Controversies in obstetrics and gynaecology

This meeting on Controversies in Obstetrics and Gynaecology will focus on several topics that have been generating debate both among the clinicians and the general public.

Pelvic congestion

Pelvic congestion has been identified as one of the potential cause of pelvic pain. Although many women are routinely offered treatment for pelvic congestion-associated pelvic pain, there is uncertainty about the valid diagnostic criteria and efficacy of various treatment strategies on offer.

Dr. Jocelyn Brookes will provide an update on the most recent developments in this field and try to reconcile often opposing views about the significance of this condition.

Hysteroscopy

A recent call by the National Institute of Health Research to develop a project looking at the merits of hysteroscopic removal of retained placenta has caused some controversy with some clinicians. Doubts have been expressed about the efficacy, safety, and appropriateness of such approach.

Mr. Dimitrios Siassakos was a co-applicant of the proposal to carry out such a study. He will give us an overview of the global use of hysteroscopy and share his thoughts about the need to take a deeper look at this issue.

In a nutshell, the procedure involves removal and storage of ovarian tissue taken from women in their reproductive years. When women reach menopause, the ovarian tissue is transplanted back in a hope that it would restore normal ovarian function and enable natural conception to occur later in life. We will learn from Mr. Yousri Afifi about the science supporting this novel treatment and ethical and wider social issues raised by this work.

The microbiome in pregnant women

Recent reports of the microbiome in pregnant women have suggested that the composition of the vaginal bacterial flora has a significant effect on various important pregnancy outcomes, such as the risk of pre-term birth.

It has also been suggested that the gut microbiome plays an important role in infant development. This has led to a trend for "vaginal seeding", in which mothers rub vaginal fluid on the face and mouth of their babies after a Caesarean delivery in an attempt to modify their microbiome.

Professor Phil Bennet is one of the lead researchers in this field. In his lecture, he will discuss the potential benefits and risks of these novel and controversial interventions.