1 / 24

June 2005

ObG Watch. June 2005. Louise Brown...Then & Now. 25 Years of IVF. IVF-ET: Past, Present & Future Howard Jones Jr ObG Survey 2005. 1.3 to 1.5 Million IVF Babies in the World – 1% of Births in USA Indication: Tubal Disease / Endometriosis / Male Factor. Future of IVF.

jasonbailey
Download Presentation

June 2005

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ObG Watch June 2005

  2. Louise Brown...Then & Now

  3. 25 Years of IVF

  4. IVF-ET: Past, Present & FutureHoward Jones Jr ObG Survey 2005 • 1.3 to 1.5 Million IVF Babies in the World – 1% of Births in USA • Indication: Tubal Disease / Endometriosis / Male Factor

  5. Future of IVF • Non invasive detection of Oocyte with potential to achieve Singleton • PGD to overcome Chromosomal aberration • Fusion of Meisis-induced Somatic cells • Exogenesis

  6. Britain's First Human Clone

  7. Robodocs start ward rounds! RP6 Robots Sr Mary & Dr Robbie Start Ward Rounds from 18 May 05 at St Mary Hospital, London Face to Face interface with Consultant far away

  8. Needle Suspension for SUI Systematic Review - Cochrane library Feb 2004 9 Trials – 347 women – 9 Different NS Procedures Abdominal Retropubic Suspension Vs NS: Failure after 1 year: 16% Vs 29% Morbidity same Anterior Vaginal Repair Vs NS: Failure: 36% Vs 33% (Same) Conclusion: NS probably not as good as Abdominal Suspension More Studies needed

  9. Oral Pills in Urogynaecology

  10. DULOXETINE for Stress Incontinence • Selective Serotinin (5-HT) & Nor Epinephrine Reuptake Inhibitor • Rhabdosphincter Activity • Efferent Pudendal nerve Activity • Pelvic Floor Tonus Marketed as “ULOZET” -40 mg bd (Inca) -Urol 2004;6 (Suppl 3)

  11. RCT: BJOG March 2004 • 494 women • 40 mg bid x 4 weeks • Incontinence Episode Frequency (IEF) reduced by >50% • Incontinence Quality Of Life (I-QOL) Improved after 4 to 12 weeks of treatment

  12. Tolterodine L-tartarate Reduces Urinary Frequency Reduces Urgency

  13. DESMOPRESSINControls Nocturia • Minirin 0.1 mg OD • Potent Antidiuretic • Reduces Nocturnal Voids • Better sleep

  14. Parameters for Prediction of Caesarean Section

  15. Parity ( more in Primi ) Height: 5% at 170 cm Vs 30% at 140 cm McGuinness & Trivedi 1999 Increased Maternal Age Main et al 2000 Male Fetus: Delayed maturation of Sympatho adrenal system = Less catecholamine during hypoxia & acidosis Lieberman et al 1997 Anthropoid pelvis: Occ.Tr & Occ Postrcaldwell & Moloy 1933 Variables

  16. Occipito Posterior & CS • CS Rate of 30-42%-Sizer&Nirmal 2000 • Disproportion due to Deflexion-Floberg et al 1987 • Inadequate Head to Cx Forces – Lessuterine activity-Allman et al 1997 • Increased Fetal Distress: Decelerations • Longer labor • Increased rate of Augmentation

  17. USG Diagnosis of Occ Postr in Early labor to predict CS-Nicolaides et al Int J ObG June 2004 • 601 cephalic singletons at onset of labor • Vaginal Delivery 86% & CS14% • CS in Occ postr 19% Vs Non OP 11% • Conclusion: Diagnosis of Occ postr at onset useful predictor of CS among other parameters a case for Admission USG?

  18. Premature Ejaculation

  19. Intra Vaginal Ejaculation Latency Time ( IVELT ) Definition: ”Persistent or Recurrent ejaculation with minimal sexual stimulation before during or after intromission and before the man wishes it”

  20. IVELT • Systematic Review of 21 RCTs • 79 Publications between 1944 & 2003 • Incidence: 31% • Traditionally Treated with Antibiotics / Neuroleptics / Anti depressants • Anti Depressants effective Waldinger et al Int J Impotence Res 2004

  21. Dapoxetine • Anti depressant • Increases Sexual Stamina (IVELT) 3-fold • Will earn J&J $400 million by 2007 Am Urol Assocn 24 May 2005

  22. Thank you!

More Related