3rd International Conference on Gynecology and Obstetrics Pathology June 28-29, 2019 Quality Airport Hotel Gardermoen, Oslo, Norway

Reproductive cancers are cancer that is related to the organs in reproduction. The most common reproductive cancers in women are cervical cancer, ovarian cancer, uterine cancer, vaginal cancer, Vulvar cancer. Cervical cancer is the Cancer of the cervix, the lower end of the uterus that extends to the vagina. Ovarian cancer is the Cancer in the ovaries, the two organs that make female hormones and produce a woman’s eggs. Uterine cancer is the Cancer in the uterus (womb), the organ where the baby grows when a woman is pregnant. Vaginal cancer is the Cancer of the vagina, the hollow channel that leads from the uterus and cervix to the outside of the body. Vulvar cancer is the Cancer of the vulva, the area around the opening of the vagina

\r\n It is the most natural thing that every woman experiences after a certain age in her life. It can occur between the ages of 42 and 56 but usually occurs when a women in almost 51. During this period the ovaries stop producing eggs and level of oestrogen declines. It is the natural cessation of ovarian function and menstruation. The symptoms of premature menopause are often the same as those experienced by women undergoing natural menopause.

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\r\n Uterine prolapse transpire when  the pelvic floor muscles and ligaments stretch and weaken.They can no longer provide enough support for uterus. In turn, the uterus protrudes out of the vagina.
\r\n  It can occur in women of any age. It usually affects postmenopausal women who've had one or more vaginal deliveries.
\r\n Mild uterine prolapse usually doesn't require treatment, but  uterine prolapse is making you uncomfortable causing any disruptions in your regular life, you may benefit from  the treatment.

\r\n It is a process of fertilisation where an egg is combined with sperms outside the body, in vitro ("in  outside glass"). This process involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova (egg or eggs) from the woman's ovaries and letting sperm fertilise them in a liquid in a laboratory. After the fertilised egg commonly knows as zygote undergoes an embryo culture for 2–6 days, it is implanted in the same or another woman's uterus, with the intention of attaining a successful pregnency

\r\n When a woman is carrying more than one baby, it is known as multiple pregnancies. If more than one egg is released during the menstrual cycle and each one is fertilized by a sperm, more than one embryo may implant and grow in the uterus. Increment has been seen in multiple pregnancies. This is because more women older than 35 years are having babies. Women who belong to this age group are at high risk of having twins. Another reason for the increase is that more women are undergoing fertility treatments to become pregnant. These treatments increase the risk of multiple pregnancies. A multiple pregnancy can affect the health of both mother and the child. The most common complication of multiple pregnancies is preterm birth. Diagnostic tests for preterm births include Chorionic villus sampling and amniocentesis. However, these tests may be difficult to perform as each fetus has to be tested.

\r\n Gynecology and Obstetrics Pathology deals with all of life’s major passages from birth, reproduction, aging, to death. It has seen major medical advancements and has created an unexpected ethical dilemma for our discipline. The moral dilemmas that faced in this field range from public advocacy for the very basic needs of health and human rights for women to the most complex issues surrounding the growing knowledge and use of the human genome.

When we say about women’s health in some perspective of it, we tend to mean about women’s reproductive health. Women’s health should be given utmost care because they are the ones who bear the responsibility of carving a better tomorrow by giving birth to healthy individuals. In addition to this, in developed countries women are included in the country’s workforce to a large extent. Talking about women’s health, this and  family planning, go hand in hand. Unprotected sex, unplanned pregnancy, sexually transmitted diseases all add up to the factors of maternal mortality. In developed countries the life expectancy of women has increased but most women at an  older age experience various diseases like osteoporosis, arthritis, anaemia, cardiovascular diseases and etc. The sexual and reproductive health of the women is often ignored which leads to ovarian cancer, breast cancer, uterine cancer and cervical cancer. Women should pay heed to their health rather than ignore the symptoms. Family planning is another such issue which is directly linked to women’s health. Before conceiving or planning for a baby, the health conditions of the mother and the financial condition of the family should be assessed. The former two aspects are very important in bringing up a child in a healthy and stable environment.

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. If the topic of reproductive medicine is taken into account it can be further sub-divided into prenatal medicine and postnatal medicine. 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 gynaecological problems are also assessed under reproductive medicine.

The technology which is used to achieve pregnancy artificially is known as the assisted reproductive technology. Assisted reproductive technology includes procedures namely fertility medication, fertilization (IVF)  and surrogacy. ART is primarily used in treating infertility among couples. It belongs mainly to the field of reproductive endocrinology and infertility. ART includes many techniques such as intra-cytoplasmic sperm injection (ICSI), cryo-preservation, trans-vaginal ovum retrieval, embryo transfer, assisted zona hatching, autologous endometrial co-culture, zygote intra-fallopian transfer, cytoplasmic transfer, egg donors, sperm donors, pre-implantation genetic diagnosis, embryo splitting, GIFT, ZIFT, sex selection and surgical sperm retrieval. All these methods are being widely used as problems of infertility are increasing at an alarming rate worldwide. While some of these methods are safe but majority of them are harmful to the foetus as the babies are born with some kind of birth defects or genetic defects. ART also carries the risk of heterotopic pregnancy. In IVF and ICSI babies are born with low birth weight, decreased expression of proteins in energy metabolism, visual impairment and cerebral palsy. ART procedures in the United States have doubled in the last 10 years with the cost ranging from $2,000 to $30,000. ART procedures should only be performed after examinig the medical condition of the couple. Many a times ART proves to be harmful to both the mother and child.

Pathology has come a long way since its extensive applications in the field of medical sciences from 1950’s and maybe even before that. Gynaecologic pathology has come up with developments in the recent times. Innovations such as immunohistochemistry, tissue pathways and molecular pathologies have opened up path-breaking arenas in terms of gynaecologic pathology. Molecular pathology is emerging as an important discipline in pathology which is focussing on the study of diseases by examining molecules, tissue fluids and bodily fluids. Nowadays cancers like breast and ovarian cancer can be detected by examining the fluids rather than opting for biopsy. Immunohistochemistry on the other hand plays an important role in the differential diagnosis of gynaecological lesions.

Minimally invasive gynecologic surgery has been shown to be appropriate among the doctors as an alternative in wide ranging surgical procedures. For the execution of this kind of surgery, patient selection is very crucial. In case of minimally invasive gynaecologic surgery there are various advantages  to it. The advantages being shorter period of stay at the hospital decreased analgesic requirements, faster recovery, lower intra-operative and post-operative complications and improved quality of life. The usage of laproscopy has been extensive for the management of benign gynaecologic conditions such as treatment and evaluation of endometriosis and benign adnexal masses. According to the American Society of Cancer 40,100 women were affected by uterine cancer in the year of 2008 and the number has increased by four-fold in the upcoming years. Minimally invasive gynecologic surgery includes vaginoplasty which is the reconstruction of the vagina. These surgeries reconstruct the vagina and the other female genitalia which have been destructed by chemotherapies and radiation. Reconstruction surgery after cancer treatment, McIndoe surgical Technique, Bowel vaginoplasty, Sex assignment surgery, Labiaplasty, Elective vaginoplasty, Hymen surgical procedures, Balloon vaginoplasty and Wilson Method  comes under minimally invasive gynaecologic surgery.

Gynaecologic and Obstetrics Pathology is the medical pathology subspecialty dealing with the study and diagnosis of disease involving the female genital tract, which includes vagina, uterus, and ovaries and the breasts. Obstetrics Pathology is the study of diagnosis and diseases involve during pregnancy and childbirth, and the postpartum period. A physician who practices Gynaecologic Pathology is a Gynaecologic PathologistObstetrics Pathology is the study of diagnosis and diseases involve during pregnancy and childbirth, and the postpartum period. A physician who practices 

Reproductive Endocrinology is a sub-division in Gynaecology and Obstetrics which trains professionals in the field of reproductive medicine, hormonal dysfunction during pregnancy as well as it deals with the issue of infertility among couples. Reproductive endocrinologists not only treat people affected by infertility but also treat patients with hormonal dysfunctions.  Regulation and proper functioning of the endocrine system is very important for the human body. Improper secretion of hormones leads to many complications in pregnancy. Dysfunction of reproductive hormones is one of the most common reasons for infertility among men and women. Hormonal changes not only affect the human body but also the human mind to a larger extent. When pregnancy is taken into account a milieu of hormones constitutively affects the development of the baby during embyrogenesis and the mother, including human chorionic gonadotrophin and progesterone. Over activity or under activity of the hormonal glands in our body induces many diseases like Diabetes, Thyroid, Polycystic Ovarian Syndrome, Hirsutism, Virilism and so on. The onset of pubertymenstrual cycle andmenopause are all due to the endocrine system functioning in our body. Reproductive endocrinology exclusively deals with the complications of infertility and tends to give it solution through reproductive medicine and hormonal injections.

Methods and devices used to prevent pregnancy are often known as birth control or contraception. Contraceptionhas been in practice since time immemorial but the modern ways of contraception had come into play in the 20^thcentury. Birth control is not only used in cases of unwanted pregnancies but it is also used in cases where pregnancy is proved to be fatal to the foetus as well as the mother. It also protects people from getting affected by sexually transmitted diseases. Contraception also plays a pivotal role in family planning as well. It affects demographics like population control, population density and so on. Birth control also helps in increasing economic growth of a country by decreasing the number of dependent children, more women in the working sector and less use of scarce resources. Nowadays in the market, various kinds of contraception are available both for men and women that have long term and short term effects respectively. While some contraceptions are permanent,  others are temporary. Among the permanent ways of contraception, sterilization is one of them which are vasectomy in males and tubal ligation in females. Among the non-permanent methods of contraception there are emergency contraception pills, patches, vaginal rings, injections, intrauterine devices. Other physical barrier methods include usage of condoms, diaphragms, birth control sponges and fertility awareness methods.  Worldwide 26^th September is celebrated as the World Contraception Day.

Urogynaecology is sub-division of gynaecology. Urogynaecologists are specially trained medical professionals who treats clinical problems related to dysfunction of the pelvic floor and bladder. In some countries Urogynaecology is also known as Female Pelvic Medicine and Reconstructive Surgery. Some of the disorders in pelvic floor include urinary incontinence, pelvic organ prolapse and faecal incontinence. Other conditions where urogynaecology is practiced are Cystocele, Enterocele, Female Genital Prolapse, Lichen sclerosus, Overactive Bladder and Rectovaginal fistula. In modern times, Urogynaecologists are responsible for the care of women who encounter trauma to the perineum during childbirth. Some of the tests which are performed in urogynaecologic pathology include Cystourethroscopy toxin injection, dietary modification, robotic reconstruction, sacral nerve stimulation and urethral injection.

Cervix is the lower part of the uterus which opens into the vagina. When the abnormal cells of the cervix grow out of control, cervical cancer occurs. Cervical cancer can be easily detected in the early stages by a test called ‘Pap test’. In the year of 2016, 12,990 cases of cervical cancer were registered in the United States only with 4,120 deaths. Most kinds of cervical cancer is caused by a virus known as Human Papillomavirus or HPV. There are many types of HPV. however  every kind does not result in cervical cancer. Some causes genital warts which does not have any symptoms.  The main causes of cervical cancer are smoking, usage of oral contraceptive pills and getting multiple pregnancies. The symptoms of cervical cancer include irregular bleeding from the vagina besides the definitive time span of regular  menstrual cycle, pain in the lower abdomen, pain during sexual relations and abnormal vaginal discharge. Every kind of cervical cancer is not fatal to the women. Treatment that includes surgeries and chemotherapies has been proved to be successful in treating cervical cancer in the initial stages. Surgeries such as hysterectomy, brachytherapy, trachelectomy,  removal of pelvic lymph nodes with or without removal of ovaries and fallopian tubes, chemotherapy and radiations helps in treating cervical cancer. There are various ways in which cervicalcancer could be prevented. Barrier protection, that is usage of condoms while having sex, screening and vaccination are the ways in which cervical cancer could be prevented.

Gynaecologic Oncology is a specialized field that deals with cancers pertaining to the female genitalia and reproductive system. Ovarian cancer, uterine cancer, vaginal cancer, cervical cancer and vulvar cancer are all a part of gynaecologic oncology. According to the data collected by The Society of Gynecologic Oncology 8,200 women in the United States are affected by gynaecologic cancer annually. This number rose to 94,730 in the year 2015. Some of the ovarian malignant germ cell tumor are dysgerminoma, embryonal carcinoma, polyembryoma, choriocarcinoma and immature teratomas. Nowadays, cervical cancer is the most talked about gynaecologic cancer caused by Human Papillomavirus. In most of the cases cervical cancer is not even diagonosed in the first stage. It is often diagonosed in the later stages. Doctors nowadays suggest women who are above 40 years of age to go through Pap-smear tests every two years. The rate of survival in case of gynaecologic cancers is higher if it is detected in the early stagesof the disease. Chemotherapy and radiations are often used to treat cancers and lesions in the reproductive tract. There are various complications that come in after the patient goes through chemotherapy. The most common gynaecological complications of pelvic radiation are ovarian failure in pre-menopausal women and vaginal stenosis (vs). followed by sexual dysfunction and menopause.

Infections in the female genitalia and the accessory sex organs are commonly and collectively known as Gynaecologic Infectious Diseases. While some of these diseases can be cured easily by the usage of antibiotics while others need to be paid serious attention to while curing them. Some of the infectious diseases are vulvo vaginitis, cervicitis, pelvic inflammatory diseases and sexually transmitted diseases. These diseases can also occur during pregnancy and their severity increases with the progress of pregnancy in most cases. Infections like Cytomegalovirus, Herpes simplex virus infection, Rubella, Toxoplasmosis, Hepatitis or Syphilis, Listeriotic, Bacterial Vaginosis can damage the foetus as well affect labour or choice of delivery method. To prevent these kind of diseases, personal hygiene is of utmost importance. All the above mentioned diseases can be cured by consuming the right dosages of antibiotics like Aminoglycosides, Cephalosporin’s, Metronidazole, Penicillin’s.

Health problems that occur in the mother’s body due to pregnancy are termed as complications in pregnancy. These complications can be now sub-divided into many sections. While some complications are common in every expecting mother, others can be particular to selective individuals only. According to the statistics it is found that 90% of the females in some or the other stages of pregnancy have experienced complications. While some complications are easy on the body like mild nausea and morning sickness but other complications like asthma, diabetes, thyroid diseases and hypertension needs to be taken care of under the quality guidance of gynaecologists and obstetrics. Some of the medical complications prove to be fatal to the foetus as well as the mother. Women suffering from other medical complications like HIV, urinary tract infections, ectopic pregnancies  etc. should go for immunization and medical assistance from time to time to keep the intensity of the complications under control.  Some of the medical complications like diabetes and hypertension are so chronic that they continue to persist in the body even after the delivery of the baby. Avoiding smoking, consumption of alcohol and maintaining a healthy lifestyle decreases the chances of having complications in pregnancy.

Obstetrics is that branch of medicine and surgery that deals with childbirth and midwifery. This field of science concentrates itself on all the aspects of childbirth and its aftercare. Obstetricians deal with prenatal and postnatalcare, foetal assessments, done during the entire span of pregnancy i.e. ultrasounds and TVS done during the first, second and third trimester of pregnancy. Obstetricians also look after the safety of the foetus during the ultrasounds. Foetal assessment includes obstetric ultrasonography to detect ectopic pregnancy, computerized tomography, fetal screening, foetal haematocrit, foetal karyotype, oxytocin challenge test. The incurrent diseases that occur during the gestational period like diabetes mellitus, systematic lupus erythematosus, thyroid diseases, hypercoagulability in pregnancy are also treated by obstetricians. All the steps and processes during induction and labour like disturbance in cervical membranes, rupturing of the amniotic membranes, intravenous infusion of synthetic oxytocin, cervical insertion of a 30 ml Foley catheter are all done by the obstetricians, supported by the midwife The various complications that come during pregnancy like foetal distress, shoulder dystocia, placental abruption are handled and taken care of by the obstetricians as well. So in the end we can conclude that ‘Obstetricians’ are the one-to-go person in case of any complications during the gestational period.

Ultrasound is done during pregnancy to track the development of the fetus in the mother’s womb.  It is not only helpful in tracking down development but also helps to find out any fetal anomalies, if there are any. Ultrasound reveals the heartbeat of the foetus, the radius of the head, the length of the hands and feet  and also his/her height and weight.. There are various kinds of ultrasound which can be done during pregnancy namely Transvaginal Ultrasound, 3-D Ultrasound, 4-D Ultrasound and Fetal Echocardiography. While the Sonography reports in the first trimester provides information about the fetal heartbeat, it also,examines the placenta, uterus, ovaries, cervix, checks for multiple pregnancies, the sonography done in the second and third trimester reveals much important criteria like placental abruption, placental previa, characteristics of Down’s syndrome if there are any possibilities. The ultrasound in this stage also determines whether the foetus is carrying any form of congenital disease whether hereditary or non-hereditary or not. Genetics is not given enough importance before conceiving. As most of the pregnancies come unplanned passing on of genetic disorders from parents to the baby is very common. Genetic disorders are also known as ‘recessive disorders’. Some of the genetic disorders are Sickle Cell Disease, Thalassemia, Tay-Sachs Disease Fragile X Disease etc.

‘Care’ is word that is related to all stages of conceiving a child. Before delivery, a women has to take care of only  herself and after delivery she has to care of herself as well as her baby.  Nine months of delivery can be divided into three stages and that is pre-partum care, Intra-partum care and postpartum care. In the initial stages that is the pre-partum the expecting mother for the various pathology and radiological assessments in order to keep a constant vigil on the development of the foetus in her womb. This makes it easy to find complications in pregnancy like preclampsia, eclampsia, miscarriages, bleeding etc. Immunization of the mother is of core importance as this protects the foetus from many deadly diseases. After conceiving and leading upto the delivery of the baby, the body of the mother undergo changes and so does her psychological state of mind. Post partum 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. Postpartum depression, peri-partum cardiomyopathy, urinary  incontinence, puerperal fever are the other complications which come in after the delivery of the baby.

Polycystic ovary syndrome is a hormonal disorder causing enlarged ovaries with small cysts on the outer edges of ovaries. It is common among women of reproductive age. PCOS is a problem with hormones that affects women during their childbearing years (age’s between15 to 44). 2.2 and 26.7 percent of women in this age group have PCOS. The cause of PCOS is not known, it appears that PCOS may be related to many different factors working together. These factors include insulin resistance, increased levels of hormones called androgens, and an irregular menstrual cycle.