Advancement in Gynecology and Obstetrics: POGS hosts 33rd annual and 6th International Conference on EndoART
2024-12-27 - 2024-12
PUNE: The Pune Obstetric and Gynaecological Society (POGS) hosted its 33rd Annual Conference and the 6th International Conference on Pearls and Pitfalls in Endoscopy and ART (EndoART) in collaboration with various committees of the Association of Maharashtra Obstetrics and Gynaecological Societies (AMOGS) at the Sheraton Grand Hotel.
This two-day event, 21st and 22nd December, featured keynote addresses, presentations, workshops, research papers, poster competitions, and discussions led by national-level experts.
The conference focused on advancements in ART techniques and endoscopic surgeries, which created new opportunities for research and dialogue.
Dr. Aarti Nimkar, President of POGS, said that this is the 33rd annual conference and the effort is to enrich the members with advanced techniques and knowledge through scientific sessions and workshops. This is also a platform to share clinical expertise and seek solutions to practical difficulties.
Dr. Sunita Tandulwadkar, President-elect of FOGSI, said that through obstetrics and gynaecology, we should strive for women's health. "We will reach out to the younger generation through outreach programs to get them into the POGS and FOGSI and serve society."
Dr. Kiran Kurtakoti, President of the Association of Maharashtra Obstetrics and Gynaecological Societies (AMOGS), said that earlier there was no super speciality; it was only gynaecology, but today the field has branched into 3-4 super specialities, including IVF, Fetal Medicine, and Cosmetic Gynaecology.
Dr. Meenu Agarwal, Convenor of ENDOART 2024, said that this is the first time we are having the annual conference on a specific topic of EndoART. The workshops included topics like imaging science, cosmetic gynaecology, hysteroscopy, laparoscopy, embryology, combination induction, and self-defence techniques.
Top 5 gynecology articles of 2024
2024-12-31 - 2024-12
1. FDA warns of false positive HSV-2 test risks
In a recent statement, the FDA reminded health care providers and clinical laboratory staff about the risk of false positive genital herpes simplex virus type 2 (HSV-2) serological test results.To reduce the risk of a false positive HSV-2 serological test result, the FDA provided information on risk factors and recommendations for health care providers and clinical laboratory staff. Additionally, the FDA has stated it will provide new information as it becomes available.
2.Caesarean deliveries linked to reduced fecund ability and increased infertility risk
Fecund ability ratio is reduced among women with more than 1 child reporting a previous caesarean delivery (CD) vs vaginal delivery, while the risk of infertility is increased, according to a recent study published in the American Journal of Obstetrics & Gynecology.
Women with a prior CD had a lower fecund ability ratio than those with prior vaginal delivery, with absolute infertility risks of 9.9% and 7.3%, respectively. This indicated a corresponding risk ratio of 1.21 for women with previous CD
3.Adverse outcomes of hysterectomy with bilateral salpingo-oophorectomy
The addition of bilateral salpingo-oophorectomy (BSO) alongside hysterectomy is associated with multiple adverse outcomes, according to a recent study published in the American Journal of Obstetrics & Gynecology.Hysterectomy with BSO was associated with increased colorectal cancer risk compared to hysterectomy only or no surgery. In patients aged under 45 years, a hazard ratio (HR) of 1.27 was reported, vs an HR of 1.25 in patients aged 50 years and older.
Colorectal cancer mortality also had an increased association in patients aged under 50 years, with an HR of 1.78. Kidney cancer risk had an HR of 1.23 in patients with hysterectomy and BSO, indicating increased risk.
4 A deep dive into devices for sexual health
Many women are dissatisfied with their sex lives, and reports suggest they feel discouraged as their doctors often fail to inquire about sexual health concerns.Gynaecologic providers should feel more comfortable proactively addressing the sexual well-being of their patients. Low libido, lack of arousal, diminished or absent orgasm, and painful sex are common complaints. Can sex toys or devices such as dildos, vibrators, or graduated dilators be part of the solution? Is this a data-free zone best left to the internet or the marketplace, or can health care providers help guide and support their patients who are seeking better sex?
5.Diabetes linked to altered long-term inflammatory response in mesh implantation
There is a link between diabetes and altered long-term inflammatory response in complicated mesh implantation, according to a recent study published in the American Journal of Obstetrics & Gynecology. Of the 32 cytokines/chemokines and 7 growth factors associated with inflammatory response, most did not have differentially expressed genes. Exceptions i
Leadership and Legacy: Dr.Sunita Tandulwadkar in Women’s Healthcare
2025-01-02 - 2025-01
Dr. Sunita Tandulwadkar is a visionary leader and an accomplished professional in the field of obstetrics and gynecology, known for her pioneering contributions to infertility treatment, endoscopy, and women’s health. With over three decades of experience, she has transformed the landscape of reproductive medicine and gynecological surgery in India. As the Head of the Department of Obstetrics and Gynecology at Ruby Hall Clinic, Pune, she has established one of the most advanced fertility and endoscopy centers in the country. Her groundbreaking work includes introducing 3D laparoscopic surgery and innovating surgical techniques, such as robotic tube- tubal anastomosis, which have set new benchmarks in the field.
A true trailblazer, Dr. Tandulwadkar is globally recognized for her pioneering application of stem cell therapy in infertility, delivering the world’s first baby using ovarian stem cell rejuvenation for a woman aged 45. Her unwavering commitment to innovation has led her to design advanced laparoscopic instruments and establish new protocols that are now widely practiced. Beyond clinical work, she is deeply committed to teaching and has mentored over 300 gynecologists who are now practicing worldwide. Through her work, she continues to inspire the next generation of specialists in reproductive medicine and endoscopy.
Dr. Tandulwadkar’s contributions extend beyond the operating room and classroom. Her leadership roles include serving as President of the Indian Association of Gynecological Endoscopists and the Pune Obstetrics and Gynecology Society, where her initiatives have brought global recognition to Indian gynecological practices. She has organized numerous national and international conferences, including the prestigious STAR Global Summit, and has introduced impactful training programs such as the EAGLE Project, aimed at empowering young gynecologists. As the Founder President of the Society of Ovarian Rejuvenation, she continues to lead advancements in ovarian health and fertility preservation.
Her work has been widely recognized, with over 150 awards from various organizations, including the Pride of FOGSI, Best Gynecologist of Maharashtra, and multiple accolades from the Economic Times for her expertise in IVF and endoscopy. However, her contributions are not limited to accolades; her social initiatives speak volumes about her dedication to community service. She has spearheaded campaigns to prevent female feticide, organized cervical cancer awareness drives, and initiated the “Sponsor a Birth” program, providing free IVF treatments to underprivileged families. Her work in cancer screening camps and free antenatal care for low-income families has touched countless lives.
As she assumes the presidency of the Federation of Obstetrics and Gynecology Societies of India (FOGSI), on 9 th Jan 2025 , Dr. Tandulwadkar envisions a transformative agenda for women’s healthcare in India. Her flagship projects, such as Sampoorna, wh
Reproductive Coercion Rising for Domestic Violence Survivors
2025-01-03 - 2025-01
With reproductive coercion, an intimate partner prevents a woman from making decisions about her body.Intimate partner violence is a factor in 64 percent of all homicides of pregnant and postpartum women.Healthcare professionals treating pregnant women must assess for risk of coercion and violence and offer help.
According to new data from the National Domestic Violence Hotline (NDVH), reports of abuse involving reproductive coercion nearly doubled in the year after Roe v. Wade was overturned. Clearly, restricting women’s access to reproductive care and abortion has a tremendous impact on everyone, but abuse survivors especially.
Reproductive Coercion:
Reproductive coercion is defined as behaviors or actions by an intimate partner that prevent a woman from making critical decisions about her body or reproductive health. In an intimate partnership with one exerting abusive power over the other, reproductive coercion becomes another form of abuse that increases danger, instills fear, and furthers entrapment.
From my assessment of controlling behaviors used by partners with women in my recovery groups, sexual abuse can take various forms:Using threats or coercion to have sex with you or have sex you don’t like.Waking up to find your partner having or attempting sex with you.Rape–forcing sex acts against your will. (This is less frequently identified; at times, I believe rape occurred, but this was just too painful to admit.)
Reproductive coercion can also include refusing to use contraception and/or preventing a partner from using contraception, restricting her from getting the healthcare she needs, and preventing a partner from receiving abortion care. In whatever form, reproductive coercion endangers women’s lives and sense of safety.
Pregnancy Puts an Abuse Survivor at Higher Risk for Homicide
Intimate partner violence is a factor in 64 percent of all homicides of pregnant and postpartum women, and more than half of all homicides committed against pregnant and postpartum women occur in their own homes (Campbell et al., 2022).In the United States, homicide is the leading cause of death of women who are pregnant or have given birth within a year. According to researchers from Harvard T.H. Chan School of Public Health, women in the United States who are pregnant or have given birth are more apt to be murdered than die from a childbirth-related cause. In addition, they identify that homicides are directly linked to a deadly combination of intimate partner violence and firearms (Oct. 2022).
A 2022 study found that being pregnant or postpartum increases a person’s risk of homicide by 35 percent compared to those of reproductive age who are not pregnant or postpartum; 55 percent of those homicides occurred in the home and are thus classified as domestic violence (Wallace, 2022).Marium Durrani, vice president of policy at NDVH, stresses that if you cannot make decisions regarding reproductive health, it could mean, unfortunately, that this inab
An Audit Cycle of Gynecological History Documentation in Emergency Surgical Admissions of Female Patients of Childbearing Age Presenting with Acute Abdominal Pain at a District General Hospital
2025-01-06 - 2025-01
Abdominal pain constitutes a significant proportion of emergency surgical admissions in developed countries, with associated mortality rates ranging from 0.4% to 4.4% [1,2]. Approximately one-third of these admissions are of female patients of reproductive age (FRA). Within this cohort, the possibility of ectopic pregnancy (EP) should be carefully considered. EP poses a significant risk to maternal health, with the potential for both mortality and morbidity. It is imperative to exclude EP in any sexually active woman of reproductive age presenting with acute abdominal pain. Typically rupturing between six and 12 weeks post conception, EP often presents in individuals unaware of their pregnancy status [3]. This condition remains a leading cause of maternal mortality in early pregnancy, with an estimated 16,000 women affected annually in England and Wales [4]. An investigation highlighting the significant risk to women's health posed by delayed diagnosis of EP reveals that NHS data indicates 30 cases of EP were misdiagnosed in 2017-2018, leading to substantial patient harm [5]. Between 1996 and 2006, a concerning 87 fatalities were reported in the United Kindom (UK), directly linked to diagnostic and therapeutic failures in 56 cases [6].
Given the significant morbidity and mortality associated with EP, particularly in cases of delayed diagnosis, it is imperative to diligently exclude this condition in all women of reproductive age presenting with acute abdominal pain. In accordance with current National Institute for Health and Care Excellence (NICE) guidelines, documentation of pregnancy status is mandatory prior to any elective surgical procedure [7]. A comprehensive preoperative assessment should include a detailed medical history, encompassing the date of the last menstrual period, contraceptive use, sexual activity, and other pertinent gynecological factors. A positive urine or serum beta-human chorionic gonadotropin (?-hCG) test is essential to confirm pregnancy, although it is important to recognize that a negative test does not definitively exclude the possibility of EP, especially in early gestation [8]. This underscores the importance of a comprehensive medical history encompassing the date of the last menstrual period, contraceptive use, sexual activity, and other relevant gynecological factors.
Materials & Methods:
This quality improvement audit was undertaken within the surgical department of Royal Albert Edward Infirmary, a district general hospital in Wigan, UK. Prior to commencing the audit, a formal proposal was submitted to and approved under the code GenSurg/CA/2021-22/09 by the research and audit department of Wrightington, Wigan and Leigh NHS Foundation Trust. The audit periods were: January 1, 2022, to March 31, 2022, for the first cycle and July 1, 2022, to September 30, 2022, for the second cycle The study population comprised female patients aged 12-50 years who presented to the emergency department with acute abdomina
Study outlines Novel Approach for Conservative Management of Placenta Accreta Spectrum Disorder Cases
2025-01-06 - 2025-01
Placenta Accreta Spectrum (PAS) Disorders: A Simplified Conservative Surgical Approach AS disorders, encompassing placenta accrete, increta, and percreta, are life-threatening conditions during pregnancy, characterized by abnormal placental adhesion. They often result in massive postpartum hemorrhage, maternal morbidity, and mortality. Placenta increta and percreta invade the deeper uterine layers and beyond the serosa, complicating placental separation. The standard treatment is caesarean hysterectomy, which, while life-saving, leaves women infertile and impacts self-esteem and societal status in some cultures.
A retrospective study conducted between June 2013 and December 2023 evaluated a conservative surgical technique aimed at preserving fertility in 245 patients with placenta previa and PAS disorders. All procedures were performed by a single experienced surgeon using spinal anesthesia and a Pfannenstiel incision. Diagnosis of PAS was made using transvaginal and transabdominal ultrasonography.
Surgical Technique:
Preparation and Incision: Patients received prophylactic antibiotics before surgery. A transverse uterine incision above the placenta's upper border was made to maintain uterine wall integrity and avoid excessive bleeding. Delivery and Hemostasis: The fetus was delivered, and the umbilical cord clamped without placental separation. The surgeon exteriorized the uterus, applied a hand tourniquet for hemostasis, and carefully removed the placenta. Bleeding areas were clamped and sutured. Repair and Closure: Hemostatic sutures were placed to control bleeding, and the uterine incision was closed in two layers with continuous sutures. Care was taken to avoid injury to adjacent organs, such as the bladder and ureters.
Outcomes:
165 patients underwent scheduled surgery, and 80 were operated on under emergency conditions. An average of 0.52 units of blood transfusion was required per patient. No maternal deaths or cesarean hysterectomies were reported. Surgical complications were minimal, with five cases of spontaneous intra-abdominal bleeding and eight minor complications. The mean surgical duration was 54 ± 11 minutes, and hospital stays averaged 1.71 ± 1.30 days.
Conclusion: This conservative technique offers significant advantages, including reduced blood loss, shorter surgery and recovery times, and fertility preservation. While effective, it requires skilled surgeons with adequate training. The study emphasizes that adopting this technique could benefit many patients globally, providing a safe alternative to hysterectomy in PAS cases.
