InternationalFederationofGynecologyandObstetrics

FIGOMission

• The International Federation of Gynecology and Obstetrics (FIGO) is a unique organization, being the only international professional body that brings together 130 obstetrical and gynecological associations from all over the world.

• FIGO is dedicated to the improvement of women’s health and rights and to the reduction of disparities in health care available to women and newborns as well as to advancing the science and practice of obstetrics and gynecology. The organization pursues its mission through advocacy, programmatic activities, capacity strengthening of member associations and education and training.

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InternationalFederationofGynecologyandObstetricsWorkingGrouponGoodClinicalPracticeinMaternal-FetalMedicine

Chair: G C Di Renzo

Expert members:E Fonseca, BrasilE Gratacos, SpainS Hassan, USAM Kurtser, RussiaF Malone, IrelandS Nambiar, MalaysiaM Sierra, MexicoK Nicolaides, UKH Yang, China

Expert members ex officio:C Fuchtner, FIGOM Hod, EAPMGH Visser, SM CommitteeE Castelazo , CBET CommitteeL Cabero, WG GDMV Berghella, SMFMY Ville, ISUOGM Hanson, DOHaD, WG NutritionPP Mastroiacovo, ClearinghouseJL Simpson, March of DimesD Bloomer, GLOWM

InternationalFederationofGynecologyandObstetricsWorkingGroupontheChallengesofLabour andDelivery

Chair: R Romero

Expert members:D Farine, CanadaMT Gervasi, ItalyJ M. Robson, IrelandT Duan, ChinaS Rosales, MexicoT Kimura, JapanL Yeo, Korea-USA

Expert members ex officio:C N Purandare, FIGOG C Di Renzo, FIGOM Stark, NESAGH Visser, SM CommitteeE Castelazo , CBET CommitteeC Lees, RCOGA Conde’ Agudelo, NIH NICHDD Bloomer, GLOWM

International Federation of Gynecology and ObstetricsMarch of DimesWorking Group on Preterm Birth Prevention

Chairs: J L SimpsonG C Di Renzo

Expert members:Ernesto CastelazoMary D’AltonEduardo FonsecaChris HowsonBo JacobssonJames MartinJane NormanT Y Leung

Expert members ex officio:CN Purandare, FIGOJ Howse, March of DimesG Visser, SM CommitteeD Bloomer, GLOWMJim Larson BCGDavid Ferrero, BCG

International Federation of Gynecology and ObstetricsGDM initiative

Chair: M Hod

Expert members:Mukesh AgarwalBlami DaoGian Carlo Di RenzoHema DivakarEran HadarAnil Kapur

Expert members ex officio:CN Purandare, FIGOGH Visser, SM CommitteeD Ayres do Campo, SM CommL Cabero, CBET CommitteeD Bloomer, GLOWMR Fabienke, Novo Nordisk

Good practice advice

• Folicacidsupplementation•Predictionandpreventionofpretermbirth•Noninvasiveprenataldiagnosisandtesting

Good practice advice

• Thyroiddiseasesinpregnancy•MgSO4useinobstetrics•Appropriateuseofultrasoundinpregnancy•Hyperglycemiaandpregnancy

GoodpracticeadvicefinalisedinJune2016

•AspirinUseinPregnancy• Irondeficiencyanaemia•ManagementofTwinPregnancy•MicronutrientsinPregnancy

GoodpracticeadvicetobediscussedonDecember2016

• Intrauterinegrowthrestriction•RecurrentMiscarriage•Predictionofpreeclampsia

Hyperglycemia in pregnancy

International Federation of Gynecology and ObstetricsWorking Group on Good Practice on Maternal-Fetal Medicine

Hyperglycemia in pregnancy

• Allpregnantwomenshouldbetestedforhyperglycemia.Universaltestingbyallmemberassociations

• WHO(2013)andIADPSG(2010)criteriafordiagnosisofgestationaldiabetesmustbeused

• DiagnosisofHDPshouldbeonproperlycollectedvenousplasmasamples.Indevelopingcountriesaplasmacalibratedhandheldgluocometer isacceptable

• ManagementofHDPshouldbeinaccordancewithavailablenationalresourcesandinfrastructure

• Nutrition andphysical activity counselling is amust andcontinue after birthalso

• Insulin is added if lifestyle anddiet modification does not controlHyperglycemia.Metformin andor glyburide may beused in2nd and3rdtrimesters.Oraldrugs may befirst choice in2nd and3rd trimester

• Postpartum 8weeks visit counselling andlife style modifications for motherandchild is necessary

• Public health measures toincrease awareness andacceptance ofpreconception counselling should beapplied for all women planningpregnancy.

International Federation of Gynecology and ObstetricsWorking Group on Good Practice on Maternal-Fetal Medicine

CONCLUSIONS

FOCUSONGLOBALSTRATEGIES

AMELIORATEOURPROFESSIONOVERCOMINGTHELIMITSOFNATIONALSOCIETIESGUIDELINES:THEBESTPRACTICEADVICEGLOBALSTRATEGIESFOR:PRETERMBIRTHPREVENTIONNONCOMMUNICABLEDISEASESPREVENTINGEXPOSURETOTOXICCHEMICALS

FIGHTINGTHEINEQUITY

Gatheringdataonmaternalmortalityandmaternalhealthisnotoriouslydifficult.However,onethingisclearfromallthestatistics:althoughmaternalandperinatalmortalityandmorbidityisfallinggloballytheperspectivesforwomen-infantsinpoorresourcescountriesaremuchworstthanforthoseinindustrialisedcountries.

Accesstocare

HealthcareSystems/InsuranceCoverage

Education/Counseling

PreventivetoolsBest

Practice

Riskfactors/MarkersImplementation

Window of Opportunity

Pregnancyoffersawindowofopportunitytoprovidematernalcareservicestomotherandoffspring

Reducetraditionalmaternalandperinatalmorbidityandmortality

indicators

AddressintergenerationalpreventionofpretermbirthandNCDs,suchas

diabetes,hypertension,cardiovasculardisease,andstroke.

OnSept2015theUNGeneralAssemblyadoptedthe“Agenda2030:TransformingourWorld”,withaconsensusoftheWorldGovernmentCommunity- introduced17sustainabledevelopmentgoalsSDGs.ManyofthesuggestedSDG’shaveEnvironmentalandReproductivehealthembeddedintheirgoals

Itisasheerco-incidencethatSeptember2015witnessedthe20th anniversaryoftheBeijingWorldConferenceonWomenundertheslogan-“Planet50-50by2030:SetitupforGenderEquality”.

‘TheAgenda2030;Transformingourworld’ orPlanet50-50by2030’ i.e.SDGswillnotmaterialisewithoutthecontributionof50%ofitspopulationi.e.women- Thiscanbeachievedonlywithgenderequality,equaleducationandemploymentopportunities+providingsexualreproductivehealthandrights.

ReproductiveHealthandRightswillnotbecompleteunlessweimproveenvironmentalHealth

FIGOwasnotandwillnotbeapassiveobservertobringaboutthisrequiredchangeandwillacttomakethesedreamsrealforwomen.