European Gynecology and obstetrics congress

Biography:

I graduated in medicine in 1999, and start my residency in 2001 in medical genetics (São Paulo University / SP) which was done tree years later. In additional, in 2002, I undertook a fellow at University of Toronto doing molecular cytogenetics (SKY and CGH) on samples from my patients with chromosome rearrangement. I have my title of specialist in clinical genetics by the Brazilian Society of Clinical Genetics, and also had my PhD title working on molecular biology with Preimplantation Genetics Testing (PGT). Now, I am a head of genetics department in private lab and involved in projects to develop new approaches to detect genetic diseases on non invasive prenatal diagnosis (NIPT) and PGT. I have more that 20 papers published on the international scientific medical journal which all are in the pubmed, over that 50 poster presentations in Brazilian and international lectures of medical genetics. In addition, I am a speaker at the main medical congresses in Brazil.

Abstract:

Preimplantation genetic testing (PGT) requires the use of assisted reproductive technology (ART) to create several embryos, followed by biopsy of embryonic cells for genetic testing and transfer of selected embryos to the womb to establish a pregnancy. PGT-M refers to testing for nuclear DNA mutations causing monogenic disorders, with an autosomal dominant, autosomal recessive or X-linked transmission pattern, but also mitochondrial DNA mutations. It also refers to exclusion testing and to HLA typing with or without concurrent testing for a monogenic disorder. HLA typing of ART-created embryos was first reported in 2001. The aim is to establish a pregnancy that is HLA-compatible with an affected sibling who requires haematopoietic stem cell transplantation. HLA-typing can be performed with or without PGD for the exclusion of a single-gene disorder.The principle of the methods is based on haplotyping (i.e. determination of the group of alleles within a genetic segment on a single chromosome being inherited together). Therefore, genetic markers located close to the gene of interest are genotyped in DNA samples of the couple and relevant family members with known genetic status during preclinical work-up. Genetic markers that are informative, flank the locus of interest and allow discrimination of the parental haplotypes, are selected for use in the clinical test.The HLA typing was performed by using short tandem repeats (STRs) as microsatellite markers present in the HLA locus (Fig.).We analyzed trophectoderm biopsy from 728 embryos and a total of 123 embryos (16.89%) were HLA compatible. PGT-M was tested for 8 different monogenic disorders in 82% (597/728) of all embryos, such as thalassaemia and sickle cell anaemia. For the remining 18% of embryos , the indication for HLA -matching was for healthy embryos could matched with the affected child so that cord blood from the future newborn can be used to transplant the sibling for other medical reasons

Biography:

Director Emeritus of the Obstetric-Gynecological Department of the Hospital of Clusone (Bergamo - Italy). Since 2014 Head of the medical clinic for the diagnosis and treatment of Endometriosis and since 2017 Referent of the Multidisciplinary Team for Endometriosis care at the Policlinic San Pietro (San Donato Group) in Ponte San Pietro (Bergamo - Italy).

Abstract:

Ovarian endometrioma is a particular anatomopathological entity in the context of endometriotic pathology. The ovary is the organ most frequently affected by endometriosis and in 30% of cases the pathology is bilateral. The effect of endometriosis on fertility is varied; however, women with severe endometriosis and the presence of endometriomas appear to have significantly lower pregnancy rates following IVF treatment when compared with women with severe endometriosis but without endometriomas.The endometrioma transforms the macro- and microenvironment in the ovary to a highly inflammatory one. The endometriotic tissue may secrete several products, including cytokines, chemokines, and growth factors. These substances may activate specific signaling pathways in the follicular cells, leading to premature follicular development and accelerated atresia. Surgical treatment is indicated if the endometrioma becomes symptomatic and increases in size despite medical therapy, and in cases of related infertility.However, endometrioma surgery can reduce the follicular reserve either through stripping that does not take into account the correct cleavage plan and involves an exaggerated “traction-counter traction”, or with an indiscriminate electro-hemostasis or, with a too narrow suture that causes ischemia.In consideration of this important issues we have organized a surgical technique that tries to safeguard as much as possible the follicular reserve of the ovary affected by endometrioma.The highlights of the technique are: a meticulous search for the correct cleavage plan, stripping replacement with cautious detachment and hemostasis of vascular connections performed directly on the cystic wall, use of a hemostatic adhesive and abolition of electroemostasis.The three-month follow-up includes an early follicular transvaginal ultrasound with antral follicle count. Continuous progestin or estroprogestin therapy is prescribed, except for women who wish to become pregnant. If the pregnancy does not begin within 6 months the AMH dosage is requested for a possible sending to a PMA center.

Biography:

Dr. Alfred Shihata, President/CEO of FemCap Inc., invented FemmyCycle menstrual cup and FemCap cervical cap. He is affiliated with Scripps Institutions of Medicine & Science and holds medical degrees in England, Canada and the USA. He has six patents and brings over four decades of women’s reproductive health research as a medical device designer. He received the “Why Didn't I Think of That?” award from BIOCOM, Southern California’s largest biotech trade association. He has published in the New England Journal of Medicine and other medical/scientific journals. * Dr. Shihata is a Life Member of the Society of American Inventors and the Association of Reproductive Health Professionals

Abstract:

Globally 1.9 billion women are of menstruating age.  Menstrual cups are gaining more popularity among women, who prefer cups over pads and tampons. [1]. The innovative FemmyCycle (Figure 1) has several advantages over traditional menstrual cups. (Figure 2) Objective: To mitigate and correct the side effects caused by traditional menstrual cups. The most common side effect among traditional cups is leakage.

Methodology: We focused our study on all causes of leakage and other side effects caused by traditional menstrual cups. Methods of corrective and preventive actions included; the no-spill design, the use of a removal ring instead of a rigid stem, the use of a flask shaped body rather than the conical shape of traditional menstrual cups (Figure 2), and the elimination of suction holes as well as the need to manually open the cup. (Figure 3 & 4)  We analyzed 834 independent reviews by women who have had prior experience with traditional menstrual cups to obtain objective results. Findings: The implementation of these design changes and enhancements of the written and digital instructions produced measurable, positive results in favor of the FemmyCycle. We analyzed all the reviews for FemmyCycle to measure the prevention of leakage and other side effects. We selected the reviewers who volunteered to compare the FemmyCycle with their experience using traditional cone shaped cups. There were many reasons why women preferred FemmyCycle, but the most common by far was the prevention of leakage followed by the ease of insertion, ease of removal and comfort when inserted. Conclusion: The implementation of the design changes from a conical shaped cup with a removal stem to a flask shape cup with a removal ring, in addition to the added no-spill feature and enhanced instructional material, improved the acceptability of the FemmyCycle.

Biography:

To be updated

Abstract:

We study the impact of the dehydroepiandrosterone (DHEA) by the women with diminished ovarian reserve and very low DHEA-S in the blood. In vivo study. The paper also presents a review of the literature regarding diminished ovarian reserve and the use of dehydroepiandrosterone. We present a description of 5 patients with diminished ovarian reserve (DOR). Patients reported because of problems with getting pregnant. Infertility lasted for several years. The patients disagreed on IVF for ethical  and religious reasons. All of the presented patients were diagnosed with diminished ovarian reserve (very low AMH or high FSH, elevated estradiol concentration on day 3 of the cycle). We found also a very low DHEA-S concentration. The patients were given dehydroepiandrosterone. After several months of treatment (3-6 months), the patients became pregnant. None of them had procedures for in vitro fertilization. Five patients gave birth to healthy children. Our experience with DHEA is much bigger, but these 5 cases are very well documented. The obtained results indicate that DHEA supplementation in conditions of its deficiency improves the functioning of the ovaries and increases the chance of pregnancy.

Biography:

Abstract:

Background: Vitamin D deficiency has been a worldwide health problem, and pregnant women were considered as ahigh risk group among whom the prevalence of vitamin D deficiency is increasing to be around 5-40% and to reach a rate of 10-56% in breastfed infants.  Recent studies revealed the importance of vitamin D during pregnancy and correlated its level to several pregnancy and neonatal outcomes.

Objectives: We aimed to assess the effect of low level of maternal vitamin D on the progress of labor affecting primary C-section rate, pregnancy outcomes (such as: risk of uterine atony and postpartum hemorrhage, pregnancy induced hypertension, preeclampsia and gestational diabetes) and neonatal outcomes (such as: low birth weight and preterm birth).

Methods: A prospective cohort study was conducted in two university hospitals in Lebanon between September 2016 and January 2017. A questionnaire was used for collecting date after taking informed consent to participate in the study. Demographic data, calcium intake, vitamin D intake including the dose, obstetric history complicating the current or previous pregnancy, mode of delivery and finally maternal and neonatal outcomes were recorded. Blood samples were collected from all patients participating in the study for vitamin D level measurement. Patients were divided in two groups: the control group (vitamin D level>30ng/ml) and the deficient group (≤30ng/ml).

Results: A total of 381 patients were included in this study. In total, 40.9% of the deficient group delivered by C-section for failure of induction, failure to progress or failure to descend; compared to 12.8% only of the control group (p value <0.0001). There was also a significant association between vitamin D deficiency and risk of uterine atony and postpartum hemorrhage (4.7% and 5.6%, respectively in the study group with low level of vitamin D compared to 0.7% and 1.3% in the control group with significant p value 0.033 and 0.040, respectively).

Conclusion: Low maternal vitamin D level was associated with increased risk of primary C-section, uterine atony and postpartum hemorrhage.

.

Biography:

Dr Laing is an epidemiologist, trained at the London School of Hygiene and Tropical Medicine in London.  For many years she worked in non-communicable diseases, cardiovascular disease, diabetes and cancer.  For the past ten years, in addition to teaching at the Medical School, she has been volunteering in an Antenatal Clinic in the Gambia and during that time has been running the first cohort study of birth outcomes in the Gambia.

Abstract:

At the outset of this century the World Health Organisation recommended that the first visit to the antenatal clinic should be during the first trimester, women should attend at least 4 times and delivery accompanied by a trained birth attendant.  Attendance in the first trimester enables both the early detection and treatment of existing complications and also offers opportunities to prevent complications. Between 2012 and 2016 we conducted a cohort study of 1611 consecutive pregnant women attending the antenatal clinic at a health centre in the Gambia.  Overall 384 (23.9%) women attended during the first trimester. Of the 1366 women who were followed to the end of the pregnancy 468 (41.6%) had at least 4 antenatal visits.  The women almost all planned an attended birth.  Overall only 212 women (15.8%) complied with all 3 WHO recommendations. To examine factors associated with compliance we conducted a quantitative and a qualitative study.  Following multivariate analysis women aged 30 or more, and women whose partner had tertiary education were most likely to attend in the first trimester.  Married women and women with educated partners were most likely to attend at least 4 times. The qualitative study consisted of in-depth interviews with 25 women, 13 health care workers and 9 male partners.  Three areas were identified: intentional concealment of early pregnancy was common inititally to avoid adverse social consequences or for fear that malign interventions would cause a miscarriage.  In the absence of symptoms many women considered it unnecessary to attend the antenatal clinic until well into the second trimester.  Practical barriers included conflicting domestic demands and the attitudes of some health care workers. Barriers to antenatal care are many and these will vary considerably from health centre to health centre.  Prior to outreach programmes local issues should be considered.

Biography:

To be updated

Abstract:

Stillbirth affects over 2.64 million families worldwide annually. Stillbirths are often preceded by maternal perception of decreased fetal movement (DFM). DFM is also strongly linked to adverse perinatal outcomes such as neurodevelopmental disability, infection, fetal to maternal haemorrhage (FMH), emergency delivery, umbilical cord complications, small for gestational age (SGA) and fetal growth restriction (FGR /IUGR). Decreased fetal movements for some women may be associated with placental dysfunction, which could lead to fetal growth restriction and/or stillbirth. While evidence is still emerging in this area, some studies indicate that a reduction in stillbirth rates may be achieved by increasing maternal, clinician and community awareness about the importance of DFM. Fetal movements are an important simple maker of fetal wellbeing, while reduced fetal movements can be the early symptom of fetal compromise and failure to respond by a mother or maternity provider might lead to intrauterine fetal death (IUFD). Fetal movement counting (Fetal Kicks monitoring) is very controversial, maternal anxiety has been highlighted as a big issue in those who follow fetal kick counting advice. The value of maternal fetal movements (FM) monitoring has been assessed in a number of studies of pregnant women. There are conflicting results with most showing no overall reduction in perinatal losses even when fetal movement monitoring has been recommended. Fetuses that are experiencing sub acute and slow progressing fetal compromise can be saved if mothers detect reduced fetal activity and present to their midwife or Obstetrician.

Biography:

To be updated

Abstract:

Amenorrhea is the absence of menstrual bleeding. There are two types of amenorrhea, primary and secondary. Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. Treatment goals for patients with amenorrhea may vary considerably, and depend on the patient and the specific diagnosis. The objective of the presentation is to describe the guidelines for the diagnosis and treatment of different types of amenorrhea and relate the major recommendations for the patient management.

Congenital malformations of the female genital tract are common miscellaneous deviations from normal anatomy with amenorrhea and reproductive consequences. Until now, three systems have been proposed for their categorization but all of them are associated with serious limitations. The ESHRE/ESGE classification system of female genital anomalies (2013) is based on anatomy.

Turner syndrome is usually accompanied by hypergonadotropic hypogonadism and primary or secondary amenorrhea due to gonadal dysgenesis. European Society of Endocrinology Clinical practice guidelines 2017 recommend that estrogen replacement should start between 11 and 12 years of age increasing to adult dosing over 2–3 years (moderate recommendation), and adding progesterone once breakthrough bleeding occurs or after 2 years of estrogen treatment (strong recommendation). 

Biography:

To be updated

Abstract:

Objective: To evaluate the role of measuring umbilical cord thickness, interventricular septum thickness and HbA1c level in prediction of fetal macrosomia in patients with gestational diabetes mellitus. Methods: This prospective case-control study included 80 pregnant women. They were divided into two groups: 40 pregnant women as case group with gestational diabetes mellitus and 40 non-diabetic pregnant women as control group. Ultrasound examination was performed where the sonographic cross sectional area of umbilical cord. The umbilical arteries and the umbilical vein were measured in a free loop of the umbilical cord, using the software of the ultrasound machine. The cross-sectional area of Wharton’s jelly was computed by subtracting the cross sectional area of the vessels from that of the umbilical cord and the interventricular septum thickness was measured. HbA1c level was measured for diabetic patients.

Results: Umbilical cord diameter increased in patients with gestational diabetes more than the control group (3.03±1.26) cm. Increase in interventricular septal thickness (0.85±51) cm was also associated with fetal macrosomia in diabetic patients. HbA1c levels in patients with GDM (7.0±1.2) % showed increased cases of fetal macrosomia.

Conclusion: The results of the study showed the usefulness of sonographic umbilical cord thickness, interventricular septum thickness and HbA1c in prediction of fetal macrosomia in Patients with gestational diabetes mellitus.

Biography:

To be updated

Abstract:

Objective. Improving the accuracy of the diagnosis of endometrial consistency and predicting endometriopathy.

Subjects and methods. 96 patients with a history of reproductive failure were examined. An analysis was made of menstrual blood with the measurement of glutathione peroxidase-1, interleukin-6 and E-selectin by the ELISA method of the "sandwich" type with monoclonal antibodies. In order to determine the normative parameters, the material of 30 healthy women was examined. To evaluate the results, the logistic regression method was applied. A mathematical model was developed that made it possible to determine the probability of endometriopathy at the threshold value of the integrative index P≥0.29.

Results. Patients with diagnostically significant P levels have signs of chronic inflammation, dyshormonal mucosa, and dystrophic changes in the endometrium. The average probability of the disease is Pc. For the patients it was 0.59, for the healthy - 0.22. The diagnostic sensitivity of the test is 93.3%, specificity is 92.86%.

Conclusion. The calculation of the prognostic probability of endometriopathy based on the measurement of the concentration of biologically active substances in menstrual secretions is appropriate for the primary non-invasive diagnosis (screening) of the non-tumor pathology of the endometrium. The diagnostic technique is patented.

Keywords: fertility disorders, endometrial non-tumor pathology, prognosis of endometriopathy, laboratory diagnostics, parameters of menstrual effluence.

Biography:

Dmitry Kravchenko graduated on 2010:From the Sechenov Moscow Medical Academy cum laude (diploma number BCA 0733875).

2010 – 2012: residency on oncology, department of radiosurgery of the Blokhin Cancer Research Center.

2012 – 2017: post-graduate research.

2018: defended a thesis (PhD) on “features of adjuvant hormonal therapy in young breast cancer patients”.

2018 – 2019: worked as a chemotherapist in a consult department of the Blokhin Cancer Research Center.

2019 – currently: works as a chemotherapist in a chemotherapy department of the Blokhin Cancer Research Center.

Specialization: breast, ovarian, gastric and colorectal cancer.

Symposia attended as a speaker:

29.03.2019 - V annual Russian Head-and-Neck Congress (“febrile neutropenia prophylaxis”).

Speaks Russian (native), English (C2), Spanish (C2), Italian (C1), Portuguese (B2), French (A2).

Professional interests: cancer targeted and immunotherapy.

Abstract:

Breast cancer (BC) keeps being the most predominant malignant disease in women. In recent years, a trend towards “rejuvenescence” of the malady has been observed that affects its features. Despite modern methods of diagnosis and complex treatment used in young patients, survival rates in this age group are inferior that’s associated with biological and morphological peculiarities of BC in young age. Gradually are being collected data according to what age might be an independent factor exacerbating prognosis. For BC patients younger 40 years, various aspects of adjuvant therapy remain ambiguous: prolonged tamoxifen use, aromatase inhibitors prescription, BRCA profiling, ovarian function suppression, a role of chemotherapy-induced amenorrhea in prognosis, fertility and social concerns. The issue of appropriate, personalized adjuvant hormone therapy of BC is complex and heterogenous that requires a necessity to further conduct international randomized trials.

Key words: breast cancer, young age, endocrine therapy, chemotherapy, BRCA, ovarian suppression 

Biography:

To be updated

Abstract:

To be updated

Biography:

To be updated

Abstract:

Objective: To evaluate Subendometrial and Uterine artery resistance and pulsatility index continuous analysis as a predictor of Endometrial receptivity in Assisted Reproductive Technology (ART) Cycles.

Design: Serial 2D transvaginal coloured power doppler ultrasound performed in women on ART cycle to evaluate a pattern that better predicts implantation rates. 169 subjects on a prospective case control study were assessed. Uterine artery and Subendometrial resistance and pulsatility index was performed to all subjects at baseline (prior to ovarian controlled stimulation), at day 6, 8 and 10 of controlled ovarian stimulation, at trigger day and at embryo transfer day. Also the ratio of fluxometric parameters between Subendometrial blood flow and uterine artery was measured.

Results: No statistical difference was noted between two groups in terms of demographics and ART procedures and scores. Uterine artery resistance and pulsatility index showed statistical difference between the two groups (implantation versus non-implantation group). Also statistical significance was obtained between two groups in terms of Subendometrial vascularization. Ratio between Subendometrial and Uterine artery showed lower values of fluxometric parameters in all range for the Subendometrial territory.

Conclusions: Serial Subendometrial and Uterine artery fluxometry may be a useful tool for clinicians in predicting endometrial receptivity enhancing elective embryo transfers in the same ART cycle.

Biography:

Dr Gondjout taliana stéphie is actually doing her 3rd year residency in gynecology and obstetrics in Dakar at the University of Cheikh Anta DIOP. She did her medical study in Ukraine at I. Horbachevsky Ternopil Medical University.

Abstract:

This case report, it’s about a patient I met during prenatal consultation, she was in the 2nd semester of her pregnancy, exactly at 25 weeks. During the physical examination, we found, she had a hypoplasia of minor labia, an incomplete vaginal diaphragm with a vaginal cup, and a hypertrophy of clitoris. We decide to make some biological and instrumental examinations. After getting the result, we concluded she has a pseudo hermaphroditism associated with malformation of 1/3 of vagina. Reason why the way of the delivery choose was a C-section. Female pseudo hermaphroditism isthe most frequent (FPH) sexual ambiguity. It is characterized by the extension of abnormality of the sexual differentiation during the fetal life in the female fetus by a maternal or fetal hyper-genesis. The authors propose through a clinical case with a patient 46XX DSD pregnant. The main cause of this pathology is congenital adrenal hyperplasia, which we lead to deficits of 21-hydoxylase, 11-beta-hydroxylase, 3-beta-hydroxysteroid dehydrogenase, but 95% of the congenital adrenal hyperplasia is the deficiency of 21-hydoxylase. The treatment of congenital adrenal hyperplasia depend of the cause, hormone replacement therapy like (dexamethasone, hydrocortisone), most often the treatment for life is needed. From this we propose to make review of literature focusing on it. Conclusion: The pseudo female hermaphroditism isthe most frequent affection of sexual ambiguities, when it is associated with a pregnancy as in this clinical case, the interest is even greater. From a practical point of view, the etiological diagnosis procedure must begin with a clinical examination of anomalies of external genital development, a karyotype and a hormone balance (17- hydroxy-progesterone).The management is multidisciplinary combining medical, surgical, and psychological treatment, and the patient may decide to undergo surgery later for clitoridoplasty

Biography:

Dr. Alfred Shihata, President/CEO of FemCap Inc., invented FemmyCycle menstrual cup and FemCap cervical cap. He is affiliated with Scripps Institutions of Medicine & Science and holds medical degrees in England, Canada and the USA. He has six patents and brings over four decades of women’s reproductive health research as a medical device designer. He received the “Why Didn't I Think of That?” award from BIOCOM, Southern California’s largest biotech trade association. He has published in the New England Journal of Medicine and other medical/scientific journals. * Dr. Shihata is a Life Member of the Society of American Inventors and the Association of Reproductive Health Professionals

Abstract:

Biography:

Professor Natalia Artymuk - Head of the Department of Obstetrics and Gynecology of Kemerovo State Medical University, President of the Kemerovo Regional Public Organization "Association of Obstetricians-Gynecologists", Chief Specialist of the Ministry of Health of the Russian Federation of Obstetrics and Gynecology in the Siberian Federal District, member of the Presidium of the Board of the Russian Society of Obstetricians-Gynecologists.

Abstract:

Statement of the Problem: Obesity is currently a growing problem worldwide and is associated with serious health risks. This is a global epidemic, and its consequences for morbidity and mortality, both in adults and in children, are becoming increasingly important. The first basic measure for correcting body weight as part of pre-conception care is to prescribe a balanced hypocaloric diet in combination with exercise and correction of eating behavior using behavioral therapy.

Purpose of this study was to evaluate the dynamics of anthropometric, hormonal and metabolic parameters in infertile obese women with a balanced hypocaloric diet.

Methodology & Theoretical Orientation: The study included 23 infertile women of reproductive age with grade I gluteofemoral obesity. All patients were prescribed a balanced, low-calorie diet (1200 kcal / day), exercise, and behavioral therapy. An anthropometric, metabolic and hormonal parameters were conducted before and after 12 months after treatment.

The results. Twenty (87%) of the 23 women included in the study completed the treatment protocol. A decrease in body weight from 4 to 24 kg was registered in all patients who completed the protocol by an average of 10.58 ± 5.70 kg (p <0.001). A statistically significant decrease in the volume of adipose tissue was recorded both due to subcutaneous and visceral fat and other indices p <0.001). The decrease of body weight was accompanied by a statistically significant decrease in the level of leptin (p <0.001), E1 (p = 0.049), E2 (p = 0.032), fasting glycemia (p <0.001), HOMA-R (p = 0.002), cholesterol (p < 0.001), TG (p = 0.004), cholesterol-LDL (p = 0.001), Ka (p <0.001) and an increase in the content of progesterone (p = 0.030). The ovulatory menstrual cycle was restored in all women (p = 0.007), the desired pregnancy within a year occurred in 1 patient.

Conclusion & Significance:  The use of a hypocaloric diet for 12 months in infertile women with obesity of the first degree helps to normalize metabolic processes, reduce body weight and in 100% of cases restore the ovulatory menstrual cycle.

Biography:

To be updated

Abstract:

Statement of the Problem: Preterm birth (PB) is one of the main causes of perinatal morbidity and mortality in newborns. The cause of PB is multietiologic, however, it is considered that one of the main risk factors is a disturbance of the vaginal microbiocenosis in a pregnant woman. Some studies have shown an interaction between vaginal microbiota in early pregnancy and the risk of PB.  

Purpose of this study was to assess the morphological features of the placenta and the microflora of the vagina and placenta in women with preterm birth.

Methodology & Theoretical Orientation: This was retrospective, case-control study. The study was conducted during 2018 and included 150 women who gave birth at the Reshetova L.A.  Kemerovo Regional Clinical Perinatal Center (Kemerovo, Russia). Group I included 50 women with preterm vaginal birth; Group II consisted of 100 women with term vaginal birth. We used morphological investigations of the placenta, bacteriological examination of the contents of the vagina, scrape from the surface of the placenta.

The results of the study showed that the features of the histological structure of the placenta in women with PB is a high incidence of ascending infection (54%), especially Grade II-III (16% and 10%) with a predominance of choriodeciditis (40%) and intervillusitis (32%), as well as a higher frequency of placental insufficiency (54% vs 35% in the control group) and placental villous immaturity (100%). In patients with premature birth in the early pregnancy, a high frequency of vaginal disbiosis was recorded (75%). There is no established relationship between the microbiocenosis of the vagina in early pregnancy, placenta microbiocenosis, and the placenta infection. Microflora were isolated from vagina in 97% and 61% of women (p<0.001), from placenta – in 61% and 50% of women (p>0.05). The main vaginal microflora were St. haemolyticus (30.6%), C. albicans (20.2%), Corynbacterium spp (19.4%).  Lactobacilli were isolated in early pregnancy only in 5.6% of women with PB. The main placenta microflora were E.Coli (22.2%) and Ent.Faecalis (14.3%). The coincidence of the microbiocenosis of the vagina and the placenta (E. coli and St. haemolyticus) was observed just in two patients.

Conclusion & Significance:  Patients with preterm birth had a high incidence of vaginal microbiocinosis disorders in early pregnancy, placental infection, and placental insufficiency.

Biography:

Dr Garashova is an experienced healthcare provider in the field of obstetrics&gynecology and a sciensist.. She had years of experience in research, evaluation, teaching and administration both in hospital and education institutions. Her first scientific research was devoted to the study of clinical significance of soluble FAS antigen and VEGF-factor in women with ovarian cancer. Her present research is devoted to the study of incidence, pathogenetic mechanisms and clinical manifestations of tumors of the genitalia in postmenopausal women. She has more than 40  articles and Textbook of Gynecology for student of a medical university. Dr.Garashova also has experience in private healthcare sector management.

Abstract:

Statement of the Problem: It is known that obesity is a predisposing factor for many pathological conditions, including the hyperplastic processes of the endometrium and endometrial cancer, thereby reducing the quality of life. Researchers established a relationship between an increase in body mass index (BMI), the age of a woman, and the presence of endometrial cancer. Obesity plays a significant role in the development of endometrial cancer type I and is characterized by an increase in its frequency by 4-5 times compared with women with normal body weight. An increase in BMI for every 5 kg / m2 increases the likelihood of endometrial cancer by 1.5 times. Metabolic and endocrine changes in postmenopausal women associated with obesity may explain the increased incidence of endometrial pathology. The purpose of this study is to reveal the relationship between the increased BMI and the incidence of endometrial pathology in postmenopausal women in Azerbaijan. Materials&Methodology: 115 postmenopausal women with a thickening of the endometrium (according TVU data) were examined.  Of these, 50 (43.5%) had endometrial cancer, 34 (29.6%) had complex endometrial hyperplasia without atypia, 15 (13%) had atypical endometrial hyperplasia, and 16 (13.9%) patients had endometrial polyp.  The average age of patients was 59.7 ± 0.6 (50-83) years.  The body mass index was calculated for all patients and was average 32.3 ± 6.7 (23.2-58) kg / m2. Results: Among 50 patients with endometrial cancer 22 (44%) had I degree of obesity, 12 (24%) had II degree, and 7 (14%) patients had III degree of obesity (BMI>40 kg/m2). 20 (58.8%) of patients with complex endometrial hyperplasia without atypia, and 10 (66.7%) with atypical hyperplasia had different degrees of obesity with BMI>30kg/m2. 11(68.7%) patients of 16 with endometrial polyp were obese. Thus, 82 (71.3%) of 115 postmenopausal women with increased endometrial thickness were obese.  Conclusion: Increased BMI is a consistent and leading risk factor for endometrial hyperplasia and endometrial cancer in postmenopausal women.  Recommendations: to increase the awareness of women about the screening methods, to improve the lifestyle and nutritional habits for the prevention of gynecological and other obesity related diseases.