Motherhood - Sahakara Nagar

The uterus or womb is a strong structure that is held up by the pelvic muscles and tendons. In case that these muscles or tendons extend or get distinctly powerless, they are no longer ready to support the uterus, bringing about prolapse. Uterine prolapse happens when the uterus hangs or slips from its ordinary position, into the vagina or birth channel.

Uterine prolapse might be fragmented or complex. A deficient prolapse happens when the uterus is just halfway drooping into the vagina. An entire prolapse depicts a circumstance in which the uterus falls so far down that some tissue rests outside of the vagina.

The danger of having a prolapsed uterus increases as a woman ages and her estrogen levels diminish. Estrogen is the hormone that keeps the pelvic muscles solid. Harm to pelvic muscles and tissues during pregnancy and labor may likewise lead to prolapse. Women with more than one vaginal birth and in their postmenopausal period are under the most significant risk. Any action that puts weight on the pelvic muscles can expand your danger of a uterine prolapse. Different variables that can increase your risk for the condition include:

1. Obesity
2. Constant coughing
3. Constipation

Women who have a minor uterine prolapse might not have any side effects. Direct to serious prolapse may bring about side effects, for example:

1. Having an inclination that you are sitting on a ball
2. Vaginal bleeding
3. Expanded discharge
4. Issues with sex
5. Feeling the uterus or cervix leaving the vagina
6. A pulling or substantial feeling in the pelvis
7. Constipation
8. Bladder infections

In case that you experience these symptoms, it is important to see your specialist. Without appropriate diagnosis, the condition can weaken your vagina, bladder, and sexual capacity. Treatment is not generally fundamental for this condition. In case that prolapse is serious, talk with your specialist about which treatment choice is suitable for you. Nonsurgical medicines include:

1. Shedding pounds to take the strain off of pelvic structures
2. Maintaining a strategic distance from truly difficult work
3. Doing Kegel works out, which are pelvic floor exercises that strengthen the vaginal muscles
4. Taking estrogen substitution treatment
5. Wearing a pessary, which is a device embedded into the vagina that fits under the cervix and pushes up and settles the uterus and cervix

Surgical medications include uterine suspension or hysterectomy. During uterine suspension, your specialist puts the uterus once again into its normal position by reattaching pelvic tendons or utilizing surgical materials. During a hysterectomy, your specialist expels the uterus from the body through the stomach area or the vagina. Surgery is usually successful; however, it is not suggested for women who anticipate having a baby later on.

Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.

Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:

1. Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
2. Mammogram and breast ultrasound: You will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
3. Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.

Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding.

Hysterectomy is a procedure that is used to treat a wide variety of conditions. A partial hysterectomy is performed for the removal of the uterus whereas a myomectomy is performed for the removal of the fibroids. A complete hysterectomy is performed in order to remove the uterus and the cervix. With hysterectomy, there comes some critical and sensitive topic that needs to be discussed with the surgeon. Here is a list of top 10 things that need to be known about hysterectomy:

1. The sex life concern: Unlike common apprehension, hysterectomy doesn’t necessarily mean the end of sex life. In the worst case scenario where the cervix is removed, it takes around 6 weeks before one can resume the sex life.
2. Hysterectomy can’t cure endometriosis: Endometriosis is a condition that is characterised by menstrual cramp, painful intercourse and chronic pain. Hysterectomy is not the first line of treatment for a condition like this. If any doctor has suggested it, it makes sense to take a second opinion.
3. Hysterectomy doesn’t mean menopause: This procedure doesn’t mean a menopause or an inability to get pregnant. There are certain other misconceptions such as getting night sweats, hot flashes and menstrual cramp etc. On the contrary, a well-performed procedure will ensure that a person doesn’t feel a thing after the surgery.
4. The loss in ovaries: Depending on the condition of a patient, a doctor might remove the fallopian tube, uterus and ovaries. It necessarily means a sudden loss of oestrogen and progesterone hormone abruptly. Both this hormone are critical for bone and sexual health. It might also lead to menopause, decreased urge in sex and hot flashes during the night. It is therefore very important to discuss each and every aspect of the procedure before the surgery begins.
5. Hormonal therapy: Since the removal of ovaries is likely to cause physical discomfort to the body, hormonal therapy can come to the rescue of an individual. Hormonal therapy can curtail the risk of blood clot formation, heart diseases, stroke etc.
6. Explore other non-surgical options: Hysterectomy is not the last word for any uterus or ovary related problems. The goal is to keep the uterus intact. There are certain less evasive procedures to save ovaries and uterus. This is where multiple opinions come handy.
7. Less invasive options: There exist less invasive surgeries for treatment related to uterus and ovaries. For instance, a robotic hysterectomy causes far less pain as compared to traditional procedure. It also ensures less loss of blood from the system resulting in less weakness.
8. The morcellation technique: In case a uterus has to be removed, doctors these days use a process known as morcellation. The latter involves making small cuts into various places of the uterus in order to bring it out. The false apprehension of this process causing cancer cells in the body is not true. Only if a patient is suffering from a particular kind of cancer, it might spread to other parts of the body. A doctor has to be consulted to assure such a thing doesn’t happen.
9. Cancer apprehension: For people facing a gene defect such as BRAC1 and BRAC2 hysterectomy can reduce the chance of ovarian cancer by a good 80 percent.
10. Physiological healing post hysterectomy: Although physical healing takes no more than 6 weeks after the procedure, the emotional healing might take some time. It makes sense to seek professional help for postoperative depression.

Pregnancy can wreak havoc in your body; be it your hormones overflowing or the constant crying of your newborn that makes you agitated after a point of time. Your baby will probably be your top priority in times like these but maybe, you can put yourself on the list as well once in a while because carrying a human inside isn’t a very easy task.

Vaginal soreness
On the off chance that you suffered a vaginal tear or an episiotomy while delivering, the injury may sting for a couple of weeks. Broad tears may take more time to heal. Meanwhile, you can promote healing by:

1. In case of sitting becoming uncomfortable, try sitting on a cushion or cushioned ring.
2. Utilize a squeezer-bottle in order to pour lukewarm water over the vulva while you're urinating. Press a cleansed washcloth immovably against the injury when you hunker down for passing stool.
3. Cool the injury using an ice compress, or place a cool witch hazel cushion between the wound and a clean sanitary napkin.
4. Take stool softeners or analgesics as prescribed by your healthcare provider.
5. For treatment of episiotomy wound in 1st week - betadine wash should be used 3-4 times a day.

While you're recovering, anticipate that the uneasiness will gradually reduce. Contact your doctor if the pain increases; the injury gets swollen, hot and excruciating; or if you notice a discharge with pus.

Vaginal discharge
Vaginal discharge (lochia) might be a problem for several weeks post-delivery. Expect a red, overwhelming stream of blood for the initial few days. The release will continuously decrease, getting to be watery and changing from pink or chestnut to yellow and finally white. Contact your doctor if:

1. You have substantial vaginal drying
2. The discharge has a foul scent
3. You have a temperature of 100.4 F (38 C) or more

Contractions
You may feel contractions for the initial few days post-delivery. These constrictions, which frequently seem like menstrual cramps help in preventing excess bleeding by compressing the vessels. These contractions have a tendency to get more intense with subsequent deliveries. Your healthcare supplier may suggest an OTC pain reliever as well. Contact your healthcare personnel in the event of fever or if the stomach area is tender to your touch. These symptoms and side effects could show a uterine disease.

Menstruation is the monthly discharge of blood from the vagina, which lasts for about 5 to 6 days. It is the shedding of the inner lining of the uterus, when pregnancy does not occur after the release of egg from the ovary. Menstrual periods are generally often accompanied by painful cramps in the lower abdomen, heavy bleeding, weakness, water retention, irritability and malaise.

What is Menorrhagia?

Very heavy or prolonged periods are medically termed as menorrhagia. It is abnormally heavy bleeding if there is a requirement to change sanitary napkins or tampons several times within a very short span of time. Passing large blood clots, night time bleeding, bleeding for over 7 -8 days, are other symptoms that one might be suffering from menorrhagia.

Common Causes Behind It

1. Menorrhagia is mostly a cause of hormonal imbalance, particularly in the levels of estrogens and progesterone.

2. Fibroids, cysts or polyps in the organs of the reproductive system, which includes the uterus, ovaries or fallopian tubes.

3. History of miscarriage or failed pregnancies.

4. Use of contraceptives

How can you treat heavy bleeding during menses

1. Change of diet: You must include more minerals, iron, magnesium and calcium in your diet. Your diet must comprise a lot of green vegetables, fresh fruits and dairy products.

2. Some non steroidal anti inflammatory drugs such as ibuprofen may be prescribed to reduce the blood loss.

3. Certain hormonal therapies to regulate the hormonal imbalances and menstrual irregularities.

4. Home remedies such as intake of certain herbs, ginger and coriander seeds help to control heavy bleeding.

5. Increasing magnesium intake to balance out levels of oestrogen.

6. It is best to stick to natural remedies, as it generally does not create complications in other bodily functions.

If the bleeding cannot be controlled even after a change of diet and home remedies, you must visit the gynaecologist as soon as possible. Heavy bleeding is a serious problem, especially if accompanied by dizziness, fluctuations in the blood pressure, nausea and weight loss. Severe cramps and constant bleeding can hinder daily routine, therefore, the earlier you receive medical attention, the quicker you will get relief.

What is Prenatal care?

It is crucial for a woman who is on her way to becoming a mother to pay special attention to her health. Health care offered to a pregnant woman is also known as prenatal care or antenatal care. It is a very important phase in a woman's life, so go for regular prenatal checkups as they go a long way in reducing risks of complications during pregnancy and child birth. This, in turn, increases the chances of giving birth to a healthy baby.
Contrary to popular belief, prenatal care does not begin when a woman is told that she is pregnant. Prenatal care should ideally be started at least three months before you try to conceive a child. This prepares your body and mind for the changes that pregnancy will bring. Some healthy habits to follow during this period include:

• Quit Drinking alcohol and smoking
• Consult a gynecologist about any existing medical conditions, medication you may be on and what supplements you should start taking
• Avoid contact with chemicals and toxic substances

Once your pregnancy is confirmed, you will need to visit the doctor regularly for checkups.

Prenatal checkups are meant to keep an eye on your health and the health of your baby. In most cases, you will be asked to come in every month for the first two trimesters and every two weeks during the seventh and eighth month of your pregnancy. During the ninth month, your doctor may want to see you once a week until the delivery. In cases where a pregnancy is considered high risk because of existing medical conditions, the age of the mother or any other factors, the doctor may ask a for more frequent checkups.

A prenatal checkup involves a physical examination, tests, screenings and dietary consultations. Some of the common tests include blood tests to check for HIV, the mother’s blood type and anemia. Your blood pressure will also be monitored. When it comes to the baby’s health, determining the rate at which the baby is growing and heart rate are most important. In the later stages of your pregnancy, the position of the baby will also be noted. It is important to not skip these checkups even if you are feeling fine.

Keep your doctor informed about any changes you may notice in your health. Do not take any medication without consulting your doctor even if it is for something as simple as a cold. Do not feel shy about talking to your doctor and ask him or her anything you would like to about your pregnancy and childbirth.

 

Babies can enter this world in one of two ways: Pregnant women can have either a vaginal birth or a surgical delivery by Caesarean section, but the ultimate goal is to safely give birth to a healthy baby.

A C-section, or Caesarean section is a surgical procedure to remove baby through an incision in the mother’s abdomen and then a second incision in the uterus.

A C-section may be a necessity in certain situations, such as delivering a very large baby in a mother with a small pelvis, or if the baby is not in a heads-down position and efforts to turn the baby before a woman gives birth have been unsuccessful.

Sometimes the decision by an obstetrician to perform a C-section is unplanned, and it is done for emergency reasons because the health of the mother, the baby, or both of them is in jeopardy. This may occur because of a problem during pregnancy or after a woman has gone into labor, such as if labor is happening too slowly or if the baby is not getting enough oxygen.

Some C-sections are considered elective, meaning they are requested by the mother for non-medical reasons before she goes into labor. A woman may choose to have a C-section if she wants to plan when she delivers or if she previously had a complicated vaginal delivery.

Reasons for a C-section may include-

1. Health problems in the mother
2. The mother carrying more than one baby
3. The size or position of the baby
4. The baby’s health is in danger
5. Labor is not moving along as it should

The surgery is relatively safe for mother and baby. Still, it is major surgery and carries risks. It also takes longer to recover from a C-section than from vaginal birth. It can raise the risk of having difficulties with future pregnancies. Some women may have problems attempting a vaginal birth later. Still, many women are able to have a vaginal birth after cesarean (VBAC).

How You Might Feel-

You won’t feel any pain during the C-section, although you may feel sensations like pulling and pressure. Most women are awake and simply numbed from the waist down using regional anesthesia during a C-section.

That way, they are awake to see and hear their baby being born. A curtain will be over your abdomen during the surgery, but you may be able to take a peek as your baby is being delivered from your belly.

However, women who need to have an emergency C-section occasionally require general anesthesia, so they’re unconscious during the delivery and won’t remember anything or feel any pain.

Recovering from a C-section-

After a C-section, a woman may spend two to four days in the hospital, but it may take her up to six weeks to feel more like herself again.

Her abdomen will feel sore from the surgery and the skin and nerves in this area will need time to heal. Women will be given narcotic pain medications to take the edge off any post-surgery pain, and most women use them for about two weeks afterward.

A woman may also experience bleeding for about four to six weeks after a surgical birth. She is also advised to not have sex for a few weeks after her C-section and to also avoid strenuous activities, such as lifting heavy objects.

Dilation and curettage procedure which is commonly referred to as D&C is a minor surgical procedure where the cervix is dilated while a special instrument is used for scraping out the lining of the uterus. It is important to know what you can expect before, after and during the process so that you can stay ahead of unnecessary worries and help the process to be smooth and fruitful.

When do doctors recommend dilation and curettage process?
You may be required to undergo the dilation and curettage procedure for one of many reasons. It can be used for removal of tissues in the uterus during or after an abortion or miscarriage or to remove little pieces of placenta after delivery. This process aids in preventing infection as well as heavy bleeding. On the other hand, it can help in diagnosing and treating abnormal uterine bleeding including polyps, fibroids, hormonal imbalances and even uterine cancer. A sample of the tissues in the uterus is tested under a microscope to check if there is any abnormal cell present.

What can you expect during the dilation and curettage process?
The D&C procedure is a minor one and takes about 15 minutes even though you will have to spend about 4 to 5 hours in the healthcare facility. Before the procedure, your doctor would check complete history, and at this point, you should tell your doctor if you suspect that you are pregnant, you are sensitive to latex or any medicines or if you have a history of bleeding disorders. You will then be given anesthesia so that you don’t feel any pain or discomfort during the procedure. Before this procedure, you will have to empty your bladder.

The D&C procedure comprises two main steps, dilation, and curettage.
Dilation involves opening of the lower part of the uterus or the cervix for allowing insertion of a slender rod. This is done to soften the cervix so that it opens and allows curettage to be performed. Curettage involves scraping of the lining and removal of the uterine contents with the help of a spoon-like instrument known as a curette. This may cause some amount of cramping, and a tissue sample would be taken out for examination in the laboratory.

After the completion of the procedure, you may experience slight bleeding and cramping. In some rare cases, adhesions or scar tissues may start forming inside the uterus, and this condition is termed as Asherman’s syndrome which can cause changes in the menstrual cycle along with infertility. This problem, if arises, can be solved with the help of surgery and therefore, you should report any abnormality in your menstrual cycle to your doctor.

The most devastating period for any pregnant women is a miscarriage. This normally happens because of genetic abnormality noticed in the fetus caused due to tripling of a chromosome. This is also called ‘spontaneous abortion’ because the body rejects the random genetic abnormality. Apart from this, there are many other reasons for miscarriage namely blood clotting, deshaped uterus, uterine fibroids, unhealthy cervix and so on. Now, this could lead you to the next question - What can we do to prevent miscarriage?

Time to meet the gynaecologist:
When there is tripling of chromosomes or genetic mismatch, the body actually rejects the fetus, thereby preventing birth of an unhealthy baby. But, if the miscarriage repeats several times, then you have to meet your gynaecologist for further tests and appropriate medical intervention.

Symptoms of miscarriage:
In the normal course, when miscarriage occurs, the women would experience back pain or vaginal bleeding or blood in the vaginal mucus or cramping or abdominal pain. Ironically, sometimes the miscarriage may happen without any of these symptoms. It would get noticed only during routine scanning. However, in the normal course, the chance of a miscarriage is highest before the 12th week. But if miscarriage happens after the 12th week and before the 24th week, then it is called spontaneous abortion. Thereafter, it is known as a ‘still born’ baby.

However, there are some steps that can help women prevent a miscarriage. These steps are briefly explained here.

• Nicotine retards growth of fetus and it is for this reason the couple should shun smoking, months before they plan pregnancy. This change in lifestyle has remarkable effects in preventing miscarriage. Similarly, caffeine can also be the cause of miscarriage. Therefore, women should regulate their intake of coffee as per the advice given by the gynaecologist.
• Women suffering from chronic ailments like lupus, problems with thyroid, epilepsy and such other ailments are prone to a miscarriage. Similarly, it is also advisable that women should get tested for STD/HIV because these ailments can cause a miscarriage. Women suffering from such ailments should be under constant medical care.
• In addition to these, the women should take food rich in vitamins, proteins, Omega-3 and fibres. Further, they should also do physical exercises as per the instructions given by the gynaecologist. One should drink enough water so as to keep oneself sufficiently hydrated. Women must practice meditation, which helps in reducing stress.

The causes of a miscarriage are many; women should discuss about the issues relating to a miscarriage with their gynecologist. This helps them take appropriate preventive steps against this unwanted situation.

First-trimester screening is a prenatal test. It is conducted to get early information about a baby's risk of certain chromosomal conditions. It can detect conditions like Down syndrome (trisomy 21) and extra sequences of chromosome 18 (Trisomy 18).

It is usually conducted in two steps:

1. Blood test
2. Followed by USG

Initially, a blood test is conducted to ascertain the levels of two pregnancy specific substances in the mother's blood. The blood is tested for pregnancy associated plasma protein and human chorionic gonadotropin (HCG). Thereafter, a USG is done to find out the size of the clear space in the tissue that is present at the back of the foetus’s neck.

The screening is done between weeks 11 and 14 of pregnancy. The doctor is able to gauge the risk of your baby having Down syndrome or Trisomy 18 by using your age and results of the test. This screening is quite helpful and can guard you against deadly consequences in the future. Down syndrome is known to cause impairments in the mental and social development of the child. Trisomy 18 gets often fatal by age 1. However, first screening doesn’t find out the risk of neural tube defects.

It is the first screening done in pregnancy. It can be done before any other screening. Thus, the results are known at an early stage. You will get time to think about the future consequences can help you in deciding your course of action and the decision to either continue or terminate the pregnancy. You will be ready to know and decide whether you will be able to live and take care of a baby with special needs. You can conduct other screenings later in pregnancy. You must know that first-trimester screening is treated as being optional. It can detect the risk and cannot tell you whether your baby has the problems in real or not.

Often women get worried about the test and it’s after effects. However, there is no need to worry. It will not harm your pregnancy. The foetus remains untouched and safe during the screening. It will not lead to any miscarriage or any other complication.

A practitioner will collect your blood by inserting a needle into your veins. The blood is then sent for testing to the lab. You can resume your usual daily activities. The ultrasound will need you to lie on your back on a table and the technician will put a transducer on your abdomen. The sound waves will be changed into digital images that the technician will refer to. You can get back to your normal routine as soon as the test is over.