Evolution of OGASH by ERNST THEODOR RIPPMANN

30 MAY 2007 JW MARRIOTT (Mirage) Hotel, Cairo - EGYPT

BASICS OF EPH-GESTOSIS

EPH-Gestosis is the most important pregnancy complication, killer No. 1 for babies and mothers. It is important to know that the baby is 100 times more in danger than the mother. EPH-Gestosis is not a disease. It is a syndrome. The cardinal signs and symptoms edema (E), proteinuria (P) and hypertension (H) may appear simultaneously, or singly. The causes of E, P and H are manyfold.

Therefore it is illocigal and even harmful to treat such a heterogeneous group in just one way. The causes of the cardinal signs and symptoms vary greatly according to population group and its location. They should be discovered before a next pregnancy.

Over 100 names of this syndrome, more than 50 classifications and various techniques to assess the signs and symptoms make it impossible to compare results worldwide. Thir confusion prevents the science from progress.

BASICS OF EPH-GESTOSIS

The OG has suggested a sensible nomenclature, classifications and definitions, which could overcome this barrier.

Nomenclature EPH-Gestosis (EPH-Syndrome; EPH-Complex) Pregnancy Complicated Classification: Symptomatic Gest...

osis by Edema (E), Proteinuria (P), Hypertension (H) Pathogenetic Mono Poly EPH EP EH PH 1. Super imposed EPH-Gestosis 2. Transient/essential EPH-Gestosis (no signs and symptoms after puerperium) 3. Concommitant diseases EPH 4. Unclassified EPH-Gestosis EI (Eclampsia imminent) EC (Eclampsia convulsiva)

BASICS OF EPH-GESTOSIS

Definitions: Edema Proteinuria Hypertension In Hypotension: Excessive (inadequate) increase of body-weight during pregnancy, usually Due to fluid retention, i.e.

More than 500g/week 2000g/month 13 kg/entire pregnancy Demonstrable pretibial edema are of gestosis origine, if they are still present after a nights's bedrest. More than trace in one specimen. Preferably dipstick Last normal reading 135/85 First pathological reading 140/90 Increase of 30 mmHg systolic Increase of 15 mmHg diastolic

BASICS OF EPH-GESTOSIS

• Since EPH-Gestosis is rampant in the developing countries with little or no facilities for prenatal care, the methods to detect E, P and H have to be simple and for everybody to be understood and to be carried out.

• EPH-Gestosis means high risk pregnancy. It might just mean that the pregnant patient has to be watched and monitored closely. Such EPH Gestosis can be detected at a very early stage and treated adequately.

• It is mandatory to examine each patient thoroughly two to three months after delivery to exclude all conditions which could lead to EPH-Gestosis again in a future pregnancy.

Originator of Project OGASH

34 years after the founding of the Organisation Gestosis, i.e.2003

His

Royal Highness Prince Avtandil, Prof. A. R. Chkheidze

started with his spectacular idea. He was then already a welknown, arrived scientist at the University of Tbilisi Research Institute of Obstetrics and Gynaecology in Georgia.

Since the early eighties he had been working on the the problems of EPH Gestosis. He also had introduced the nomenclature, i.e. "Gestosis" in the USSR. Together with V.V. Abramchenko from Leningrad, now Petersburg again, he published 1988 No. 28 of the monographs of the Organisation Gestosis Press, entitled

Founding of OGASH

"The Pregnancy and Labor Management of Atypical Forms of late Gestosis (EPH-Gestosis) of He recognized that the parameters the OG needed world wide spreading and application in every day practice of therefore founded the Obstetrics.

He

O

rganisation

G

estosis

A

ffiliated and

S

ponsored

H

ospitals

OGASH

Creation of OGASH

He had come to the conclusion that without mutual understanding, without the acceptance und application of a common Name Classification Definiton i.e. a common language no comparison of results of research in the fight against EPH - Gestosis would be possible. Teaching starts as a rule in hospitals and beside the university Centers also in smaller hospitals where the young doctors get their training.

These hospitals, University teaching and training centers would agree to the obligation to apply the parameters of the OG doing their work with pregnant patients suffering from EPH - Gestosis in prenatal care in the outpatient departments, in their delivery rooms, laboratories and in their scientific publications.

To support these efforts the Library of the Organisation Gestosis and all books published by the Organisation Gestosis Press were being transferred to the

Medical Library of the Republic of Georgia

.

Creation of OGASH, OG home page and logo of OGASH

1. The World OGASH Board, An Intercontinental OGASH presidency of the Academy of Medical - Social Sciences The IAMSS correspondence and collecting data of etiology prevention OGASH and therapy by the best leaders of

2. Promoting OGASH workshops world wide 3. Promoting and supporting Growth of Science and Education Access to pertinent literature A Web site bulletin of IAMSS Publishing "OGASH Series" Monographs

4.

Proposing guidelines research programs and standards worked out by International experts on diagnostics Methods of pregnancy surveillance for everybody concerned, including laboratories 5. Supporting national and regional EPH - Gestosis centers e.g. International Center for Study of Pathophysiology of pregnancy and fetus (ICPPF) in Cairo, Egypt

Creation of OG home page and logo of OGASH

6. With updating of the Home Page, created 2004 in Tbilisi, which includes all important details of OGASH to spread the information more widely, open for professional readers, collegues, investors, sponsors and patients ( www.gestosis.ge

). His Royal Highness also created the logo of OGASH.

Logos

In the Greek mythology HERA was the sister and the wife of Zeus, the over all Lord of the Greek Universe. She was the protector of marriages, of the conjugal life, blessing the mothers during birth and helper during pathology of pregnancy.

This ancient logo will be transferred on an enamel shield and dedicated to OGASH hospitals to be fixed to the main door of the OGASH Academy, Hospital or of the OB/ GYN Department. It also might be printed as stamp to be fixed to every letter of this department, to every publication which comes from this department und nobody else would be permitted to use these special stamps.

Creation of Boards, Awards and the Academic Titles

To enforce these his ideas he created National Boards. In Egypt it is The EGYPT OGASH Regional Subcommittee and its Chairman is Prof. Mohammed Nabegh El - Mahallawi, MD., PhD., FRCOG He also has deserved the highest OGASH Award. He has been honored by the title of an Honorary Academician of OGASH As corresponding members of the World OGASH Board of Intercontinental Academy of Medical-Social Sciences IAMSS here in Egypt have been named: Prof. Hany Helal Prof. Mahmoud El-Tayed Prof. Hatem El-Gabaly Prof. Ali El-Abd Prof. Amr El-Shalakani Prof. Mounir M.F. El-Hao Ass. Prof. Khaled Saiid

B U L L E T I N "OGASH-Series" Collection of scientific works Intercontinental Academy of Medical-Social Sciences (IAMSS)

Further plans concern a bulletin published by OGASH, also Congresses realized by OGASH Hospitals. They will discuss certain circumscript problems.

The result will be made available through the OGASH Series. These books will cover the many interrelationships in EPH - Gestosis. It is being expected to make these information also available on Compact Discs, easy to be stored.

OGASH owns no funds. Therefore no financial support can be given. No monetary awards are being offered. The support of the cooperating hospitals consists in the possibilities to obtain the information on the running research programs and of the most successful procedures in prophylaxis and therapy in EPH - Gestosis There will also be a "Roll of Honor" to underline the competence of the Member hospitals of OGASH.

And of course to be able to fix the logo of OGASH to your hospital is a great merit and honor.

OGASH is a great effort to foster mutual understanding in EPH - Gestosis It aims at world wide progress in this field, at reducing fetal and maternal morbidity and mortality, creating a healthy population in every country where hospitals are joining OGASH. It is a worthy project which deserves world wide recognition, acclaim and support.

So urge your hospitals to apply for membership of the OGASH.

We have prepared a request form with which you will get in touch with His Royal Highness Prince Avtandil.

Professor Avtandil Revaz Chkheidze will get in touch with you and inform you about the condition under which your hospital will be accepted in this prestigeous association.

CH- Basel, May 12* 2007