Management of Pregnancy

Complete care of your pregnancy starting with pre-pregnancy consultation and guidance, total ante-natal (during pregnancy) care and finally delivery both Vaginal and Cesarean. And finally post pregnancy guidance and contraceptive advice including intra-uterine device (like copper-T, multiload) insertion and tubal sterilization both Laparoscopic and mini-lap. At all times complete emphasis is on Normal Delivery.

High Risk Pregnancy Care

Providing of care during pregnancy associated with Thyroid problems, High blood pressure, Diabetes, multiple pregnancy (Twin pregnancy, Triplet Pregnancy) and also when pregnant at an advanced age when patients require special care to ensure delivery of a healthy Baby while ensuring safety of the mother.

Menstrual Problems

Providing of effective guidance in cases of abnormal menstrual cycle, finding out the cause by necessary tests and providing requisite medication to correct the problem effectively. In case there is necessity of minor surgical procedures like D&C, Polypectomy, Hysteroscopy or Laparoscopy, the same is effectively managed.

Fibroid Uterus

Uterine Fibroids are non-cancerous tumours in the uterus. This is a most common health problem among women of child bearing age. Generally the complaint of uterine fibroid comes between the age group of 30 to 45 years. This benign tumour can cause pain, excessive menstrual bleeding, infertility. It can vary in size, from that of a few mm to as large as a melon. Small fibroids may not need treatment while large fibroid can be treated only through surgery. Very large fibroids as large as water-melon are not very common.
Some women have no symptoms to indicate that they have fibroids, and will find out only on a routine ultrasound or gynaecological examination.
Fibroid affect at least 20% of all women during their life. Overweight and obese women are at significantly higher risk of developing fibroids, compared to women of normal weight.

Symptoms of Fibroid

Anaemia (as a result of heavy periods)
Discomfort in the lower abdomen (especially if fibroids are large)
Retention/frequent urination
Heavy painful periods
Painful sex
Swelling in the lower abdomen (especially if fibroids are large)
Other symptoms may include:
Pregnancy problems
Fertility problems
Repeated miscarriages
A fibroid can sometimes degenerate causing fever and severe pain.
During a woman's reproductive years her oestrogen and progesterone levels are high. When estrogen levels are high, especially during pregnancy, fibroid tend to swell. When estrogen levels are low fibroid may shrink as can be seen after menopause. So if you are already experiencing symptoms like pelvic pain and cramping, excessive bleeding during your menses, it’s time to go for a gynaecological check-up.

Ovarian Cysts

The ovaries are the very important part of a female body. They are a in a pair in the female reproductive system and are located one on each side of the uterus. Each ovary is about the size and shape of an almond. The ovaries produce eggs and are also the main source of the female hormones oestrogen and progesterone. They influence the development of a woman's breasts, body shape, and body hair. They also regulate the menstrual cycle and pregnancy.
A cyst is a fluid-filled sac, and can be located anywhere in the body. Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. Different types of cysts can form in the ovary.
Many cysts are completely normal. These are called functional cysts and these are very commonly found. They occur during egg formation. Functional cysts normally shrink over time, usually in few months. If you have a functional cyst, you may need a check-up once again in 1 to 2 months to make sure that the cyst has become smaller or has it completely resolved. These cysts are almost never associated with cancer. But if you are menopausal and are not having periods, you will not have functional cysts.
The other types of cysts are chocolate cyst, Simple cyst, or dermoid cyst.
Many women have ovarian cysts without having any symptoms. In some the cyst will cause these problems:

Pressure, fullness, or pain in the abdomen
Pain during sexual intercourse
Painful menstrual periods and abnormal bleeding
Nausea or vomiting

To identify the type of cyst, the following tests are needed:
1. Pelvic ultrasound
2. CA 125 blood test- It is a tumour marker and is often elevated in ovarian cancer.

PCOD

PCOD is a problem related to hormones. Oestrogen and progesterone are main female hormones and some amount of androgen which is a male hormone is also present in females. Imbalance in these hormones leads to PCOD. It is not completely understood why or how the changes in the hormone levels occur. These changes lead to problems in the ovulation process of the ovaries resulting in development of many immature eggs. Mature eggs are not formed. In normal ovulation one or more eggs get matured and are released during one menstrual cycle. In PCOD as eggs are not released from the ovaries and they form many small cysts in the ovary so the name Poly-Cystic Ovarian Syndrome. Women with this disorder often have a mother or sister who has symptoms similar to those of polycystic ovary syndrome therefore it is thought to have a genetic etiology. Most of the time, PCOS is diagnosed in women in their 20s or 30s. However, it may also affect teenage girls. PCOD produces symptoms in approximately 5% to 10% of women of reproductive age (12–45 years old). It is thought to be one of the leading causes of infertility and the most frequent endocrine problem in women of reproductive age.
Symptoms tend to be mild at first. You may have only a few symptoms or a lot of them. Rarely on a routine ultrasound is it an accidental finding while the female is not having any symptoms of PCOD. The most common symptoms are:

Delayed cycles, scanty menstrual bleeding or irregular spotting during the menstrual cycle.
Acne.
Excessive weight gain.
Extra facial hair. Often women get thicker and darker facial hair.
Hair fall (scalp)
Difficulty in conceiving (infertility).

History of menstrual irregularities with weight gain or increased facial hair gives the hint of it being due to PCOD. An Ultrasound of the ovaries leads to a clear diagnosis as we can see the typically multi cystic or poly cystic ovaries. Blood tests to see hormonal levels can reconfirm the diagnosis. Blood tests are also done for glucose metabolism as this is found to be deranged in some cases of PCOD.
Regular exercise, balanced diet is important for the treatment. One should try to lose weight with exercise and diet management preferably under the guidance of a dietitian
Hormonal pills are usually needed which should only be taken under proper medical guidance.
A diabetes medicine called metformin may also be needed.
Fertility medicines will be needed if you are trying to get pregnant.
If above treatment does not correct the problem then surgical treatment is needed through Laparoscopic surgery. Well we can say that it is a treatable problem. You need to be aware of it so that treatment is started sooner.

Adenomyosis

This is a problem usually found in women between the ages of 35 and 50. Women with adenomyosis can have painful and/or profuse heavy menses. Some women with Adenomyosis do not experience any symptoms.
Symptoms of adenomyosis are –

Pain in the lower abdomen

· Excessive pain during menses

· Pressure on urinary bladder

· Heavy bleeding during menses

· Prolonged bleeding during menses

This condition can be diagnosed with ultrasound and further reconfirmed on MRI. Transvaginal ultrasound shows an enlarged uterus with adenomyosis changes in the muscle layer.
The treatment of adenomyosis may be medical, when hormonal tablets are prescribed. Or there may be a need of surgery, the uterus needs to be removed which is usually possible by laparoscopic method.

Infertility

Infertility means inability to conceive. A couple may be considered infertile if, after two years of regular sexual intercourse, without contraception, the woman does not become pregnant.
Infertility may be primary or secondary. Primary infertility is infertility in a couple who have never had a child. Secondary infertility is failure to conceive following a previous pregnancy.
Common causes of infertility of females include:

Ovulation problems
Tubal blockage
Pelvic infection
Age-related factors

Uterine problems
The main cause of male infertility is low semen quality.
The treatment depends on the cause of infertility. It may be managed by medicines in some couples or there may be a need of some corrective surgery which is usually done laparoscopically and by Hysteroscopy.
If these methods fail there may be a need of procedures like IUI, IVF.