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The 13th World Congress on Controversies in Obstetrics, Gynecology & Infertility (COGI) Held jointly with The German Society of Obstetrics & Gynecology
Maritim Hotel, Berlin, Germany, November 4-7, 2010 |
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| Fetomaternal Medicine |
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Thursday, November 4, 2010
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| 17:30-19:00 |
Opening Session |
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Keynote Lectures - Leaders' prospective on the future Technology-based advances in obstetrics, gynecology and infertility facilitate earlier, less-invasive diagnosis: What does the future hold for our main subdisciplines? |
| Chairpersons |
Z. Ben-Rafael, Israel K. Diedrich, Germany B. Fauser, Netherldands R. Fischer, Germany Z. Shoham, Israel |
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Fetomaternal Medicine Genetic diagnosis on fetal cells in maternal blood: Will it ever become routine?
G.C. Di Renzo, Italy |
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Gyn-Oncology Ovarian Cancer: Can new markers change the fate of the disease?
R.G. Moore, USA |
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Reproductive Medicine Science vs. Practice P. Patrizio, USA |
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| 19:00-20:30 |
Opening and Cocktails |
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08:30-10:00 |
The Challenges of Perinatal Viability |
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Capsule |
Despite great advances in perinatal medicine, the challenges of the gestational period from 22 to 26 weeks are still poignant for the perinatologists
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| Chairperson |
J. Dudenhausen, Germany |
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Outcome of the periviable infant: Have we reached the limit? M. Carrapato, Portugal |
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What is the best method to deliver very premature babies? D. Skupski, USA |
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Economic considerations in the management of the periviable infant M. Carrapato, Portugal |
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Ethical dimensions in obstetric and neonatal care of the periviable infant F.A. Chervenak,USA |
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Objectives |
Upon completion of this session, the audience will have learned: |
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* To understand the burden of very premature delivery on medical, economical, societal and parental issues * To understand the risk of vaginal vs. Cesarean for periviable infants * To apply ethical principles to challenges evolving from perinatal management of the periviable infant
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| 10:00-10:20 |
Coffee break |
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10:20-11:50 |
The Challenge of Membrane Rupture Diagnosis, Chorioamnionitis and Perinatal Infection |
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Capsule |
Chorioamnionitis and Perinatal Infection are major causes of perinatal morbidity and mortality |
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Advances in the diagnosis of premature rupture of the membrane |
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Controversies in the obstetric management of chorioamnionitis |
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Diagnosis and management of chorioamnionitis form the neonatal perspective |
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Objectives |
The accurate diagnosis of premature rupture of membranes |
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* To understand the impact of perinatal infection with and without chorioamnionitis * How available tools can enhance diagnosis
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| 11:50-12:10 |
Poster viewing |
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12:10-13:40
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Prematurity
Sponsored by an unrestricted grant from Hologic (UK) Limited |
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Capsule |
Despite the high perinatal morbidity and mortality associated with preterm delivery, no existing tool is specific enough to diagnose premature labor, and no good and reliable intervention is available early enough to interrupt the vicious circle of labor. The question is: Can we really decrease prematurity? |
| Chairpersons |
A. Shennan, UK J. Deprest, Belgium |
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Diagnosis of preterm labor (PTL) and prediction of premature delivery: Who to treat, and who not to treat?
A. Shennan, UK |
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Debate: Is Cervical Length Measurement Necessary over Biochemical Markers to Predict Preterm Birth?!
The combined use of cervical length (CL) and cervicovaginal fetal fibronectin (fFN) in women with threatened preterm labour W. Henrich, Germany
Ultrasound cervical length measurement is mandatory during preterm birth assessment B. Arabin, Netherlands
Discussion |
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What are tocolytics good or bad for?
G.C. Di Renzo, Italy |
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Objectives |
Upon completion of this session, the audience will have learned: |
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* The pitfalls of diagnosis and treatment of PTL * Selecting who to treat * The place of late cerclage in the management of bulging membranes * Technique, indication, and contraindication of late cerclage
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| 13:40-14:30 |
Lunch break |
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14:30-16:00 |
Timing of Delivery and Intrapartum Complications |
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Capsule |
Despite the well-known perils of delivery, and notwithstanding the advanced methods and tools to diagnose the infrequent conditions that can negatively affect the results it should still be ascertained whether misjudgment and errors will not dominate the delivery room scene. What can we do to minimize the risk in this critical phase of human life?
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How can the risks of labor and delivery by monitoring be minimized? |
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Can we prevent complications in high-risk pregnancies (previa, accreta, diabetes, IUGR, abnormal Doppler, olygohydramnios, PIH) by well-timed delivery? |
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Fetal resuscitation in labor: Is it feasible? |
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Objectives |
To acquire understanding of the following: |
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* How monitoring can decrease risks * How planned delivery can prevent complications * How in utero resuscitation can be achieved * When to induce, and when not to induce
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| 16:00-16:30 |
Coffee break |
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16:30-18:00 |
Progesterone: From Luteal Support to Abortions |
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Capsule |
The growing place of progesterone support during pregnancy, by indication or off label, deserve a critical evaluation. Many recent publications indicate the safety of various preparations in the management of threatened abortion, recurrent abortions, and to reduce preterm labor. |
| Chairperson |
J. Dudenhausen, Germany |
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The growing palace of progesterone in prevention of prematurity and pregnancy complications G.C. Di Renzo, Italy |
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Improving blood flow with Dydrogesterone as a method to prevent abortions |
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Prevention of recurrent abortions and treatment of threatened abortion by progesterone F. Facchinetti Modena, Italy |
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Objectives |
* Understanding the role of different Progeterone compounds in the prevention of early and repeated abortion * Appreciating the increasing role of Progeterone support to prevent premature labour |
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Saturday, November 6, 2010 |
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08:30-10:00 |
Avoiding Invasive Prenatal Diagnosis |
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Capsule |
The race to attain a complete, noninvasive prenatal genetic diagnosis remains, as yet, an unachieved goal of perinatology. Nevertheless, refinement of old tools and advances in new tests are indications of the future. What are the hurdles to achieve a noninvasive prenatal genetic diagnosis, and how do ethical and patient choices affect this dilemma?
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| Chairpersons |
J. Deprest, Belgium B. Arabin, Germany |
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Only a few anomalies will escape detection with ultrasound and biomarkers: Should we be content with this combined tool? |
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Debate: Proposition: Chorionic villous sampling (CVS) is the next step after increased NT
A. Anstaklis Greece Opposition: CVS should be performed only if detailed screening for anomalies is negative
M. Bronshtein, Israel
Discussion |
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Objectives |
Upon completion of this session, the audience will learn: |
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* The advantages and limitations of current methods * Recognize all the added values of early ultrasound screening * Recognize the full constellation related to prenatal diagnosis
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10:00-10:20 |
Coffee break |
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10:20-11:50 |
Uterine Contractility |
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Capsule |
Controlling uterine contractility to induce or prevent labor is the most important task of current obstetrics. What do we have in hand and what are we striving for? |
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Should we use repeated courses of Atosiban? |
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What is the best method for induction of labor? |
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Carbetocin: A new player on the block? |
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Reducing the risk of premature labor by prophylactic progesterone: Is it feasible? |
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Objective |
To understand the role and efficacy of repeated Atosiban administration |
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* Methods to induce labor in different settings * New opportunities to prevent premature labor
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| 11:50-12:120 |
Poster viewing |
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12:10-13:40 |
Prediction of Hypertensive Disorders in Pregnancy |
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Capsule |
Hypertensive disorders associated with underlying placental and maternal changes, and are associated with endothelial dysfunction and vasospasm, leading to placental insufficiency and serious consequences to the mother and infant. A major development was achieved in the recent years in identifying various markers and tools for predicting the disorders. In addition to the traditional collection of medical and obstetric history and measurements of blood pressure and urine proteins, the effectiveness of pulsatility index of the uterine artery, pregnancy-associated plasma protein-A, placental growth factor, placental protein 13 (PP13) and direct measurements of endothelial dysfunction were shown to be very promising markers. However, since the exact pathophysiological mechanism leading to this condition is still poorly understood, it is difficult to devise a prevention plan. Hence, the question is: what is the medial benefit for prediction? Could close surveillance of the patient at risk can prevent the pathology or save maternal and fetal life? Should we keep investing in prediction in the absence of an ultimate preventive treatment?
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Prediction of preeclampsia by biomarkers - the scientific and clinical data and prospective for improved perinatal service and prevention B. Huppertz, Austria |
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Debate: Should we Strive to Predict Pre-eclampsia?
Proposition: Prediction is possible with newer methods and this is the first step towards prevention!
B. Huppertz, Austria
Opposition: Investing in prediction of pre-eclampsia is futile, since there is no effective treatment
Discussion |
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What can we learn from measuring endothelial dysfunction? |
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Objectives |
Upon completion of this session, the audience will have learned about:
* New research and tools to predict pre-eclampsia
* The role of PP-13 measurements
* The place of endothelial dysfunction measurements
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| 13:40-14:30 |
Lunch break |
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14:30-16:00 |
3-D and 4-D Ultrasound in Modern Perinatal Medicine and Neurobehavioral Assessment |
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Capsule |
3-D and 4-D
sound represents the height of modern ultrasound technology, but the role of this technology remains controversial
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| Chairpersons |
A. Antsaklis, Greece B. Arabin, Germany |
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Debate: Should 3-D and 4-D Ultrasound be Used in Every Pregnancy? Pro: A. Kurjak, Croatia Con: F.A. Chervenak, USA
Discussion |
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Are the current criteria valid for defining a causal relationship for cerebral palsy?
I. Blickstein, Israel |
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Potential of 3-D and 4-D ultrasound for neurobehavioral assessment in perinatal medicine
M. Stanojevic, Hungary
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Objectives |
Upon completion of this session, the audience will have learned about: |
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* To establish whether 3/4-D ultrasound is indicated in every pregnancy? * To establish whether 3/4-D ultrasound is of value for neurobehavioral assessment in perinatal medicine? * To understand the relationship of intrapartum events to cerebral palsy
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| 16:00-16:30 |
Lunch break |
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16:30-18:00 |
Controversies in Prenatal Diagnosis and Therapy |
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Capsule |
Implementing modern diagnosis and therapy continues to provoke controversies
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Chairpersons |
F.A. Chervenak, USA
A. Grunebaum, USA |
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Amniocentesis vs. CVS?
A. Antsaklis, Greece |
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Controversies in the management of twin-to-twin transfusion syndrome
D. Skupski, USA |
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Fetal therapy
J. Deprest, Belgium |
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Objectives |
To appreciate the continuing improvements in obstetrical ultrasound |
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* To understand current developments in the management of twin-to-twin transfusion syndrome * To appreciate new developments in invasive fetal therapy
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08:30-10:00 |
Ultrasound (US) Screening for Anomalies |
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Capsule |
Screening for anomalies with US is widely used. However, many elements of the examination remain controversial
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| Chairpersons |
J. Deprest, Belgium K. Vetter, Germany
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| Discussants |
M. Bronshtein, Israel A. Kurjak, Croatia A. Antsaklis, Greece M. Stanojevic, Croatia
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Hot Controversies |
Expert Opinions on: |
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Nasal bone: Fact or myth?
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Can "family album" assist in prenatal US screening?
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What can be gained by combining transvaginal screening (TVS) with transabdominal screening (TAS) in late (24 weeks) sonographic screening?
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Does intra-amniotic sludge predict preterm delivery?
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Can we agree on the definition of Dandy-Walker syndrome in ultrasonography?
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Early (14-16 weeks) or late (18-22 weeks) screening
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Amniotic band syndrome: Fact or myth
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Ultrasound: Its reliability in the diagnosis of placenta accreta and vasa previa
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Elective fetal reduction: In the early or late first trimester
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Folic acid: Can it prevent other conditions or only NTD? And at what dose?
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Elective fetal reduction: In the early or late first trimester |
| 10:00-10:30 |
Coffee break |
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10:30-12:30 |
Controversies over Endless Cesarean Delivery and Multiple Pregnancy |
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Capsule |
Cesarean delivery, the most common surgical procedure performed, continues to generate controversies that challenge all obstetricians. The almost universal use of CS to deliver multiple pregnancies adds to the problem
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| Chairperson |
F.A. Chervenak, USA |
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What is the ideal Cesarean delivery rate?
B. Serra, Spain |
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Patient choice - Cesarean: The role of evidence and ethics
F.A. Chervenak, USA |
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Elective preterm delivery for all monochorionic (MC) twins?
I. Blickstein, Israel |
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Management of complicated MC twins
J. Deprest, Belgium |
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Outcome of multiple pregnancies - 2010: Spontaneous vs. iatrogenic
M. Carrapato, Portugal |
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Objectives |
To respect the impact of iatrogenic prematurity caused by Cesarean delivery |
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* To provide ethical appropriate strategies for dealing with patient-requested Cesarean delivery
* To understand hot controversies in the management of multiple pregnancies |
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