Day 1 :
Pinderfields Hospital, UK
Time : 09:00-09:50
Christos Tsitlakidis has graduated from Hellenic Aristotle University School of Medicine. He is a Consultant Obstetrician and Gynecologist in Pinderfields Hospital, The Mid Yorkshire Hospitals NHS Trust, United Kingdom. He has published more than six papers in reputed journals in UK and abroad and has been Member of the RCOG.
Introduction: Caesarean carries the legacy of an emperor. It is the procedure that more than any other complicated by bleeding and infection. Modifying the procedure in several areas came out of necessity to respond to new challenges that appear over last decades. Are we learning as fast as Midwifery changing, we should move to modern obstetrics, supporting ideas old and new ones, till we find those that work.
Principles: Minimize the need for assistance. Create a clean and dry procedure. Eliminate bleeding. Operate in a controlled and calmed environment. Try and achieve natural birth simulation. Involve parents. Eradicate risk of post-natal infection.
Methods: Retraction tapes. Large intraabdominal packs. Stage stitch onto the middle of lower segment. Use of suction to drain amniotic fluid. Opening lower segment high and cutting slightly upwards laterally. Fetal pillow to disengage head. Kiwi cup for high or low head. Natural birth simulation and delay in delivery through tight incisions. Invite parental couple to observe, delivery straight to mother, delay cord clamp. Repair of lower segment in one of four appropriate ways, one applies additional compression. Cleaning scar with normal saline and vaginal toilet with antiseptic.
Conclusion: Caesarean still remains a ferocious procedure that can claim lives. Should we do not recognize the challenges from a changing world, the furies could become the Nemesis of our practice. Let’s credit the future with success.
Shiraz University of Medical Sciences, Iran
Time : 09:50-10:40
Mohammad Ebrahim Parsanezhad has graduated from Tabriz Medical School in 1979 and completed Obstetrics and Gynecology Specialty Board at Shiraz Medical School in1986. He has also completed 2.5 years of Infertility Fellowship at Gotingen University, Diako Medical Centre, Bremen Germany in 2003. He is currently a Professor and Chair, Infertility and Reproductive Medicine Division, Department of Gynecology & Obstetrics, Shiraz University, Iran. He is the Reviewer of Fertility & Sterility Journal, Member of Editorial board in Middle East Fertility Journal, Chairman of Educational Planning of Nursing and Midwifery School, Member of Editorial Board of Iranian Journal of Medical Sciences (IJMS), Member of National OB & GYN Board Examination at Ministry of Health and Medical Education. He has published 106 papers in reputed journals.
Polycystic Ovary Syndrome (PCOS) is a heterogeneous disorder in which chronic anovulation is a common feature, despite the presence of multiple microstructures in the ovaries. A growing body of evidence has suggested that serum hyperinsulinemia and as the result hyperandrogenemia contributes to the excess ovarian androgen secretion observed in women with PCOS. Still the standard therapy for anovulatory women with PCOS is administration of Clomiphene Citrate (CC). However, significant proportions of women with PCOS fail to ovulate with the use of standard dosage of CC and are called CC-resistant PCOS. Treatment options including extended clomiphene protocol, clomiphene and dexamethasone combined therapy, insulin-sensitizing agents and/or aromatize inhibitors, as adjuvants to clomiphene citrate and gonadotropins and finally surgical management of PCOD has changed the treatment strategy. Although both standard and novel treatments were addressed in the present review, special attention was paid to the evidence in support of the introduction of glucocorticoids and aromatizes inhibitors as well as surgical management of anovulatory women with CC-resistant PCOS.