- Email: [email protected]
I67 Ovarian cancer screening
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Invited presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S1–S92
complications can be seen. If hormonal ovarian stimulation is useful, well-advised management would administer a low effective gonadotropin dose in a patient whose disease has been silent preferably for at least 6 months. Further data are needed to establish safety and efficacy of ART in SLE patients. I66 Anthropology of a public health practice: the case of the family planning in Mali A. Coulibaly. Mali The present work is an anthropological study of family planning in Bamako, Mali. Like everywhere else, the schedules of family planning programs aim at changing the reproductive behaviour of the local people they target. Our work wishes to demonstrate that the norms applying to these schedules are not the only normative referents for the individuals and that they also generate numerous “ways of thinking and behaving”. Indeed, the individuals experience other normative worlds which have an influence on the reproductive behaviours. The main norms are religious or linked to customs – and insist on the importance of procreating – as well as globalized (these norms are essentially conveyed by the media) thus promoting infertile sexuality and sexual pleasure. In concrete terms, all these norms are assembled by the social actors who in turn build themselves complex identities. Therefore the norms of these schedules are regularly “assimilated” by the local people in ways which often work against the expected objectives of programs. From then on, taking these multiple features into account is required to build an understanding of family planning. To collect the data, we use qualitative methods based on non directed interviews and sessions of observations. To analyze the subject we use an interdisciplinary approach with concepts relating to anthropology of development, cultural anthropology, and sociolinguistic. I67 Ovarian cancer screening R. Crawford. Gynaecological Oncologist Cambridge University Hospitals NHS Foundation Trust Ovarian cancer typically presents late and despite advances in care over the last few decades we have not seen the survival improvements noted in other cancers. Screening has had a great impact in cervical and breast cancer and it is clear that women with early stage disease survive longer. It is for this reason that we have looked for screening that would be applicable to improve outcomes in ovarian cancer. In producing a satisfactory screening programme, we need to establish the natural history of the disease and then be able to intervene early leading to improved outcomes. In this review, I shall discuss some of the theories behind the development of ovarian cancer and then review the literature in relation to sporadic ovarian cancer. Both results from the American PLCO and British UKTOCS studies will be analysed. I shall also discuss the role of screening in the management of women with a family history of ovarian cancer. I68 Psychological aspects of gynaecology F. Criado-Enciso In any medicine area, psychological and social factors are important, but there is no doubt in Gynaecology these aspects became much more relevant. The noun Hysteria (H´ıstera=Matrix), is not a casual. During many centuries the feminine reproductive organs have being seen as a mental disorder origin. Pfannestiel was, at the beginning of twentieth century, the one who putted the genital origin of psychiatric disease away, as well as he avoid the use of hysterectomy for these reasons, fact which was usual at that time.
Within medicine specialities, one of the most sensitive fields to take into account from a psychosomatic point of view was the gynaeco-obstetric. Psychosomatic Gynaecologic Disorders: Psychogena Amenorrhoea, Primary Dysmenorrhoea, Chronic Pelvic Pain, Premenstrual Tension, Premenstrual Dysphoric Disorder, Dyspareunia, Anorgasm, Sterility, Pregnancy Psychosomatic Pathology with Emotional disorders (Depress and Anxiety). Because of exposure time, we just talk about Premenstrual Tension and Premenstrual Dysphoric Syndrome, due to the actuality and frequency of it, from a diagnostic, educational measures and hormonal psychopharmacs treatments, mainly focused in contraceptives with Drospirenone, points of views. I69 Delivering on the promise – IPPF’s global action to safe abortion services K. Culwell Unsafe abortion [1] accounts for 13% of maternal mortality (WHO [1]) and results in nearly 70,000 deaths worldwide annually; 99% of these occur in the developing world. Besides mortality, unsafe abortion is responsible for temporary or permanent disability, including secondary infertility, in millions of women. IPPF regards abortion as a public health and human rights issue. Our advocacy efforts focus on placing abortion issues on the global sexual and reproductive health agenda, and raising awareness of the contribution of unsafe abortions to maternal mortality and morbidity rates across the world. The new ‘IPPF Abortion Law Tool’ (2008) assists Member Associations in their analysis of the national laws that impact upon the services they provide and inform their advocacy strategies. Recent successful campaigns include the Portuguese Member Association’s advocacy efforts, which contributed to the eventual liberalisation of the law; abortion in Portugal is now available on request during the first trimester of pregnancy. In Morocco, where the Member Association’s study on unsafe abortion received national media attention, public and religious leaders decided to undertake a review of the current legal framework in relation to abortion. Likewise, Member Association’s advocacy campaigns for increasing access to safe abortion services have led to the registration of medical abortion drugs in both Armenia and North Korea as well as government approval of regional abortion training centres in India. IPPF advocates for a woman’s right to choose and have access to safe abortion. IPPF’s vast network of clinics provide comprehensive abortion care services including pre-abortion counselling, surgical and (where possible) medical drug-induced procedures, and postabortion care including contraceptive counselling and provision. In countries where abortion is legally restricted, as is the case in Ghana, Nigeria, Peru and Venezuela, several of our clinics offer treatment for incomplete abortion. IPPF works to integrate abortion to the full extent permitted by law into the overall sexual and reproductive health services of our Member Associations. The ‘First Trimester Abortion Guidelines and Protocols’ developed by IPPF in 2008 collates internationally accepted best practices in comprehensive abortion care to support providers in their work. It is only through the realisation of women’s rights to free, informed choices and bodily integrity that the Millennium Development Goal to achieve universal access to reproductive health care and reduce maternal mortality will be met. Reference(s) [1] Defined by the World Health Organization (WHO) as ‘the termination of a pregnancy carried out by someone without the skills or training to perform the procedure safely, or in an environment that does not meet minimal medical standards, or both’. WHO (2003) http://www.who.int/reproductive-health/publications/ unsafeabortion_2003/ua_estimates03.pdf
Invited presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S1–S92
complications can be seen. If hormonal ovarian stimulation is useful, well-advised management would administer a low effective gonadotropin dose in a patient whose disease has been silent preferably for at least 6 months. Further data are needed to establish safety and efficacy of ART in SLE patients. I66 Anthropology of a public health practice: the case of the family planning in Mali A. Coulibaly. Mali The present work is an anthropological study of family planning in Bamako, Mali. Like everywhere else, the schedules of family planning programs aim at changing the reproductive behaviour of the local people they target. Our work wishes to demonstrate that the norms applying to these schedules are not the only normative referents for the individuals and that they also generate numerous “ways of thinking and behaving”. Indeed, the individuals experience other normative worlds which have an influence on the reproductive behaviours. The main norms are religious or linked to customs – and insist on the importance of procreating – as well as globalized (these norms are essentially conveyed by the media) thus promoting infertile sexuality and sexual pleasure. In concrete terms, all these norms are assembled by the social actors who in turn build themselves complex identities. Therefore the norms of these schedules are regularly “assimilated” by the local people in ways which often work against the expected objectives of programs. From then on, taking these multiple features into account is required to build an understanding of family planning. To collect the data, we use qualitative methods based on non directed interviews and sessions of observations. To analyze the subject we use an interdisciplinary approach with concepts relating to anthropology of development, cultural anthropology, and sociolinguistic. I67 Ovarian cancer screening R. Crawford. Gynaecological Oncologist Cambridge University Hospitals NHS Foundation Trust Ovarian cancer typically presents late and despite advances in care over the last few decades we have not seen the survival improvements noted in other cancers. Screening has had a great impact in cervical and breast cancer and it is clear that women with early stage disease survive longer. It is for this reason that we have looked for screening that would be applicable to improve outcomes in ovarian cancer. In producing a satisfactory screening programme, we need to establish the natural history of the disease and then be able to intervene early leading to improved outcomes. In this review, I shall discuss some of the theories behind the development of ovarian cancer and then review the literature in relation to sporadic ovarian cancer. Both results from the American PLCO and British UKTOCS studies will be analysed. I shall also discuss the role of screening in the management of women with a family history of ovarian cancer. I68 Psychological aspects of gynaecology F. Criado-Enciso In any medicine area, psychological and social factors are important, but there is no doubt in Gynaecology these aspects became much more relevant. The noun Hysteria (H´ıstera=Matrix), is not a casual. During many centuries the feminine reproductive organs have being seen as a mental disorder origin. Pfannestiel was, at the beginning of twentieth century, the one who putted the genital origin of psychiatric disease away, as well as he avoid the use of hysterectomy for these reasons, fact which was usual at that time.
Within medicine specialities, one of the most sensitive fields to take into account from a psychosomatic point of view was the gynaeco-obstetric. Psychosomatic Gynaecologic Disorders: Psychogena Amenorrhoea, Primary Dysmenorrhoea, Chronic Pelvic Pain, Premenstrual Tension, Premenstrual Dysphoric Disorder, Dyspareunia, Anorgasm, Sterility, Pregnancy Psychosomatic Pathology with Emotional disorders (Depress and Anxiety). Because of exposure time, we just talk about Premenstrual Tension and Premenstrual Dysphoric Syndrome, due to the actuality and frequency of it, from a diagnostic, educational measures and hormonal psychopharmacs treatments, mainly focused in contraceptives with Drospirenone, points of views. I69 Delivering on the promise – IPPF’s global action to safe abortion services K. Culwell Unsafe abortion [1] accounts for 13% of maternal mortality (WHO [1]) and results in nearly 70,000 deaths worldwide annually; 99% of these occur in the developing world. Besides mortality, unsafe abortion is responsible for temporary or permanent disability, including secondary infertility, in millions of women. IPPF regards abortion as a public health and human rights issue. Our advocacy efforts focus on placing abortion issues on the global sexual and reproductive health agenda, and raising awareness of the contribution of unsafe abortions to maternal mortality and morbidity rates across the world. The new ‘IPPF Abortion Law Tool’ (2008) assists Member Associations in their analysis of the national laws that impact upon the services they provide and inform their advocacy strategies. Recent successful campaigns include the Portuguese Member Association’s advocacy efforts, which contributed to the eventual liberalisation of the law; abortion in Portugal is now available on request during the first trimester of pregnancy. In Morocco, where the Member Association’s study on unsafe abortion received national media attention, public and religious leaders decided to undertake a review of the current legal framework in relation to abortion. Likewise, Member Association’s advocacy campaigns for increasing access to safe abortion services have led to the registration of medical abortion drugs in both Armenia and North Korea as well as government approval of regional abortion training centres in India. IPPF advocates for a woman’s right to choose and have access to safe abortion. IPPF’s vast network of clinics provide comprehensive abortion care services including pre-abortion counselling, surgical and (where possible) medical drug-induced procedures, and postabortion care including contraceptive counselling and provision. In countries where abortion is legally restricted, as is the case in Ghana, Nigeria, Peru and Venezuela, several of our clinics offer treatment for incomplete abortion. IPPF works to integrate abortion to the full extent permitted by law into the overall sexual and reproductive health services of our Member Associations. The ‘First Trimester Abortion Guidelines and Protocols’ developed by IPPF in 2008 collates internationally accepted best practices in comprehensive abortion care to support providers in their work. It is only through the realisation of women’s rights to free, informed choices and bodily integrity that the Millennium Development Goal to achieve universal access to reproductive health care and reduce maternal mortality will be met. Reference(s) [1] Defined by the World Health Organization (WHO) as ‘the termination of a pregnancy carried out by someone without the skills or training to perform the procedure safely, or in an environment that does not meet minimal medical standards, or both’. WHO (2003) http://www.who.int/reproductive-health/publications/ unsafeabortion_2003/ua_estimates03.pdf