International Conference on Gynecology and Obstetrics April 01-02, 2019 Holiday Inn Paris - Marne la Vallée, Paris, France

Samara Sabur is a junior medical doctor, training in obstetrics and gynecology at the Northern Beaches Hospital in Sydney, Australia. She is currently completing a Master of Public Health through the University of Sydney and is an associate lecturer at the School of Medicine in University of Western Sydney. She has previously presented research at the European Congress of Obstetrics and Gynecology as well as the Australasian Gynecological and Endoscopy Society annual scientific meeting.

Intravascular leiyomyomatosis (IVL) is a rare smooth muscle cell tumour that is histologically benign with metastatic behaviour. The tumour arises from the uterus and grows within the venous system, extending to the inferior vena cava, right-sided cardiac chambers and pulmonary vessels. IVL can be fatal, resulting in thromboembolic events, congestive heart failure and intra-pulmonary leiyomyomatosis. There is also a risk of recurrence if the tumour is not completely resected.1 rn rnPresentation usually occurs after the disease has advanced with symptoms of haemodynamic instability, dyspnoea, palpitations, chest or abdominal pain.2 Typically, diagnosis is based on macroscopic description of worm-like tumour projections in the veins and/or microscopic evidence of intraluminal leiyomyomas.3 rn rnWe report a case of a 44-year-old woman who underwent a total abdominal hysterectomy and bilateral salpingectomy for simple hyperplasia, diagnosed from uterine curettage performed for menorrhagia. Intraoperatively, increased vascularity and aberrant vessels were noted on the serosal surface. The macroscopic pathology examination was normal, however, the histopathology demonstrated smooth muscle tumours in 2 vessels, consistent with IVL. The patient underwent computed tomography imaging of the chest and abdomen to rule out metastases and is scheduled for yearly follow-up due to the risk of recurrence. rn rnThis case highlights a rare but important diagnosis that gynecologists should be suspicious of when abnormal vascularity is seen on the uterus, especially due to the high risk of morbidity and recurrence with IVL. We review the literature and discuss management options for optimal outcomes of this disease.rn

Samara Sabur is a junior medical doctor, training in obstetrics and gynecology at the Northern Beaches Hospital in Sydney, Australia. She is currently completing a Master of Public Health through the University of Sydney and is an associate lecturer at the School of Medicine in University of Western Sydney. She has previously presented research at the European Congress of Obstetrics and Gynecology as well as the Australasian Gynecological & Endoscopy Society annual scientific meeting.

The placental site nodule (PSN) and its neoplastic counterpart epitheloid trophoblastic tumour (ETT) are forms of non-molar gestational trophoblastic disease that are thought to arise from incomplete involution of the placenta, particularly in women with previous uterine surgery e.g. caesarean section (CS) or curettage.1 Presentation is varied and non-specific including abnormal uterine bleeding (AUB), amenorrhoea, infertility and incidental finding through abnormal cervical smear cytology.2 rn rnAs symptoms usually occur long after the last pregnancy, average latent phase 3-years2, placental pathology is not usually considered. However, it is extremely important for clinicians to distinguish these lesions due to emerging evidence that PSNs may have potential to develop malignant transformation to ETTs.3-5 rn rnWe report 2 cases of PSN illustrating an interesting spectrum of pathological diagnoses with differing natural histories and management. rn rnCase 1: - 29-year-old, G2P2: 2 vaginal deliveries - AUB 4-years after last delivery, non-responsive to medical management - ultrasound normal - hysteroscopy normal, endometrial curettage: PSN - Endometrial ablation performed due to ongoing AUB - endometrial biopsy pre-ablation: normal rn rnCase 2: - 39-year-old, G3P2: suction curettage for miscarriage, 2 CS - Pelvic pain 6-months after first CS - ultrasound: possible retained products of conception - hysteroscopy: scant material, curetting: PSN - symptoms resolved - AUB 1 year following second CS - ultrasound normal - hysteroscopy normal, endometrial curettage: PSN, differential diagnosis ETT. - Gyne-oncology review: hysterectomy performed. rn rnThese cases demonstrate the highly variable presentations of PSN. Diagnosis should alert practitioners to arrange ongoing follow-up, given the potential to develop ETT. rn

Purpose: To improve effectiveness of infertility treatment in women with autoimmune thyroiditis (AIT).\r\nMaterials and methods: 84 women with infertility and autoimmune thyroiditis, 42 women with infertility and normal function of the thyroid were examined (levels of TPO-ab - thyroperoxidase antibodies and TG-ab-thyroid globulin antibodies in blood, AS-ab - antispermal antibodies in the cervical canal) and treated. Women with autoimmune thyroiditis were additionally treated by i.v. human immunoglobulin 300 g / kg № 3 with interval of 3 weeks and diet with increased selenium supply. \r\nResults. The level of TPO-ab in the main group was 283.1±37.8 U / ml and was significantly higher (10.9 times) than in the control group 25.9±1.8 U/ml (p<0.05). The level of TG-ab was also significantly increased in the study group (169.8±16.4 IU/ml), 2.6 times higher than in the control group 66.0±4.7 IU/ml (p<0.05). Increased AS-ab level in the cervical canal was detected in 26 (61.9%) women of the main group, in 6 (14.3%) – in the control group (p<0.001). Significant differences were found in the average level of ASA: in the study group 68,83±4,29 U/ml, in the control group 37,7±3,3 U/ml (p<0,05). The level of ASA in the study group and the comparison group was 1.8 times higher than in the control group. \r\nConclusion. Thus, the use of the treatment regimen developed by us contributed to a better ovarian response to the stimulation of CC: in the study group, 31 (73.8%) women, in the comparison group – only 21 (50.0%) women (p<0.05), as well as an increase in the incidence of pregnancy in women with AIT 2.3 times.\r\n\r\n

The aim of the research project was to analyze differences in psychological functioning between healthy mothers and infertile women treated with ART methods in Poland, where the acceptance of these methods is still lower than in western Europe countries therfore the social stigma of infertility exists.\r\n \r\nMethods: 100 female participants took part in the study: 50 mothers and 50 infertile women. Mean age of heathy participants was 30,7 (SD=4,81) and the mean age of infertile participants was 31 (SD=3,9). The study was conducted in a matched pair design. The groups were homogeneous in terms of education, place of residence, form and duration of the relationship between partners.\r\nThe difference in life satisfaction was measured with the SWLS (Diener, Emmons, Larsen, Griffin, 1985) in Juczyński\'s adaptation (2009). Perceived stress was measured with PSS-10 (Cohen, Kamarck, Mermelstein, 1983) in the polish adaptation (Juczyński, Ogińska-Bulik, 2009). The measurement of resilience was made using the Lifespan Individual Resilience Scale in Polish adaptation by Malina (2016). The quality of relationship was also measured using: Relationship Quality Inventory (IJZ) in polish adaptation by Suwalska-Barancewicz, Liberska and Izdebski (2015). Sexual satisfaction was measured with the use of Sexual Satisfaction Questionaire by Nomejko, Dolińska-Zygmunt (2012). Results and \r\n\r\nConclusion: The premilinary analisys indicate a statistically significantly differences between the two compared groups of women \r\n