAS from World Association of Laparoscopic Surgeons in 2017 .Fellowship in Assisted Reproductive Technology at WLH,NCR Delhi in 2017 .she is head section of obstetric and gynaecology department in MEDICLINIC  AL Bateen ABU DHABI .she is member in MEFS and speaker in many conferences.

Abstract:

Loosing pregnancies before 20 weeks of pregnancy is a frequent obstetric complication  and has several  reasons  such as  parental chromosomal anomalies ,maternal thrombophilic disorders ,uterine structural anomalies ,and antiphospholipids antibodies .

In 50% of cases the pathophysiology remains unknown .the clinical association between RPL and PCOS is more than common however the incidence rate uncertain till now .the high LH and obesity are risk factor of spontaneous abortion hyperinsulinemia has been  proposed as pathway for the effect on obesity although its effect on androgen production(theory of INSULINE RESISTANS) as a key factor behind   PCOS /OBESITY and risk of RPL).  PCOS and miscarriages symptoms and how   to avoid miscarriages with PCOS , and the treatment  options,  then planning to get pregnant again after miscarriage 

Biography:

Dr Mai O.El gamal , Fetal medicine specialist with 6 years expertise ,member of ultrasound special care unit of the fetus Ain Shams University ,one of the oldest and biggest hospitals and educational institutes in Egypt and middle east

Experienced in female imaging with special interest in research and education, responsible for teaching and training doctors. Actively participated for 2 years in Ain Shams Obstetrics and Gynecology international conference (ASOGIC 19-20) and other local conferences and workshops

Abstract:

An ectopic pregnancy is defined as the implantation of a fertilised ovum outside the endometrial cavity; Condition is associated with high morbidity and mortality. With incidence of 2% and increasing as a result of an increase in the number of patients with risk factors as ART and PID also increasing diagnosis rates whoever Mortality rate is decreasing because of improved diagnostic techniques and heightened awareness among clinicians and patients.

Ectopic pregnancy of unusual locations account for 4% of all ectopic pregnancies associated with increased morbidity and mortality rates compared to usual tubal ectopic pregnancies. Advances in imaging techniques and high index of suspicion aid early diagnosis and intervention preventing catastrophic complications.

Presenting cases of: Advanced Abdominal ectopic, heterotopic pregnancy with monochorionic twin pregnancy located in tube, cervical ectopic, corneal ectopic and caesarean scar ectopic encountered during our practise each with its characteristic ultrasound picture.

Early ultrasound diagnosis of rare forms of ectopic aid proper management of patients    gives time for conservative measures especially when future fertility is of concern.  Prevent extensive surgeries which may jeopardise fertility and life threatening complications as rupture uterus, haemorrhage, DIC associated with undiagnosed cases.

Biography:

Dr. Tariq masood khan (mcps, mcps, fm, dcps, obg)

Family / emergency medicine specialist / internist

Student ms obs/gyn

Obstetrics and gynaecology department

Lady willingdon hospital lahore

Abstract:

Eclampsia is a life threatening condition with highest mortality and morbidity characterized by uncontrolled hypertension un-consciousness fits albumin urea in the setting the of Pre Eclampsia.

STUDY

An extensive elaborative study carried out from 2005 to 2009, to study the therapeutic and prophylactic role of Magnesium Sulphate and Diazepam in Eclampsia.

STUDY PERIOD

Four years 2005 to 2009

OBJECTIVE

To study MgSo₄ Vs Diazepam reducing MMR, NMR in Eclampsia

STUDY DESIGN

This was a comparative study. Total 500 patients of fulminent pre- Eclampsia / Eclampsia were studied included booked / un-booked patients attending Lady Willingdon Hospital were admitted evaluated assessed and put on MgSo₄ Vs Diazepam divided in two groups. The results were compared which showed of MgSo₄ as superior in efficacy of compared to Diazepam in improving over all mortality morbidity in Eclampsia.

MATERIAL AND METHODS

Total 500 patients of Eclampsia admitted and studied in Unit – 2 Lady Willingdon Teaching Hospital of King Edward Medical University Lahore managed in ICU according to a specially design proforma, protocol and were given MgSo₄ and Diazepam for control of fits, Hydralazine, Labetalol and Isoket infusions for lowering – blood pressure (MgSO₄) A+B. (Diazepam) with multi disciplinary involvement divided in two groups compared and followed up.

RESULTS

In Group-A there were 20 mothers and in Group-B 40 mothers died. It was observed that maternal mortality was significantly higher in Group-B women as compared to that of Group-A. i.e. (p-value=0.005) In Group-A there were 20 mothers and in Group-B 40 mothers died. It was observed that maternal mortality was significantly higher in Group-B women as compared to that of Group-A. i.e. (p-value=0.005)

CONCLUSION

The comparative study and of role of MgSO4 Vs Diazepam in reducing Mortality, morbidity in maternities, neoneties, efficacy showed the superiorness of Magenesium Sulphate as compared to Diazepam with out any doubt.

KEY WORDS

Therapeutic, Prophylactic role, Magnesium Sulphate, Diazepam,  Eclampsia 

Biography:

From 2010 to 2016 Dr. Romanov studied at the faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia. From September 2012 to October 2015 Dr. Romanov had been working as an assistant researcher in the Department of Biochemistry and Molecular Medicine, Faculty of Fundamental Medicine, Lomonosov Moscow State University. Now he is undergoing last year of his residency in National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare of the Russian Federation. Dr. Romanov is constantly working on developing his practical skills and also performs research on noninvasive methods of improvement effectiveness of assisted reproduction technologies. He regularly participates in scientific meetings on obstetrics, gynecology, perinatology and assisted reproduction technologies. 

Abstract:

According to in vitro experiments, up to 75% of morphologically normal human blastocysts cannot spontaneously leave the zona pellucida (ZP), which can lead to implantation failure.

The aim of the study was to identify predictors of human blastocyst hatching success in assisted reproduction programs.

Materials and methods. This prospective case-control study included 83 blastocysts - 36 blastocysts (43.4%) in group of spontaneous hatching and 47 blastocysts (56.6%) in control group.

Hatching success assessment was performed after 144–146 hours post fertilization. The expression of cathepsin V (CTSV), GATA binding protein 3 (GATA3) and human chorionic gonadotropin beta (CGB) genes were detected by qRT-PCR (“DNA Technology”, Russia).

Results and discussion. The efficacy of spontaneous hatching of human blastocysts are determined not by the quality of the ZP, but by the quality of the blastocysts themselves. The rate of blastocysts with the thickening or other defects of the ZP was similar in the two groups. High-quality embryos have enough adaptation possibilities for the timely release both from the normal and the thickened ZP. The quality of blastocysts on the fifth day of culture by Gardner classification was higher in the group of spontaneous hatching.

Expression of CTSV, GATA3 and CGB genes was higher in blastocysts in spontaneous hatching group, which was associated with high ICM and TE quality. This indicates that hatching is a special stage of blastocyst development, characterized by a chronological and chronogenetic determinism. This may be a mechanism that prevents the implantation of a defective embryo with retarded development or other development disorders. The expression of CTSV, GATA3 and CGB genes is lower in low-quality blastocysts, which does not allow them to commit spontaneous hatching and to implant into the endometrium.

Biography:

Dr. Akira Shirane is a gynecology and obstetrics  at kurashiki medical center , Japan 

Abstract:

The symptoms of intestinal endometriosis are especially severe such as dyschezia.

These symptoms negatively effect on the QOL of the women remarkably.

Surgeries are considered when medical therapy does not succeed or in the setting of infertility.

We evaluated symptoms, surgical procedures, post-operative recurrence and postoperative pregnancy rate.

Setting: Kurashiki medical center

Patients: the cases who were diagnosed with intestinal endometriosis and had surgeries

Designs: Retrospective cohort study

Interventions: Laparoscopic low anterior resection of Rectum plus alpha over ten years (from January, 2008 to December, 2017).

Result: We have experienced 23 fertility sparing surgeries(33.9±5.24 years old; mean ±SD) which are observed for more than six months. In 18 cases, patients complain of dyschezia. These symptoms significantly improved after surgery in all cases.

Recurrences were found in five out of ten cases without hormone therapy, while no recurrence was found in thirteen cases of hormone (dienogest, LEP)-administrated group.

Nine cases had a desired conception and seven were successful (two natural, five ART) in pregnancy and five acquired babies.

Conclusion: Many of patients desired babies before surgeries. However, once they have finished surgical treatments, they tended to hesitate to get pregnant for fear of a recurrence. For patients who try to have fecundity-sparing surgery, doctors should provide education regarding the high risk of recurrence and usefulness of the Assisted Reproductive Technology (ART).

Moreover, recently we encourage the patients to have preoperative oocyte pick up (OPU) and embryo freeze preservation because of these benefits as below.

1. Acquire frozen embryos that are more successful than fresh embryos in pregnancy rate

2. Provide patients the defined motivations toward surgery

3. Eradicate concerns of postoperative diminished ovarian reserve

4. Pregnancy is expected under the improved pelvic environment by surgery.

Biography:

Dr Dheeraj,is presently doing 3^rd Year Post graduation in M.S(Obstetrics and gynaecology) in Sri Rama Chandra Medical college,Chennai,one of the prestigious college in INDIA

He finished his under graduation from Andhra Medical College,KING GEORGE HOSPITAL,VISAKHAPATNAM in 2015

He is presently doing his research on the “MATERNAL HIGHLY SENSITIVE C REACTIVE PROTEIN AS PREDICTOR OF PRE ECLAMPSIA”

Abstract:

CASE DESCRIPTION-

Broad ligament haematoma is a rare complication following a normal vaginal delivery.

We report one such case of a woman who developed this complication within 3 hrs of normal vaginal delivery.

She is G2P1L1, 38 wks GA, in active labour.

 Pt was allowed for spontaneous progression of labour, following which she delivered vaginally. Within 3 hrs patient looked clinically very pale with vitals being deranged and complains of inability to void urine, severe perineal pain.

On basis of clinical examination and transabdominal ultrasound features a diagnosis of right sided broad ligament haematoma was made.

Based on patients haemodynamic instability surgical management in the form of obstetric hysterectomy was done.

DISCUSSION

Broad ligament haematoma is a relatively uncommon complication that can occur following a spontaneous vaginal delivery.

 It can be silent and not cause any obvious vaginal bleeding. Clinical symptoms are vague with persistent perineal pain, urge to defecate, unable to void within first few hours of delivery.

Imaging modalities like transabdominal ultrasound and MRI can help in confirming the diagnosis. It has been suggested that MRI depicts postpartum hemorrhage even in deep extraperitoneal regions where the hematoma is clinically non-apparent, and in addition it can delineate the extent of the hematoma.

Broad ligament haematoma can be managed both conservatively and surgically depending on patients haemodynamic status, size and rate of haematoma expansion.

Small non spreading ones can be managed conservatively however larger ones might need internal illiac artery ligation, UAE or even hysterectomy.

Our patient was haemodynamically unstable after confirmed diagnosis and given the circumstances that the haematoma was expanding we decided on the surgical management i.e subtotal hysterectomy.

Biography:

Kok-Min Seow received his MD degree from the National Yang-Ming University, Taipei, Taiwan in 1996. After completing residency training at the Shin-Kong Wu Ho-Su Memorial Hospital, he served as an attending physician at the Shin-Kong Wu Ho-Su Memorial Hospital. In 2007, he obtained his PhD degree from the department of clinical medicine, National Yang-Ming University. He is also an associate professor at the school of medicine, National Yang-Ming University since 2014. His clinical interests include prenatal ultrasound diagnosis and laparoscopic surgery and his research interest is insulin resistance in polycystic ovary syndrome and high risk pregnancy, such as cesarean scar pregnancy.

Abstract:

oxytocin in preventing primary postpartum hemorrhage in infertile women with twin pregnancy undergoing elective cesarean delivery.

Uterine atony is the major cause of postpartum hemorrhage (PPH), accounting for up to 80% of PPH cases. PPH is the leading cause of maternal morbidity and mortality worldwide, resulting in up to 28% of maternal deaths. This study is to compare the efficacy and safety of carbetocin with those of oxytocin infusion in women with twin pregnancy undergoing elective cesarean delivery.

The present observational study conducted from January to December 2014 at a single center in Taiwan enrolled 64 women with twin pregnancy induced using in vitro fertilization–embryo transfer. The women were divided into a carbetocin group who received a single injection of 100 mg carbetocin (n = 25) and a control group who received a continuous intravenous infusion of 10 IU oxytocin in 500 mL 0.9% NaCl solution (125 mL/h) for 24 h (n = 39). Operative outcomes were compared between the groups. The mean estimated blood loss during surgery was lower in the carbetocin group compared with the control group (871 ± 305 and 922.8 ± 430 mL, respectively), but the difference was not significant (P = 0.06). There was also no significant difference in the drop in hemoglobin level between two groups. The mean operative time was significantly shorter in the carbetocin group compared with the control group (P = 0.001). In conclusion, carbetocin is as effective as 

Biography:

Sosa-Palaviccini MO

 MD Ob Gyn

Head of Service of Prenatal Diagnosis

Universitary Hospital Antonio María Pineda. Barquisimeto – Venezuela

Abstract:

Pregnancy with trisomy 18 and hepato omphalocele. Antenatal ultrasound showed longilinear avascular structures inside the umbilical cord and attached to the small intestine within the omphalocele. The insertion of the cord into the fetal omphalocele is lateral, which would allow traction movements as a pulley. Fetus dies from ruptured omphalocele. Stillbirth presents postaxial polydactyly of one foot (not diagnosed antenatally) and tubular structures coming from the umbilical cord attached to the intestine, pulling it firmly until it forming intestinal diverticules. It is postulated that this is the mechanism as the physiological umbilical hernia originates and as the Meckel's diverticulum originates. It is recommended to perform color Doppler ultrasound to any umbilical cord of fetuses with omphalocele. The fetal surgeon could cut these adherences during pregnancy, to allow the intestinal return inside the abdomen

Biography:

Juan Ren, female, MD，PH.D, Professor, Oncology Department, Did researches in Cleveland Clinic Foundation,USA from 2003 to 2008. Reviewers of the National Natural Science Foundation of China (NSFC) and the Scientific Research Scholarship for the Returned Overseas Chinese Scholars of Education Ministry of China. Has published more than 40 articles and won the second Prize of Progress in Scientific Technology of Shaanxi Province, the First Prize award of Science and Technology of Shaanxi Province, and the First Prize award of research findings of Cleveland foundation. Got New Century Talent Supporting Project of Education Ministry. Got 4 NSFC projects and 2 science and technology projects of Shaanxi Province. She has been invited as speakers in more than 40 international academic meetings and has been served as Editorial members of many international journals.

Abstract:

The purpose of this study was to comprehensively compare the 3-dimensional (3D) magnetic resonance imaging (MRI)-guided and conventional 2-dimensional (2D) point A-based intracavitary brachytherapy (BT) planning for cervical cancer with regard to target dose coverage and dosages to adjacent organs-at risk (OARs). Methods: A total of 79 patients with cervical cancer were enrolled to receive 2D point A-based BT planning and then immediately to receive 3D planning between October 2011 and April 2013 at the First Hospital Affiliated to Xi’an Jiao Tong University (Xi’an, China). The dosevolume histogram (DVH) parameters for gross tumor volume (GTV), high-risk clinical target volume (HR-CTV), intermediate-risk clinical target volume (IR-CTV) and OARs were compared between the 2D and 3D planning. Results: In small tumors, there was no significant difference in most of the DVHs between 2D and 3D planning (all p>0.05). While in big tumors, 3D BT planning significantly increased the DVHs for most of the GTV, HR-CTV and IR-CTV, and some OARs compared with 2D planning (all P<0.05). In 3D planning, DVHs for GTV, HR-CTV, IR-CTV and some OARs were significantly higher in big tumors than in small tumors (all p<0.05). In contrast, in 2D planning, DVHs for almost all of the HR-CTV and IR-CTV were significantly lower in big tumors (all p<0.05). In eccentric tumors, 3D planning significantly increased dose coverage but decreased dosages to OARs compared with 2D planning (p<0.05). In tumors invading adjacent tissues, the target dose coverage in 3D planning was generally significantly higher than in 2D planning (P<0.05); the dosages to the adjacent rectum and bladder were significantly higher but those to sigmoid colon were lower in 3D planning (all P<0.05). Conclusions: 3D MRI image-guided BT planning exhibits advantages over 2D planning in a complex way, generally showing advantages for the treatment of cervical cancer except small tumors.

Biography:

My name is Dr Jeni Panaiotova. I have graduated medicine and took speciality in Obst and Gyn in Medical University, Sofia, Bulgaria.  During the years the passion in Fetal medicine, that was rising in me, made me to apply and finish training in Fetal Medicine at Fetal Medicine Foundation, London, United Kingdom. Being part of the FMF team and observing how most of the diseases could be predict as early as first trimester of pregnancy me and my team decided to start a research of predicting placenta accreta in the first trimester. The aim of our research was to improve the work of obstetricians, dealing with this serious and life threatening obstetric condition, which incidence is rising due to the rising incidence of delivery by Cesarean Section worldwide. After four years of hard work, we completed our research and according to the results we were able to predict placenta accreta.

Abstract:

To estimate the diagnostic accuracy of ultrasound in prediction of morbid adherent placenta at 11-13 weeks.

This was a prospective study in women attending the first trimester screening test for chromosomal abnormalities. Patient-specific risk was designed, based on the history of previous uterine surgery and placenta position. On the basis of these risks, the population was stratified into high-and-low risk groups for MAP. High risk group was followed up in a special designed MAP clinic at 11-13,20-24 and 28-34 weeks. The ultrasound markers used in this study were: non-visible CS scar, irregularity of the uterine-bladder interface, retroplacental myometrial thickness, presence of intraplacental lacunar spaces, presence of retroplacental arterial/trophoblastic blood flow and 3D Power Doppler irregular placental vascularization. The diagnosed was made on three or more than three ultrasound markers.

The study population of 22,604 pregnancies at 11-13 weeks, were assessed. 1,130, were exclude, because of no pregnancy outcome at the end, or because the pregnancy ended with termination or a miscarriage.  The rest 21,474 were assessed at 11-13 weeks for previous uterine surgery and low lying placenta. We exclude 20,176 and 1,298 were assessed as high risk patients and those patient were referred to the MAP clinic at 11-13 weeks. 42 patients did not attend the first appointment and 243 were excluded, because the placenta was high. From the rest 1,013 patients, 14 patients were diagnosed with MAP and 999 patients with no MAP. All of the patients were followed at 20-24, 28-34 weeks and at the time of the delivery. 13 patients were correctly diagnosed with MAP, there was one false positive and 34 patients correctly diagnosed with placenta previa.

This study shows the feasibility of first trimester prediction of MAP, by using a combination of patient’s history of a previous uterine surgery, placenta position and specific ultrasound markers

Biography:

Dr. Shalini Rathore Consultant Gynaecologist, Specialist in High Risk Pregnancy, Fetal Medicine, Endo-Gynaecologic Surgery & Fertility Med. Experience Director & Consultant November 2009 - Present

Abstract:

In this study middle cerebral artery (MCA) peak systolic velocity(PSV)  and ductus venosus (DV) spectral waveform was measured with doppler to investigate their role in management of non immune hydrops foetalis.

METHOD : 30 singleton pregnancy with non immune hydrops foetalis were included in the study. The MCA-PSV and DV spectral waveforms were recorded in all foetuses. If MCA-PSV values greater than 1.50 MoM, fetal blood sampling by cordocentesis was performed and managed accordingly for anaemia. In foetuses with abnormal DV spectral waveform, cardiovascular causes and chromosomal abnormalities were examined.

RESULT : 11 of 30 foetuses had MCA-PSV values greater than 1.50 MoM. The causes of anaemia were investigated and include severe maternal anaemia, pre- eclampsia, cytomegalovirus infection etc. 8 cases showed reversed flow in the DV; of them 7 had congenital heart disease on echocardiography; and 1 had a normal echocardiogram, but had an abnormal karyotype.

CONCLUSION : Estimation of the MCA-PSV and DV spectral waveforms during colour doppler study of these foetuses with nonimmune hydrops  foetalis can help in their categorisation and further management which improved their outcome

Biography:

Dr.Muhamed Bakry, KFS General Hospital, Egypt

Abstract:

Among the many physiologic changes that occur during pregnancy, the maternal immune system is altered to dampenthe maternal inflammatory response and allow for fetal antigen tolerance (1, 2). Although such immunologic changesdiminish the chance of fetal rejection, they potentially increase maternal and fetal vulnerability to certain infectiousdiseases. Common infections that cause mild-to-moderate disease in healthy adults and children can cause serious maternal and fetal complications if acquired during pregnancy. A unique concern with maternal infection is the potential for mother-to-child transmission or congenital infection. Cytomegalovirus (CMV), parvovirus B19, varicellazoster virus (VZV), and toxoplasmosis are common infections associated with moderate-to-severe fetal and infant complicationswhen acquired congenitally. The purpose of this document is to update the current understanding of these infections, including their clinical presentations; their modes and risks of perinatal transmission; and their maternal,fetal, and infant effects, and to offer guidelines for preventing and managing these infections during pregnancy

Biography:

Dr. Swadha Kotpalliwar is a gynecology and obstetrician at K.J.Somaiya Medical College And Research Cente, Mumbai, India

Abstract:

Objective

To evaluate the risk of pregnancy-associated morbidities such as hypertension, diabetes, hypothyroidism and adverse perinatal outcomes in elderly women (age >=35 years) in comparison to controls (age 25 to 30 years)

Methods

All women delivered in Fernandez hospital in 2015 were eligible for the study. Those with age 35 years or more at conception were considered as cases, for each case a control was chosen matching for date of birth (the immediate next delivery), singleton pregnancy and parity status (primi or multi). The outcomes of the study included adverse pregnancy outcomes (PIH or diabetes or hypothyroidism), delivery outcomes (very preterm (<35 weeks) or C-section or assisted vaginal delivery) and fetal/ neonatal outcomes (very low birth weight or LGA or fetal or neonatal death).

Results

Among the 7605 deliveries during the study,  928 mothers are included in the study. Elderly women were likely to have hypertension, diabetes mellitus, hypothyroidism, elective C-section rate, and neonatal complications such as earlier gestation at delivery, need for NICU admission, respiratory distress and jaundice. In comparison to controls, elderly women are likely to have adverse pregnancy outcomes (n=298, 64.2% vs. n=171, 36.9 %, p=<0.001), similar delivery outcomes (n=365, 78.7% vs. n=355, 76.5%, p=0.47) and similar adverse neonatal outcomes (n=75, 16.2% vs. n=84, 18%, p=0.48) as defined in the study. On regression analysis correcting for pre-pregnancy hypertension, diabetes, hypothyroidism, BMI at booking and mode of conception, elderly pregnancy increases the risk of adverse pregnancy outcomes by an Odds of 2.4 (95% CI 1.73 to 3.20).

Conclusion

Elderly women are an increased risk of having adverse pregnancy outcomes, elective C-section, earlier gestational at delivery and increased neonatal morbidities. 

Biography:

I am 33 years old. I graduated from Tarbiat Modares University in 2010 in midwifery. I am currently a Ph.D. student of reproductive health of Shahid Beheshti University and I teach at the Azad Islamic University of Qom branch.

Abstract:

Preeclampsia is potentially life-threatening and dangerous complications of pregnancythis study were performed to assess the relationship between blood lead levels with preeclampsia. This longitudinal (prospective) study conducted on 1033 pregnant women who came to prenatal clinics of Tehran city, IRAN. The gestational age of mothers upon entry in the study was 14-20 weeks. Demographic questionnaire and reproductive history was completed and also a venous blood sample was taken from all the pregnant women upon entry. Preeclampsia was defined as blood pressure equal or more than 140/90 mmHg along with proteinuria after 20th week of pregnancy. In present study, the incidence of preeclampsia was 1.9% .mean level of maternal blood lead was 4.7±4.9 µg/dl. There was a significant relationship between maternal blood lead levels and preeclampsia. The results of this study showed that the high blood lead levels in early pregnancy can causes preeclampsia and regard to importance of it to prevention of its complication, Its requires to more consideration and advise.

KEYWORDS: Preeclampsia, Maternal blood lead levels, Pregnancy.

Biography:

-           Jordanian Board in OBGYN.

-           Consultant Obstetrician and Gynecologist, Head of OBGYN ED till 2016, Al-Yamamah Women and Children's Hospital, Ministry of Health, Riyadh /Saudi Arabia.

-           Member and cofounder of Optimizing Maternal Mortality and Healthcare Advisory Taskforce (OMMAHAT) established in 2015.

-           Member and cofounder of the Critical Obstetric Care Group (COC) established in 2011, Riyadh/ Saudi Arabia.

Since 2008, special interest in OBGYN emergency and critical care as a unique specialized unit serving high risk population.

- Since 2000, special interest in legal medicine and bioethics.

Abstract:

- Critical, because all these areas deal with critical patients.

- Maternity, because all are related to pregnant women.

- Complex, because they congregate nearby in one area.

OBGYN Emergency Room:

Is the main reception of any case coming, it is a specialized ER that deals with Obstetrical and gynecological cases by triaging them and accordingly to their final destination.

Operating Room:

An operating room(s) that is dedicated for OBGYN emergency cases.

Labor and delivery Room:

For those in active labor, an area for active management.

High Dependency Unit:

It is an intermediate care unit, or step down, or level-I ICU.

-  It is one area from administration point of view; all the policies are carried out similarly in all areas, like medication protocols, booking priority code, admission discharge policies….etc. By this, work process is carried out in harmony.

- Once a patient is admitted through ER any further destination within the CMC is like moving a patient from one bed to another within the same ward, thus preventing bureaucracy, delay in care, personal conflicts, and jeopardy to patient's safety.

- Any obstacle, problem, or complaint is easily monitored and corrected.

-  Any point of care test can serve the whole area, like a CBC machine, or coagulation profile, or patient controlled analgesia PCA pump….etc.

- Interdepartmental relation between the CMC and radiology department, laboratory and blood bank, pharmacy, will be more defined and clear.

- Forms, check lists; flow charts are unified.

- Data, census, quality indicators, and performance, all are unified.

-  OVR's, supply, maintenance, baby protection, infection control, patient safety, training, rotation of staff from one area to another, familiarity with different places is so helpful and important.

-  Code Orange (massive transfusion) implementation will be easier and more reliable.

Biography:

Eman A Elgindy, MD, PhD (Maastricht University, the Netherlands)

Professor Obstetrics and Gynecology, Zagazig University, Egypt. Director of Rahem Fertility center, Egypt.

Abstract:

PCOS is the most common endocrine disorder in women, with a prevalence of 15% when Rotterdam criteria are applied. Three ESHRE/ASRM PCOS Consensus Workshops were performed.  They put outlines for diagnosis, evidence-based treatment and women’s health aspects of PCOS. In current presentation, there will be an emphasize on the first 2 workshops guidelines. Reconsideration of some of these guidelines will be addressed in accordance with the up to date evidence and best practice approaches 

Biography:

Dr. Kais Razzouk
Breast Surgery - Breast Reconstruction
Gynecological surgery
Gynecological and mammary cancerology
Nice Santa Maria Breast Institute

Abstract:

Introduction:

Breast reconstruction after total mastectomy and irradiation is a real challenge for the surgical teams. And is a crucial step for the patient in the life after breast cancer. The effect of radiotherapy on the skin often leads to preferring the reconstructions by flaps. However, reconstructions by prosthesis carries a high risk of complications and unsatisfactory cosmetic results. The optimization of skin trophicity by lipofilling and its positive impact on the results of secondary prosthetic breast reconstruction led us to perform an autologous fat grafting prior to secondary implant breast reconstruction after mastectomy and radiotherapy.

Patients and method:

All patients were treated at the same center between 2012 and 2015. They all had a total mastectomy and irradiation. They all had one or more sessions of lipofilling prior to breast implant reconstruction. Patients were followed to collect this data: postoperative complications, prosthesis removal, cosmetic result, and tumor recurrences. Results: Fifty-four patients were included. The mean pre-pectoral lipofilling session was 1.1 (1-2). The average volume of fat injected is 150cc (80-250). The average time between the end of treatment and the first session of lipofilling is 20.4 months (3-60). The mean volume of the prosthesis is 400cc (290-620). The mean follow-up time is 22 months. No local tumor recurrence was reported. One patient had a cutaneous necrosis after lipofilling. Implant explantation was performed in three cases (5.5%). The mean cosmetic result is 4.7 (3.5-5).

Conclusion:

Pre-pectoral lipofilling prior to implant breast reconstruction improves the chances of success by optimizing the trophicity of the skin. It significantly reduces the risk of prosthesis explantation.

We consider that this technic is a way for a minimal invasive breast reconstruction.

Biography:

H.M. Youssef

Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Egypt,  Mansoura IVF-ET Center 

Abstract:

A 34 years old gravida three para 1, presented for the first time to our department at 14 week gestation with single living cervical ectopic pregnancy. The patient was admitted and the diagnosis was confirmed. Following counseling and a written informed consent obtained for hysterectomy the patient was scheduled for surgery. Laparotomy was done and a loop was applied on the anterior division of the internal iliac arteries on both sides. The peritoneum of the lower uterine segment was dissected to expose the cervix and to free the urinary bladder. Both uterine arteries were ligated. A c-shaped incision was done on the upper part of the cervix, the fetus was gently and easily extracted and the cervix was digitalized to manually remove the placenta. The cervical canal was explored and an intra-cervical balloon tamponade was applied. The anterior division of the left internal ileac artery was ligated and the loop on the right internal ileac artery was removed because the bleeding was controlled. The patient received 2 units of packed RBCs. The postoperative period passed smooth and the catheter was deflated gradually after 2 days. The patient was followed up by β-HCG estimation after discharge until it became negative

Biography:

Dr Sujoy Dasgupta is currently working as a Consultant in Reproductive Medicine & Surgery at Genome - The Fertility Centre, Kolkata, India. He has his expertise in evaluation and passion in improving the fertility treatment and reproductive health. He presented papers and posters in various national and international conferences. He has been invited to deliver lectures in more than 40 conferences at regional, national and international levels. He has, to his credit, 15 research publications at national and international journals and chapter contributions in three text books. He takes keen interest in medical education, particularly for trainee doctors. He has also been involved in “MRCOG Orientation programme” for training the doctors aspiring for MRCOG. His area of interest includes male subfertility, recurrent pregnancy loss, low cost IVF and fertility treatment in sexual dysfunction.

Abstract:

Statement of the Problem: Semen analysis is an integral part of evaluation of a subfertile male. Because a semen result reflects the genital tract health of a man three months prior to collection, there is risk of significant day to day variation. Additionally, the results vary from one laboratory to another. In 2010, the WHO published recommendations on standard reporting of semen analysis. A number of Western studies found the lack of uniformity among the laboratories in assessing and reporting semen samples. Our study looked into the adherence of reporting of semen analysis with the WHO 2010 guidelines.

Methodology: An observational study has been carried out after collecting semen analysis reports from different parts of Eastern India and Bangladesh. The sources of the reports included individual patients presented to subfertility clinics and gynaecologists, reports sent by the patients online to their treating doctors and directly from the laboratory. The reports were subsequently analyzed against the standard of semen sample reporting recommended by the WHO, 2010.

Findings: Majority of the laboratories did not follow all the standard points laid down by the WHO. Although all of the laboratories mentioned sperm concentration and morphology, majority of them did not report motility properly. Regarding physical characteristics, there have been discrepancies in reporting pH and viscosity. Very few laboratories used reference values, and among those who the values, large portions were still not using the WHO 2010 criteria. However, most of the laboratories attached to the ART (Assisted reproductive Technology) clinics performed better in terms of reporting than non-ART laboratories.

Conclusion & Significance: Even more than seven years after publication of WHO 2010 guidelines for semen analysis, majority of the laboratories do not adhere to the all the recommendations. There is need for increased awareness for the laboratory persons in this regard. 

Biography:

Diana Thomas is the Founder and CEO of The World Egg Bank. In 1985, she graduated magna cum laude with a M.A from Arizona State University.  After her experience with unexplained infertility, she had to find her own egg donor in the 1990s when this option was uncommon. She quickly discovered that there was a desperate need for a company that understood and empowered recipients with information and choice. She began one of the first egg donor agencies in the US.  In 2004, her egg donor agency evolved with the new technology of freezing eggs, and The World Egg Bank was formed. She has delivered thousands of donor eggs to potential parents around the world. 

Abstract:

Egg donation has been offered through IVF clinics in the US since the 1980s, but at a rare and infrequent rate. The original technology used for egg donors was difficult for both the egg donors and the recipients. The US Center for Disease Control (CDC) first began reporting egg donation cycles in 1996, the year I had my first child through egg donation, making my son one of the first 100 babies born from donor eggs in the US. In 2004, The World Egg Bank opened the first ‘commercial’ and independent egg bank in the world. By 2009, we shifted from slow freeze to vitrification technology, with Dr. Masashige Kuwayama’s vitrification and warming technology. This has allowed egg banking to become a simpler process for the recipients, making it a more popular choice for intended parents. With the increase of fertility clinics operating their own egg banks the search for a donor has become less complicated. However, it still raises the question about quality and consistency.

The World Egg Bank’s model is unique amongst all other egg banks.

§  We manage all donor processes from our own state of the art medical facility.  Our centralized model ensures we conduct all donor screening, stimulation, retrievals, and ova vitrification with optimized protocols and experienced laboratory systems and staff in our singular location. We do not run a multi-service infertility practice, nor do we hire outside clinics to manage donor cycles, perform retrieval or vitrify our ova. 

§  Our focus is entirely on providing quality donor ova. We have the highest consistent quality banked donor ova available in the US because all donor processes are managed by the same highly trained staff.

§  We have been shipping donor ova since 2004 and have been recruiting and screening donors for more than 23 years.

§  We support the recipient’s clinic at the time of first ova warming by sending one of our highly-trained embryologists to verify and assist with our protocols, at our expense.

§  We have a large roster of over 400 donors with thousands of ova already banked, ready to ship.

§  Our donors meet FDA, HFEA (UK), Canadian and Australian compliance requirements. Our laboratory is nationally certified, including specific requirements set by the states of New York and California.

§  We are science driven. Our stimulation protocols, vitrification technique, shipping system, and all related technical and operational systems are monitored to optimize outcomes.

§  The vitrified ova are shipped directly from our laboratory to any clinic laboratory that can accept imported ova, where the clinic will perform the warming, ICSI, culture, transfer, and embryo cryopreservation.

Biography:

Biologist with more than 7 years of experience as an embryologist in different in vitro fertilization clinics. At the moment I am part of the team of Minifiv in Madrid. We are a clinic specializing in natural cycle protocols and low ovarian stimulation.After years of working in the IVF laboratory, I became interested in nutrition and healthy habits and their involvement in fertility. With a master's degree in nutrition and health, whose master's work was a bibliographical review of the "importance of nutrients in the periconceptional and gestational period." Nowadays, I am training as a technical dietician, acquiring the knowledge to promote healthy habits indispensable for optimize reproductive health.

Abstract:

About 15% of couples at childbearing age have problems conceiving. There are many factors against which we can not fight as advanced maternal age, but there are others in which we can intervene, including a healthy nutrition. The relationship between optimal nutrition and fertility is demonstrated repeatedly throughout the scientific literature.

Parental nutritional status is able to intervene in the success or failure of the reproductive stages and even in the results of assisted reproduction techniques. They are involved in metabolism pathways regulating the activity of enzymes, signal transduction, transcription and oxidative stress.

The most important consequences of unhealthy nutrition or the presence of parental obesity includes menstrual disorders, infertility, miscarriage, and obstetric complications as well as mistakes in spermatogenesis, DNA fragmentation, and epigenetic changes in the methylation patterns generated in early development.

Inadequate intake of nutrients as the group of B vitamins, folate and methionine are capable of modifying DNA methylation patterns and produce mistakes ingametogenesis, fertilization, quality and embryo development, implantation and pregnancy ongoing, predisposing the offspring to different diseases.

We will carry out a review of the consequences and implications that has the dietary habits and certain nutrients throughout the reproductive stages and their relationships gene-nutrient through epigenetic mechanisms.

A new discipline emerges for the study of the dietary influence in gene expression, through changes in the epigenome: the nutri-epigenomics. Future research are needed to understand the link between DNA methylation, micronutrients intake and future consequences in the development stages. Define epigenetic biomarkers can help us to identify and prevent the risk and develop individual therapies such a nutritional interventions based on individual epigenetic profiles.

The most promising strategies are education and individual efforts with proper knowledge of healthy habits. Being the main objective the prevention of obesity and not the treatment of it and its consequences.