Objective: This study aims to establish baseline information on the practice of minimally invasive gynecologic surgery (MIGS) among Filipino gynecologic endoscopists amid the COVID-19 pandemic. Materials and Methods: MATERIALS AND METHODS: An online survey was conducted among Fellows of the Philippine Society for Gynecologic Endoscopy (PSGE) practicing in private and government hospitals in the Philippines after informed consent. The survey had five subsections: (1) demographic data, (2) impact of COVID-19 pandemic on MIGS practice, (3) changes of practice during the COVID-19 pandemic, and (4) changes in the conduct of surgery and postoperative care. Results: A total of 119 out of 144 PSGE Fellows based in the Philippines participated in the survey, 83% were Fellows in both laparoscopy and hysteroscopy. The majority had more than 15 years of practice and were practicing in the National Capital Region. Surgeries were canceled initially but have since resumed. The majority were hysteroscopy cases, the most common being polypectomy. Majority of the respondents reduced their clinic hours and appointments. Most have used telemedicine for consultations. Use of face masks, face shields, and personal protective equipment (PPE) were the top precautions taken in the clinics. Screening and precautions per guidelines inside the operating room setting were observed. Modifications during surgery include the use of smoke evacuators, minimizing energy device use, and wearing enhanced PPE. Conclusion The volume of laparoscopy and hysteroscopy cases was greatly reduced during the pandemic. The pandemic has disrupted the practice of MIGS both in the outpatient clinics and the operating rooms. Most of the changes made are congruent to local and international automotive task force guidelines. Precautionary measures and screening procedures must remain in place to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission to patients and health-care workers.
COVID-19 ; Personal Protective Equipment ; Telemedicine

This is a case of a 35-year-old primigravid who was initially diagnosed by ultrasound (done abroad) at 12 weeks AOG with a live, singleton fetus having a sacrococcygeal mass. Congenital anomaly scan done from another local institution at 19 weeks AOG, showed a live, singleton fetus with the same aforementioned defect and a floating amorphous, echogenic structure inferior to and separate from the fetus, seemingly with extremities but without a cephalic pole, probably an acardiac twin. A repeat congenital anomaly scan at 23 weeks AOG done in our institution revealed a live, breech male fetus (pump twin) with what seemed to be another set of fetal lower limbs with talipes attached to the sacrococcygeal area of the well-developed fetus. Three-vessel umbilical cord of the pump twin was noted with normal SID ratio on color doppler. Ultrasound findings were suggestive of conjoined pump and acardiac twins. Patient underwent elective cesarean section at 38-39 weeks AOG, delivered an ischiopagustype, male conjoined twins (a well-developed term pump twin with an acardius acephalus twin) and another acardiac amorphous component completing a triplet. The most important factor in deciding on the correct choice of management is the early diagnosis of acardiac twin. Early diagnosis with ultrasound assists in prenatal management and counseling parents. Conservative management with close antepartum surveillance deserves consideration in cases of monozygotic twins with twin reversed arterial perfusion sequence.

Human ; Female ; Adult (a Person 19-44 Years Of Age) ; Twins, Conjoined ; Twins, Monozygotic ; Sudden Infant Death ; Talipes ; Triplets ; Fetus ; Lower Extremity ; Cesarean Section ; Ultrasonography, Doppler, Color ; Early Diagnosis ; Umbilical Cord