DECEMBER 2013 VOL. 40, NO. 4

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1 The Obstetrical Society of Philadelphia Newsletter DECEMBER 2013 VOL. 40, NO. 4 President s Message As we enter 2014, we can look back at the last few months and also ahead to the New Year. This past October, people began enrolling in the Federal Health Insurance Exchanges as required by the Affordable Care Act (ACA), which was signed into law in Some components of the ACA have already been implemented: elimination of preexisting conditions, inclusion of children up to age 26 on their parents plans, and preventative care including wellness exams. Unfortunately in October, technical difficulties encountered on the federal website severely limited the IN THIS PAGE 1 PAGE 2 PAGE 3 PAGE 4 PAGE 5-8 PAGE 9 PAGE 10 President s Message Upcoming Lecture: Embryo Donation: An Underutilized Family Building Option Jeffrey Keen, MD Third Party Reproduction : A Part of Assisted Reproductive Technology Steven J. Sondheimer, MD Embryo Donation - An Update Stephen W. Sawin, MD November Meeting - Ob/Gyn - Past, Present & Future Announcements Issue Council Members number of people who were able to enroll in a health plan. A repair of the website by federal and private sector information technology experts has now allowed millions to visit HealthCare.gov. State marketplaces performed much better than the federal exchanges. The Federal Government announced that as of November s end, there were only 365,000 citizens enrolled a disappointing start. Dr. Ralph Hale, our speaker in November, discussed the Affordable Care Act in his lecture, Obstetrics and Gynecology, Past, Present and Future. Dr. Hale felt that it was too early to determine whether or not the ACA will be a success. He stated that 50% of healthcare dollars are paid by Medicare and Medicaid and that the objective of the ACA is to control the cost of medical care and to provide coverage for the uninsured. Dr. Hale discussed the changes that are taking place in our specialty. The advances in medicine and the increased volume of knowledge needed to practice will result in an increase in subspecialization. There will be a move toward standardization of care and team-based care. The lecture was well received, and I felt very fortunate to have Dr. Hale as our guest. He is a man with an understanding of the history of our specialty and a vision of its future. January s speaker, Dr. Jeffrey Keenan is a graduate of Jefferson Medical College. Dr Keenan returns to Philadelphia to discuss the controversial topic of embryo donation at our joint meeting with the Philadelphia Area Reproductive Endocrine Society (PARES). Dr. Keenan, Professor of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility at the University of Tennessee Medical Center, has lectured and written extensively on embryo donation. The Obstetrical Society of Philadelphia and PARES look forward to welcoming Dr. Keenan at our January meeting. This month s newsletter contains two articles on embryo donation. In the first article, Third Party Reproduction: A Part of Assisted Reproductive Technology, Dr. Steven Sondheimer discusses embryo, egg and sperm donation. Dr. Sondheimer is Professor of Obstetrics and Gynecology, Division of Infertility and Reproductive Endocrinology at The Perelman School of Medicine, University of Pennsylvania. In the second article Stephen Sawin, MD, of the South Jersey Fertility Center and past president of the Philadelphia Area Reproductive Endocrine Society, discusses the politics of embryo donation. I wish everyone a fulfilling and joyous New Year. Marjorie Angert, DO, FACOG, MPH President - Obstetrical Society of Philadelphia, THE OB SOCIETY OF PHILADELPHIA VOLUME 40-ISSUE 4 P A G E 1

2 Upcoming Lecture Embryo Donation: An Underutilized Family Building Option Jeffrey Keenan, MD, HCLD Professor of Obstetrics & Gynecology Division of Reproductive Endocrinology & Infertility University of Tennessee Medical Center Since 1827, when scientists first learned that the female body contains ova, until the present, advances in science and medicine have changed the ability to reproduce (or not to reproduce) to more closely match the desires of couples, and recently single woman and same-sex couples. Identification of the female sex hormones, progesterone and estrogen, in the early 1900 s set the stage for experimentation with in vitro fertilization (IVF) using animal and then human ova/sperm in the mid-twentieth century. The first test tube baby was born in England in The following year, after holding eleven public meetings in the United States, the National Ethics Advisory Board approved federal funding for IVF research. America s first test tube baby was born in Today IVF is more common, although it may be reserved for those who can afford it. Advances in human reproduction and treatment of infertility have not always been well received. Religious groups and the public have often been opposed to medical research and procedures in the reproductive field. Some religious groups have long forbid the use of contraceptives for birth control and also the use of external fertilization to achieve pregnancy. Over the years, public opinion has shifted from the belief that IVF is foreign and goes against nature to acceptance of IVF as a normal choice available to individuals and couples. * Embryo donation is a topic that is gaining attention. If one Googles Embryo Donation, the eighteenth site listed is the information page of the American Society for Reproductive Medicine (ASRM). On this page one can find documents from the ASRM s Ethics Committee that provide guidelines and information for practitioners and patients. ** Many of the other websites listed in a Google search belong to facilities that provide patients the option of using embryo donation to create a family. In January, Jeffrey Keenan, MD will address the Philadelphia Obstetrical and the Philadelphia Area Reproductive Endocrine Societies on the topic of Embryo Donation. His lecture, Embryo Donation, An Underutilized Family Building Option is sure to educate and elucidate all who attend. Fay D. Wright, MD Newsletter Editor Dr Jeffrey Keenan is a board certified specialist in reproductive endocrinology and infertility as well as obstetrics and gynecology. Dr. Keenan has been in practice for more than twenty years and is currently a Professor of Obstetrics and Gynecology at the University of Tennessee Medical Center. He specializes in the surgical treatment of complex reproductive tract problems, including pelvic pain, endometriosis, pelvic adhesive disease, uterine fibroids, and congenital anomalies. In his position as professor, Dr. Keenan trains both residents and medical students in the finer aspects of reproductive surgery, medicine, and robotic expertise. Dr. Keenan is the only robotically trained reproductive endocrinologist in East Tennessee. Use of the robotic operating system has allowed him to treat even advanced cases of endometriosis, large ovarian cysts, uterine fibroids, and other severe gynecologic diseases in a minimally invasive fashion. In the last several years, Dr. Keenan has performed more than 95% of his operations in a minimally invasive, outpatient manner. Dr. Keenan graduated from Jefferson Medical College in Philadelphia and completed his residency at Vanderbilt University Medical Center. Since completing his fellowship training in reproductive endocrinology and infertility at Wayne State University in Detroit, Dr. Keenan has been practicing in Knoxville. In 2010, Dr. Keenan became the only full professor in the Department of Obstetrics and Gynecology at University of Tennessee Medical Center. * introduction/babies-introduction/ ** Teri Wiseley - Executive Secretary Cell: obphila@yahoo.com Address: Theresa B. Wiseley, CMM Executive Secretary Obstetrical Society of Philadelphia 308 Rolling Creek Rd. Swarthmore, PA Always happy to help... WELCOME Teri Wiseley, CMM THE OB SOCIETY OF PHILADELPHIA VOLUME 40-ISSUE 4 P A G E 2

3 Third Party Reproduction : A Part of Assisted Reproductive Technology Steven J. Sondheimer, M.D. Professor of Obstetrics and Gynecology Perelman School of Medicine University of Pennsylvania Penn Fertility Care The first successful in vitro fertilization (IVF) pregnancy in 1978 (Steptoe and Edwards) was the result of a single oocyte in an unstimulated cycle and the transfer of a single embryo two days after retrieval and fertilization. As IVF became more successful with multi-follicular stimulation via gonadotropins, such as Pergonal, stimulated cycles became the norm. The increased number of eggs retrieved results in more embryos to transfer and improved pregnancy rates. Cryopreservation of embryos made possible the transfer of fewer fresh embryos, because it allowed for the subsequent transfer of thawed embryos. Successful pregnancy using thawed cryopreserved embryos was first reported 30 years ago. Storage time has not yet appeared to affect post-thaw embryo survival. There has been a press report of twins (fraternal) born 16 years apart! Modern in vitro fertilization often results in cryopreserved embryos. Embryos that undergo modern cryopreservation by vitrification at the day 5 or day 6 blastocyst stage have implantation rates after thaw similar to that of fresh blastocysts. With older freezing techniques of earlier stage embryos, the implantation rate is less, but it is still in an acceptable range. Spoonn / FreeDigitalPhotos.net Cryopreserved embryos may be from young couples with infertility using their own gametes, from older women using donor eggs with their partner s sperm, or from couples (same-sex couples included) using donor sperm and/or donor eggs. These couples or individuals are in control of the disposition of their frozen embryos. At the time of creation of the embryos, a consent form is signed to specify the disposition of the embryos, if one or both of couple were to die. They may elect to dispose of the embryos, donate them to the other partner, or donate them for research. As situations change with the passage of time, a consent can be modified by the parties involved. If after completing their family, individuals or couples want to stop paying the maintenance fee and dispose of their embryos, a new consent disposition form is signed. A new consent may allow for discarding the embryos, donating them to another woman or couple to help them achieve family building, or donating them for research. Embryo research is presently illegal in Pennsylvania. Donation of embryos to another couple is often called embryo adoption, but the American Society for Reproductive Medicine s (ASRM s) Ethics Committee has emphasized that the donation should not be equated legally with adoption and that the embryo is not a fully entitled legal being. The couple should not have to go through the state s legal process for adoption, but rather the transfer should be guided by the physician s normal practice, similar to donor egg or sperm usage. Egg donation is different from embryo donation. Obviously with embryo donation, fertilization has already occurred. The oocyte and sperm have already been committed. Embryo donation is less expensive than oocyte donation, because unlike egg donors, embryo donors are not compensated. Egg freezing prior to fertilization is now a reality and many women are choosing to freeze oocytes as insurance against future infertility due to aging. Similar to sperm banks, donor programs are banking unfertilized eggs. Banked oocytes that are less expensive than traditional donor eggs are now a reality. THE OB SOCIETY OF PHILADELPHIA VOLUME 40-ISSUE 4 P A G E 3

4 Embryo Donation An Update Stephen W. Sawin, MD South Jersey Fertility Center Immediate Past President - P.A.R.E.S. It has been estimated that there are 600,000 excess embryos cryopreserved in fertility clinics throughout the United States. While the majority of these embryos are intended for future use by the parents who created them, a significant proportion have no clear disposition. Nachtigall et al surveyed over 100 couples whose embryos had been frozen for an average of 4-5 years and found that 72% were undecided as to the disposition of their embryos. Of those who were considering their options, surprisingly 39% were considering donation to science, while only 7% planned to donate to another couple and 3% planned to thaw their embryos (Fertil Steril :431 & :2069). Another study of 1,000 patients at nine fertility clinics found that 60% were very unlikely and only 7% were very likely to donate their embryos to another couple (Fertil Steril :499). At an average cost of $500 per year to store embryos, patients voiced displeasure with the fees for storage but also admitted that without the bill for storage, they would be inclined to do nothing and forego any decision. It is not clear how long cryopreserved embryos remain viable, but pregnancies have resulted from embryos stored for over ten years. Barriers to embryo donation include a lack of awareness of donation as an option, as well as legal and kinship concerns. With this in mind, the Office of Population Affairs of the Department of Health and Human Services has appropriated money for a public awareness campaign to increase understanding of the issue of frozen embryos and the option of embryo donation. With strong support from the Bush administration, the campaign has been funded at a rate of 1 to 4 million dollars per year since During this time several states have followed New Jersey s lead by creating state laws to fund embryo research. In 2004, New Jersey became the first state in the nation with such a law and in 2006, New Jersey allocated 23 million dollars to embryo research funding. These state laws are a reaction to the Dickey- Wicker amendment, a rider attached to a federal appropriations bill passed in The amendment disallows federal funds to be used for embryo research if the embryos are destroyed during the research process. Federal law does allow federal funding of research using stem cell lines created before August Several countries have laws requiring that abandoned embryos be thawed. In the mid 1990 s, 3,000 embryos were thawed in England under such a mandate (Edwards et al Hum Repro :3-5). The American Society for Reproductive Medicine (ASRM) has ethical guidelines under which abandoned embryos may be thawed, if more than five years have passed and diligent efforts to contact the patient have failed. Few if any clinics would thaw embryos without the explicit consent of their patients. ASRM does not condone donating abandoned embryos for research or donating embryos to another couple without prior consent from the original genetic parents. For many couples however, embryo donation has emerged as an important option when faced with the dilemma of excess cryopreserved embryos. Embryos may be shipped in liquid nitrogen tanks from the original IVF clinic to the recipient s clinic with relative ease. The term embryo adoption is discouraged by ASRM, and legal adoption processes are not necessary because the law views embryo donation as a transfer of property. The FDA does regulate donated tissues and via the Good Tissue Practice Guidelines published in May 2005, the FDA encourages but does not require the genetic parents of the embryos to be screened for infectious diseases before the embryos are transferred to a recipient. The embryos are to be labeled as unscreened if it is not possible to screen the genetic parents. This regulation is redundant as it repeats the screening that is done at the time of the original IVF cycle and thus constitutes another barrier to embryo donation. For embryos generated from donor eggs, the male partner would have to have been screened within seven days of the original egg retrieval and the egg donor would have been screened within 30 days, for the resulting embryos to be deemed suitable for donation in the future. In 2011, the CDC reported that 1,019 donor embryo cycles were performed in the United States with an average success rate of about 35% live births per transfer. While not as successful as donor egg for recipient couples, this option is more affordable and more cost effective. Donor embryo cycles can average $3,000 per attempt while donor egg cycles exceed $20,000 per try. One study found that the average cost per live birth for donor embryos was $22,000 while for donor eggs it was $41,000. Several embryo donation agencies have filled the need of matching prospective recipients with patients who have embryos to donate. Dr Jeffrey Keenan of the National Embryo Donation Center in Knoxville, Tennessee heads one of the largest embryo donation agencies in the country and will be our guest speaker for the combined OB Society and PARES meeting in January. I look forward to his presentation on this interesting topic and hope to see you there as well. Stuart Miles / FreeDigitalPhotos.net THE OB SOCIETY OF PHILADELPHIA VOLUME 40-ISSUE 4 P A G E 4

5 November Meeting - Ob/Gyn - Past, Present & Future Ralph W. Hale, MD Dr. George Neubert started off the November meeting by reading from the minutes of an Obstetrical Society meeting that took place in January, 1878, when Dr. William Goodell (Goodell s sign) was president. The minutes from 1878 included an excerpt from Dr. George Pepper s 1877 presentation on the mechanical treatment of displacements of the unimpregnated uterus. Two themes coursed through the minutes that were read. The first theme was that when physicians are rendering opinions or decisions, it behooves us to take a middle course, rather than opine on a singular treatment. Secondly, the speaker suggested that the mission of a society (professional) is to educate the members and the masses so that they may confront the social issues of the day, maybe not all, but some. Perhaps this advice translates to keep an open mind and provide education to our members and our patients that will work for the good of them and the community at large. Dr. Larry Glazerman announced that there would be a dinner meeting on December 2, where Dr. Martin Martino, a gynecologic oncologist from Lehigh Valley would be speaking. At the council meeting in December, Dr. Glazerman advised that the meeting was very successful. At least forty people attended. The meeting was sponsored by the Robotic Training Network and featured Simulation Olympics for the residents.* Dr. Sherry Blumenthal reminded members that ACOG District III wants to bring education to the hospitals, as it can be difficult for practitioners to attend meetings out of town. For information, please go to District III s website where there is a list of available lecturers who can come to your institution. The cost of the program is covered by ACOG. ** The President of the Obstetrical Society, Dr. Marjorie Angert introduced our guest speaker, Dr Ralph Hale. As a resident, Dr. Angert knew Dr. Hale to be a patient mentor. If approached by a resident with a problem, he calmly listened and gave an answer, although it may not have been the answer sought. Most of us are aware that Dr. Hale was the Executive Vice President of the ACOG for many years and served in multiple professional organizations. Dr. Hale has also been involved in developing programs and research on the topic of women and exercise. He has been active in U.S Water Polo and Swimming and served on the U.S. Olympic Committee. At the onset of his lecture, Dr. Hale noted that our specialty is only about 70 yrs old and thus is a relatively young specialty. He also pointed out that recent changes in our field have come about very rapidly. In 1993, when Dr. Hale began his tenure at ACOG, he observed the following at the College No computers Experimental ACOG.net IBM Selective typewriters at every desk No Female Pelvic Medicine No Maintenance of Certification (MOC) Ortho/Wyeth were strongest supporters Mesh was a net Di Vinci was an Italian artist/sculptor Fee for service was the predominant practice model Twenty years later in 2013 No typewriters anywhere in ACOG building Computer at every desk Internet at most desks Female Pelvic Medicine - an ABMS specialty Wyeth was purchased by Pfizer Ortho no longer exists. Robotic surgery is available on every corner Patient Protection and Affordable Healthcare Act Drs. Montgomery, Hale, Angert & Honebrink (Continued on page 6) THE OB SOCIETY OF PHILADELPHIA VOLUME 40-ISSUE 4 P A G E 5

6 (November Meeting cont.) Dr. Hale noted that the American College (now Congress) of Obstetrics and Gynecology (ACOG) has played a major role in the development of our specialty. Dr. Hale also feels that ACOG is one of the most adaptive specialty organizations in the nation. It has managed to change with the times. Dr. Hale provided a detailed history of the immense transformation that has taken place in obstetrics and gynecology since the 1880 s. In the late 1800 s, medicine was unorganized. Physicians trained in various systems. Some physicians completed an apprenticeship. Others attended schools of various levels of respectability and some even designated themselves as physicians. The only major national association that existed was the American Medical Association, which was formed in Philadelphia in By the late 1800 s/early 1900 s, obstetrics was practiced mainly by midwives. Physicians were called only when there was a problem and prenatal care was uncommon. The entry of male physicians in the conduct of labor occurred in the late 19 th century. Gynecology was considered a separate entity and in most medical schools and hospitals, it was part of the surgery department. Dr. Hale reviewed the history of various medical organizations across the country. He reminded the audience that the Obstetrical Society of Philadelphia has a rich history. The first unofficial meeting of the Obstetrical Society took place in June of 1868 when a number of physicians met at the home of Albert Smith Hodge (Smith Hodge pessary). Later that year, 28 founding members met and adopted a constitution. Francis G. Smith was elected as the first president. Dr. Hale pointed out that in the absence of national organizations, city-based organizations were the norm. Most obstetricians lived in the city and there was a need to establish standards of care. The Flexner Report was published in In his lengthy report, Dr. Abraham Flexner cited a lack of consistency in the education and training of physicians. In response to his lengthy treatise, major changes in medical education and licensing of physicians occurred over the next 20 to 40 years. ACOG was formed in 1951 as the American Academy of Obstetrics and Gynecology, was renamed in 1956 and is today is 62 years old. In 1967, as the specialty was becoming more diverse, the Council on Resident Education was formed. Dr. Hale noted the following events: 1945 President Truman tries to introduce a national health program APGO is formed in order to improve teaching of the specialty Medicare and Medicaid are introduced. Medicare s payment system impacts all of medicine Bill Clinton introduces his plan for national health insurance, which is ultimately unsuccessful The Patient Protection and Affordable Care Act is passed. Objectives are to control costs and provide health coverage for the previously uninsured Major components of the PPACA to be initiated Final phases of the PPACA to be implemented. Dr Hale delineated aspects of PPACA that have already gone into play: Inclusion of children up to age 26 on parents health plan(s) Elimination of pre-existing conditions Mandated contraceptive coverage Preconception care coverage Wellness exams including breast and pelvic exams Mandated health coverage delayed one year State Health Exchanges or Federal Healthcare Exchange Other aspects of PPACA were reviewed: Promotes the use of electronic medical record Initiates work on quality measures Dr. Hale after a fantastic lecture. Modifies reimbursement based on results Involves: safety, care coordination (physician and non-physician providers), community programs, decreased cost and increased efficiency (Continued on page 7) THE OB SOCIETY OF PHILADELPHIA VOLUME 40-ISSUE 4 P A G E 6

7 (November Meeting cont.) Dr. Hale acknowledged that advances in medicine in the past twenty years, including technology, robotics and genetics have shaped and will continue to shape the future of our specialty. The increase in the volume of knowledge necessitates the use of practice guidelines, continuing education, maintenance of board certification, and an increase in sub-specialties. The internet has allowed patients to take a more active role in their medical care. Dr. Hale discussed the reasons for the emergence of hospitalists (laborists) and the changes in manpower/womanpower in our field. Dr. Hale stated that our specialty will change in many ways: more subspecialties or areas of special interest that limit practice, knowledge expansion and practice profile changes, and more government involvement. In MFM, he predicts that all women who are considering a pregnancy or who are pregnant will undergo a genetic screen. Concentrations in pre-delivery fetal surgery and diagnosis of genetic disorders will be developed. In oncology, cancer types will be identified by molecular analysis, rather than by tissue of origin. Cancer centers where surgery is performed will be regionalized and there will be a proliferation of local chemotherapy centers. Surgery will trend toward minimally invasive techniques. Dr. Hale foresees that IVF will become the predominant treatment for infertility. A branch of research that concentrates on the genomic aspects of early pregnancy will come about. As life expectancy of women increases beyond 100 years, female pelvic medicine and reconstructive surgery will become the other major surgical subspecialty in Ob/Gyn. Dr. Hale listed and detailed the subspecialties that he believes will develop in the years to come: Adolescent Health Contraception and family planning Hospitalist/Laborist Non-MFM geneticist Minimally invasive surgery Cosmetic surgery Medical gynecologist Generalist Lastly Dr. Hale specified other changes that will occur in the future: Greater collaboration with and use of non-physician healthcare providers More regionalization of care Continued predominance of women entering the specialty Private practice will disappear. Hospitals will be the predominant employer. American College of Physicians Together with Dr. Angert and all the members of the Obstetrical Society of Philadelphia, I would like to thank Dr. Ralph Hale for presenting a vast amount of information about the past, present and future of obstetrics and gynecology. The entire lecture was enthralling, but I found the question and answer session at the end of the evening to be the most interesting. Please remember that you can view Dr. Hale s presentation on our website. * ** Educational_Outreach_-_ROUNDS_Project Fay D. Wright, MD Newsletter Editor Dr. Hale signs the book! THE OB SOCIETY OF PHILADELPHIA VOLUME 40-ISSUE 4 P A G E 7

8 November Meeting Drs. Sondheimer, Porcelan & Kaufman Drs. Hale, Angert & Pellegrini Drs. Widzer, Glazerman, & Angert Drs. DeBrakeleer, Kaczmarczyk, Sehdev & Brest Drs. Zeidman, Schwartz & Gutman Drs. Fitzsimmons, Neubert & Sehdev Drs. Delvadia & Mehta THE OB SOCIETY OF PHILADELPHIA VOLUME 40-ISSUE 4 PAGE 8

9 Announcements MEETINGS January 9, :30 pm ***Joint Meeting with P.A.R.E.S. *** Jeffrey Keenan, M.D., Director, Southeastern Center for Fertility & Reproductive Surgery, Professor, University of Tennessee Medical Center Embryo Donation: An Underutilized Family Building Option February 13, :30 p.m. Cornelius O. Skip Granai, III, M.D., Director, The Program in Women s Oncology, Women and Infants Hospital of Rhode Island, Professor of Obstetrics and Gynecology, Brown University. The Battistini Lecture - If I Were You and You Were Me March 13, :30 p.m. Hani K. Atrash, M.D., M.P.H, Director, Division of Healthy Start & Perinatal Services, Health Resources and Services Administration. U.S. Department of Health & Human Services The Blockley Lecture - Preconception Health and Healthcare for Improving Pregnancy Outcomes April 10, :30 p.m. ***Joint Meeting with the Philadelphia Perinatal Society*** Susan Cu-Uvin, M.D., Director, Global Health Initiative, Professor of Obstetrics and Gynecology and Medicine and Health Sciences, Brown University 30 Years into the HIV/AIDS Epidemic: What is New for Women and Their Children? ACOG District III ROUNDS Available Now! As a service to our members, District III has addressed the changes in demographics of ACOG, and the fact that many members no longer wish to attend out-of-town conferences for education and CME. District III (PA, NJ, DE, and the Dominican Republic) will bring educational programs to individual institutions in a Grand Rounds format. The cost of the speakers expenses and honorarium will be covered by ACOG. All presentations have been reviewed as appropriate for CME credit, although at this time, the institution must issue the CME. The presenters all have expertise in the subject of each Grand Rounds, and the program should have significant educational benefit to attending & residents physicians, and medical students. To request a ROUNDS program, please use the ACOG Website or the direct link: District_III/Educational_Outreach_-_ROUNDS_Project Additional questions should be addressed to Chris Himes, chimes@agog.org May 2, :00 am to 4:00 pm, Reading Hospital Resident Education Day May 8, :30 p.m. Marjorie Angert, D.O., M.P.H., President, Obstetrical Society of Philadelphia President s Night- Topic to be announced The venue for the evening programs is: The Top of the Bell Tower Building 1717 Arch Street 50 th Floor, Philadelphia, Pa. Reception and Buffet from 5:30 7:00 p.m. Lecture followed by Q/A 7:00 8:30 p.m. Parking beneath the building Please visit the website for registration information. THE OB SOCIETY OF PHILADELPHIA VOLUME 40-ISSUE 4 P A G E 9

10 OBSTETRICAL SOCIETY OF PHILADELPHIA Council Members: PRESIDENT Marjorie Angert, DO, MPH Hospital of the University of Pennsylvania Pennsylvania Hospital Philadelphia Department of Public Health Retired PAST PRESIDENT Albert El-Roeiy, MD Crozer-Chester Medical Center One Medical Center Boulevard Upland, PA SECOND YEAR PAST PRESIDENT Jane Porcelan, MD, JD Lankenau Medical Building, West 100 Lancaster Avenue, Suite #433 Wynnewood, PA PRESIDENT ELECT Jason Baxter, MD, MSCP Thomas Jefferson University 834 Chestnut Street, Suite #400 Philadelphia, PA VICE PRESIDENT Helen M. Widzer, MD 268 Diana Court Gulph Mills, PA SECRETARY Dipak Delvadia, DO DUCOM - Dept. OB/GYN 245 North 15th Street Philadelphia, P Al9l TREASURER A. George Neubert, MD Chair, Department of Obstetrics and Gynecology-The Reading Hospital and Medical Center P.O. Box Reading, PA FOUNDATION Arnold W. Cohen, MD Albert Einstein Medical Center 5500 Old York Road Philadelphia, PA l9l41 RESIDENT EDUCATION AND ARCHIVES Mark B. Woodland, MS, MD DUCOM - Dept. OB/GYN 245 North 15th Street Philadelphia, PA l9l RESIDENCY PROGRAM LIAISON Guy Hewlett, MD Director of Medical Education Designated Institutional Official One Medical Center Blvd. POB 302 Upland, PA HEALTH ACTION COMMITTEE Joan H. Zeidman, MD 919 Conestoga Road Building 1, Suite #104 Rosemont, PA BYLAWS Carl Della Badia DO DUCOM - Dept. OB/GYN 245 North 15th Street Philadelphia, P Al9l ACOG LIAISON Sherry. L. Blumenthal, MD 2701 Blair Mill Rd. Suite C Willow Grove, PA ASSISTANT SECRETARY Catherine Salva MD Hospital of the University of Pennsylvania, Ravdin Courtyard 1000 Philadelphia, PA NOMINATION COMMITTEE Susan Kaufman, DO Suite S-93, Executive Mews 1930 State Hwy 70 East Cherry Hill, NJ ARRANGEMENTS Jacqueline N. Gutmann, MD 1015 Chestnut Street, Suite #1500 Philadelphia, PA RESIDENT EDUCATION COMMITTEE Peter F. Schnatz, DO The Reading Hospital and Medical Center Department of OB/GYN 6th Ave & Spruce Street West Reading, PA COUNCIL AT LARGE Jack M. Fitzsimmons, MD Virtua Perinatal Associates 100 Bowman Drive Voorhees, NJ COUNCIL AT LARGE Donald DeBrakeleer, DO Center for Women s Health of Montgomery County 1000 Walnut Street, Suite 122 Lansdale, PA RESIDENT EDUCATION COMMITTEE Larry Glazerman, MD Lankenau OB/GYN Clinical Care Center 100 E. Lancaster Avenue, Clinic Area B5 Wynnewood, PA COUNCIL AT LARGE REPRODUCTIVE HEALTH Steven J. Sondheimer, MD Hospital of the University of Pennsylvania 3701 Market Street, 8th Floor Philadelphia, PA COUNCIL AT LARGE Norman Brest, MD Lankenau Medical Building, East 100 East Lancaster Avenue, Suite 561 Wynnewood, PA MEMBERSHIP DIRECTOR Harish Sehdev, MD Pennsylvania Hospital 2 Pine east 800 Spruce Street Philadelphia, PA RESIDENT EDUCATION COMMITTEE Adrian Quesada-Rojas, MD Suite Ogletown-Stanton Road Newark, DE RESIDENT EDUCATION COMMITTEE Xuezhi Jiang, MD The Reading Hospital and Medical Center, Department of OB/GYN 6th Ave & Spruce Street West Reading, PA NEWSLETTER EDITOR Fay Wright, MD 111 E. Levering Mill Road Bala Cynwyd, PA THE OB SOCIETY OF PHILADELPHIA VOLUME 40-ISSUE 4 P A G E 10