The Junior Obstetrics & Gynaecology Society have their meeting with RCPI Institute of Obstetricians & Gynaecologists
The annual meeting between RCPI Institute of Obstetricians & Gynaecologists and the Junior Obstetrics and Gynaecology Society took place at No 6 Kildare Street on 29 November.
The Junior Obstetrics and Gynaecology Society has been representing Trainees in Ireland since 1988.
After the meeting was declared open by Society Chair Dr Mei Yee Ng, Dr Aziza Ahmed (registrar in Obstetrics and Gynaecology) presented a research project to uncover the laparoscopy rate at Cork University Hospital, discovering that it was 18%. Dr Celine Dignam (UCD Bachelor of Medicine, Surgery, and Obstetrics student) reviewed the Termination of Pregnancy service at the National Maternity Hospital established after the 2018 Health Act, and found that rate of patients’ complications was low.
The outcomes of preterm premature rupture of membranes at the National Maternity Hospital was the focus of Dr Alex Taylor’s presentation (Higher Specialist Training in Obstetrics & Gynaecology Trainee), which found maternal morbidity rate at the hospital to be 62%. Dr Jenna Mullen (RCSI Bachelor of Medicine, Surgery, and Obstetrics student) presented a study relating to bariatric patients seeking antenatal care at Rotunda Hospital Dublin, finding that 48% of patients underwent bariatric procedures outside the recommended deferral of pregnancy for 12-18 months.
Dr Aoibhinn Smyth made a case for multidisciplinary teams managing cardiac disease in pregnancy, utilising the cardiac registry database at Mater Misericordiae University Hospital to show that in 149 pregnancies, arrhythmia was found to be the most common cardiac disease, with hypertension as the most common risk-factor for disease.
Dr Mize Omar (Basic Specialist Training in Obstetrics & Gynaecology Trainee) shared results of an audit conducted at Rotunda Hospital Dublin, finding that in a majority of tachysystole cases, Terbutaline was administered appropriately. Dr Jill Mitchell (Higher Specialist Training in Obstetrics & Gynaecology Trainee) investigated links between intrapartum fetal oxygen saturation monitoring and adverse perinatal outcomes, presenting evidence that adding fetal monitoring to traditional monitoring may reduce odds of caesarean section without impacting neonatal outcomes.
Registrar Dr Prerna Kamath presented an audit at The Coombe Hospital, looking at the results of routine day-two full-blood-count in postoperative care of women with caesarean section. Dr Sara Mohan (Higher Specialist Training in Obstetrics & Gynaecology Trainee) looked at the implementation of the Free Contraception Scheme at Wexford General Hospital, and found patients still have barriers to access contraception under the scheme.
A study on the use of vapes was presented by Dr Aisling Moore, which found an overwhelming majority of patients at The Coombe Hospital felt there isn’t sufficient information available about vaping during pregnancy. Dr Kamath and Dr Barbara Guerrini (Basic Specialist Training in Obstetrics & Gynaecology Trainee) shared their experience of the European Network of Trainees in Obstetrics and Gynaecology’s exchange programme, in which they visited hospitals in Switzerland. They noticed cultural differences in training, including doctors being present during all births, the use of the Sonata System, the use of Sterillium instead of water, and induction mocktails offered to patients.
An afternoon session was curated by RCPI Institute of Obstetricians & Gynaecologists. Urogynaecology specialist Ms Orfhlaith O’Sullivan speculated on the future of stress urinary incontinence treatments, and argued for the end of the HSE pause on vaginal mesh implants, and bringing back Total Procedure Time for stress incontinence. Gynaecologist Dr Sambit Mukhopadhyay (Norfolk and Norwich University Hospital Foundation Trust) presented a history of the vaginal hysterectomy procedure, up to the advent of laparoscopic hysterectomy in the 1980s.
In a debate about hospitals monitoring caesarean section rates, Dr Michael Robson (obstetrician and gynaecologist, The National Maternity Hospital) argued that rates can result in inappropriate targets, with maternity units appearing to be penalised for having high caesarean section rates, while Prof John Morrison (fetomaternal medicine, University Hospital Galway) argued that monitoring caesarean section rates reveals the decline of instrumental delivery, such as the ceased use of Kielland's forceps. Dr Michael O’Dowd (former chair of RCPI Institute of Obstetricians & Gynaecologists) presented on the recent narrative of Charlotte Bronte believed to have died due to pregnancy complications rather than from tuberculosis.
The event ended with a meeting led by Prof Patricia Crowley (Polycystic Ovary Syndrome Clinic, Tallaght University Hospital), who assessed the 2023 annual reports by The National Maternity Hospital, Coombe Hospital, and Rotunda Hospital Dublin. In Dublin, 21,883 women delivered babies that were less than 500g, and caesarean section rates at the hospitals varied between 36-44%.
Prof Crowley referred to a new phenomenon of a large cohort of patients over 35 years-of-age. At The National Maternity Hospital, nearly 50% of patients were over 35 years-of-age, with similar statistics at Coombe Hospital and Rotunda Hospital Dublin. 50% of patients at The National Maternity Hospital were born outside the EU, while 20-25% of patients at Coombe Hospital and Rotunda Hospital Dublin were born outside of the EU.
Histories of psychological distress and trauma were cited by 25% of patients at Coombe Hospital. Prof Crowley pointed out that history of assisted reproduction was missing from that hospital’s report.
All three reports cited extremely low rates of stillbirth and eclampsia. “There is a lot to be proud of in these reports,” said Prof Crowley.
She also warned that as adverse events become rarer, Trainees may have less experience and skills to deal with those events. “Look out for your colleagues when bad things happen,” she said.