6th International Conference on Gynecology and Obstetrics August 25-26, 2018 Prague | Czech Republic

Menstrual disorders are when a woman’s menstrual cycle irregular, causing symptoms such as dysmenorrhea, premenstrual syndrome, menorrhagia, oligomenorrhea, amenorrhea, missed & irregular periods. Menopause is well known concept in Gynecology. Menopause is the time in which when menstrual periods stop permanently, and they are no longer able to bear children are also known as climacteric.

Women with little or no prenatal care have negative outcome and who receive prenatal care during the first trimester have better pregnancy outcomes. To avoid or reduce the frequency of maternal death, miscarriages, birth defects, low birth weight, neonatal infections and other preventable health problems, all the pregnant women should thoroughly undergo routine prenatal care, including prenatal screening and diagnosis. To identify risk factors and initiate preventive care measures, women should regularly get their labs and screening tests done throughout pregnancy. Maintaining maternal health optimizes the success for positive pregnancy outcomes.

The role of ultrasound in obstetrics and gynecology has made tremendous impact in patient care. Ultrasound has permitted the imaging of the fetus and placenta in obstetrics and maternal internal organs in gynecology with very good clarity to allow advanced diagnosis and helped to guide various lifesaving interventions in both the cases of the fetus and the mother. The gynecology societies and associations and mainly the International Society of Ultrasound in Obstetrics and Gynecology and World Federation of Ultrasound in Medicine and Biology disapprove the use of ultrasound for the sole purpose of providing the souvenir images of the fetus which give a chance on knowing the gender of the fetus.

The current form of fetal monitoring was firstly introduced in the 1960s. Fetal monitoring was well established worldwide for monitoring pregnancies from ~26 weeks gestation right through to labor & delivery of the new born. Antenatally, pregnant women are monitored for, typically, 20 to 30 minutes at a time, repeated at intervals determined by their risk level. This will depend on their obstetric history, social factors, medical & clinical factors. In the UK, NICE have issued guidelines for trace interpretation, together with appropriate decision support & clinical management pathways. In labour, pregnant women are typically monitored continuously throughout labour, right up to delivery.

There are specific reasons for bleeding in the first term of pregnancy. They are inevitable abortion, incomplete abortion, and complete abortion. Bleeding sometimes may be a cause of missed abortion and because of blighted ovum. The complications that result is hypovolemic shock, infection, septic shock, anemia. To rule out the above the following investigations are. They are pregnancy test positive, ultrasound, complete blood count, blood group for repeated miscarriage refer to a gynecologist for the following investigations: genetical, immunological profile, infection screening, hysteroscopy, endocrine.

Although laparoscopic procedures are performed with few instruments, technology remains very important, considering the significance of the interaction between the surgeon and the instruments. Several considerations concerning patient care apply to all patients and procedures, but some considerations exist that are of unique importance in the gynecologic setting. Since reproduction is essential to the species, there are personal, familial, and social implications in obstetric and gynecologic surgery.

The field of maternal-fetal medicine includes several stages of women’s health and pregnancy. They are preconception care, specialized prenatal care and intrapartum care, obstetric and medical complications of pregnancy, diagnosis and management of fetal anomalies, fetal complications, and fetal testing. It is familiar that the training and experience learned by obstetric care providers may allow them to manage some complex pregnancies.

There are several types of infections that occur during pregnancy. Transmission of HIV virus from the infected mother to child may occur during pregnancy, labor, delivery, and breastfeeding. Hepatitis B is a viral disease of liver with an incubation period of 6weeks -6months. Genital herpes is caused by the herpes simplex virus either type 1 or 2 (HSV-1 or HSV-2). During primary infection of HSV the Mother can infect the fetus during delivery.

There are number of complications that occur primarily during childbirth. These complications are termed to be obstetric labor complications, and the different problems that occur primarily after childbirth are termed to be puerperal disorders. Complications of pregnancy, childbirth, and the puerperium are estimated to be found in atleast 1.6% of mothers in the US and in 1.5% of mothers in Canada. In the immediate postpartum period (puerperium) of the mother, 87% to 94% of women report at least one health problem during the postpartum period. Long term health problems that are persisting after 6 months of postpartum are reported by 31% of women in the world.

The term postnatal period cab be defined as the first six weeks after the baby birth which is critical to the health and survival of a mother and as well as her newborn. After hours and days after birth, it is the most vulnerable time for both. During this time, mistakes like lack of care may cause death or disability. Due to improper care, there could be missed opportunities to promote healthy behaviors, affecting women, newborns, and children. The critical maternal health outcome considered is maternal morbidity which includes includes hemorrhage, infections, anemia and depression. There are two critical neonatal outcomes, they are neonatal mortality and morbidity. Growth, cognitive development and breastfeeding status are other important outcomes that were considered for guidelines of development.

Before delivery, a woman must take care of only herself and after delivery she has to care of herself as well as her baby. Postpartum care is primarily important to the newly born baby as well as the mother. Breastfeeding is of the most important key parameter postpartum care. Next comes in line protection of the new born from external infections and providing the baby with all the vaccinations at regular time intervals. Nine months of delivery can be divided into three stages and that is pre-partum care, Intra-partum care and postpartum care. This quality standard covers the care of women who go into labor at term (37+0 weeks to 41+6 weeks) and their babies during labor and immediately after the birth. In a study based in the United Kingdom (UK) in 2007 Breeze et al. reported that only 40% of women faced with a diagnosis of lethal fetal anomaly chose to continue with their pregnancies, with the other 60% electively terminating the pregnancy.

Obstetricians and gynecologists are usually working in close contact with the main sources of promising stem cell types; embryonic stem cells (ES), umbilical cord blood stem cells (UCB) and fetal stem cells. Several recent studies reviewed and outlined possible areas in which stem cell research can be applied in fields related to Gynecology and Obstetrics. The use of hemopoietic stem cells in the treatment of gynecological tumors. The use of stem cells in the derivation of neural dendritic cells as a possible immunotherapeutic modality for solid malignant tumors. In-utero stem cell transplantation has been successfully used as a possible therapeutic strategy for immuno-deficiencies and severe congenital diseases of the fetus such as thalassemia.

Novel laser technology enables broad range of clinical as well as cosmetic gynecological treatments. Labiaplasty is the most common cosmetic gynecological procedure. A study of female genital plastic surgery showed the enhancement of self-esteem and functional improvement after cosmetic gynecological procedures.

Reproductive endocrinology and infertility discipline is a surgical subspecialty of obstetrics and gynecology. In this, the physicians get trained in reproductive medicine addressing hormonal functioning as it pertains to reproduction as well as the issue of infertility in women. While most Reproductive Endocrinology specialists primarily focus on the treatment of infertility, apart from that they are also trained to evaluate and treat hormonal dysfunctions in females and males outside infertility. Reproductive endocrinologists were generally given special training in the discipline of obstetrics and gynecology. After special training in obgyn, they undergo the sub-specialty training i.e., fellowship program in reproductive endocrinology to treat all the diseases and malignancies related to women’s health.

There are approximately 400,000 new cases of cervical cancer worldwide annually. In 2017 there were 12,820 anticipated new cases identified with approximately 4,210 deaths in the United States. The most common symptom of cervical cancer is abnormal vaginal bleeding— specifically, postcoital and intermenstrual bleeding, menorrhagia, and postmenopausal bleeding. Other symptoms include pelvic fullness/pain, unilateral leg swelling, bladder irritability, and tenesmus. Cervical cancer is also commonly asymptomatic, found only following an abnormal Pap smear, colposcopy exam, or cervical biopsy.

Urogynecology is sub-division of gynecology. Urogynecologists are specially trained medical professionals who treats clinical problems related to dysfunction of the pelvic floor and bladder. In some countries Urogynecology is also known as Female Pelvic Medicine and Reconstructive Surgery. Some of the disorders in pelvic floor include urinary incontinence, pelvic organ prolapses and fecal incontinence. Other conditions where urogynecology is practiced are Cystocele, Enterocele, Female Genital Prolapse, Lichen sclerosus, Overactive Bladder and Rectovaginal fistula.

Urinary tract infections are one of the most common bacterial infections seen in primary care, secondary to infections of the respiratory tract. Women are particularly at risk of developing UTIs because of their short urethra, and certain behavioral factors which include delay in micturition, sexual activity and the use of diaphragms and spermicides. Uncomplicated UTIs are usually treated empirically with antibiotics. However, not everyone diagnosed with a UTI and treated with an antibiotic will necessarily have a bacterial infection.

The branch of medicine dealing with the prevention, diagnosis and management of reproductive problems is known to be reproductive medicine. The aim of Reproductive Medicine is to improve and maintain the quality of reproductive health. The knowledge of reproductive medicine is based on reproductive anatomy, endocrinology, physiology and pathology. The issues addressed in reproductive medicine are sexual education family planning, reproductive system diseases, birth control, infertility and sexual dysfunction. Ovulation, pregnancy, menstruation, menopause and other gynecological problems are also assessed under reproductive medicine.

The estimation of NCI is that endometrial, or uterine, cancer is diagnosed in an estimated 39,090 American women this year, more than twice the number of women who will be diagnosed with cervical (lower part of the uterus) and ovarian (female reproductive glands) cancers combined. Abnormal vaginal dying, for example, seeping after sex (vaginal intercourse), seeping after menopause, draining and spotting amongst periods, and having longer or heavier (menstrual) periods than common. Seeping in the wake of douching, or after a pelvic exam is a typical side effect of cervical tumor however not pre-disease.

Midwifery is the approach to childbirth and women’s health care that is used extensively in many parts of the world, including Europe, Australia, New Zealand, and Japan. Medicine focuses on the pathologic potential of pregnancy and birth, whereas midwifery focuses on its normalcy and potential for health. Pregnancy, childbirth and breastfeeding are normal bodily and family functions. Midwives know about the medical risks, identify complications early, and collaborate with physicians to assure medical care for serious problems.

Sexual and reproductive health and rights of women include the right to legal and safe abortion. A woman has the right to birth control. She has the freedom from coerced sterilization and contraception. She also possesses the right to access good-quality reproductive healthcare and the right to education. She also has access to make free and informed reproductive choices. Reproductive rights may also include the right to receive education about sexually transmitted infections and other aspects of sexuality, and protection from practices such as female genital mutilation.

The initiation of family planning remains unfinished still today. Despite of the great progress over the last few decades, more than 120 million women worldwide wish to prevent unwanted pregnancy, but they and their partners are not properly utilizing the method of contraception. The reasons for unmet need are many and are as follows. They are services and supplies are not yet available everywhere or the choices of contraception are very limited. Moreover, the job of family planning will be left unfinished. In the next 5 years about 60 million girls and boys will reach sexual maturity. Generation after generation, there will always be need for people of family planning and other health care services for women.

The study of neonatology includes various aspects like neonatal care, infections that occur and complications that are caused to the neonates. The various complications that neonatal study deals with are low birth weight/ prematurity. This also includes apnea of prematurity, neonatal bilirubinemia, hypotension, patent ductus arteriosus, respiratory distress syndrome, retinopathy of prematurity and necrotizing enterocolitis, and hemorrhagic & ischemic brain injury in the preterm infant.

The goal of pediatric and adolescent gynecology is to create an “adolescent-friendly environment” in the office setting for physical examination. Strategies are developed by focusing on minimally invasive surgery. Gynecologic surgeons are increasingly being called upon to manage Müllerian anomalies; pre-operative as well as intra-operative expertise will be emphasized. Surgeons will aid in fertility preservation when a young female/male patient is diagnosed of cancer or any other chronic debilitating disease.