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O330 GYNAECOLOGY TRAINING ASSOCIATES(GTAS): THE FUTURE IN THE TRAINING OF FINAL YEAR MEDICAL STUDENTS?
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S261–S530
and collected for histological examination by light microscope. The patients were divided into 2 groups: -Group I (n = 10)control group as female factor was excluded. -Group II(n = 16) included patients with endometriosisss. -The range of ages for both groups was from 25–39 yrs. Written informed consent was obtained from all patients. Results: In control groups, 6/10 (60%) got successfully pregnant. The follicular cells revealed the normal morphological characteristic features. In Endometriotic group, 4/16 (25%) got pregnant. Abnormal follicular cells were seen with increase morphological variation. Conclusions: The present work has shown: The existence of a number of major structural variations between normal granulosa cells and those obtained from women above 35 years old and women suffering endometriosis. Morphological variations of granulosa cells may play a role in infertility and subsequent failure of I.V.F.&E.T. Methods that measure apoptosis in human granulosa cells can be used as diagnostic tool for screening female infertility. O330 GYNAECOLOGY TRAINING ASSOCIATES(GTAS): THE FUTURE IN THE TRAINING OF FINAL YEAR MEDICAL STUDENTS? S. Iyengar1 , N. Raut1 , J. Clark1 . 1 Obstetrics and Gynaecology, Birmingham Women’s NHS Foundation Trust, Birmingham, United Kingdom Objectives: Pelvic examination is by nature an intimate examination and access to practical training may be limited. A study conducted in Birmingham showed that 1 in 10 final year medical students had not performed a pelvic examination and worryingly 2 in 8 had never examined a conscious patient. We aimed to set up GTA training sessions in a supportive and non-threatening environment with the opportunity for repeated practice, focusing also on communication skills and methods of patient education and relaxation. We have successfully conducted the pilot programme and aim to soon set up the TARGET trial (Teaching Associates Randomised to evaluate the effectiveness of Gynaecological pelvic Examination versus Traditional teaching using manikins). Materials: We employed GTAs after advertising through posters and conducting formal interviews. All final year medical students posted to Birmingham Women’s Hospital for their obstetrics and gynaecology rotation were included in our programme. Methods: The GTAs were trained to perform and teach gynaecological examination by a consultant gynaecologist and registrar. During the first week of the clinical rotation of medical students, teaching was conducted in small group sessions of approximately two and half hours each. Feedback (verbal and written) was given to the students at the end of each session. The students also filled in a feedback form about the session. Results: We collected feedback from students. It showed excellent improvement in 40% of students for communication skills, 49% for speculum examination and 54% for bimanual examination. Conclusions: We have successfully recruited and trained GTAs who have conducted small group teaching sessions under indirect supervision. They are now confident to run these sessions independently. The feedback from students has been extremely encouraging. They have not only enjoyed these sessions but feel this has increased their level of confidence and interest in the specialty. This has re-emphasised the importance of including GTA training sessions for the medical students as an important part of their fifth year clinical rotations. We are now working towards starting the TARGET trial (Teaching Associates Randomised to evaluate the effectiveness of Gynaecological pelvic Examination versus Traditional teaching using manikins).
S377
O331 RUPTURE OF A NONCOMMUNICATING RUDIMENTARY HORN PREGNANCY AT 19TH WEEK OF GESTATION: A RARE OBSTETRIC EMERGENCY B. Yuksel1 , B. Karamustafaoglu1 , A.C. Iyibozkurt1 . 1 Istanbul University, Istanbul Faculty of Medicine, Dpt. of Obstetrics and Gynecology, Istanbul, Turkey Objectives: Rudimentary horn pregnancies are rare and may be complicated by uterine rupture and may present with hypovolemic shock. Materials: A case of ruptured rudimentary horn pregnancy. Methods: Presentation of a rare case from a tertiary care clinic. Results: A 23 year old primigravida applied to our emergency clinic with abdominal pain with an abrupt onset, acute abdomen and hypovolemic shock. Gynecologic examination and ultrasound revealed hemoperitoneum and a fetus of around 19 weeks of gestation with intact membranes floating in the abdomen expulsed from a noncommunicating rudimentary horn. The other side of the uterus was unicornuate, the endometrium was normal and continuous with the single cervix. Emergency laparotomy was performed: A 375 gr fetus was delivered and ruptured rudimentary horn was excised. The remaining half of uterus was repaired. Conclusions: Hemoperitoneum with acute abdomen and hypovolemic shock may result from a ruptured rudimentary horn pregancy in 2nd trimester. Emergency surgery is life-saving and hemi uterus of the non-involved side may be conserved.
O332 COMPARISON OF SALINE HYSTEROSONOGRAPHY & HYSTEROSALPINGOGRAM IN ASSESSMENT OF FALLOPIAN TUBE PATENCY & INTRAUTERINE ABNORMALITIES IN INFERTILITY ASSESSMENT R. Izhar1 , S. Tahir2 , F. Mansuri1 . 1 OB/GYN, karachi medical & dental college, Karachi, Pakistan; 2 dow medical college, Karachi, Pakistan Objectives: The objective of study was to establish that sensitivity & specificity of Saline hysterosonography(SHG) are comparable with those of Hysterosalpingogram(HSG) in the diagnosis of uterine abnormalities and tubal blockage. Materials: The study was performed in a private hospital and infertility center in Karachi, Pakistan. 250 Women complainig of primary or secondary infertility were recruited. Non randomized purposive sampling technique was used. Methods: These patients had either HSG or SHG done as initial investigation of tubal assessment. Some abnormality detected in initial investigation was the reason for referral of these patients for the other procedure. After the second procedure the patients were asked to fill a questionnaire designed to compare acceptability & pain scores of the two procedures. Findings like presence or absence of peritoneal spill, filling defects in uterine cavity and abnormalities of uterine cavity were recorded. Abnormalities like polyp were further evaluated by performing a diagnostic curettage. Histopathology was performed to confirm the diagnosis. Results: Pain score for SHG were significantly lower than that for HSG.(3–4/10 compared with 8–10 /10) Post procedure pain was
and collected for histological examination by light microscope. The patients were divided into 2 groups: -Group I (n = 10)control group as female factor was excluded. -Group II(n = 16) included patients with endometriosisss. -The range of ages for both groups was from 25–39 yrs. Written informed consent was obtained from all patients. Results: In control groups, 6/10 (60%) got successfully pregnant. The follicular cells revealed the normal morphological characteristic features. In Endometriotic group, 4/16 (25%) got pregnant. Abnormal follicular cells were seen with increase morphological variation. Conclusions: The present work has shown: The existence of a number of major structural variations between normal granulosa cells and those obtained from women above 35 years old and women suffering endometriosis. Morphological variations of granulosa cells may play a role in infertility and subsequent failure of I.V.F.&E.T. Methods that measure apoptosis in human granulosa cells can be used as diagnostic tool for screening female infertility. O330 GYNAECOLOGY TRAINING ASSOCIATES(GTAS): THE FUTURE IN THE TRAINING OF FINAL YEAR MEDICAL STUDENTS? S. Iyengar1 , N. Raut1 , J. Clark1 . 1 Obstetrics and Gynaecology, Birmingham Women’s NHS Foundation Trust, Birmingham, United Kingdom Objectives: Pelvic examination is by nature an intimate examination and access to practical training may be limited. A study conducted in Birmingham showed that 1 in 10 final year medical students had not performed a pelvic examination and worryingly 2 in 8 had never examined a conscious patient. We aimed to set up GTA training sessions in a supportive and non-threatening environment with the opportunity for repeated practice, focusing also on communication skills and methods of patient education and relaxation. We have successfully conducted the pilot programme and aim to soon set up the TARGET trial (Teaching Associates Randomised to evaluate the effectiveness of Gynaecological pelvic Examination versus Traditional teaching using manikins). Materials: We employed GTAs after advertising through posters and conducting formal interviews. All final year medical students posted to Birmingham Women’s Hospital for their obstetrics and gynaecology rotation were included in our programme. Methods: The GTAs were trained to perform and teach gynaecological examination by a consultant gynaecologist and registrar. During the first week of the clinical rotation of medical students, teaching was conducted in small group sessions of approximately two and half hours each. Feedback (verbal and written) was given to the students at the end of each session. The students also filled in a feedback form about the session. Results: We collected feedback from students. It showed excellent improvement in 40% of students for communication skills, 49% for speculum examination and 54% for bimanual examination. Conclusions: We have successfully recruited and trained GTAs who have conducted small group teaching sessions under indirect supervision. They are now confident to run these sessions independently. The feedback from students has been extremely encouraging. They have not only enjoyed these sessions but feel this has increased their level of confidence and interest in the specialty. This has re-emphasised the importance of including GTA training sessions for the medical students as an important part of their fifth year clinical rotations. We are now working towards starting the TARGET trial (Teaching Associates Randomised to evaluate the effectiveness of Gynaecological pelvic Examination versus Traditional teaching using manikins).
S377
O331 RUPTURE OF A NONCOMMUNICATING RUDIMENTARY HORN PREGNANCY AT 19TH WEEK OF GESTATION: A RARE OBSTETRIC EMERGENCY B. Yuksel1 , B. Karamustafaoglu1 , A.C. Iyibozkurt1 . 1 Istanbul University, Istanbul Faculty of Medicine, Dpt. of Obstetrics and Gynecology, Istanbul, Turkey Objectives: Rudimentary horn pregnancies are rare and may be complicated by uterine rupture and may present with hypovolemic shock. Materials: A case of ruptured rudimentary horn pregnancy. Methods: Presentation of a rare case from a tertiary care clinic. Results: A 23 year old primigravida applied to our emergency clinic with abdominal pain with an abrupt onset, acute abdomen and hypovolemic shock. Gynecologic examination and ultrasound revealed hemoperitoneum and a fetus of around 19 weeks of gestation with intact membranes floating in the abdomen expulsed from a noncommunicating rudimentary horn. The other side of the uterus was unicornuate, the endometrium was normal and continuous with the single cervix. Emergency laparotomy was performed: A 375 gr fetus was delivered and ruptured rudimentary horn was excised. The remaining half of uterus was repaired. Conclusions: Hemoperitoneum with acute abdomen and hypovolemic shock may result from a ruptured rudimentary horn pregancy in 2nd trimester. Emergency surgery is life-saving and hemi uterus of the non-involved side may be conserved.
O332 COMPARISON OF SALINE HYSTEROSONOGRAPHY & HYSTEROSALPINGOGRAM IN ASSESSMENT OF FALLOPIAN TUBE PATENCY & INTRAUTERINE ABNORMALITIES IN INFERTILITY ASSESSMENT R. Izhar1 , S. Tahir2 , F. Mansuri1 . 1 OB/GYN, karachi medical & dental college, Karachi, Pakistan; 2 dow medical college, Karachi, Pakistan Objectives: The objective of study was to establish that sensitivity & specificity of Saline hysterosonography(SHG) are comparable with those of Hysterosalpingogram(HSG) in the diagnosis of uterine abnormalities and tubal blockage. Materials: The study was performed in a private hospital and infertility center in Karachi, Pakistan. 250 Women complainig of primary or secondary infertility were recruited. Non randomized purposive sampling technique was used. Methods: These patients had either HSG or SHG done as initial investigation of tubal assessment. Some abnormality detected in initial investigation was the reason for referral of these patients for the other procedure. After the second procedure the patients were asked to fill a questionnaire designed to compare acceptability & pain scores of the two procedures. Findings like presence or absence of peritoneal spill, filling defects in uterine cavity and abnormalities of uterine cavity were recorded. Abnormalities like polyp were further evaluated by performing a diagnostic curettage. Histopathology was performed to confirm the diagnosis. Results: Pain score for SHG were significantly lower than that for HSG.(3–4/10 compared with 8–10 /10) Post procedure pain was