FETOMATERNAL MEDICINE – COGI – The Multidisciplinary Gynecology Congress

Scientific Program – FETOMATERNAL MEDICINE

Friday, November 13 & Saturday, November 14, 2026

Friday, November 13

08:30-10:00	CONTROVERSIES IN TWINS	HALL D
Chairpersons	Asma Khalil, UK Nir Melamed, Canada
08:30-08:45	Should we use twin-specific growth charts or singleton charts to diagnose growth restriction? Asma Khalil, UK
08:45-09:00	Should progesterone be used in twins with a short cervix? Nir Melamed, Canada
09:00-09:30 09:00 09:10 09:20	Debate: Does cerclage help or harm in twin pregnancies with cervical shortening? Pro: Con: Liran Hiersch, Israel Discussion
09:30-10:00 09:30 09:40 09:50	Debate: Should we suggest fetal reduction in Bichorionic/Biamniotic (BC/BA) twins Pro: Yariv Yogev, Israel Con: Eyal Sheiner, Israel Discussion

10:00-10:30

Coffee break, visit the exhibition and e-poster viewing

10:30-12:00	IUGR – INTRAUTERINE GROWTH RESTRICTION	HALL D
Chairpersons	Nir Melamed, Canada
10:30-11:00 10:30 10:40 10:50	Debate: Estimated Fetal Weight (EFW) 3rd percentile, normal doppler indices. When to deliver 36? 37? 38? Later? Pro: Nir Melamed, Canada Con: Asma Khalil, UK Discussion
11:00-11:30 11:00 11:10 11:20	Debate: Can we prevent the recurrence of fetal growth restriction (FGR)? Is there a role for aspirin? Low Molecular Weight Heparin (LMWH)? Pravastatin? Pro: Liran Hiersch, Israel Con: Amir Aviram, Canada Discussion
11:30-11:45	Testing the placenta in pregnancies with FGR – black box or crystal ball? What to ask the pathologist? How it guides for future treatment?
11:45-12:00	Nutrition, supplementation and toxic nutrients in pregnancy: How to integrate our knowledge for better pregnancy outcome? Gian Carlo Di Renzo, Italy

12:00-12:05

Change of session

12:05-12:30	PLENARY SESSION	HALL A Streamed to all halls
Capsule	PCOS is the most common endocrinopathy that affect all phases of women’s life
Chairpersons	Bart Fauser, Netherlands Joop Laven, Netherlands
12:05-12:30	PCOS in OBGYN (overview of PCO in reproductive life, menopause, pregnancy etc) Terhi Piltonen, Finland

12:30-12:35

Change of session

12:35-13:35

Industry supported session – HALL A
Industry supported session – HALL B

13:35-14:30

Lunch break, visit the exhibition and e-poster viewing

14:30-15:30	LARGE FOR GESTATIONAL AGE (LGA) – BEING LARGE IS NOT SO SIMPLE	HALL D
Chairpersons	Asma Khalil, UK Howard Berger, Canada
14:30-14:40	Can we accurately predict macrosomia? The use of AI Giuseppe Rizzo, Italy
14:40-15:05 14:40 14:45 14:50	Debate: What is the optimal timing and mode of delivery in cases of suspected LGA/macrosomia? Should we offer induction of labor (IOL)? Pro: Emmanuel Attali, Israel Con: Asma Khalil, UK Discussion
15:05-15:30 15:05 15:10 15:15	Debate: Should we perform late third trimester oral glucose tolerance test (OGTT) in cases of suspected LGA Pro: Yariv Yogev, Israel Con: Gerard Visser, Netherlands Discussion

15:30-15:35

Change of session

15:35-17:00

CONTROVERSIES AROUND PROM AND PPROM (PRETERM AND TERM PRELABOR RUPTURE OF MEMBRANES)

HALL D

Chairpersons

Liran Hiersch, Israel
Apostolos Mamopoulos,Greece

15:35-16:00

15:35
15:40
15:45

Debate: Should all women with PPROM receive antenatal corticosteroids at presentation?

Pro: Nir Melamed, Canada
Con: Gerard Visser, Netherlands
Discussion

16:00-16:20

16:00
16:05
16:10

Debate: PPROM with cerclage: To remove or not to remove? If yes when? After completion of corticosteroids

Pro: Yariv Yogev, Israel
Con: Amir Aviram, Canada
Discussion

16:20-16:40

16:20
16:25
16:40

Debate: Should tocolysis be used in PPROM to allow steroid administration?

Pro:
Con: Themistoklis Dagklis, Greece
Discussion

16:40-17:00

14:40
16:45
16:50

Debate: Immediate delivery vs expectant management in PROM between 34 and 37 weeks

Pro: Apostolos Athanasiades, Greece
Con: Apostolos Mamopoulos, Greece
Discussion

17:00-17:15

Coffee break, visit the exhibition and e-poster viewing

17:15-18:30	FROM PREDICTION TO PREVENTION IN OBSTETRICS	HALL D
Chairpersons	Asma Khalil, UK Apostolos Athanasiadis, Greece
17:15-17:35 17:15 17:20 17:25	Debate: Should we provide aspirin for all? Pro: Amir Aviram, Canada Con: Discussion
17:35-17:55 17:35 17:40 17:45	Debate: Metformin for the obese gravida at early pregnancy? Pro: Emmanuel Attali, Israel Con Dimitrios Goulis, Greece Discussion
17:55-18:15 17:55 18:00 18:05	Debate: Tubectomy at cesarean section for risk reduction of ovarian cancer? Pro: Rinat Gabbay-Benziv, Israel Con: Nikolaos Thomakos, Greece Discussion
18:15-18:30	Measurement of sFlt-1 and/or PlGF for preeclampsia risk stratification in the second trimester either as a single predictor or combined with other biomarkers for all?

Saturday, November 14

08:30-10:00	PRETERM DELIVERY	HALL D
Chairpersons	Gian Carlo Di Renzo, Italy
08:30-08:55 08:30 08:35 08:40	Debate: Once cerclage always cerclage? Evidence for prior pregnancy Pro: Con: Discussion
18:55-09:20 08:55 09:00 09:05	Debate: When to deliver in suspected chorioamnionitis during active labor? To perform immediate cesarean section? Pro: Con: Howard Berger, Canada Discussion
09:20-09:35	Should prediction models and new biomarkers replace traditional risk factors in preterm birth screening? Dilli Anumba, UK
09:35-10:00 09:35 09:40 09:45	Debate: Should we administer progesterone after arrested preterm labor after 24 weeks of gestation Pro: Howard Berger, Canada Con: Discussion

10:00-10:30

Coffee break, visit the exhibition and e-poster viewing

10:30-12:00

CONTROVERSIES ISSUES IN LABOR AND DELIVERY

HALL D

Chairpersons

Apostolos Mamopoulos, Greece
Jim Thornton, UK

10:30-11:00

11:30
11:40
11:50

Debate: Induction of labor following a previous cesarean section

Pro: Yariv Yogev, Israel
Con: Jim Thornton, UK
Discussion

11:00-11:30

11:00
11:10
11:20

Debate: Delivery in the extremely premature newborn. Cesarean section for all?

Pro:
Con: Howard Berger, Canada
Discussion

11:30-12:00

11:30
11:40
11:50

Debate: Different countries different medicine? In terms of cesarean section rate

Low CS rate: Eyal Sheiner, Israel
High CS rate: Asma Khalil, UK
Discussion

12:00-12:05

Change of session

12:05-12:30	PLENARY SESSION	HALL A Streamed to all halls
Capsule	Epigenetics and reprogramming research in infertility and in utero development focuses on how DNA methylation, histone modification, and RNA interact during gametogenesis, early embryogenesis and placentation, disruption of which causes infertility and pregnancy complications
Chairpersons	Rene Frydman, France Mina Popovic, Spain
12:05-12:30	Epigenetics and reprogramming David Monk, UK

12:30-13:30

Lunch break, visit the exhibition and e-poster viewing

13:30-15:00	DIABETES AND OBESITY	HALL D
Chairpersons	Yariv Yogev, Israel Gerard Visser, Netherlands
13:30-13:45	How do you know that your patient is well controlled? Yariv Yogev, Israel
13:45-14:15 13:45 13:55 14:05	Debate: When to start pharmacological treatment? Should we use oral agents? Which? Pro: Rinat Gabbay-Benziv, Israel Con: Gerard Visser, Netherlands Discussion
14:15-14:45 14:15 14:25 14:35	Debate: GLP-1 medications for GDM Pro: Con: Discussion
14:45-15:00	Gestational weight gain and pregnancy outcomes after GLP-1 receptor agonist discontinuation

15:00-16:30	PANEL EXPERTS CASE DISCUSSION – DAILY DILEMMAS IN MODERN OBSTETRICS	HALL D
Chairpersons	Yariv Yogev, Israel Gerard Visser, Netherlands
Discussants	Asma Khalil, UK Apostolos Athanasiadis, Greece Gian Carlo Di Renzo, Italy Nir Melamed, Canada Giuseppe Rizzo, Italy
	Umbilical cord varix- IOL? What antenatal surveillance is recommended? 28 weeks of gestation, Breech presentation in active labor. To give or not to give MgSo4? Corticosteroids? 3rd Anatomy scan for all? When do you recommend cesarean section for suspected macrosomia? 4000? 4250? 4500? 5000? G1Po 39+2 weeks of gestation with normal pregnancy follow-up- Should we perform IOL by maternal request? Should we perform once weekly/bi-weekly fetal surveillance in well-controlled GDM? G1P0, 26 years old. Low risk pregnancy. Amniocentesis for all? NIPT? None? Should Obese women be induced at 39 weeks?

Against empirical metformin use in the obese gravida at early pregnancy: A critical appraisal

Dimitrios G. Goulis,
Professor in Reproductive Endocrinology, Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece

Obesity in pregnancy confers substantial maternal and fetal risks, including gestational diabetes mellitus (GDM), hypertensive disorders, macrosomia, and adverse neonatal outcomes. The pharmacological potential of metformin, an insulin sensitizer with a well-established safety record in type 2 diabetes mellitus and polycystic ovary syndrome (PCOS), has prompted increasing interest in its prophylactic use in obese pregnant women. However, current evidence does not support its routine antenatal prescription in this population, and several mechanistic, clinical, and ethical concerns warrant critical scrutiny.The landmark EMPOWaR and MOP trials, both double-blind, placebo-controlled randomized studies, demonstrated no statistically significant reduction in primary outcomes, including large-for-gestational-age (LGA) neonates, GDM incidence, gestational weight gain, or composite adverse perinatal outcomes, in obese women receiving metformin from the first trimester. Despite the well-documented transplacental passage of metformin, the implications of fetal exposure remain incompletely characterized across gestation. Notably, metformin-exposed offspring in some cohorts have demonstrated paradoxical increases in childhood adiposity at follow-up assessments, raising concerns about long-term metabolic programming, a finding with considerable epigenetic plausibility, given metformin’s AMPK-mediated interference with mitochondrial function during critical developmental windows.From a pharmacokinetic standpoint, renal clearance of metformin increases substantially during pregnancy due to augmented glomerular filtration, rendering standard dosing regimens potentially subtherapeutic; in contrast, dose escalation introduces gastrointestinal intolerability and a theoretical risk of lactic acidosis in patients with pregnancy-associated physiological hemodynamic shifts. Furthermore, conflating insulin resistance in obesity with established GDM pathophysiology oversimplifies the metabolic heterogeneity of the obese gravid state, in which inflammatory dysregulation, adipokine imbalance, and placental dysfunction contribute independently to adverse outcomes beyond hyperglycemia alone.
Ethical considerations also merit emphasis: Obese pregnant women without confirmed glucose dysregulation or polycystic ovary syndrome represent a population for whom informed consent regarding off-label use, unresolved fetal safety data, and the absence of regulatory approval for this indication must be transparently communicated.
In conclusion, although metformin’s therapeutic role in confirmed GDM and insulin-resistant states remains validated, its empirical prescription in normoglycemic obese pregnant women at early gestation is premature, insufficiently evidence-based, and potentially carries risk to the developing conceptus.

The 34^th World Congress on Controversies in Obstetrics,
Gynecology & Infertility (COGI)
November 12-14, 2026 | Athens, Greece

November 12-14, 2026 | Athens, Greece

Scientific Program – FETOMATERNAL MEDICINE

Friday, November 13