2nd International Meeting on Gynecology and Obstetrics Pathology November 19-20, 2018 Holiday Inn Paris - Marne La Vallee | Paris, France

Ilta Bylykbashi graduated from University of Tirana in the year 2003. She was awarded the title of “Best student of University”. She has been working in the University Hospital under the department of Obstetrics and Gynecology. She has published several papers in diff erent journals and participated in international and national conferences.

Placenta Previa (PP), both major and minor, aff ects approximately 1 in 250 pregnancies and, at times it can be life threatening, with an associated perinatal mortality rate 3-4 times higher than normal pregnancies. Th e aim of this study was to compare general and obstetrical characteristics and outcomes of pregnant women presenting with diff erent types of PP in the premises of University Hospital for Obstetrics and Gynecology “Queen Geraldine” during 2013-2017 in Tirana, Albania, a post-communist South-East European country. In total there were diagnosed 169 PP cases among 34992 births, with an incidence rate of 0.48%. Major PP (total or partial) was present in 79 women (46.7%) and minor PP (marginal) was present in 90 women (53.3%). In total 10 hysterectomies were performed among PP women (9 in major PP women). Placenta accreta was present in 8 major PP women (10.1%) and 1 minor PP women (1.1%). Maternal and gestational age, parity and previous cesarean deliveries were similar (P>0.05) among major and minor PP women. Almost all PP women needed (96.4%) blood transfusion. Morbidity among PP women included: post-partum hemorrhage (23.1%), puerperal sepsis (36.7%), wound infection (5.3%), acute renal failure (4.1%), disseminated intravascular coagulation and urinary tract infection (1.8% each). Signifi cantly more major than minor PP women needed 4 or more units of blood. Major placenta previa entails a more disadvantageous morbidity and mortality profi le compared to minor PP women in Albania. Th is fi nding has medical and public health implications.

Hashviniya Sekar is currently an O&G Trainee in the North Central and East London Thames Deanery, London. Having graduated from King\'s College London with Distinction in Medical Sciences and Clinical Sciences as well as a First Class Honours in Maternal & Fetal Health Physiology, she is actively involved in research and medical education. She has published in a leading Menopause journal and has been a co-author for books on questions in Obstetrics and Gynaecology for Undergraduate students.

Aim: To describe a case of a pregnant lady who presented with acute appendicitis in the 3rd trimester and was managed with Laparoscopic appendectomy and made a very good recovery. Traditionally in the 3rd trimester, laparotomy is done due to the size of the gravid uterus and the theoretical risk of perforation of the gravid uterus with the veress needle. However, laparotomy is associated with increased maternal and fetal morbidity risks. Our aim is to discuss rise in the cases of successfully managed 3rd trimester cases laparoscopically. Background:Acute appendicitis is the most common general surgical problem during pregnancy and studies report an incidence ranging from 1 in 500 to 1 in 2000 pregnancies. Th e diagnosis is challenging in the pregnant patient and the role of biochemical investigations and imaging is limited. Delay in diagnosis due to non – classic presentation and misdiagnosis leads to delay in surgical intervention resulting in high maternal morbidity and fetal mortality rates. Surgical intervention should be prompt in strongly suspicious cases. As for the operative technique, laparoscopic appendectomy is advocated in the fi rst 2 trimesters, however, in the third trimester the guidelines are unclear. CaseReport: We report the case of a woman who was 31 weeks pregnant and presented with acute onset abdominal pain, vomiting and diarrhoea. She was promptly diagnosed with acute appendicitis and had a successful laparoscopic appendectomy in the 3rd trimester and subsequently made a rapid recovery. Discussion: Th e use of the laparoscopic approach in the third trimester is fast becoming recognised as a safe mode of intervention. Systematic reviews have reported that these patients are not at increased risk of fetal loss or preterm labour. Over the past few years, there have been an overwhelming number of case reports of successful third trimester laparoscopic appendectomies. In keeping with this change in behaviour, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has published a set of guidelines in 2017 to aid physicians in the diagnosis and management of surgical conditions in pregnant patients, focusing on the use of laparoscopy.

Widya Solichin, MD is a third year Indonesian OB-GYN resident of Victor R. Potenciano Medical Center in Manila, Philippines. She graduated from the Faculty of Medicine Trisakti University, Jakarta, Indonesia, 2011. She has published 3 papers of research in obstetrics and gynecology.

Yolk sac tumor is a rare highly malignant ovarian tumor in pregnancy that arises from the germ cell of the ovary. It is accounted for 2-4% of cancer in women of reproductive age. It leads to signifi cant mortality and morbidity to both mother and baby. Th is is a case report of a 26-year old Filipino woman who presented with a rapid enlarging ovarian new growth on her fi rst and subsequent prenatal ultrasound. Th e patient underwent an Exploratory Laparotomy at 23 weeks and 4 days of gestation. Histopathology showed yolk sac tumor. Chemotherapy was delayed to the end of the pregnancy due to the patient’s concern of fetal risks.

Marion Ariadne C. Burgos has completed her Doctor of Medicine degree from Far Eastern University-Nicanor Reyes Medical Foundation at age of 23. She is currently an obstetrics and gynecology resident at the same hospital institution.\r\n\r\n\r\n

Obstetrical hemorrhage is one the leading causes of maternal morbidity and mortality in our country. \r\n\r\nThe objective of this report is to present a case of a 30-year-old, Gravida 3 Para 1 (1021) who had persistent vaginal bleeding post dilatation and curettage due to missed abortion at 11 weeks gestational age. Differential diagnosis included retained secundines, gestational trophoblastic neoplasia, uterine arteriovenous malformation, and placental accrete syndrome. This could be differentiated by beta human chorionic gonadotrophic hormone and transvaginal ultrasound. \r\n\r\nWhat made the case interesting is the dilemma in the diagnosis. In a case of persistent vaginal bleeding after curettage and with a history of cesarean delivery, one will initially think of placenta accrete syndrome. But then, initial diagnostic tests pointed out to uterine arteriovenous malformation. Due to the dilemma of the service team in clinching the diagnosis for a single disease entity, pelvic magnetic resonance imaging with contrast was done revealing a possible placenta accreta, but cannot totally rule out vascular tumor.\r\n\r\nSince patient was initially desirous of future pregnancy, medical management was started and was scheduled for CT angiography. However, due to persistent vaginal bleeding, she underwent Total Abdominal Hysterectomy. Histopathology result revealed a placenta increta.\r\n\r\nIn the advent of technology, a wide array of diagnostic modalities can be used to make an appropriate diagnosis. Clinical correlation and a high index of suspicion must be at all times considered above all. No matter how rare the condition, it should still be at the back of our minds. \r\n\r\n