Aim
To clarify the status of minimally invasive gynecologic surgery (MIGS) in the Asia/Oceania region.
Methods
Survey questionnaires were sent out to the representative of AOFOG countries. They consisted of questions on the general status of MIGS, the clinical indication of MIGS, cost coverage, company support, training and certification for MIGS, patient preference for MIGS and requirements for the AOFOG.
Results
Developmental stage of MIGS in this region was roughly divided into three categories: fully developed countries, countries in the developmental stage and countries in the rudimentary stage. Clinical indication of MIGS and training opportunity of young doctors were correlated with the developmental stage.
Conclusion
Support by AOFOG should be considered according to the developmental stage of each country. Collecting updated information on MIGS in each member country is important to provide adequate support.
Introduction: If the direction of the cervical canal is known, the commonly performed procedures as sono salpingography, embryo transfer, IUD insertion, cervical dilation etc. will be easier. The reported resultant trauma to the cervical canal and uterus during these procedures also can be avoided. As we know the cervical canal is tortuous in majority of cases, but the exact course is not yet reported or known. Objective: The objective of the present study was to try to identify the various directions of cervical canal while performing routine hysteroscopic surgeries. Methods: Four-point cervical canal direction was assessed while performing routine hysteroscopic procedures using 5fr Bettocchi operative assembly with 2.9 mm 12-degree telescope (Karl-Storz). The study group was patients with infertility who required hysteroscopy and laparoscopic evaluation as per infertility treatment protocol or else required hysteroscopy for AUB. The study was carried out at tertiary care referral hospital for minimal access surgeries for a period was of 2 yr. 9 months year from May 2017 to Feb 2020. Results: Down-right or left-up-straight combination of movement (DRUS, DLUS) was the most common cervical direction found in 72 % patients. If DURS (down-up-right-straight) movement is added these 3 movements together are seen in about 82% of patients. No cervical dilation is required when 5 fr hysteroscopic assembly was used in study group. No operative complications were found. Conclusion: DRUS and DLUS (down-right or left-up and straight) combination of movements are most frequent direction of cervical canal observed in 72% of patients.
This case is of Rh −ve 2 nd gravida having antibody titre detected 1:2 at 8 weeks of 2 nd pregnancy. Serial antibody titre carried out along with clinical examination. Fetal monitoring was done by assessing MCA-PSV (Middle cerebral artery peak systolic velocity) and CTG (Cardiotocograph) when required. Pregnancy was terminated when the titre reached 1:512 at 34 wks of pregnancy with abnormal MCA-PSV values. Neonate just had begun to show sign of anaemia & haemolysis at birth.
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