Three Obstetrics & Gynaecology groups unite to celebrate their specialty’s role at RCPI conference
Three professional bodies representing Obstetrics & Gynaecology in the Republic of Ireland, Northern Ireland and the UK united to look at the specialty’s role during changing times, at RCPI Institute of Obstetricians & Gynaecologists’s spring conference.
At the beginning of the event on 7 March, outgoing institute chair Prof Sam Coulter-Smith introduced the conference as a historic first joint meeting at No 6 Kildare Street between RCPI Institute of Obstetricians & Gynaecologists and the Royal College of Obstetricians & Gynaecologists (RCOG) UK and the Ulster Obstetrical and Gynaecological Society.
The morning session began with Dr Geeta Kumar (RCOG Vice President and Women’s Services Lead, Betsi Cadwaladr University Health Board – North Wales) presenting on abnormal bleeding while on Hormone Replacement Therapy (HRT). Dr Lucia Dolan (Subspecialist Urogynaecologist, Belfast City Hospital) gave an update on the work done by the Northern Ireland Regional Mesh Service, which has performed 43 mesh removal surgeries. “We wanted to restore trust in women because it was at a low level,” she said.
There have been health service pauses on mesh implants – used as treatment for stress urinary incontinence – in Ireland and the UK for nearly seven years. Whilst some women had complications, others had good results and internationally mid-urethral slings continue to be used widely. Much work has been done in order to ensure that in future women undergoing treatment will have access to all conservative and surgical options within supported multidisciplinary services including national information and consent forms and robust national guidelines.
Also referencing the upcoming seven-year anniversary pause was Dr Suzanne O’Sullivan, the new chair of RCPI Institute of Obstetricians & Gynaecologists, who thanked both Dr Dolan and Royal College of Obstetricians & Gynaecologists UK President Dr Ranee Thakar for volunteering free weekends to help provide vaginal mesh removal training in the Republic of Ireland. “I feel our speciality is good at collegiality. If we reach out to each other, there’s a lot we can do,” said Dr O’Sullivan. She also confirmed that all 19 recommendations asked by the HSE Chief Medical Officer to be addressed during the pause have been addressed.
Dr Kristine Steele, President of the Ulster Obstetrical and Gynaecological Society, presented on the category of ectopic pregnancy that is asymptomatic. She urged against gynaecologists feeling pressure to perform unnecessary intervention, and recommended expectant management as a valid approach to offer when appropriate.
The second session of the day began with Dr Gillian Blayney (obstetrician-gynaecologist, Antrim Area Hospital) presenting on the challenges of multiple pregnancy. In a presentation on how best to access fetal well-being during labour, Dr Sahr Yambas (PhD student, Trinity College Dublin Medicine) compared digital fetal scalp stimulation with fetal blood sampling. Dr Farah Nazir (The Coombe Hospital) asked if continuous glucose monitoring in early pregnancy could predict gestational diabetes mellitus.
Dr Fiona O'Toole (UCD Maternal and Fetal Medicine Subspeciality Fellow at the National Maternity Hospital) discussed iron infusions as a method to address anaemia during pregnancy. Dr Alex Dakin (RCPI Higher Specialist Training in Obstetrics & Gynaecology trainee) presented on the issue of early-onset fetal growth restriction at the Rotunda Hospital
The final session of the day began with Dr Ranee Thakar, President of the Royal College of Obstetricians & Gynaecologists UK, who gave gave an update on how the college was addressing women’s health priorities through several new projects including a new Race Equity Project (feedback revealed that 75% of the college’s membership witnessed racial discrimination at work) and a new Avoiding Brain Injury in Childbirth programme co-designed with Royal College of Midwives.
Prof Hassan Shehata (RCOG Senior Vice President, and maternal medicine specialist, Epsom and St Helier University Hospitals UK) gave a history of the medication Metformin, and how its plant origins are referenced as far back as 1500BC. With the drug being found to be useful for management of gestational diabetes, Prof Shehata and colleagues carried out a randomised trail that found a surprising decrease of preeclampsia by 76% in patients taking the medication. Metformin is not currently recommended for non-diabetic women, but Prof Shehata states that potential links with reduction in preeclampsia needs further study.
Dramatic declines in birth rates were the focus of Dr Rhona Mahony (aternal and fetal medicine specialist, National Maternity Hospital), who shared that, during the current demographic shift towards youth scarcity, fertility has become a multi-billion dollar industry. The median age for women in Ireland to have their first baby is now 30-years-old, and barriers to start families include cost of childcare, cost of housing, financial instability, inflexible working conditions, and lack of job security.
Quoting an investigation by Bloomberg in December 2024, Dr Mahony said 120,000 embryos were created in 2019 using donated eggs. “It’s not just that we’re selling eggs, it’s what we’re doing with them,” she said. Raising concerns around chromosomal anomaly and possibilities of gene-editing via in vitro fertilisation, Dr Mahony also reminded that Ireland’s Assisted Human Reproduction Act (2024) has yet to be enacted, with several disputed issues awaiting to be addressed.
Finally, Professor John Kingdom (MFM and high risk obstetric specialist), Mount Sinai Hospital Toronto) presented on the growing attention on Placenta Growth Factor (PlGF), a protein made in the placenta and secreted into the maternal blood, and its possibilities for diagnostic testing. Between 2020-2022, he was involved in a screening study that found the lowest levels of PlGF were linked with the most severe cases of preeclampsia. Prof Kingdom made a case for introduction of a new pregnancy screening model that incorporates a PlGF test. “I think it can make a real difference in obstetrics and maternal fetal medical care,” he said.
Find out more about RCPI Institute of Obstetricians & Gynaecologists.