The spring meeting of the Society was a combined meeting with the Birmingham and Midlands Obstetrical and Gynaecological Society. It took place on Saturday 6th May 2011 at the Barnsdale Hall Hotel, Rutland. The meeting was hosted jointly by the two Davids; David Horwell, EAOGS president and David Redford BMOGS president.
The president, Mr David Horwell, welcomed the members to the meeting
2. Minutes of previous meeting
The minutes of the previous meeting in Kings Lynn October 2010 were accepted as a true record.
3. Matters arising
4. Secretary’s Report – Hamed Al-Taher
Membership and bursary applications forms are available at the website www.eaogs.org.uk . Members are encouraged to send any suggestions to the President or secretary with regards to the website or any other issues related to the society.
5. Treasurer’s Report
The Society’s bank account was noted to be in a very healthy condition and the accounts will be presented at the autumn meeting as usual.
6. Bursary applications
7. Future Meetings:
a. Autumn meeting 2011 – Great Yarmouth: Joint Regional Training session
b.Members were encouraged to consider hosting future meetings and it was suggested that Cambridge or Norwich may consider organising the next meeting
8. Any other business:
Presidential nominations: David announced that his term of office as EAOGS president has come to an end and members were invited to apply for the president position to the secretary before the autumn meeting in October 2011
First Morning Session
Chair Mr Chandrika Balachandar, Consultant O&G, Walsall Manor Hospital
“Contemporary Gynaecology: Ambulate or Stagnate”
Mr Justin Clark, Consultant O&G, Birmingham Women’s Hospital, Birmingham
Mr Clark Started by explaining what is “office” and “Ambulatory” Gynaecology” and the technological advances in ultrasound equipments, hysteroscopic electrosurgery equipment and cornual tubal occlusion. He outlined how can we set up a new service, describing the benefits for patients, doctors and health service.
“Reaudit of the indications for urgent referral in women with suspected gynaecological cancers”
Dr Thangamma Katimada, Specialist Trainee ST6, Bedford Hospital
Dr Katimada conducted a retrospective audit of 50 case notes to compare the indications for urgent referral for suspected gynaecological cancer with the Department Of Health recommendations 2000 (the standards) and to determine if appropriate examination is being performed prior to referral. IT was recommended to develop a uniform local guidelines for referral and examination and to clarify ill defined terms in the guidelines. Training issues may need to be addressed to ensure GPs perform basic gynae examination prior to referral.
“Fertility outcome following methotrexate treatment for ectopic pregnancy”
Dr Namrata Sharma, Derby
Dr Sharma presented a retrospective audit of fertility outcome of 63 patients who had methotrexate treatment for ectopic pregnancy over a period of 5 years. 92% resolved but 4 patients required salpingectomy (3 ruptured and had laparotomy and one laparoscopic). 37 patients achieved subsequent pregnancy (22 had live birth). MTX should be considered for patients who are suitable and wishing to retain fertility.
“Prevalence of endometrial polyp and its effect on live birth rates in women undergoingART”
Dr Kapoor, Queens Medical centre, Nottingham
Successful implantation largely depends mainly on the quality of embryo and uterine receptivity. This retrospective study assessed endometrium in women having ACT using 3D transvaginal scan and saline infusion sono-hysterography(SIS). The overall prevalance was 3% and pregnancy rates was 25% when polyps managed conservatively and 33% when polyps removed prior to treatment. The conclusion was that, small endometrial polyps (<1.5 cm) seen during ovarian stimulation can be managed conservatively as they do not seem to compromise IVF treatment outcome.
Second Morning Session
Chair Mr David Redford, Consultant O&G, President BMOGS
“Confidential Enquiries: past, present, future”
Dr Imogen Stephens, Clinical Director, CMACE
Dr Stephens gave a brief outline of the different confidential enquiries conducted by the centre for maternal and child enquiries (previously CEMD, CESDI, CEMACH) including “Why mothers die/ saving mothers lives”, “Why children die”, “NCEPOD” and “NCISH”. CEMACE has been involved recently with diverse projects as in diabetes in pregnancy, obesity in pregnancy, H1N1, Child head injury and intrapartum care. CEMACE work programme was commissioned by NICE then NPSA which has announced recently the termination of the procurement process and that the Maternal and Newborn Clinical Outcome Review will be chaired by Dr Sheila Shribman.
“Case Report: management of a pregnant patient with septicaemia with unknown infective focus”
Dr C Gnanachandran, Walsall Manor Hospital
“What is the real value of consent for Caesarean section?”
Mr Chrysostomos Siozos, Post CCT Fellow, Norfolk & Norwich University Hospital, Norwich
Compliance with the RCOG advice on taking consent for CS was assessed over 3 months period in 2010. It was noted that several risks were not covered sufficiently in the consent taking process, women only retain a fraction of the information they receive; the more urgent the CS the less they remember. Obstetrician’s seniority seems to make a difference when consent is taken. Some women preferred not to know the risks of CS before surgery however most women would welcome further counselling on CS antenatally, irrespective of the mode of their delivery
“Update on College Activity”
Dr Tony Falconer, President RCOG
The president introduced the new college officers and gave an update of different college activities. He shared with members the outcome of a recent survey showing 90% support consultant based service and most believe that there is insufficient time to deliver training. New branding of the college includes the new website and the “scanner”, Key themes include Training, working parties, communication, leadership and financial issues.
First Afternoon Session
Chair Mr David Horwell, Consultant O&G, President EAOGS
“High quality women’s healthcare – some new ideas”
Dr Tony Falconer, President RCOG
“First Trimester determination of adverse pregnancy outcome”
Professor Gordon Smith, Head of O&G Department, University of Cambridge
Professor Smith discussed timing of events leading to adverse pregnancy outcome with evidence from ultrasound (CRL) and biochemistry (PAPP-A). There was strong relationship between PAPP-A and subsequent risk of stillbirth related to placental dysfunction. He concluded that the sequence of events leading ultimately to adverse pregnancy outcome starts in very early pregnancy and that Potential for combined serial ultrasonic and biochemical assessment of the placenta to identify women with defective placentation from the general population of low risk women
” The effects of ageing on myometrial structure and function”
Dr Hsu P Chong, Clinical Research Fellow, Addenbrooke’s Hospital, cambridge
Dr Chong showed that there is a linear association between maternal age and intrapartum CS rate. Experiments using the mouse revealed that Ageing is associated with reduced spontaneous myometrial contraction. This was direct effect independent of ovarian secretion of estradiol or progesterone.
“A study of delivery outcomes in women with and without a birth plan”
Dr A Dhanaliwala, Chesterfield Royal Hospital, Chesterfield
“An audit of postnatal contraception advice”
Dr S Lace, University Hospital of North Staffordshire
Second Afternoon Session
Chair Dr Jane Preston, Consultant O&G, James Paget Hospital, Great Yarmouth
“Pathogenesis of uterine adenomyosis”
Mr M Mehasseb, Subspecialty Trainee in Gynae Oncology, Addenbrooke’s Hospital, cambridge
Dr Mehasseb reviewed the adenomyosis pathogenesis proposing abnormal endometrium/myometrium interphace in adenomyosis uteri due to stromal invasiveness and myometrial permissiveness. He concluded that adenomyosis involves disorganisation of the endometrial / myometrial interface in a susceptible individual which is caused by endometrial and myometrial abnormalities
“Prescribing antimuscarinics for overactive bladder: how many chances do we have to get it right?”
Dr R Basra, ST5 Bedford Hospital
“From OASIS to BASIC: the role of investigations in the management of pelvic floor dysfunction”
Mr Philip Toozs-Hobson, Consultant Gynaecologist, BirminghamWomen’s Hospital
Assessors’ report on trainees’ papers and presentation of prizes
Close of the Meeting
The two Presidents drew the meeting to a close by thanking the speakers and members.
Special thanks were also given to the Pharmaceutical companies for their generous contributions in providing sponsorship for the scientific meeting.
To conclude the day, the Society Dinner was held at the hotel Restaurant