News from ACOG 2017: Obese Women face higher risks of Hormonal IUD expulsion.

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Women with a BMI of 40 or more have 3.06 times higher odds of expulsion of levonorgestrel IUD as compared with women who are overweight, obese or have a BMI less than 35 according to a study presented at the at the ACOG 2017.

Lynne Saito-Tom, MD and her colleague from University of Hawaii at Manoa, Honolulu, conducted this retrospective cohort study at Kaiser Permanente-Hawaii between January 2009 and December 2010.

The study was also published in May issue of Journal of Obstetrics and Gynecology.

The researchers recruited 1,071 eligible patients, of whom nearly one third were obese with nearly 8% had a BMI more than 35. The main independent variable was BMI at the time of insertion and the dependent variables include successful IUD insertion, difficult IUD insertion, 12-month continuation, and complications related to the LNG-IUD.

No differences were observed across different BMI groups for insertion (P = .59) or acceptance of IUD for 1 year (P = .69)

Patients with BMI 40 and more faced higher rates of complications (24%) as compared to obese (13%) , overweight or class 1 obesity counterparts (10%).

The study did not have sufficient women enrolled to explore the reasons of higher expulsion but the researchers did think that it may be related to difficult insertion in very obese women and also menorrhagia experienced by these women.

This is the first known study to evaluate LNG-IUD use by BMI in diverse Hawaiian population of Asian and Pacific Islander women. 

Larger studies are needed to stratify the expulsion and complications according to class of obesity.

Meanwhile, the researchers advocate that the study findings should not discourage physician from educating women about the benefits of IUDs.

“While the expulsion rate was higher than seen generally, it is still an effective method for most obese women. That’s much more beneficial than discouraging patients,” said the lead researcher Dr. Saito-Tom.  

News from ACOG 2017: Olympus unveils its new plasma hystero-resectoscope at the conference.

Olympus (Center Valley, Pennsylvania) a  global leader in designing innovative solutions for  medical and surgical procedure  recently announced its launch of new plasma hystero-resectoscope and other products of the entire  portfolio. 

The plasma hysteroscopic system was showcased at the American Congress of Obstetricians and Gynecological Annual Meeting (ACOG) May 6-9 in San Diego, CA.

These range of products have received FDA clearance based on lower risk of hyponatremia during the surgery as compared to monopolar electrosurgery. The lower risk of electrolyte imbalance along with precision in cutting, and better visibility improves patient outcome. It is also   cost-effective for a wide range of hysteroscopic procedures.

Plasma is one of the four fundamental states of matter besides solid, liquid, and gas. When a gas is ionized by passing current through it, electrons are stripped from its atoms, turning it into plasma.

The plasma energy is generated as a precise stream that dissipates rapidly as it comes in contact with the tissue, but with controlled penetration and minimal thermal effect.

The Olympus 8.5 mm hystero-resectoscope, in use with the world’s first 4 MM high definition telescope is used in many gynecological procedures because of its array of different type of plasma electrodes.

• The vaporization electrodes are very efficient and save lot of surgical time because it eliminates the need of for multiple resectoscope reinsertions.
• Variety of loop sizes for allows for quicker resection and coagulation of polyps, myomas and the endometrium.
• It also has a needle electrode for septum resection.

"The Olympus plasma hysteroscopic resection and vaporization system advances operative hysteroscopy to a new level of capability," said Dr. Benjamin Gocial at Main Line Fertility. 

"Olympus builds upon its excellent track record with plasma resection and vaporization through these 510(k) clearances, and we expect enthusiastic adoption of the technology in gynecology," said Randy Clark, Group Vice President of the Surgical Division at Olympus America Inc. "We have aimed not only to bring improved patient outcomes to our customers, but to provide an advanced gynecology portfolio that is cost effective for Hospitals and Ambulatory Surgery Centers."

News from ACOG 2017: Most advanced wireless, tetherless maternal-fetal simulators Train Physicians at ACOG 2017.

Meet Victoria®and Super Tory®, who are world’s most advance maternal and fetal simulators.

Victoria is closest to real human expectant mother of all the simulators currently available. She was developed as a result of decades of obstetrical experience, her anatomical accurate features help improving patient’s safety through accurate and real life training.

Victoria and Super Tory will be showcased at the American College of Obstetricians and Gynecologists Annual Clinical and Scientific Meeting (ACOG) 2017 annual meeting in San Diego, California, May 6–9.

She looks like a real life expectant mother, her eyes can interact with care-giver, thus enabling neurological examination to evaluate eye movements as a warning sign for stroke, drug overdose, head trauma and cranial impairment.

Victoria simulates shoulder dystocia, breech, and C-section deliveries with a level of fidelity that truly suspends disbelief. Participants immerse themselves deeper and faster as they engage in problem solving and collaborative teamwork. What’s more, Victoria captures participants’ performance through an array of hidden sensors. This means you can easily track progress on the way to success.

Besides being a childbirth simulator, she can also be used by trainers to practice other obstetrics scenarios like early pregnancy complications, post-partum hemorrhage and management of high risk pregnancy.

Her condition deteriorates due to blood loss during PPH, obstetricians can practice fundal massage with uterus that contracts and shrink in response. She is also fitted with three replaceable episiotomy modules, and obstetricians can practice midline, mediolateral and fourth degree perineal tear repair.  

Victoria give births to a High-fidelity, full-term baby of realistic size and weight,it has smooth skin, articulate joints, full body endoskeleton, programmable heart and respiratory sounds , cyanosis and 1 minute Apgar score.

Super Tory is also world’s most advanced neonatal simulator. Like a real neonate, it gasps for breadth imitating a real newborn in respiratory distress.  The lungs are controlled electronically and appear realistic when the mannequin responds to mechanical ventilation.

Simply pressing a button puts the baby in acute respiratory distress and his entire body also reacts to the situation.

Pediatrician and other care giver can stabilize Tory using real instruments in NICU.

Gaumard executive vice president John Eggert said, "Every specialist gets to participate in Super Tory's treatment."

"Super Tory allows healthcare providers to prepare for high risk/low frequency complications with anatomical and physiological accuracy never before seen in neonatal simulation," Mr. Eggert adds. "It's the first neonatal simulator to offer heart and lung interaction as well as motion in a mobile platform."

"Super Tory can be assessed for early onset sepsis, hyperbilirubinemia, pneumonia with pneumothorax and other conditions using real vital signs monitors.  Critical metrics such as ECG-derived respiration rate, pre- and post-ductal SpO2, and NIBP can be evaluated in real time.  And Super Tory can be paced and defibrillated using real energy, just as in a clinical live situation. His facial expressions change and you can track his chest wall motion and programmable arm and leg movements."

Super Tory weighs eight pounds and 21 inches and is fitted with an internal, rechargeable battery with life of nearly 8 hours. It remains fully functional while in transit from labor room to NICU.

Gaumard® Scientific Company has designed, manufactured and marketed simulators for health care education for more than 60 years. Users worldwide recognize Gaumard products for their innovation in simulation.

Victoria Video 

Super Tory Video 

News from ACOG 2017: Philips new OB/GYN ultrasound innovations incorporate artificial intelligence to generate lifelike 3D images creating maternal fetal bonding.

Courtesy: philips.com

Royal Philips, the parent company of Philips healthcare today announced the launch of TrueVue, GlassVue and aReveal, ultrasound visualization capabilities on its Philips EPIQ 7 and 5 and Affiniti 70 and 50 ultrasound systems. This innovative tool works to produce photorealistic, transparent and 3D visualization in just one touch that are more lifelike than older traditional technologies.

Philip is showcasing the latest advances at the American College of Obstetricians and Gynecologists Annual Clinical and Scientific Meeting (ACOG) 2017 annual meeting in San Diego, California, May 6–9.

Dr. Michael Ruma, maternal-fetal medicine specialist at Perinatal Associates of New Mexico said "Philips' latest technological advancement in OB/GYN ultrasound is a novel tool allowing clinicians to further explore the anatomic evaluation of the fetus.”

“A clinician's relationship with our patients is at its heart a personal one, especially during pregnancy. The ability to provide high-quality, lifelike images not only helps clinicians improve diagnostic confidence, but also supports the important connection between mother and fetus," he further added.

Philips TrueVue, with its virtual light source, is a proprietary advanced 3D ultrasound display method that delivers amazing lifelike 3D ultrasound image and gives the operator the ability to move the light source anywhere in the 3D volume. The flexibility of the light source allows the user to manipulate light and shadow on anatomical structures to enhance clinical confidence and may foster maternal-fetal bonding. 

                                            

                                                     

Philips GlassVue, with internal light source, provides an early, more transparent view of the fetal anatomy than traditional ultrasound. The advanced 3D imaging tool goes beyond the surface to reveal bone, organs, and other internal structures. Users have control over a flexible light source and the amount of transparency in the 3D volume.

Philips aReveal, automatically sculpts away extraneous data around the fetal face by recognizing the geometry of the skull. One touch reveals the face and one touch reverses the process. aReveal works with both TrueVue and traditionally rendered 3D volumes.

Photo gallery courtesy Philips.com

Single use lighted vaginal specula portfolio further expanded by addition of extra-small size and extra-large size: News from ACOG 2017.

Courtesy: OBP Medical

OBP Medical, a leading global developer of single-use, self-contained, illuminating medical devices announced the addition of new extra small and extra-large size specula to its OfficeSPEC and ER-SPEC range of vaginal specula at the ACOG 65th Annual conference, from May 6–9, 2017, San Diego, CA. 

They are already available in small, medium, and large sizes and are widely used by physicians in daily clinical practice.

"OfficeSPEC and ER-SPEC are widely adopted by OB/GYN practices across the globe that recognize the many clinical, operational and patient benefits of single-use lighted specula," said Jason Swift, CEO of OBP Medical.

Ob/Gyn physicians and other healthcare providers have earlier relied on for years on reusable metal specula that are disinfected and reprocessed between patients. Even after following the strict guidelines for disinfection, cross infection can still occur because protocols are insufficient or the design of the device does not allow optimal cleaning. Sometimes the turnover of patients is too fast so that protocols are not followed very strictly.

Besides this, the light source often not suited for rigorous sterilization process so it is simply wiped down or put away to without cleaning only to serve as potential source of pathogen transmission from one patient to another.

Growing body of evidence have shown that many species of bacteria are resistant to disinfectants along with some strains of human papillomavirus (HPV).

Researchers from Brigham Young University and the Pennsylvania State College of Medicine found out that HPV16, the type that carries one of the highest risks of genital cancers, is also highly resistant to disinfection. This study, the first of its kind using HPV16 native virions, shows that the most commonly used clinical disinfectants including sterilants used with vaginal speculums, have no effect on this extremely virulent form of HPV. The study was published in the Journal of Antimicrobial Chemotherapy.

Office SPEC and ER-SPEC are completely self-contained and entirely single-use vaginal specula.

They come both in sterile and non-sterile packaging depending upon to be used in Office or ER.

It has a comfortable ergonomic design for improved balance and easy maneuverability during exam.

Each device is individually packed and comes out of package ready to use, and disposed of after a single use or procedure. It does not require any additional part, assembly or extra component.

The physician has to simply pull the red tab to activate the ER-SPEC’s ultra-bright built-in LED light source. The light source does not generate heat and lasts for 30+ minutes. It provides white light that is more natural and brighter.

Further these specula are made up of high-quality acrylic and adheres to the most stringent manufacturing guidelines to ensure the safety and comfort of patients during pelvic exams. They are Latex free, eliminating the potential to cause an allergenic reaction in patients.

Jason Swift, CEO of OBP Medical further added "The expansion of our line to include extra-small and extra-large comes in response to direct customer feedback about the need for additional flexibility in sizing and ensures that our customers are able to use an OBP device for every patient need. We look forward to rolling out our expanded portfolio to users and showcasing our industry-leading specula this weekend at ACOG."

The estimated average cost of each disposable speculum is $2.34.

Click here for a list of national and international distributors for Office SPEC and ER-SPEC. 

                   Here is the demonstration video for Office SPEC and ER-SPEC

ACOG 2017 annual meeting promises academic feast of recent advances ,cutting edge research and innovations.

courtesy: ACOG

Global experts and leading physicians will convene in San Diego, CA from May 6–9, 2017 for   ACOG 65th Annual conference. This year the focus is on globally improving women’s access to healthcare.

The meeting kicks off with ACOG President Thomas M. Gellhaus, MD, FACOG opening remarks. This will be followed by first speaker of the President’s program, Dr. Peterson who is Director of the World Health Organization Collaborating Centre for Research Evidence for Sexual and Reproductive Health based in the Department of Maternal and Child Health at the University of North Carolina (UNC) Gillings School of Global Public Health. His lecture titled Health and Well-Being for All: Delivering on the Promise for Those We Serve. 

The second speaker in the President’s Program is Dr.Neel Shah, he will be talking about the complexities of American healthcare system and how to do best for the patients and the specialty you are into.

This will be followed by lecture by Dr. Winch, a psychologist and author, who will emphasize on physicians taking time off for themselves as nearly 300- 400 physicians commit suicide every year.

 “There is a lot of burnout and physician dissatisfaction, and it revolves around electronic health records and regulations and just the business of medicine,” Dr. Gellhaus said.

This year ACOG is offering 13 flipped classrooms sessions to take advantage of the format. Those who register will get the videos and interactive modules 4 weeks in advance, so that the knowledge base created can be used as a starting point in actual session.

This year debate topics include Robotic versus laparoscopic hysterectomy, USTSPF guidelines for breast cancer screening, Routine cystoscopy at the time of hysterectomy, Cosmetic gynecologic and vaginal rejuvenation, Abandoning the diagnosis of cervical insufficiency, Surgery versus medicine for pelvic pain.

ACOG received nearly 1000 abstracts for ePoster presentations this year, and about 700 of those will be presented during the meeting.The ePoster are also available in digital format to be viewed any time.

The third annual Nezhat Live Telesurgery 3-hour forum will telecast surgeries about best-practice examples of safe hysteroscopic and laparoscopic techniques from two separate locations. ACOG has also arranged a Film festival to showcase the videos of latest advances in the field.

The meeting is truly expected to cover the entire breadth and width of Ob and Gyn with over 300 speakers and various formats, videos ,ePosters and debates.

The CDC will cohost the maternal mortality session, along with a discussion of latest numbers and strategies to reduce maternal mortality.

ACOG Vice President of Education Dr. Sandra Carson said "But overall, I think our most important issue is to make sure that women have access to the total spectrum of reproductive health. This year, in particular, we are reminding our members that it's especially important to support their patients and try to help them gain access to care."

Richard Hansell, MD, chair of the scientific program for the meeting pointed out “We're obviously all at the meeting to be educated, but having the opportunity to see and meet people you haven't seen for years is special to me."