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2nd World Congress on Gynecology & Obstetrics at Miami, USA
2nd World
Congress on Gynecology & Obstetrics scheduled to be
held in Miami,
USA during September
19-20, 2019 Our two main two scientific sessions are Maternal Fetal
medicine & Midwifery explained below
Maternal
Fetal Medicine :
Maternal–fetal medicine is a branch of medicine that focuses on managing health concerns of the mother and fetus prior to, during, and shortly after pregnancy.
Maternal–fetal medicine is a branch of medicine that focuses on managing health concerns of the mother and fetus prior to, during, and shortly after pregnancy.
Challenges: Approximately one-third of women in the United States give birth via cesarean delivery. While life-saving in the right circumstances, cesarean birth also carries with it significant risks, including an increased likelihood of infection, hysterectomy, placenta implantation abnormalities in future pregnancies, and respiratory illness in infants. In a study presented today at the Society for Maternal-Fetal Medicine's (SMFM) annual meeting, The Pregnancy Meeting, researchers unveiled findings that suggest that induction of labor at 39 weeks of gestation among healthy, first-time mothers reduces the rate of cesarean birth as compared to expectant management among the same population.
In a study with more
than 6,100 pregnant women across the country, researchers randomly assigned
half of the women to an expectant management group (waiting for labor to begin
on its own and intervening only if problems occur) and the other half to a
group that would undergo an elective induction (inducing labor without a
medical reason) at 39 weeks of gestation. Results include:
- Lower
rates of cesarean birth among the elective induction group (19%) as
compared to the expectant management group (22%)
- Lower
rates of preeclampsia and gestational hypertension in the elective
induction group (9%) as compared to the expectant management group (14%)
- Lower
rates of respiratory support among newborns in the induction group (3%) as
compared to the expectant management group (4%)
"Safe reduction of
the primary cesarean is an important strategy in improving birth outcomes, one
of our Doctor who presented today's findings and is professor in obstetrics and
gynecology at Northwestern University's Feinberg School of Medicine. The
research presented is part of, "A Randomized Trial of Induction Versus
Expectant Management," more commonly referred to as the ARRIVE Trial,
which was funded by the Eunice Kennedy Shriver National Institute of Child
Health and Human Development (NICHD).
SMFM's current
guidelines do not recommend routine induction of labor for low-risk pregnant
women at 39 weeks of gestation. "SMFM will wait to evaluate the
peer-reviewed publication of the ARRIVE Trial before providing any guidance or
changes to our existing recommendations," said Alfred Abuhamad, MD, the
President of SMFM.
Midwifery is the health
science and health profession that deals with pregnancy, childbirth, and the
postpartum period (including care of the newborn), in addition to the sexual
and reproductive health of women throughout their lives.
he health care system
-- what the researchers call "midwifery integration" -- and birth
outcomes. States with high midwifery integration, like Washington and Oregon,
generally had better re
Challenges:
Midwife-friendly laws and regulations tend to coincide with lower rates of premature births, cesarean deliveries and newborn deaths, according to a new U.S.-wide "report card" that ranks all 50 states on the quality of their maternity care.
The first-of-its-kind study found a strong connection between the role of midwives in t sults, while states with the least integration, primarily in the Midwest and South, tended to do worse. The findings were published today in the journal.
"Our findings
suggest that in states where families have greater access to midwifery care
that is well integrated into the maternity system, mothers and babies tend to
experience improved outcomes. The converse was also demonstrated; where
integration of midwives is poorer, so are outcomes," said Melissa Cheyney,
a licensed midwife, medical anthropologist and associate professor in Oregon
State University's College of Liberal Arts and one of the study's co-authors.
As with most population
health studies, the statistical association between the role of midwives and birth
outcomes doesn't prove a cause-and-effect relationship. Other factors,
especially race, loom larger, with African-Americans experiencing a
disproportionate share of negative outcomes. However, almost 12 percent of the
variation in neonatal death across the U.S. is attributable solely to how much
of a part midwives play in each state's health care system.
"In communities in
the U.S. that are underserved -- where the health system is often stretched
thin -- this study suggests that expanding access to midwifery is a critical
strategy for improving maternal and neonatal health outcomes," said
Saraswathi Vedam, an associate professor in the Department of Family Practice
at the University of British Columbia, who led the team of U.S. epidemiology
and health policy researchers responsible for the study.
About 10 percent of
U.S. births involve midwives, far behind other industrialized countries, where
midwives participate in half or more of all deliveries. Each state has its own
laws and regulations on midwives' credentialing, their ability to provide
services at a client's home or at birth centers, their authority to prescribe
medication and the degree to which they are reimbursed by Medicaid.
"A large body of
cross-cultural research has actually demonstrated similar relationships between
midwifery care, systems integration and improved maternity care outcomes,"
Cheyney said. "This study is important because it suggests that the same
relationships hold true in the United States. There are significant policy implications
stemming from this work."
The research team
created a midwifery integration score based on 50 criteria covering those and
other factors that determine midwives' availability, scope of practice and
acceptance by other health care providers in each state.
Washington had the
highest integration score, 61 out of a possible 100, followed by New Mexico at
59 and Oregon at 58. North Carolina had the lowest score, 17. The complete
list, with links to each state's report card.
An interactive map
created by the researchers reveals two clusters of higher midwifery integration
-- one swath stretching from the Pacific Northwest to the Southwest, and a
cluster of Northeastern states.
Vermont, Maine, Alaska
and Oregon had the highest density of midwives, as measured by the number of
midwives per 1,000 births. The lowest midwifery integration was in the Midwest
and Deep South.
The study used higher
rates of vaginal birth and breastfeeding as positive maternity care outcomes.
Higher rates of caesarean birth, premature births, low birth weight and newborn
deaths were indicators of poor outcomes.
The Deep South, which
not only had lower integration scores, but also higher rates of African
American births, had the worst rates of premature birth, low birth weight and
newborn mortality. The West Coast states of California, Oregon and Washington
consistently scored well on those measures.
Contact Information :
David Williams | Organizing committee
E mail id : wcgo-2019@scientificfederation.org
Phone Number : 04068176306
Website : https://scientificfederation.com/gynecology-2019/
David Williams | Organizing committee
E mail id : wcgo-2019@scientificfederation.org
Phone Number : 04068176306
Website : https://scientificfederation.com/gynecology-2019/
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