Scientific Program

Day 1 :

  • Gynecology and Obstetrics| Maternal Fetal Medicine| Midwifery

Session Introduction

Jonathan Hernandez-Nunez

Tshilidzini Hospital, South Africa

Title: Risk factors for preterm birth in South Africa and Algeria
Speaker
Biography:

Jónathan Hernández-Núñez is the Medical Director in Tshilidzini Hospital, South Africa. He is also a Specialist in the field of Gynecology and Obstetrics . His area of interest includes womens helathcare. he completed his master's degree in integral care for women from South Africa. His eminence in the field of Gynecology and Obstetrics helped him to prove his career as  an assistant professor and research associate in the corresponding field. 

Abstract:

Statement of the Problem: Prematurity continues to be one of the great problems of obstetrics due to the great morbidity and mortality associated with it; a clear prevention strategy to reduce preterm birth rates has not yet been reached. The purpose of this study was to identify the risk factors associated with preterm delivery. Methodology & Theoretical Orientation: A case-control study was conducted at Tshilidzini Hospital in South Africa and Mohamed Golliat Hospital in Algeria between January 2015 and December 2016. The universe was 97 patients with preterm delivery and the initial sample was matched with the universe for the group of cases, also a control group of 291 patients with term delivery were selected, all randomly selected from a list of random numbers following a 3:1 ratio; the sample was definitively made up of 89 cases and 255 controls. The data were collected through a form filled by review of the obstetric and hospital files; statistically we used the frequency distribution, mean, standard deviation, percentage, Ji square test, Student's test and Odds Ratio. Findings: The risk factors for preterm delivery were the maternal age of 35 years or older (OR = 2.94), single marital status (OR = 2.98), maternal obesity at the beginning of pregnancy (OR = 1.78 ), previous history of chronic hypertension (OR = 3.77), seven or more prior abortions (OR = 7.17), previous preterm delivery (OR = 3.46), preeclampsia-eclampsia (OR=5.99), urinary tract infection (OR = 3.41), multiple pregnancy (OR = 5.00) and oligohydramnios (OR = 6.06); not the cultural level, the toxic habits, the parity, nor the short interpregnancy intervals. Conclusion & Significance: There are multiple risk factors that predispose to preterm delivery and contribute to increase perinatal morbidity and mortality, many of which are susceptible to be modified from primary health care.

Speaker
Biography:

Mamta Ratt Datta Practices as an Obstetrics and Gynecologist at the Apollo Medicare Clinic in Jamshedpur, India. She has has 21 years of experience in the field of Gynecology and Obstetrics. Hee professional qualification includes MBBS, MD, MBCGOC Part-1 at London with specialization in Gynecology and Obstetrics. She is very much expertixes in Gynecologic filed with her eminence and practice. 

 

Abstract:

Of the 800 pregnancies studied, 140 had early miscarriage. Crown rump length (CRL), gestation sac diameter (GSD), fetal heart rate (FHR) values less than 5th percentile (OR 26.48, 26.94, 100.63 respectively) and yolk sac diameter (YSD) more than 95th percentile (OR 1.04) were significant predictors of early miscarriage. When these abnormal parameters   coexisted in any pregnancy, the miscarriage risk was significantly high (OR 35.27). A normal YSD could not significantly reduce the risk of miscarriage, if the other three parameters were below the 5th percentile (OR 35.27). Every 10 beats per minute (bpm) decrease in FHR below 130, there was a 26.73% increase in risk of miscarriage.. GSD-CRL   difference < 5mm was associated with significantly increased miscarriage risk (OR 4.88). 

S Chhabra

Mahatma Gandhi Institute of Medical Sciences, India

Title: Women's Health Journey Is On Slippery Road
Speaker
Biography:

S Chhabra is a Director Professor of Obstetrics and Gynecology in the College of Mahatma Gandhi Institute of Medical Sciences, India and CEO of Akanksha Shishu Kalyan Kendra and OSD in Dr. Sushila Nayar Hospital, Sewagram.

Abstract:

Women suffer globally, with variations in the burden of sufferings of their body and mind. On one side their body structure, functions, make them vulnerable to various disorders, on the other side, there are society’s gender inequalities and norms. The extent of the disorders with which they suffer is mammoth. In India with world’s 15% population, bias starts with attempts at prevention of a girl’s entry into her mother’s womb and female foeticide, infanticide, problems of inequalities in childhood and during adolescence are persisting. Women suffer during reproductive life and beyond. There is growing burden of infertility because of various reasons with sequale of work up, therapy, under assisted reproduction (ART) and surrogacy also. Here also it is women who suffer all the dangers of surgeries, hormones and mental trauma. Pregnancy and birth related disorders, dysfunctions continue to kill women around the world. Preventable maternal deaths and severe illnesses continue in resource poor countries and woman’s life is at stake with each pregnancy. Maternal mortality, severe morbidity have increased even in affluent America. There are consequences of reproductive health events, even with normal functions, more so with dysfunctions as they age, be it Genital prolapsed or Stress continence. Gynaecological cancers are common with challenges of early diagnosis and management. Cervical cancer almost preventable continues to kill women. Other gyn. cancers also continue to affect woman’s life around the world with delayed diagnosis and complicated therapies. Over all women have to walk on the slippery road of their health journey from prebirth to death, Womb to Tomb. All attempts need to be made to make the health journey of a woman as safe as possible by preventing preventable and for others appropriate, affordable, accessible and timely therapies.

Aboubakr Elnashr

Benha University, Egypt

Title: Prevention of infection related preterm labour
Speaker
Biography:

Dr. Aboubakr Elnashar is a Professor of Obstetrics and Gynecology at Benha University, Egypt. He is the President of clinical society of obs and gyn. He is the member of the board of Egyptian Society of Fertility & sterility from 2015 and till now. He is the editor of the Egyptian Fertility sterility Journal and the Benha Medical Journal. He is the Associate Editor of Middle East fertility Society Journal. He was the assistant secretary general of Egyptian society of fertility & Sterility (2002- 2006). Dr. Elnashar had many publications both national and international. He is managing and directing of many training courses in cytology, colposcopy, ultrasonography, foetal monitor, reproductive endocrinology and ART. Qualification includes, M.B.CH.B. (Very good with honor, 1978, Zagazig University) Post graduate qualifications 1. Master in Ob/Gyn (Very good, 1982), Zagazig University 2. Diploma in cervical pathology (1986, Barcelona, Spain) 3. Medical Doctora in Ob/Gyn (1989, Zagazig University) Post graduate appointments Registrar, assistant lecturer, Lecturer, Assistant professor Ob/Gyn in Benha Faculty of Medicine from January 1996. Appointments 1. Professor of Ob/Gyn, Benha Faculty of Medicine, Egypt, from March 2001 till now 2. Chief of early detection of cancer unit, Benha University Hospital, Egypt. 3. Consultant of IVF &ICSI in Delta Fertility Center & Benha Fertility Center, Egypt.

Abstract:

PTL is the most common cause of perinatal morbidity and mortality in the world. PTL early in pregnancy is more likely due to infection. Antibiotic prophylaxis during the second or third trimester of pregnancy is effective in reducing risk of PTL in pregnant women with bacterial vaginosis (BV) in the current pregnancy, pre-labour rupture of membranes, postpartum endometritis. Limited data showed that routine use of antibiotics during pregnancy might prevent infectious morbidity for the mother, but could not reduce neonatal morbidity and mortality. Prophylactic antibiotics is not indicated for previous PTL of unknown aetiology but for abnormal genital tract microflora detected in current pregnancy. BV is more likely to respond to oral clindamycin than metronidazole. 

  • Reproductive Medicine | Infertility

Session Introduction

Gopa Chowdhury

Rajendra Institude of Medical Sciences, India

Title: PCOS and Pregnancy Outcome
Speaker
Biography:

Dr Gopa Chowdhury, Rtd. Associate Prof, Obstetrics & Gynaecology, MD, FICOG, has her expertise in different areas of Gynecology and Obstetrics and is passionate about spreading her knowledge through papers, articles, Knowledge sessions and her work with patients in the rural region of Jharkhand. She is an Executive member of ROGS and has held different positions as Speaker, Panelist, Chair-person in ROGS and National conferences. Dr Gopa was also the Vice President – FOGSI ROGS (Ranchi Obst, & Gynae Society); 2013-2015 and is an ongoing active member of the group. Besides her work as Associate Prof., she Several Papers published in State, National, International Journals and has been an active participant in CMEs, Conferences (State, National, International): FIGO-SAFOG, RCOG, FIGO, AOCOG, SICOG (oral and paper presentation), National-YUVA-FOGSI, AICOG as delegate and faculty

Abstract:

Polycystic ovarian syndrome (PCOS), an intergenerational condition, is one of the most common endocrine syndrome affecting the reproductive system, encompassing metabolic, cardiovascular, dermatological, psychological conditions starting from adolescence. 4-8% prevalence in reproductive age. Effects manifest via deranged hormone profile with main complaints of menstrual irregularity, hirsutism, and infertility.

Diagnostic criteria:

GDM-50-100 gm oral glucose tolerance test, PIH-BP >= 140/90 mm of Hg with Protinuria >= two by dipstick (>3gm / 24 hr.). Gestational age >= 20 weeks, premature delivery < 37 weeks

Results: Conception:

  • After Metformin 49% (1345)
  • After Ovulation induction with Clomiphene Citrate 37% (1016)
  • After Gonadotropin 0.3% (82)
  • No turn up 11% (303).
  • Women with PCOSare at higher risk for pregnancy complications. 69% (1686) delivered after 37 completed weeks. 23% (562) before 37 weeks. 8% (195) spontaneous abortion.
  • Significant obesity. BMI >= 25 present in 72% (1686)
  • Major pregnancy complications:
  • PIH 54% (1213), GDM 56% (1258), premature delivery 23% (517)
  • Caesarean delivery high in 32% (719) mainly due to GDM causes big baby and severe PIH 29% (652)

Aboubakr Elnashr

Benha University, Egypt

Title: Antioxidants for female infertility: Review of systematic reviews
Speaker
Biography:

Dr. Aboubakr Elnashar is a Professor of Obstetrics and Gynecology at Benha University, Egypt. He is the President of clinical society of obs and gyn. He is the member of the board of Egyptian Society of Fertility & sterility from 2015 and till now. He is the editor of the Egyptian Fertility sterility Journal and the Benha Medical Journal. He is the Associate Editor of Middle East fertility Society Journal. He was the assistant secretary general of Egyptian society of fertility & Sterility (2002- 2006). Dr. Elnashar had many publications both national and international. He is managing and directing of many training courses in cytology, colposcopy, ultrasonography, foetal monitor, reproductive endocrinology and ART. Qualification includes, M.B.CH.B. (Very good with honor, 1978, Zagazig University) Post graduate qualifications 1. Master in Ob/Gyn (Very good, 1982), Zagazig University 2. Diploma in cervical pathology (1986, Barcelona, Spain) 3. Medical Doctora in Ob/Gyn (1989, Zagazig University) Post graduate appointments Registrar, assistant lecturer, Lecturer, Assistant professor Ob/Gyn in Benha Faculty of Medicine from January 1996. Appointments 1. Professor of Ob/Gyn, Benha Faculty of Medicine, Egypt, from March 2001 till now 2. Chief of early detection of cancer unit, Benha University Hospital, Egypt. 3. Consultant of IVF &ICSI in Delta Fertility Center & Benha Fertility Center, Egypt.

Abstract:

Main results and the role of chance: Three Cochrane SR and Three non Cochrane SR. Evidence was insufficient to support the use of pentoxifylline in the management of endometriosis in terms of subfertility and relief of pain outcomes. 2. There is some but limited evidence for the beneficial effects of vitamin D supplementation on menstrual dysfunction in polycystic ovary syndrome (PCOS) 3. Myo-inositol provided a beneficial effect for PCOS. 4. Antioxidants; were not associated with an increased life birthrate (LBR) compared with placebo or no treatment. 5. Combined antioxidants were associated with clinical pregnancy rate (CPR). 6. An association was seen between antioxidants and CPR in women with PCOS; however, heterogeneity was extremely high. 7. No association was seen between antioxidants and CPR in women with endometriosis or unexplained infertility. 8. Pentoxifylline was found to be associated with an increased CPR. Limitations, reasons for caution: Despite numerous advances in antioxidant, there is a need for further randomized controlled studies within a larger population to determine their efficacy and safety.Wider implications of the findings: Antioxidants are readily available, mostly unregulated. Significant number of infertile females is taking antioxidants in the expectation that this will improve their chances of conception

Speaker
Biography:

Wenxin Zheng, M.D., tenure Professor of Pathology and Obstetrics and Gynecology, American board certified pathologist, director of the Gynecologic Pathology and Molecular Pathology program at the University of Arizona, graduated from Shanghai Medical College Fudan University and trained at Columbia University, Cornell University, and Brown University Medical Centers in anatomic pathology and gynecologic pathology. Dr. Zheng is an internationally recognized gynecologic pathologist with expertise in hormonal etiology of sporadic ovarian cancer, type II endometrial carcinogenesis, and hormone replacement therapy.

Abstract:

Background: Ovarian low-grade serous carcinomas (LGSC) are thought to evolve in a step-wise fashion from ovarian epithelial inclusions (OEI), serous cystadenomas (SC), and serous borderline tumors (SBT). Our previous study showed that the majority OEIs are derived from the fallopian tubal epithelia (FTE) rather than from ovarian surface epithelia (OSE). This study was designed to gain further insight into the cellular origin of LGSC by differential gene expression profiling studies. 

Methods: Gene expression profiles were studied in 44 samples including 11 LGSCs, 7 SBTs, 6 SCs, 6 OEIs, 7 FTEs, and 6 OSEs. Correlation analyses of ovarian serous tumors including its precursor OEIs with FTE and OSE samples were performed by unsupervised hierarchical clustering. Rank-sum analyses and Pearson correlation tests were then applied to determine the likelihood of cellular origin of LGSC and its precursors. Final validation was done on selected genes and corresponding proteins.

Results: Gene expression profiles distinguish LGSC from OSE, but not from FTE cells. Furthermore, dendrograms produced by unsupervised hierarchical clustering showed ovarian serous tumors and OEIs were clustered closely in a branch, but separated from OSEs. After ascertaining the reliability of sequencing data, we found that OVGP1, WT-1, and FOM3 highly expressed in fallopian tube and OEI, and ovarian serous tumors, but not in OSE. In contrast, ARX and FNC1 were mainly expressed in OSE, but not in other studied samples.   

Tamer A Hosny

Alexandria University, Egypt.

Title: Two Oophoropexy for ovarian torsion: 3 a new easier technique
Speaker
Biography:

Dr. Tamer Hosny was born in 1980 in Egypt. He studied medicine at Alexandria University, Egypt  and graduated in 2003. He is a lecturer at the Department of Obstetrics and Gynecology at Alexandria university. In 2013, he was awarded the European Inter university Diploma of Advanced Operative Laparoscopy by the University Of Auvergne, France. In 2014, he got his Phd study in reprodcutive syrgery. ALso he got a fellowship in Chu Estaing, Clermont ferrand , France. At 2016 he awarded GESEA Diploma Special interests lie in the field of MIS in gynecology. 

Abstract:

Oophoropexy for ovarian torsion is easily done by many tools either by suturing to the lateral pelvic wall, plication of  the ovarian ligament, or even fixation to the back of the uterus, but it is a little bit difficult to do for pregnant women with less manipulation. We propose that using a trocar site closure needle can be an easier and faster technique to do  this. Seven patients presented with ovarian torsion; four of them were pregnant at 7, 15, 19, and 20 weeks of gestation,  two patients had ovarian hyperstimulation in IVF cycles, and one adolescent patient had a hemorrhagic cyst. They were diagnosed by clinical presentation and ultrasound with Doppler analysis and confirmed by laparoscopy where they underwent detorsion and fixation of the ovary using the trocar site closure needle. Follow-up of all the cases after 1 week showed improvement of the symptoms and then normal Doppler flow of the target ovary after 3 weeks by ultrasonography which revealed normal Doppler flow in the previously torsioned ovary. Two pregnant women underwent cesarean delivery where the operated ovary was observed during the delivery and was normal in shape and freely mobile with no adhesions. We propose that this technique is easier, faster, and more comfortable especially in ovarian torsion in pregnant women and torsion in hyperstimulated ovaries

  • Uro- Gynecology | Gynecological Oncology

Session Introduction

Pravin Mhatre

Seth G.S. Medical college,K.E.M. Hospital and N.Wadia Hospital, India

Title: New Laparoscopic vaginoplasty developing normal vagina, Identification of the progenitor cell and Genetic decoding of MRKH syndrome.
Speaker
Biography:

Dr. Pravin Mhatre is the Scientific Director of Kedar Hopital which has already made its mark as one of the reputed hospitals for gynecology services in India. Dr. Mhatre is a consultant to the Breach Candy Hospital, N. Wadia Hospital in Mumbai. He  has done pioneering work in the field of Ovarian Transplant and has been credited with world's first successful "Ovarian Transplant".He has developed a new Vaginoplasty technique resulting in formation of normal Vagina and identification of Stem cell. He has performed more than 100 cases of Vaginoplasty. Dr. Mhatre has served as Honorary professor emeritus of Gyn/Obst at Seth G.S. Medical college / N. Wadia Hospital for 30 years.For more than 8 years Dr. Mhatre has conducted many rural tubal ligation camps all over India. For this honorary contribution in women's heath care his team has received Presidents Medal from government of India. Dr. Mhatre has delivered guest lectures in many international and national congresses and has been an invited Professor at Oxford University (UK), University of Georgia (Atlanta USA) & Colombo University.  Dr. Mhatre has been honored as first Gyn.Transplant surgeon by government. He has been Interviewed on BBC London / Asia live on 7th May 2002 and 18th December 2002 for the worlds first successful Ovarian Transplant. BBC World on 24th December 2002 declared this Ovarian Transplant as The significant medical achievement of the year 2002.He has started the First Ovarian Bank in 2005, currently in joint collaboration with NIRRH and TATA Hospital

Abstract:

Host of vaginoplasty techniques have been described. None has been successful in developing normal vagina. Modified laparoscopic peritoneal vaginoplasty (LPV) by Dr. Mhatre’s technique is performed in Mayer–Rokitansky–Küster–Hauser syndrome (MRKHS) culminating in normal vaginal development.These serial metaplastic changes converting peritoneum to normal vagina are documented and the progenitor cell responsible for this change is identified.

  • This study aims to confirm normal development of neovagina by anatomical and functional parameters of histology, cytology, and ultrasonography (USG) with Doppler in LPV.
  • To identify peritoneal progenitor cell by OCT4/SOX2 immuno-histochemistry markers.
  • To demonstrate the metaplastic conversion of peritoneum to neovagina and the progenitor cell concentration, distribution pattern.

This is prospective experimental study, conducted at teaching hospital and private hospital. Seventy-five women of MRKHS underwent LPV followed by histology, cytology, pH, three / four dimensional USG along with Doppler blood flow of neovagina. Nine women underwent peritoneal biopsy for identification of progenitor cells with OCT4/SOX2 markers. One patient underwent serial biopsies for 4 weeks for histology and progenitor cell immunohistochemistry.Eighteen women of MRKH and fifteen controls were subjected for genetic workup.