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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
 
  Fetomaternal Medicine Print


POSTERS

 
Thursday, November 4, 2010
 
17:30-19:00 Opening Session
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

17:30-17:55

Reproductive Medicine
ART: Where did we come from; where we are heading?
R. Frydman, France

17:55-18:20
 
Fetomaternal Medicine
Genetic diagnosis on fetal cells in maternal blood: Will it ever become routine?
G.C. Di Renzo, Italy

18:20-18:40
 
Gyn-Oncology
Ovarian Cancer: Can new markers change the fate of the disease?
R.G. Moore, USA

18:40-19:00
 
Reproductive Medicine
ART: The Future of Reproductive Medicine
P. Patrizio, USA
 
19:00-20:30
Opening and Cocktails

 
Friday, November 5, 2010
 

08:30-10:00
 The Challenges of Perinatal Viability
Capsule
Despite great advances in perinatal medicine, the challenges of the gestational period from 22 to 26 weeks are still poignant for the perinatologists
   
Chairperson
J. Dudenhausen, Germany
D. Farine, Canada
 
 
Outcome of the periviable infant: Have we reached the limit?
M. Carrapato, Portugal
 
What is the best method to deliver very premature babies?
D. Skupski, USA
 
Economic considerations in the management of the periviable infant
M. Carrapato, Portugal
Ethical dimensions in obstetric and neonatal care of the periviable infant
F.A. Chervenak,USA
 
Objectives
 
Upon completion of this session, the audience will have learned:
 
 
* 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
       
10:00-10:20 Coffee break
 

10:20-11:50
Early Diagnosis of Premature Rupture of Fetal Membranes (PROM)
Sponsored by an unrestricted grant from AmniSure® International LLC
Capsule
Early diagnosis of PROM by highly sensitive and specific tool, can enhance treatment of this hazardous fetal and maternal condition
 
Chairpersons
 
D. Farine, Canada
A. Grunebaum, USA
H. Helmer, Austria
 

Debate: Are we now in the Verge of Resolving the Longstanding Controversy that has Surrounded PROM Diagnosis?
    
PROM and the Controversy that surrounded its Diagnosis.
A. Grunebaum, USA
The Advent of the PAMG-1 Immunoassay lay to rest the controversy regarding diagnosis of PROM
H. Helmer, Austria
Discussion
 
 
 
Objectives
 
Upon completion of this session, the audience will learn
 
* The risks involved in an inaccurate diagnosis to both patient and physicians
* The clinical and financial burden of inaccurate diagnosis
* How available tools can enhance diagnosis of PROM
 
    
11:50-12:10
Poster viewing

12:10-13:40
 
Prematurity
Sponsored by an unrestricted grant from Hologic (UK) Limited
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
 
 
Diagnosis of preterm labor (PTL) and prediction of premature delivery: Who to treat, and who not to treat?
A. Shennan, UK
 
 
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
 
 
 
 
  
 
 
 
What are tocolytics good or bad for?
G.C. Di Renzo, Italy
 
Objectives
 
Upon completion of this session, the audience will have learned:
 
* 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
        
13:40-14:30 Lunch break

14:30-16:00
Uterine Contractility
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?
 
Chairpersons
J. Dudenhausen, Germany
N. Gleicher, USA
 
 
What is the best method for induction of labor?
TBA
 
Carbetocin: A new player on the block?
D. Farine, Canada
Efficacy of non-medical methods to induce labor
I. Blickstein, Israel
 
Objectives
 
To acquire understanding of the following:
 
* To understand methods to induce labor in different settings
* New opportunities to prevent premature labor     
      
16:00-16:30 Coffee break

16:30-18:00
Progesterone: From Luteal Support to Abortions
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
 
 
The growing palace of progesterone in prevention of prematurity and pregnancy complications
G.C. Di Renzo, Italy
 
Improving blood flow with Dydrogesterone as a method to prevent abortions
S. Daya, Canada
 
Prevention of recurrent abortions and treatment of threatened abortion by progesterone
F. Facchinetti Modena, Italy
 
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

 
Saturday, November 6, 2010

08:30-10:00
Controversies in Prenatal Diagnosis and Therapy
Capsule
Implementing modern diagnosis and therapy continues to provoke controversies
  
Chairpersons
F.A. Chervenak, USA
A. Grunebaum, USA
 
 
Management of complicated MC twins
J. Deprest, Belgium
Amniocentesis vs. CVS?
A. Antsaklis, Greece
 
Fetal therapy
J. Deprest, Belgium
 
Controversies in the management of twin-to-twin transfusion syndrome
D. Skupski, USA
 
Objectives
 
To appreciate the continuing improvements in obstetrical ultrasound
 
* To understand current developments in the management of twin-to-twin transfusion syndrome
* To appreciate new developments in invasive fetal therapy
        
10:00-10:20
Coffee break

10:20-11:50
Avoiding Invasive Prenatal Diagnosis
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?
 
Chairpersons
J. Deprest, Belgium
B. Arabin, Germany
Y. Zalel, Israel 
 
 
Only a few anomalies will escape detection with ultrasound and biomarkers: Should we be content with this combined tool?
 
 
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
 
 
 
 
  
 
Objectives
 
Upon completion of this session, the audience will learn:
 
* The advantages and limitations of current methods
* Recognize all the added values of early ultrasound screening
* Recognize the full constellation related to prenatal diagnosis
 
11:50-12:10 Poster viewing

12:10-13:40
Prediction of Hypertensive Disorders in Pregnancy
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?
 
      
Prediction of preeclampsia by biomarkers - the scientific and clinical data and prospective for improved perinatal service and prevention
B. Huppertz, Austria
 
 
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
G. Visser, The Netherlands
Discussion
 
 
 
 
 
 
What can we learn from measuring endothelial dysfunction?
G. Pillar, Israel
 
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
 
13:40-14:30 Lunch break

14:30-16:00
3-D and 4-D Ultrasound in Modern Perinatal Medicine and Neurobehavioral Assessment
Capsule
3-D and 4-D ultrasound represents the height of modern ultrasound technology, but the role of this technology remains controversial
     
Chairpersons A. Antsaklis, Greece
B. Arabin, Germany
 
 
Debate: Should 3-D and 4-D Ultrasound be Used in Every Pregnancy?
Pro: A. Kurjak, Croatia
Con: F.A. Chervenak, USA
Discussion
 
 
 
 
      
 
Are the current criteria valid for defining a causal relationship for cerebral palsy?
I. Blickstein, Israel 
 
Potential of 3-D and 4-D ultrasound for neurobehavioral assessment in perinatal medicine
M. Stanojevic, Hungary
  
 
 
Objectives
 
* 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
    
16:00-16:30 Coffee break

16:30-18:00
Evidence-Based Medicine (EBM): "Holy Grail" or More Doubts?
Capsule
This debate is certain to continue: Evidence-based medicine (EBM) has become the new “Holy Grail” of clinical decision making. Of course, EBM is, however, only as good (or bad) as the best available evidence (BAE). BAE, in turn, is dependent on the quality of published studies, which are often weak because of poor study design, flawed statistical evaluations, or outright fraud. Meta-analyses of randomized clinical trials (as propagated by Cochrane) have become a favored tool in establishing BAE, often overlooking that many of these trials are seriously underpowered and, therefore, do not allow for the conclusions they claim. EBM may, therefore, possibly be viewed with the same healthy degree of skepticism as that for IBM programmers who brought “garbage in, garbage out!” to the early days of software development
  
Chairpersons
B. Fauser, Netherlands
J. Studd, UK
 
 
Debate: EBM: What's Next?
Proposition: EBM represents the only valid approach towards medical decision making
S. Daya, Canada
Opposition: EBM has limited value in daily clinical care and cannot replace clinical judgment
N. Gleicher, USA
Discussion
 
 
Can we really conduct efficacy trials in intracytoplasmic sperm injection (ICSI) with pregnancy as the outcome when the conclusion is likely to be worthless because of postrandomization manipulation?
S. Daya, Canada
 
Objectives
 
Upon completion of this debate, the audience will learn:
 
* How BAE is established
* Advantages and limitations of BAE
* Levels of evidence and how they are established
* Different clinical study formats and their respective advantages and disadvantages
 
        

Sunday, November 7, 2010

08:30-10:00
Ultrasound (US) Screening for Anomalies
Capsule
Screening for anomalies with US is widely used. However, many elements of   the examination remain controversial
 
Chairpersons A. Kurjak, Croatia
K. Vetter, Germany
 
Discussants
M. Bronshtein, Israel
A. Antsaklis, Greece
M. Stanojevic, Croatia
Y. Zalel, Israel
 
Hot Controversies
Expert Opinions on:
 
  • Nasal bone: Fact or myth?
  • Can "family album" assist in prenatal US screening?
  • What can be gained by combining transvaginal screening (TVS) with transabdominal screening (TAS) in late (24 weeks) sonographic screening?
  • Does intra-amniotic sludge predict preterm delivery?
  • Can we agree on the definition of Dandy-Walker syndrome in ultrasonography?
  • Early (14-16 weeks) or late (18-22 weeks) screening
  • Amniotic band syndrome: Fact or myth
  • Ultrasound: Its reliability in the diagnosis of placenta accreta and vasa previa
  • Elective fetal reduction: In the early or late first trimester
  • Folic acid: Can it prevent other conditions or only NTD? And at what dose?
  • Elective fetal reduction: In the early or late first trimester
10:00-10:30 Coffee break

10:30-12:30
Controversies over Endless Cesarean Delivery and Multiple Pregnancies
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
  
Chairperson F.A. Chervenak, USA
 
 
What is the ideal Cesarean delivery rate?
B. Serra, Spain
 
Patient choice - Cesarean: The role of evidence and ethics
F.A. Chervenak, USA
Elective preterm delivery for all monochorionic (MC) twins?
I. Blickstein, Israel
Outcome of multiple pregnancies - 2010: Spontaneous vs. iatrogenic
M. Carrapato, Portugal
 
Objectives
 
To respect the impact of iatrogenic prematurity caused by Cesarean delivery
 
 
* To provide ethical appropriate strategies for dealing with patient-requested Cesarean delivery
* To understand hot controversies in the management of multiple pregnancies

POSTERS

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