Main Dr. Surekha Jain, Shalimar bagh. Aaj main aap ko batana chahti hoon AUB yaniki abnormal uterine bleeding kya hoti hai. Jaisa ki naam batata hai abnormal uterine bleeding ka matlab hai woh mahamari ya aurat ko vo bleeding jo samay par na ho or normal flow se zada ho. Moti moti baat yahi hai ki waqt par nahi hoti, samay se irregular hoti hai aur jitna din ka flow hona chahiye usse jyada hoti hai. Lekin is bleeding ko har umar mein alag alag tarah se treat kiya jata hai. Shuruvat hum karenge is baat se ki agar kisi ko jyada ya excessive bleeding hoti hai, mahamari excessive hoti hai to usse kitni nuksan ho sakte hain. Kisi bhi Umar mein jyada bleeding hone se patient ko anaemia hoga khoon ki kami hogi usse usko thakan hogi, normal routine work karne mein mushkil hogi aur iss tarah se wo ek bimari ki stithi mein aa jayegi.
Sabse pehle hum is baare mein baat karenge ki jo vayask avastha hoti hai jab ki ladki ko bleeding mensuration chalu hota hai ya jisko medically hum puberty kehte hain, puberty ke dauran ya puberty se ek saal, do saal ke aas paas agar humko abnormal uterine bleeding hoti hai to uske karan bilkul alag hote Hain. Uske zadatar karan hote hai usme sabse pehla karan hota hai ek saal tak ki bache ko paripakva awasthe me nahi hota. Usme hypothalamus pituitary ovarian uterine axis jo ki puri ek axis hai jo ki patient ko bleed karati hai ya har mahine mahamari deti hai, woh paripakva vo mature nahi hoti. Immaturity ki wajah se immature signals aate hain or har mahine anda nahi banta isliye patient ko kabhi kabhi jaldi or kabhi kabhi late bleeding bhi hoti hai. Ek saal tak isilye pareshan hone ki jyada zarurt nahi hai. Fir bhi agar ye he awastha zada din tak rahe to hume kya karna chahye?
Sabse pehle complete haemogram patient ka pura hemoglobin dekha jaye, kitna hai? Kam hai zada hai? Uska coagulation profile kya janmjaat koi coagulation ki bimari to patient ko nahi hai. Ek Von Willebrand factor bhi hota hai uski test bhi karayi jani chahiye. Thyroid ka bhi test karaya jana chahiye. Ye common karan hai puberty ke around abnormal uterine bleeding ke. Uske alawa 1 ultrasound bhi zarur karana chahiye halaki ye kam bahut kam hota hai. Is awastha me fir bhi kae ovarian tumors or abnormal development of the genital tract bhi iska karan ho sakta hai. Ab doosra hum aate hain vo awastha jo kareeb 25-40 saal tak ke beech me jisko hum kehte hai childbearing age. Childbearing age mein abnormal uterine bleeding ke bahut sare causes ho sakte hain. Jis mein sabse pehla karan pregnancy se related hota hai. Pregnancy se related matlab patient pregnant hai, usse pata nahi bleeding ho gayi or usko tab pata chala vo doctor ke pass ayi jise hum threatened abortion kehte hain.
Kae bar patient pregnant hai, incomplete abortion ho gaya, patient bleed karti rahi, use maloom nahi hai, usko hum incomplete abortion kehte hain. Aur uiske alawa missed abortion bhi hota hai, patient ne time pass kia, andar he bachcha kharab hogya or thoda thoda karke bleeding hoti rahi. To pregnancy se related iske alawa ek aur stithi hoti hai jise kehte hai vesicular mole, jisme ki bachcha pura sa banta he nahi hai or vo khatarnak bimari hoti hai. Islye doctor se jab bhi apko pregnancy me bhi bleeding ho turant doctor se consult karna chahye. Ectopic pregnancy matlab jabki pregnancy uterus mein na ho kar tubes mein hoti hai jo jaanleva bhi ho sakti hai tab bhi thodi thodi bleeding ho sakti hai.
Kehne ka tatpariye ye raha ye raha ki agar aap pregnant hai, apko pata hai or thodi bhi bleeding hoti hai to doctor se jarur consult karna chahye. Iske alawa ye childbearing age main aur bahut sari problems aisi hai jo aapko is tarah ki bleeding de sakti hai. Jaise agar patient PCOD hai, to har mahine uska anda nahi banta or uski growth andar jo bachchedani me endometrium layer endometrial layer vo jyada grow kar jati hai, itna grow karti hai ki vo fir hold nahi kar sakti or fir jyada bleed karti hai. To matlab kehne ka yahi hua ki apko jab bhi aniyamit bleeding ho ya normal se jyada khoon Jaye to apko doctor se zaroor consult karna chahiye. Childbearing age me teesra ek karan, jo sadharantya hota hai vo hai fibroid uterus matlab thodi thodi gathein, rasolia uterus me ban jati hai Jo is tarah ki problem de sakti hai. Or adenomyosis chota chota wall me gathein banjati hai bachedani ki, vo bhi is tarah ki problem de sakti hai ya pelvic inflammation ya pelvic infection.
Bahut tarah ke infections hote hain Jo soojan desakte hai pelvis me, pelvic area me or bleeding jyada hosakti hai ya fir doctor dwara jaise apne koi copper-T lagvaya hai, multiload lagvaya hai ya mirana lagvaya hai vo bhi kabhi kabhi mahine ke beech me bhi thodi thodi spotting ho sakti hai ya mahine ke time me bahut zada bleeding hosakti hai. Ye or agar apko bachchedani ke muh pe koi jhakham hai vo bhi apko bleeding zada desakta hai. Childbearing age mein hame kya kya investigation karni chahiye? Isme aur investigation ke alawa sabse important ye hai agar apko postcoital bleeding hai matlab aapko husband se contact karne ke baad bleeding hoti hai to woh ek nishani ho sakti hai ki aap bachchedani ke muh yani cervix ka cancer develop kar sakte hain, aisi condition main PAP smear ya HPV DNA aaj kal test hota hai jo ye doctor ko badi aasani se bahut jaldi bata deta hai ki han aapke saath ye problem hai or usko badi aasani se treat kiya ja sakta hai.
Iske alawa investigation mein sab aate hain hemogram, blood sugar, thyroid aur urine ka koi infection yeh saree routine test aapko doctor se milke jarur karne chahiye. Ab aate hain hum vo awastha jo bhudapa kehlati hai ya menopause kehlati hai, pre-menopause and menopause both. Pre-menopause me agar apko irregular bleeding hoti hai to dubara se woh karan ho sakta hai ki apka physiologically anda theek se nahi ban raha kyunki ab apka vanning period hai dhere dhere apki hormones kam hoti ja rahi hai isiliye aap bleed kar rahi hai. Lekin agar apka menopause agya hai ek saal tak apko koi bleeding nahi hue hai uske bad achanak koi bleeding hoti hai to vo khatre ki nishani hosakti hai.
Aise me zarur apko doctor ko dikhana chahye jo apke upar bahut sare test karke apko bata sakti hai ki koi early cancer to nahi hai. Early cancer ke liye aaj kal PAP smear or HPV DNA jaise maine bataya vo to karte he hai, ek or acha test hai jo humari doorbeen hoti hai jisse hum puri bachchedani dekh sakte hai or bata sakte hai ki andar kya kharabi hai. In sab test ko karane se aap khatarnak bimariyo se asani se bach sakte hai, ultrasound, MRI ye sab hmare ko sehyog dete hai diagnosis banane me. To mai friends apko yahi kehna chahti hu koi bhi abnormal uterine bleeding ko aap neglect mat kariye, usko seriously lijiye or ek bar doctor ki raye zarur lijiye.
I am Dr Surekha Jain, I am practicing since last 38 years in Shalimar Bagh Delhi. And I am curtsy consultant to Shalimar Bagh Fortis hospital. Today I am going to talk about a very important hormone which is known as pregnancy hormone or beta HCG. Why it is called pregnancy hormone because this hormone beta HCG is the first hormone to increase and which can diagnose pregnancy very early. Why we should diagnose pregnancy very early, now days in a era of assistant reproductive techniques like IVF, ETSY, IUI etc. We want to know whether our patient is pregnant or not very early so that we can support her and we can give her certain medications which will help her to continue her pregnancy. This is a pregnancy hormone which starts as soon as when embryo is form that is 14 to 15 days after your ovulation or egg pick up. We can detect up to 100mIU’s of Beta HCG on the 14th day after ovulation, if pregnancy is occur. So to know the welfare of the pregnancy or to know first of all whether you are pregnant or not, we do your beta HCG. Anything about 10mIU/ML is taken as positive, it is just positive but to know whether the patient is doing fine or not, we can repeat this hormone every 48 to 72 hours that is every third day and it should almost double up every third day which shows that now the pregnancy is going fine and now we are assured. And we keep on following the patient. When the beta HCG levels they reach around 1000 to 1500 International unit the gynaecologist or your doctor should be able to see by Trans vaginal sonography at least sack. If she cannot see the sack at 1000 to 1500 International unit then there must be something wrong either blighted over or anything else. Now how can you test a beta HCG there are two methods to test beta HCG one is urine and other is blood, urine beta HCG is very simple to test anybody can test it at home. You can buy a simple strip from any chemist and then you can put fresh clean urine in the small socket formed on the slide 3 drops of fresh urine and wait for about 3 to 5 minutes. What you can see on the slide is either a one single line of about red or violet colour which shows that you are not pregnant but you have done your test alright. But if you see 2 parallel lines of equal strength you are happy because indicates that you are pregnant and your pregnancy is fine. But in case you don't see any of the lines, it shows that you have not done that test correctly or you are suffering from some severe urinary tract infection or your urine is very diluted. You have taken it after lot of consumption of water or some liquids. So Urine Pregnancy Test is very easy the drawback with Urine Pregnancy Test is it just tells you that you are pregnant, it doesn't tell you what will happen or what time of the pregnancy it is. Now the second method to test beta HCG is blood, it's very important definitive and very good test to know about the conception and its progress and the time of weeks. So if you get your blood beta HCG done in your blood as I told you anything about 10mIU/ML is positive test and then you follow it every third day to find out that it becomes double or not and then when it is about 1000mIU/ML then it should be seen in the trans vaginal sonography. What is the use of this hormone, why this hormone is there it is with some purpose the purpose of this particular hormone is that when you conceive and after just fertilizations 8 to 10 days after fertilization the embryo goes and implants in the uterus and there it is formed by the plasanta, this sends a message to the ovary that corpus luteum has to keep on working because corpus luteum give the hormone progesterone which is very-very necessary for the pregnancy. Now once the corpus luteum is giving progesterone and gradually the plasanta develops. When the plasnta develops it takes so what the corpus luteum, see the nature's method tell the Corpus luteum to maintain the corpus luteum in pregnancy the beta HCG is keep on increasing till 8 to 10 weeks it is the highest it around 10 weeks its level is about 100, 1000 international unit but as soon as the plasnka takes over the work of making progesterone corpus luteum is no more required. And hence the beta HCG also keeps on reducing and it makes effective Plateau at around 20 weaks its only 20000 then it goes to Plateau and it remains at the same level till full top. Beta HCG other than telling you about the welfare of the pregnancy has certain other many important jobs to do. First of all if your beta HCG is not corresponding with the weeks of pregnancy shown in your lab report, it shows that either your pregnancy is not progressing well or you might be having ectopic pregnancy that is your pregnancy might be other than the in the uterus. It can be it outside the uterus which is very dangerous for the health of the patient. Second it shows if it is very high it shows either you are having multiple pregnancy or some pregnancy related cancers which are known as trophoblastic disease of the pregnancy. Which are also again very dangerous and followed by beta HCG test and thirdly this test is also done to know about the welfare of the foetus in the first trimester of your pregnancy that is known as double marker. So it's a very-very important hormone and is related to all the pregnancy welfares, miscarriages, blighted ovum, ectopic, twins, cancer-related pregnancy that's all, ok.read more
Causes, symptoms and diagnosis of Thyroid
Hello friends. I am Dr. Surekha Jain practicing as a gynecologist and obstetrician since last 40 years. I own my own hospital at Shalimar Bagh with the name of Jain Child and Maternity Hopsital Pvt. Ltd. I am also attached with the Fortis Hospital, Shalimar Bagh as a Senior Gynecologist and Obstetrician. Today, I am planning to tell you about Thyroid Diseases during Pregnancy. The reason for choosing this topic is that it is very common nowadays to find thyroid disease during pregnancy and the smallest variation in the thyroid organ can really affect your pregnancy. The thyroid disease is present in two forms: Hyperthyroidism and Hypothyroidism. Hyperthyroidism means over active thyroid and Hypothyroidism means which is under active thyroid.
Thyroid is an organ which is located in the front of your organ like a butterfly and it releases hormones which control metabolism of your body it controls even single cell of your body. Thyroid affects the whole body. During pregnancy, why we are worried about the thyroid disease that if you already know that you have hyperthyroidism or hypothyroidism at the very first consultation of your pregnancy, you should tell your obstetrician that you are either Hyperthyroid or hypothyroid and what drugs you are already taking. So that the doctor can help you adjust those medications. In case you do not know the status of your thyroid at very first visit the doctor will you investigations to be done and thyroid status is one of them.
Why is it so important to do early? Because the thyroid functions are more important in the first trimester of pregnancy to control the development of the baby. You very well know that during the very first three months of your pregnancy, the child being made, all the organs, all the systems are developed and after that the child only grows inside so the first three months are very crucial. And thyroid controls the activities in the mother and the baby. So, you should know the status of thyroid. Now, let us know what are the most important irregularities you can have in thyroid? Hyperthyroidism, even though it is rare, in early pregnancy signs and symptoms they quite mimic hyperthyroidism like excessive vomiting, nausea, irritability, giddiness and irregular heartbeat, even nervousness. So, these are very common in pregnancy as well as in hyperthyroidism.
So, if they are in a moderate amount, you can think of having these symptoms because of pregnancy. But, in case there is excessive, your doctor will definitely test you for hyperthyroid by doing certain blood tests and manage you accordingly on anti-thyroid drugs. The second most important is hypothyroidism. Hypothyroidism being more common than hyperthyroidism, therefore, it is very important to manage hypothyroidism in early pregnancy. In first, seven to nine weeks, the fetus doesn’t have any thyroid function in itself. So whatever it is getting it is from the mother. If the mother is deficient, the child will also become deficient and later on it can have multiple problems of nervous system, skeletal system, and developmental problems. Now, how do you diagnose the thyroid disease? It is very simple. Only by blood test you can diagnose thyroid. Three blood tests are there, TSH (Thyroid Stimulating Hormone), T3 and T4. These are the hormones which are released by thyroid and thyroid stimulating hormone is the controlling hormone which keeps adjusting itself according to the hormone. Only by test you can come to know whether you are youth thyroid that is normal thyroid or you are hypothyroid or hyperthyroid.
If thyroid is not controlled properly during pregnancy then there can be multiple things which can happen to the mother and the baby. Now, if it not controlled in the first trimester, then developmental problems can be there. Baby can have certain congenital birth defects but later on it can lead to prematurity, and high blood pressure. Now, how can you come to know you are suffering from symptoms only? Hyperthyroidism can lead to severe nausea, vomiting, and slight tremors in your body, trouble sleeping, weight loss, or low weight for pregnant women. How can you know about hypothyroidism? Symptoms of hypothyroidism are such as extreme tiredness, weight gain, confusion, constipation, concentration and memory problems.
So, once your doctor knows whether you are hypo or hyper, they will treat you accordingly. If you want to know more, you can contact me through Lybrate, Dr. Surekha Jain. I am a certified thyroid disease treatment giver to the patients so you can contact me by chat, telephone, by putting your questions directly to me through Lybrate. They know my telephone number, my address. You can contact me, come to me, you can chat with me and even have video chat with me. Thank you.read more
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Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
Pap Smear Procedure
Urinary Incontinence (Ui) Treatment
Family Planning Procedure
Nutrition For Pregnant Women
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