Biography:

Marion Ariadne C. Burgos has completed her Doctor of Medicine degree from Far Eastern University-Nicanor Reyes Medical Foundation at age of 23.  She is currently an obstetrics and gynecology resident at the same hospital institution.

Abstract:

Obstetrical hemorrhage is one the leading causes of maternal morbidity and mortality in our country.

The objective of this report is to present a case of a 30-year-old, Gravida 3 Para 1 (1021) who had persistent vaginal bleeding post dilatation and curettage due to missed abortion at 11 weeks gestational age.  Differential diagnosis included retained secundines, gestational trophoblastic neoplasia, uterine arteriovenous malformation, and placental accrete syndrome.  This could be differentiated by beta human chorionic gonadotrophic hormone and transvaginal ultrasound. 

What made the case interesting is the dilemma in the diagnosis.  In a case of persistent vaginal bleeding after curettage and with a history of cesarean delivery, one will initially think of placenta accrete syndrome.  But then, initial diagnostic tests pointed out to uterine arteriovenous malformation.  Due to the dilemma of the service team in clinching the diagnosis for a single disease entity, pelvic magnetic resonance imaging with contrast was done revealing a possible placenta accreta, but cannot totally rule out vascular tumor.

Since patient was initially desirous of future pregnancy, medical management was started and was scheduled for CT angiography. However, due to persistent vaginal bleeding, she underwent Total Abdominal Hysterectomy.  Histopathology result revealed a placenta increta.

In the advent of technology, a wide array of diagnostic modalities can be used to make an appropriate diagnosis. Clinical correlation and a high index of suspicion must be at all times considered above all. No matter how rare the condition, it should still be at the back of our minds. 

Biography:

Dr. Emmanouella Chatzidaki has completed his PhD at the age of 26 years from the Univeristy of Cambridge, UK and postdoctoral studies from Karolinska Isntitute, Sweden and the Institute of Molecular Biotechnology, Austria. She is a senior PostDoc at the Institute of Molecular Biotechnology, Austria. She has published several papers in reputed journals with over 3,000 citations.

Abstract:

The frequency of egg aneuploidy and trisomic pregnancies increases with maternal age. Since multiple causes contribute to egg aneuploidy, it is likely challenging to prevent the “maternal age effect” using a single approach. To test our hypothesis that ovulations contribute to oocyte ageing and chromosome missegregation, we used genetics, hormonal contraception and successive pregnancies to reduce ovulations. We observed that ovulation reduction is sufficient to prevent egg aneuploidy and age associated errors during meiosis I division of the oocyte, in aged mice. By interrupting ovulations with successive pregnancies, we discovered that eggs from aged mated females display lower aneuploidy and reduced precociously separated sister centromeres compared to those from aged virgin females. When putting mice on hormonal contraception we find a near 2 fold reduction in aneuploidy incidence. To reduce ovulations further, we generated Gpr54 knockout mice, which remain in a pre-pubescent state. Remarkably, aneuploidy is reduced 3-fold in eggs from Gpr54-/- versus Gpr54+/+ aged females. These data suggest protection is due to reduced ovulations. We further observed that ovulations contribute to loss of Rec8-cohesin, which is essential for sister chromatid cohesion in meiosis. Single-nucleus Hi-C revealed a deterioration of 3D chromatin organization that depends on ovulation frequency and Rec8, which restricts loops extrusion. We conclude that ovulation suppression leads to retention of Rec8, which maintains chromatin structure and promotes chromosome segregation and production of euploid eggs. Our work implies that hormonal contraception can reduce the risk of Down’s syndrome pregnancies at advanced maternal age.

Biography:

Ari Irawan Romulya has completed her MD at the age of 28 years from jenderal Achmad Yani University, Bandung, Indonesia and currently undergo residency in Obstetric and Gynecology Department at Padjajaran University, Bandung, Indonesia

Abstract:

Introduction. Adenomyosis is a condition in which endometrium is ectopically placed in the myometrium. The most frequent symptoms of adenomyosis is chronic pelvic pain. Pain is a sensoric stimuli that can be affected by COX-2. Some studies found that 25-Hidroxy-Vitamin D₃ serum level has the ability to affect COX-2 serum level and modulate pain sensation. The aim of this study is to analyze correlation between 25-Hidroxy-Vitamin D₃ and COX-2 serum level in patient with adenomyosis.

Methods. This was an analytical observational study. Subjects were women diagnosed with adenomyosis who met the study criteria (n = 35). Their 25-Hidroxy-Vitamin D₃ and COX-2 serum level were measured. The study was conducted at the Gynecologic Clinic of Obstetrics and Gynecology Department, Hasan Sadikin Hospital, Bandung Indonesia in June until November 2019.

Results There was a significant correlation between 25-Hidroxy-Vitamin D₃ and COX-2 serum level in woman with adenomyosis.

Conclusion 25-Hidroxy-Vitamin D₃ serum level can affect COX-2 serum level in woman with adenomyosis.

Biography:

William J. Rowe M.D. FBIS (Fellow British Interplanetary Society), FACN (Fellow American College of Nutrition, Retired Fellow Royal Society of Medicine), is a board certified specialist in Internal Medicine. He received his M.D. at the University of Cincinnati and was in private practice in Toledo, Ohio for 34 years. During that time he supervised over 5000 symptom - limited maximum hospital-based treadmill stress tests. He studied 3 world class extraordinary endurance athletes and published their exercise-related magnesium deficiencies. This triggered a 20 year pursuit of the cardiovascular complications of Space flight

Abstract:

12 moon walkers, James Irwin on day after return from Apollo 15 mission, showed extraordinary bicycle ( B) stress test (ST) hypertension ( 275/125) after 3 minutes exercise; supervising > 5000  maximum treadmill  ST, author never witnessed ST- blood pressure approaching this level.  Symptom-limited maximum B stress test showed “cyanotic fingernails”; possibly venous blood trapped peripherally, supporting author’s “Apollo 15 Space Syndrome,” postulating that severe fingertip pain during space walks, triggered by plasma fluid, trapped distally;  mechanism could be related to endothelial dysfunction, providing “silent ischemia” warning.  Neil Armstrong returned to Earth with severe diastolic hypertension  ( 160/135), consistent with ischemic left ventricular dysfunction; 50 mm increase in comparison with resting  BP 110/85. With inhalation of lunar dust, brought into habitat on space suit, with high lunar iron (I) this dust inhalation, along with reduced (R) space flight- transferrin, R antioxidant, calcium  (Ca) blocker -  magnesium, conducive to severe oxidative stress, Ca overload  with potential endothelial injuries. Using moon walker studies as example, my recent editorials show that I dust, released from brakes, with over 90% of brakes made of I, is a major hypertension factor and may also contribute to myocardial infarctions.

Biography:

Dr Musarrat Hasan is Consultant Ultrasound Specialist, Director Institute Of Ultrasound Imaging, Karachi, affiliated with JUREI at Thomas Jefferson University Hospital, Philadelphia, USA. He is Fellow Member of American Institute Of Ultrasound In Medicine (AIUM). He is co-opted Counseller for Asian Federation Societies Of Ultrasound In Medicine And Biology (AFSUMB). He is Chairman, History and Archiving Committee, AFSUMB. He is President of the Ultrasound Society Of Pakistan. He is the member of the Editorial Board of American Journal Of Sonography. He has presented several papers in International and National conferences. He has trained more than 7000 doctors in the field of Ultrasound in the last 37 years. To his credit, he has many research papers in international journals.

Abstract:

Objectives

The purpose of the study was to assess the utility and importance of ultrasound-guided aspiration of pelvic masses and to review our experience.

Methods

186 cases of pelvic masses were referred to our Ultrasound Clinic in Karachi from November 2008 to November 2019. Based on Ultrasound criteria, diagnosis of cysts, abscesses, endometriomas and pelvic collections were made. Diagnostic/ therapeutic aspirations were carried out. Masses were aspirated per-abdominally by free-hand technique whereas endovaginal aspirations were done via puncture adapter technique. 14-18 gauge needles were used based on the viscosity of the fluid as determined by the zone of enhancement. All patients were reassessed after 15 days to evaluate any pain, discomfort, spill or recurrence.

Results

After meeting the selection criteria, 186 cases of pelvic masses were aspirated. Out of them, 18 turned out to be ovarian abscesses whilst 120 were chocolate cysts (endometriomas). 7 peritoneal abscesses and 4 psoas abscesses were also drained. 28 were found to be ovarian cysts with clear transparent fluid and 9 were found to be ovarian cysts with a tinge of red or dark yellow fluid. On follow-up, recurrance was observed in 28 patients (18.8%), 8 patients (5.4%) complained of mild pain and slight discomfort right after the procedure which was relieved by Paracetamol. No fluid collection was seen in the cul de sac.

Conclusions

Ultrasound-guided aspiration of pelvic masses is a relatively safe, simple and cost-effective alternative to more invasive methods such as laproscopy and laparotomy. The paper will highlight the sonographic features of different cystic masses with special reference to ovarian abscesses versus endometriomas.

Biography:

Mahtab Karimi is a Gynecologist at the Sari –Iran, Nime Shaban Hospital. She is also a part of the IVF Department of Hazrat-e Maryam Fertility Center located in Iran. She has been the Chief Director of Obstetrics and Gynecology Department of Shohada Hospital, Bandar Gaz, and also the Chief Director of Obstetrics and Gynecology Department of Imam Khomeini Hospital Bandar Torkaman, Iran, 2012-2013

Abstract:

We  here report two case of ovarian torsion We  checked the presence of all possible factors that could explain the onset of  the syndrome. Ovarian hyperstimulation syndrome (OHSS) is almost exclusively associated with ovulation induction with gonadotropins[3] OHSS continues to be a serious complication of assisted reproductive therapy (ART), with no universally agreed upon best method of prevention If OHSS is diagnosed, the etiology should be determined in order to focus the treatment and avoid future complications.[4]

Keywords: Ovarian torsion, ovarian hyperstimulation syndrome, case report

Biography:

Associate professor of Obstetrics &Gynecology, College of Medicine,Mansoura University Egypt and Jouf University KSA. Consultant obs&gyn at Mansoura university hospital, Egypt, Visiting consultant at Abha & Beesha maternity and children hospital KSA.One  of the consultants of the Mansoura Integrated Fertility centre

Qualifications

Degree of MBBCh. In November 1992 with general grade "Very Good with Honor Degree", Faculty of Medicine, Mansoura University. MSc. of OBS. &GYN. Titled " Fetal pelvic index: A method of identifying fetal pelvic disproportion in breech presentation. MD degree of OBS. &GYN.titled“Effect of injection site of   oocyte during intracytoplasmic sperm injection on the rate of fertilization and cleavage.

Activities:

Spraker at national and international conferences, Publications at international peer reviewed journal. Trainer of many workshops hold at Mansoura university hospital. Supervisors of under and postgraduate students at OBS &GYN department,Mansoura and Jouf  university.Membership of many clinical societies.

Abstract:

Background: Vitamin D deficiency during pregnancy has been associated with some adverse neonatal outcomes as well as an increased risk of late pregnancy complications that include preeclampsia, gestational diabetes mellitus and increased risk of preterm labour.

Aim of work: to assess the corellation of pregnants serum Vit D level and different pregnancy complications regarding both mother and fetus and assess whether feto-maternal morbidities is associated with hypovitaminosis D or not.

Patients and Methods: 322 participants who meeted the inclusion citerias were classified into 2 groups. The first one was 110 pregnants with normal pregnancy regarding both fetal and maternal conditions were selected as control group.The second one was 212 pregnants suffering from pregnancy complications and were further subdevided into,58 cases with severe preeclamptic toxaemia associated with intrauterine growth restriction, 82 case with GDM, 26 cases of abortion, 16 cases undisturbed ectopic pregnancy,14 case with premature rupture of membranres=PROM and 16 cases with inevitable preterm labour. Serum recovered from peripheral blood samples by centrifugation was aliquot stored till used at -80 ^oC. Specific quantitative ELISA immunoassay kits from Sunlong Biotech Co. Ltd. were used to measure 25-OH-VitD (in ng/mL) and 1,25-DiOH-VitD (in pg/mL) (cat# SL2762Hu and SL2845Hu, Hangzhou, Zhejiang, China). The direct DiOH-VitD/OH-VitD ratio was calculated for each patient.

Results: .25 -OH -Vit D showed significant differences only between control and GDM groups while there were no significant differences among control and other groups. On the other hand,1,25-DiOH-VitD assay showed a very marked significant reductions in comparing control versus all of 6 complicated groups. Very similar to 1,25-DiOH-VitD pattern, DiOH-VitD/OH-VitD ratio showed nonsignificant difference among the complicated groups. However, there were very marked significant reductions comparing control vs. all of the 6 complicated groups

Conclusions: There is a strong association of vit D status and certain pregnancy complications.1,25 Di-OH-Vit D assay seems to be more reliable than 25-OH-Vit D and could be used as a suitable biomarker in assessment of vit D status in pregnancy. Vit D supplementation during pregnancy may assist in reducing related complications.

Keywords: Vitamin D, Pregnancy Outcomes, Pregnancy Complications