7^th International Conference on Gynecology and Obstetrics October 19-20, 2020 Rome, Italy

Biography:

Alo Oluwafemi David has completed his Masters in Biostatistics from the University of Ibadan in Nigeria. He is a senior data analyst at Marie Stopes International Organization, Nigeria. He has published more than 3 papers in reputed journals.

Abstract:

The population of Nigeria is projected to increase by 44% between 2015 and 2030. However, less than one-quarter of women within reproductive age in Nigeria uses modern contraceptive methods despite its importance in slowing unsustainable population growth and reduction of maternal morbidity and mortality. This study aims at examining the influence of individual and community level factors on the use of modern contraceptive method.

This is a secondary analysis of household and Service Delivery Point datasets from a 2018 survey conducted by PMA2020 in Nigeria. Data was abstracted for a total of 10,826 females within ages of 15 – 49 years across 295 enumeration areas in seven States. A 2-level binary logistic regression was used to examine the association between study variables and use of modern contraceptives while adjusting for the clustering effect.  There was significant influence of age, educational level, parity, socio-economic status, intention to have children in the future and awareness of family planning methods on the use of modern contraceptives. Also, women who perceived support from someone in the community on family planning were more likely to use modern contraceptive unlike those without such support. Those who believed that contraceptive methods are used by almost all and some of their friends or relatives were more likely to use modern contraceptive compared to those who think otherwise.

The study shows the need to reduce inequalities between FP utilization across women with different socio-economic status as well as increasing the awareness for modern contraceptive methods.

Biography:

Dr. Ana Katrina Rubin-Siton had  her degree of doctor of medicine from the University of Santo Tomas and completed her residency training at the Departement of Obstetrics and Gynecology in the University of Santo Tomas Hospital Phlippines, wherein she was the chief resident during her 4th year. She has presented her previous case report in the 20^th International Meeting of the European Society of Gynaecological Oncology that was held in Vienna. Austria, last November 2017.   She has also won a 1st prize in oral presentation in the Society of Gynecologic Oncology of the Philippines, held last  July 2018.

Abstract:

Postpartum hemorrhage has an estimated mortality rate of 140,000 per year or one maternal death every four minutes¹ WHO in 2017 estimates that in India, 529,000 maternal death occur every year, wherein 136,000 or 25.7% of death takes place and two third of these deaths occur after delivery. ¹

Objectives

To study the effectiveness of prophylactic administration of tranexamic acid in reducing blood loss in low transverse cesarean sections and to determine side effects.

Methodology

Participants were randomized into two groups by simple randomization and assigned to their treatments accordingly after being satisfying the eligibility criteria. The study group was given 1 g TA administered intravenously 10 minutes before the start of the cesarean section; in addition to 10 IU oxytocin per IV after delivery of the baby. The control group was given a corresponding volume of sterile saline as placebo (10 mL) and also received 10 IU oxytocin intravenously (IV) after delivery of the baby.

Results

Tanexamic acid group had significantly lower amounts of blood loss compared to those in the placebo for all time endpoints both from the total blood loss from placental delivery and 2 hours postpartum. Two side effects were noted in study group, nausea (35%) and vomiting (7%).

Conclusion

Tranexamic acid reduces the risk of post-partum bleeding by 26.32% (ARR 95% CI 17.46% to 35.17% risk reduction in PPH), and the number needed to treat to prevent one adverse event is 4 patients. It did not show significant maternal adverse effect nor fetal side effects.

Biography:

She is Assistant Professor in CKM Hospital

Abstract:

Abstract:

Premenarchial transvers vaginal septum is a benign condition. The incomplete vertical fusion or failure of canalization  of  urogenital sinus and Mullerian duct results in a transverse vaginal septum that varies in thickness and can be located at almost any level in the vagina with prevalence in superior vagina - 46%, mid vagina - 40% and inferior vagina – 13%,usual presentation as primary amenorrhoea and cyclic pelvic pain. The incidence varies from 1:2100 to 1:70,000.

Case Report:

A case report of 14-year-old female came to hospital in December 2018 with complain of acute lower abdominal pain, severe in intensity along with difficulty in passing urine since 2 days. She had similar complain 2 months back for which urine was drained with catheter and history of not yet attend menarche and cyclical lower abdominal pain since 8 months was obtained from her mother. On general examination she had normal secondary sexual characteristics with normal development of breast and pubic hair .On abdominal examination abdominal mass of 12 weeks with suprapubic tenderness found. Urine was drained with foleys catheter of around 1500ml .External genitalia are normal. In vagina approximately 1 to 2cms deep,  transverse vaginal septum with no bulging seen. On per rectal examination vagina was bulky tender, tense cystic mass felt over vagina. USG revealed heamatocolpos with normal kidneys and ureters. An excision of vaginal septum done , 400ml dark chocolate liquid collected , marsupialization of the edges done. Cervical catheter and vaginal stent left in situ and removed on14 post op day and discharged by instructing how to use vaginal dilator for 3 months to keep vagina patent and on OCP. She had resumed normal menstruation and no other complaints.

Conclusion:

Transverse vaginal septum is a developmental failure of vertical fusion of female genital tract, the incidence of which is rare with unknown aetiology. The usual presentation of the condition is either in neonatal period with mucocolpus, or at are after puberty with pain – amenorrhea and hematocolpus difficulty in micturition ,for which surgery is the mode of treatment.

Biography:

Dineth Adrienne C. Gutierrez is a resident trainee in Obstetrics and Gynecology at Mary Johnston Hospital in Manila, Philippines. She obtained her undergraduate degree in Bachelor of Science in Psychology at De La Salle University-Manila and her Doctor of Medicine degree from Pamantasan ng Lungsod ng Maynila College of Medicine.

Abstract:

ABSTRACT: Schistosomiasis is a tropical disease caused by parasitic flatworms of the genus Schistosoma that enter the human body through the skin. The different species of these schistosomes have predilections for specific organs in the body, and signs and symptoms depend on which areas are affected. Cases of Schistosomiasis of the female reproductive tract are rare but have been seen in areas of the world where Schistosoma haematobium, in particular, is endemic. When Schistosomiasis involves the fallopian tubes, it produces fibrotic scars and tubal occlusion, leading to infertility and ectopic pregnancy. A thorough literature search has revealed no reported local case of tubal Schistosomiasis to date. Furthermore, the only Schistosoma species that has been found in the Philippines is Schistosoma japonicum, while the species most often isolated in tubal Schistosomiasis, in contrast, is Schistosoma haematobium. A case of a 32-year-old primigravid from Northern Samar, with amenorrhea of 8 weeks and 5 days, who presented with vaginal spotting and hypogastric pain is hereby reported. She underwent salpingostomy for ectopic pregnancy and was later, upon histopathological examination, found to have tubal infection by Schistosoma, which was treated with Praziquantel. This case is note-worthy because of the following reasons: a) no local case reports on tubal Schistosomiasis are currently available based on literature search; b) Schistosoma haematobium, the major species implicated in Schistosoma infection of the fallopian tube, is not found in the Philippines; and c) the finding of Schistosomiasis concomitant with a tubal pregnancy in a previously asymptomatic patient is quite rare. This case report highlights tubal Schistosomiasis, despite its rarity in the Philippines, as a significant risk factor for ectopic pregnancy. Knowledge on this disease and a high index of suspicion is important in managing affected patients.

Biography:

Dr. Bautista has her expertise in the field of Maternal Fetal Medicine and Ultrasound in Obstetrics and Gynecology, with further training in Ultrasound of Gynecologic Malignancies.  She is a graduate of the Fellowship Training in Perinatology at the Manila Central University in the Philippines.  She is presently taking her Masters in Hospital Administration. She is also the Assistant Training Officer in the Department of Obstetrics and Gynecology of Dr. Pablo O. Torre Memorial Hospital, and a Professor at the University of St. La Salle Medical School. She has presented various case reports and research papers in different conferences locally and abroad. 

Abstract:

Statement of the Problem:

Cervical cancer in pregnancy is a challenge to the obstetrician, oncologist and perinatologist.

This is a case of a 38 year old G4P2 (2012) who, during her prenatal course, was diagnosed with Squamous Cell Carcinoma of the Cervix.  The patient is a smoker with multiple sexual partners. Early in her pregnancy, she underwent a Pap smear which revealed Atypical Glandular Cells of Undetermined Significance.  Cervical punch biopsy was done revealing squamous cell carcinoma, which on clinical staging was at Stage IIA.  This paper aims to present a case of cervical cancer in pregnancy, present management options, and discuss the role of prenatal ultrasound in decision making for cervical cancer.

Methodology & Theoretical Orientation: A gynecologic oncology ultrasound was done to assess the tumor invasion.  2D ultrasound outlined the size of the mass, its stromal invasion.  Doppler ultrasound demonstrated abundant vascularization, in scattered vessel pattern. The scan further demonstrated absence of parametrial invasion, thus, after a course of corticosteroids, the patient subsequently underwent Radical Hysterectomy, Bilateral Salpingo-oophorectomy, Bilateral Lymph Node Dissection at 36 weeks gestation.

Findings: Patient delivered at 36 weeks to a live baby boy, via classical cesarean section with radical abdominal hysterectomy with bilateral salpingo-oophorectomy, and bilateral lymph node dissection.  Gross examination revealed a tumor at the cervix, with no involvement of the uterine corpus and parametria.  Histopathology report showed invasive squamous cell carcinoma, large-cell non-keratinizing, with invasion of the upper vaginal wall, but with no parametral infiltration. 

Conclusion & Significance: This case shows that although there is a small risk of tumor progression, delaying definitive treatment may be done in early stage disease to improve fetal outcome. A multidisciplinary team is required to make thorough investigations to determine the stage and extent of invasion as well as to make best decisions regarding time and mode of delivery.

Biography:

Khawla Al-Kuraya, a distinguished physician-scientist, is the Director of the Research Centre at King Fahad National Centre for Children’s Cancer, King Faisal Specialist Hospital and Research (KFSH) in Riyadh, Saudi Arabia. After receiving her Medical Degree from King Saud University School of Medicine in Riyadh, Saudi Arabia, she completed her Residency and Fellowship in Pathology at Georgetown University Hospital in Washington D.C. Dr. Al-Kuraya is a leader in the field of genomic cancer research. She is widely respected as Translational Scientist whose work bridges the laboratory and clinical settings. She has focused on identifying molecular signature of common Saudi tumors utilizing the recent technologies in the cancer genetic field. An author of over 120 original research articles, editorials, review articles and book chapters. Dr. Al-Kuraya’s professional memberships include the American Association for Cancer Research, College of American Pathologist and the American Society of Human Genetics. She also serves on numerous editorial boards. Dr. Al-Kuraya is the first Saudi female recipient of the prestigious “First Rank King Abdulaziz Medal” for her pioneering initiatives in cancer research, and served as a member of the Saudi Shura Council (Inter-Parliamentary Union) of the Kingdom of Saudi Arabia.

Abstract:

Background: High-grade serous ovarian carcinoma (HGSOC) is the most frequent type of ovarian carcinoma with poor clinical outcome; patients with metastasis have dismal survival. The complex process of metastasis is becoming more understandable with the use of next generation sequencing. The genomic landscape and pattern of tumor evolution from HGSOC to distant metastasis have not been elucidated.

Methods: In this study, multi-region whole-exome sequencing (WES) was performed on HGSOC primary tumors and their metastases (n=33 tumor regions) from 6 patients to understand the tumor evolution and metastatic dissemination of HGSOC tumors. The resulting catalog of variants was analyzed to explore evolutionary histories and compare the repertoire of events between primary and metastasis.

Results: All 6 cases presented branching evolution patterns in primary HGSOC, with three cases further showing parallel evolution in which different mutations on separate branches of a phylogenetic tree converge on the same gene. Linear metastatic progression was observed in 4/6 cases with late dissemination in which the metastatic tumor mostly acquires the same mutational process active in primary tumor and parallel metastatic progression, with early dissemination in the remaining 2/6 cases. Metastatic specific SNVs were confirmed to be late dissemination events. We also found the involvement of metastatic specific driver events in WNT/β-Catenin pathway. Larger studies utilizing multi-region sequencing in metastatic high-grade serous ovarian cancer cases with matching primary tissues are needed to confirm these observations. Conclusions: The study provides deeper insights into clonal evolution and mutational processes that can pave the way to new therapeutic targets.

Biography:

Mai Abul has completed her M.Sc. at the age of 27 years from Kuwait University and currently doing her PhD studies in Kuwait University, Faculty of Medicine, Department of Physiology. She is working as Teaching Assistant in the Department of Physiology in Kuwait University. She is interested in neuroendocrine research/studies. She has published one paper and working toward publishing more.

Abstract:

Fetal exposure to dexamethasone (DEX), a synthetic glucocorticoid, alters brain plasticity and cognitive functions during adulthood in a sex-dependent manner. The mechanisms underlying such long-lasting sex-dependent change of prenatal DEX is not yet well understood. The p73 gene plays an important role in the development of the brain. It encodes for two protein variants; the neural cell death protein (TAp73) and the anti-neural cell death protein (ΔNp73). Therefore, we sought to determine how prenatal exposure to DEX alters the expression of these p73 gene variants in the brain of male and female fetuses. Pregnant dams received intraperitoneal daily injections of either DEX (0.4 mg/kg, i.p.) or saline from gestation day (GD) 14 until GD21. On GD21, both body and brain weights were monitored and mRNA and protein levels of TAp73 and ΔNp73 were measured in male and female fetal brains using RT-PCR, Western blot, and immunohistochemistry. Prenatal exposure to DEX significantly reduced the body weight and brain weight of both male and female fetuses, although reduction in brain weight was less severe than that of the body weight. Administration of DEX to pregnant dams led to enhanced expression of both TAp73 and ΔNp73 gene/protein variants in the brain of male fetuses but not in that of female fetuses. Dexamethasone induced a sex-dependent effect on the expression of p73 gene variants. DEX-induced growth restriction in the brain of female fetuses is independent of p73 gene. This study strongly suggests that survival/death programs operate differently during the development of male and female brains.

Biography:

Mariam Alqaryyan has completed her MSc at age of 26 years from Kuwait University college of medicine. She is working as Teaching Assistant at Departments of Physiology Faculty of Medicine, Kuwait University, Kuwait. She is interested on endocrinology researches. She has published 2 papers, and more are working on. She is supervising medical and MSc students.

Abstract:

Molecular mechanisms affecting placental formation in intrauterine growth restricted (IUGR) pregnancies are not clearly understood. Since metastasis tumor antigens (MTA), MTA1 and MTA2 promote cell proliferation and MTA3 suppresses it, we hypothesized that IUGR alters cell survival/cell death programs driven by placental MTAs. To induce IUGR, pregnant Sprague-Dawley rats were given daily intra-peritoneal injections of either saline or Dexamethasone (0.4 mg/kg) starting from 14 days of gestation (dg) to either 19dg or 21dg. Gene and protein expressions of MTA1-3 in placental basal and labyrinth zones were investigated by real-time PCR, Western blotting and immunohistochemistry. We also explored the expressions of proliferating cell nuclear antigen (PCNA), caspase-3, p53, p21 and β–catenin. Dexamethasone-induced IUGR resulted in decreased expression of MTA1 in nuclei of cells in the basal zone. The expression of p21 was increased and that of PCNA was reduced in both placental zones of IUGR rats. Cytoplasmic expression of MTA1 and p53 increased in the labyrinth zone of IUGR placentas in association with an increase in cell death as indicated by an increased caspase-3 expression. The labyrinth zone of IUGR placentas showed a significant reduction in MTA2-3 gene expression and an increase in p53 protein levels. Total MTA3 level increased and β–catenin level decreased in the labyrinth zone of IUGR placentas associated with a reduction in cell proliferation. Taken together, these results strongly suggest that dexamethasone-induced IUGR is associated with changes in MTA expression, decreased cell proliferation and increased cell death in placentas.

Biography:

DR Vinita Singh is working as Associate Professor of Obstetrics and Gynaecology at AIIMS Raipur, India. She completed her MBBS , MD at the age of 26. She has published more than 15 paper in reputed peer reviewed indexed journal. She is a fellow of Indian  College of Obstetrics and Gynaecology (FICOG). Fellowship in WHI (Women Health Initiative) training programme on Gynecological Endoscopy, 2016.  NTTC, JIPMER - National Course on Educational Science for Teachers of Health Professionals, 2016 .  ART Training, 2014, 2015, PUNE.  Urogynaecology training & vaginal reconstructive surgery training, Ahmadabad, Dec 2016 

Abstract:

Vitamin D apart from bones has role in other organs as it’s receptor is also expressed in the ovary, placenta, and the uterus. Lower vitamin D has been related to premenstrual syndrome, uterine fibroids, dysmenorrhoea and early menarche. The promoter region for the gene encoding anti-Müllerian hormone (AMH) contains a domain for the vitamin D response element, suggesting that vitamin D can regulate AMH expression.  AMH in turn regulates follicular recruitment, which provides a mechanism for vitamin D to influence ovarian function and menstrual cycle regularity.

OBJECTIVES:   Primary objective :   (1)To measure the level of 25-OH Vitamin D in  females of reproductive age group with menstrual irregularities attending AIIMS Raipur Gynaecology OPD.

 (2) Study the association of 25-OH vitamin D with menstrual cycle characteristics including long and short cycle length and cycle irregularity.

Secondary Objective:  Counseling the students regarding importance of adequate vitamin d level and problems that might arise due to its deficiency in blood.

METHODOLOGY:

Cross Sectional Observational Study in a tertiary care, teaching hospital located in central India, AIIMS Raipur.  The subjects for the study has been recruited  after considering inclusion and exclusion criteria has been recruited among the  females of reproductive age group with menstrual irregularities attending AIIMS Raipur Gynaecology OPD.

RESULTS : Data obtained from the study is being analysed using SPSS vs. 16. Descriptive statistics for demographic data is being calculated. One sample “t test” is being used to compare 25 (OH) Vitamin D level of sample with the standard level.