Treatment of Mirena (Hormonal Iud)
Pap Smear Procedure
Dilatation And Curettage (D C) Procedure
Proton Therapy Treatment
Preimplantation Genetic Diagnosis (Pgd)
Pregnant Women Counseling
Prenatal And Birth Care
Musculoskeletal Pain Management
Ovarian Ablation Procedure
Treatment Of Female Sexual Problems
Egg Donation Procedure
Treatment Of Menstrual Problems
Treatment Of Menopause Related Issues
Treatment of Polycystic Ovary Syndrome In Adolesce
Pre And Post Delivery Care
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Patient Review Highlights
In a normal pregnancy, the baby develops with its head pointed down, and the head is usually the part which comes out first during normal delivery. However, in many cases, the baby could have its legs, feet, or buttocks pointing to the cervix. In a majority of cases, the baby may have this position, but rotates to have its head pointing down before the third trimester. However, this may not happen, and this is referred to as breech.
In a lot of cases, the doctor would try to move the baby’s head downwards usually around the 37th week, and this is referred to as external cephalic version (ECV) or even as version. The process is done externally by manipulation and hence the name external. It is done before labor and may allow for a vaginal birth. In very rare cases, it may be done during labor, but before the amniotic sac has ruptured. As a backup, there should be a provision for the patient to undergo C-section, if ECV is not successful.
- Single pregnancy, into 36 weeks of pregnancy, with no complications, and preferably not the first pregnancy
- No engagement of the fetus (any part) in the uterus
- Adequate amniotic fluid, which will provide a good environment to move the baby with minimal injury
- Suspected/known birth defects
- Multiple pregnancies (twins/triplets)
- Ruptured amniotic sac
- Fetus with a hyperextended neck
- Mother’s health is not optimal and is on cardiac medications
- Condition that mandates a cesarean section (placental separation from the uterus, placenta covering the cervix, etc.)
The fetal position is first estimated using an ultrasound. The position of the placenta and the amount of amniotic fluid are also closely monitored. Under constant monitoring, the uterus is relaxed through medications. With one hand on the fetal head and another on the buttocks, the doctor tries to rotate the fetus. Depending on how much pressure the mother is able to tolerate and how flexible the uterus is, version may be successful (success rate is about 60%).
A second attempt under epidural anesthesia may be done, if the first one did not succeed. However, the chances of success with subsequent attempts is very doubtful. The fetus is constantly monitored through ultrasound and fetal heart rate monitoring. A fetus is considered healthy if the heart rate moves up during this procedure. However, if the heart rate seems abnormally high, the procedure would be abandoned.
After the procedure, the mother and the fetus would be monitored for a while before being sent home. As the fetus is constantly monitored throughout pregnancy, the doctor would be able to tell if this procedure is required. If you wish to discuss about any specific problem, you can consult a gynaecologist.
While some couples conceive with ease, conceiving a child can be extremely difficult for others. In cases where a woman is not able to get pregnant despite having regular intercourse in tune with her biological cycle, infertility tests may be suggested to investigate the reason behind this. In most cases, these tests are suggested if a year has gone by without intercourse resulting in a pregnancy. Women may also be said to be infertile, if they cannot carry a foetus to full term.
Infertility can affect both men and women and can be triggered by a number of different reasons. In some cases, it is treatable while in others, alternative ways of having a family may need to be discussed. Hence, it is very important to understand the different types and triggers for infertility and to undergo complete infertility investigations. Some of the common types of infertility investigations are as given below.
- Blood tests: A blood test of both partners is used to assess the general health of the couple and to identify any health factors that may be impeding fertility.
- Tests for women:
- Hysterosalpingogram: This is an X ray that can identify if a blockage or any other issue in the fallopian tubes are the cause for infertility.
- Pelvic ultrasound: This is used to have a look at the anatomy of the female reproductive system and to check for fibroids.
- Laparoscopy / hysteroscopy: This is used to get a clearer picture of the ovaries, uterus and other parts of the reproductive system.
- Tracking cycle: Ovulation and the thickness of the uterus lining may also affect infertility, This can be diagnosed by tracking and assessing the menstrual cycle.
- Tests for men
- Semen analysis:This test is used to get an idea of sperm concentration, motility and the appearance of sperm in a man’s semen. In some cases, the semen may not include any sperm cells. In such cases, a follow up investigation may be required to assess if sperm cells are being created in the testicles. This is known as testicular sperm aspiration or a testicular biopsy.
- Sperm DNA: The DNA in sperm also plays an important role in fertility. This test is used to assess the sperm DNA integrity and to see how it may affect embryo development and chances of an on-going pregnancy.
Infertility treatment depends on the cause identified by the above tests and hence it is important for both partners to undergo complete testing. If you wish to discuss about any specific problem, you can consult a gynaecologist.
Cancer or the big ‘C’ can affect any part of the body including the female reproductive system. These types of cancer are known as gynaecological cancers. Gynaecological cancers occur when normal cells start growing in an uncontrolled manner. There are many different types of gynaecological cancers which are named as per the organs in which they first develop. These include:
- Ovarian cancer: Cancer that affects the ovaries and ova
- Uterine cancer: Cancer that begins inside the uterus
- Cervical cancer: Cancer that begins in the cervix or the section of the reproductive tract between the uterus and vagina
- Vaginal cancer: Cancer that begins in the vagina
- Vulval cancer: Cancer that originates in the opening of the vagina, labia minora or labia majora, clitoris or mons pubis
- Fallopian tube cancer: Cancer that affects the fallopian tubes that connect the ovaries to the uterus
- Placenta cancer: Pregnancy related cancer
Gynaecological cancers are more commonly diagnosed in cases where the woman has a family history of cancer or has mutated genes. Advancing in age, exposure to hormones, and diethylstilbestrol can also increase the risk of suffering from such cancers. Additionally, viral infections such as human papilloma virus, obesity and unhealthy lifestyle choices such as smoking have also been identified as risk factors for cancer.
However, a woman may suffer from these types of cancer even if she does not fall into any of the above risk factor categories. Hence, it becomes important to focus on the symptoms. The symptoms of gynaecological cancers depend on the organ from where the tumour originated, the size of the tumour and it’s rate of growth.
Some of the symptoms which may be noticed are:
- Abnormal bleeding from the vagina
- Bleeding after intercourse
- Unusual discharge from the vagina
- Pain or discomfort in the abdominal area
- Swelling of the abdomen
- Painful intercourse
- Itching or burning sensations in the genital area
- Lumps, warts or sores in the genital area
- Unusual bladder and bowel habits
Gynaecological cancers can be treated by using chemotherapy, radiation, hormonal therapies or surgery depending on the stage of the cancer and the type of cancer. Hence, the earlier it is diagnosed, the better it is. Keeping the risk factors in mind, if the above symptoms are noticed, the doctor may ask for a number of tests to diagnose gynaecological cancers.
These tests include:
- A pap smear
- Pelvic examination
- Blood tests
- CT scan, ultrasound, MRI or any other form of imaging tests
- Biopsy scan
If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.