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Sonography of Pelvis Health Feed

Uterine Fibroid Embolization - Everything About It!

Diploma In Medical Radio-Diagnosis, DNB - Radio Diagnosis, Post Doctoral Fellowship In interventional Radiology - Sir Ganga Ram Hospital, New Delhi
Radiologist, Jaipur
Uterine Fibroid Embolization - Everything About It!
Uterine Fibroid Embolization (UFE) is also known as Uterine Artery Embolization (UAE). It is a minimally invasive treatment method for the fibroid tumors or myomas of the uterus. Fibroid tumors are benign in nature, arising from muscular wall of the uterus, and rarely turn cancerous. Generally, they cause pressure on bowel or bladder, heavy menstrual bleeding, and pelvic region pain.

In the UFE, X-ray camera called fluoroscope is used to guide to uterus and fibroids. The delivery of small particles which are injected through a flexible thin catheter blocks the arteries providing blood flow causing fibroids to shrink.

Uses:

The procedure is used to prevent pelvic bleeding caused by malignant gynecological tumors, trauma, or hemorrhage after childbirth.

Preparation:

A thorough evaluation of the patient includes a detailed study of medical history, physical examination, menstrual history, and discussion of fertility goals.

MRI or ultrasound of the uterus is performed to assess size, location, and number of the fibroids. A biopsy of the endometric lining of the uterus might also be performed to rule out the possibility of cancer.

Equipment:

X-ray equipment, catheter, medications, and synthetic materials called embolic agents are used in this procedure.

The Procedure:

Positioning the patient on the examining table.

Tracking heart rate, pulse, and blood pressure during the procedure.

Inserting an intravenous (IV) line into a vein in hand or arm for sedative medication, fluids, antibiotics, and pain medications.

The area of body where catheter is to be inserted is sterilized and then covered with a surgical drape.

Numbing the area with a local anesthetic.

Small incision is made at the site.

Using X-ray, a catheter is guided into femoral artery located in groin area.

A contrast material provides a roadmap for catheter to maneuver into uterine arteries.

Releasing the embolic agent into both left and right uterine arteries by repositioning the catheter.

At the end of the procedure, the catheter is removed and pressure is applied to prevent bleeding.

The opening in the skin is then dressed without any suture followed by the removal of an intravenous line.

Benefits:

Some of the benefits of this procedure are:

Uterine Fibroid Embolization performed under local anesthesia is less invasive than any other available method.

No surgical incision is needed except for a small nick which does not require any suture.

Patients can resume their usual activities much earlier.

There is virtually no blood loss.

There is significant improvement and symptom relief in the condition of patients in most cases.

Generally, this procedure does not allow fibroids to grow as almost every small or large nodule is treated. Thus, it is a more permanent procedure.

Recovery:

Most patients are discharged on the same day and are given oral pain medications post the procedure. A watery, mucus-like vaginal discharge might be observed within a few days. In some cases, remnants of fibroids are also seen. If there is an infection, it is indicated by fever, chills, and pain and should be immediately reported to the doctor.

Take Away:

Uterine Fibroid Embolization (UFE) is a minimally invasive treatment method for fibroid tumors of the uterus. It does not allow the regrowth of fibroids and is hassle-free. However, it is always advisable to consult a doctor before opting for this method.
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Ectopic Pregnancy - How To Diagnose It?

MBBS, Post Graduate Diploma in Maternity and Child Health (PGDMCH)
Gynaecologist, Chandigarh
Ectopic Pregnancy - How To Diagnose It?
Many women have concerns about ectopic pregnancy and we shall be solving all doubts about this dangerous condition right here today. An ectopic pregnancy happens when a fertilised egg implants outside the uterus in a woman s body. Ectopic, in fact, means out of place . The fertilised egg usually implants in the fallopian tubes whose actual work is to transport the ovum or egg from the ovaries to the uterus for fertilisation. This is why such pregnancies are also called tubal pregnancies . Sometimes the fertilised egg can also implant in the cervix or the ovaries of the hapless woman.

Normally pregnancies happen when a fertilised egg attaches itself to the uterine wall to grow and develop. Ectopic pregnancies are a serious condition and can cause internal bleeding and infection and even death of the expecting mother. That s why knowing the symptoms is so important.

Common symptoms of ectopic pregnancy appear as pregnancy matures. Initially, the woman will have all the usual pregnancy-related symptoms like missing her period and breast tenderness, but soon the other alarming symptoms will start appearing like severe abdominal pain on one side, vaginal bleeding, severe cramps and nausea and vomiting, fainting spells and dizziness.

One should seek a doctor s advice right away in this condition because ectopic pregnancy can be fatal. Why? Because as the fertilised egg is implanted in a part of a woman s body which is not built to look after it, the embryo can burst in the fallopian tubes, cervix or wherever it has managed to implant itself. This mini-explosion inside the body is a leading cause of pregnancy-related deaths during the first trimester. This can lead to internal bleeding and infection, which is lethal.

Hence, the earlier an ectopic pregnancy is diagnosed and treated, the better. The only way to deal with an ectopic pregnancy is to abort it. The doctor can do this using either medicines or surgery.
The medicine methotrexate can be used to end a tubal pregnancy. Surgery can also be used to remove the embryo.

In some cases, doctors may have to remove the fallopian tube with the implanted embryo. This has a number of repercussions. The woman can become infertile. Even if the fallopian tubes have been scarred during surgery, it becomes difficult for her to get pregnant again.

Ectopic pregnancies are also getting quite common due to a number of factors like an increase in sexually transmitted diseases which cause scarring of tubes and infertility treatments. If a woman is over 30 years of age, has a history of pelvic inflammatory disease, surgery in the pelvic area or has had an ectopic pregnancy before, she should be very careful indeed.

What Are The Causes Of Infertility In Women?

MBBS, M.D Obstetrics and Gynaecology, Diploma in Gynecological Endoscopic Surgery
Gynaecologist, Gurgaon
What Are The Causes Of Infertility In Women?
Female infertility is not really a rare condition, it happens to one out of six couples. Infertility is a condition in which a woman is unable to conceive despite efforts. There can be a number of causes for female infertility, including problems with ovulation, uterus, fallopian tubes or ovaries. Age can also be a contributing factor to infertility. Following are the reasons that might be responsible for female infertility

Ovulatory problems
Cysts in the ovaries
Hormonal imbalance
Excessive alcohol or drug usage
Eating disorders like bulimia or anorexia
Excessive weight
Enormous stress and pressure
Thyroid gland issues
Very brief menstrual cycles
Damage of organs of the reproductive system
Pelvic inflammatory disease
Scar tissues or adhesions of some sort
Presence of polyps in the uterus
A previous serious infection in the fallopian tubes or uterus
Chronic medical illness relating to the reproductive system
A previous ectopic pregnancy
A birth defect in the uterus or fallopian tube
The DES syndrome wherein infertility can occur to the offspring due to the medication DES is given to a mother in order to prevent miscarriage or premature of the child.
Abnormal presence of cervical mucus can make it more difficult for sperms to reach the egg.
Treatment
Now that the part about the causes has been discussed, it is essential to discuss the treatment. Are there really ways to reverse infertility in women to make them fertile? Well, in some chronic cases it is not possible; however, some are treatable by the following methods:

In the case of hormone imbalance or endometriosis or short menstrual cycles, hormones are taken to treat the problems.
Medications can be taken to stimulate ovulation.
Fertility enhancing supplements can be used.
In case of infection in any of the reproductive parts, antibiotics can be taken to remove them
In order to remove blockage or scar tissues from the uterus, fallopian tube or pelvic area, minor surgeries can be performed.
Prevention
Yes, there are some tips for prevention of infertility

Taking all the steps required to avoid sexually transmitted diseases.
Avoid intake of illicit drugs
Having regular checkups with the gynecologist
Maintaining a healthy lifestyle
Exercising regularly
Having a healthy sexual relationship
This article is a short walkthrough on female infertility and answers most of the commonly asked questions. In case you have further questions, you can always consult a medical practitioner near you.

Fallopian Tubes - What Can Lead To Its Blockage?

MBBS, Diploma in Gynaecology & Obstetrics, MS - Obstetrics and Gynaecology
Gynaecologist, Delhi
Fallopian Tubes - What Can Lead To Its Blockage?
It's said that blocked fallopian tubes are the most common cause of female infertility in about 40% of women who are infertile. Fallopian tubes are channels through which the egg travels to reach the uterus and blockage of these tubes can put a stop to this from taking place. Depending on the different parts of the tubes, this form of blockage is of several types.

What are the different types of fallopian tube blockages?

1. Proximal tubal occlusion
This form of fallopian tube blockage involves the isthmus (an area of about 2 cm long, this part of the fallopian tube connects the infundibulum and ampulla to the uterus). This problem occurs after an illness like complications associated with abortion, cesarean section, PID (pelvic inflammatory disease).

2. Mid-segment tubal obstruction
It occurs in the ampullary section of the fallopian tube and is most frequently a result of tubal ligation damage. The procedure of tubal ligation is performed to put a stop to pregnancy permanently.

3. Distal tubal occlusion
This is a kind of blockage wherein the section of the fallopian tube that is close to the ovary is affected and is commonly associated with a condition known as hydrosalpinx (a condition in which the fallopian tube is filled with fluid). The latter is often brought on by Chlamydia infection, leading to the fallopian tube and pelvic adhesions.

The conditions that may give rise to this problem can include:

1. Genital tuberculosis (the TB infection that occurs in the genital tract)
2. Ectopic pregnancy (pregnancy in which the embryo places itself outside the uterus)
3. Tubal ligation removal
4. Complications related to surgery of the lower abdomen
5. Pelvic inflammatory disease (PID)
6. Uterine fibroids (benign growths that occur in the uterus)
7. Endometriosis (development of uterine tissue outside of the organ)

These disorders can lead to the development of scar tissue, adhesions, polyps or tumours to form inside the pathway. Additionally, the tubes can also get stuck to other body parts such as the ovaries, bladder, uterus and bowels. Two things can happen to the fallopian tubes, either they can become twisted or the walls of the tubes may stick together, leading to complete blockage. Moreover, even if the fallopian tubes are partially damaged, they can remain open so as to enable pregnancy to occur, while increasing your risk for ectopic pregnancy.
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Blockage In Fallopian Tubes - What Does This Lead To?

MBBS, MS - Obstetrics & Gynaecology
Gynaecologist, Thane
Blockage In Fallopian Tubes - What Does This Lead To?
It's said that blocked fallopian tubes are the most common cause of female infertility in about 40% of women who are infertile. Fallopian tubes are channels through which the egg travels to reach the uterus and blockage of these tubes can put a stop to this from taking place. Depending on the different parts of the tubes, this form of blockage is of several types.

What are the different types of fallopian tube blockages?
1. Proximal tubal occlusion-
This form of fallopian tube blockage involves the isthmus (an area of about 2 cm long, this part of the fallopian tube connects the infundibulum and ampulla to the uterus). This problem occurs after an illness like complications associated with abortion, cesarean section, PID (pelvic inflammatory disease).

2. Mid-segment tubal obstruction-
It occurs in the ampullary section of the fallopian tube and is most frequently a result of tubal ligation damage. The procedure of tubal ligation is performed to put a stop to pregnancy permanently.

3. Distal tubal occlusion-
This is a kind of blockage wherein the section of the fallopian tube that is close to the ovary is affected and is commonly associated with a condition known as hydrosalpinx (a condition in which the fallopian tube is filled with fluid). The latter is often brought on by Chlamydia infection, leading to the fallopian tube and pelvic adhesions.

The conditions that may give rise to this problem can include:
1. Genital tuberculosis (the TB infection that occurs in the genital tract)
2. Ectopic pregnancy (pregnancy in which the embryo places itself outside the uterus)
3. Tubal ligation removal
4. Complications related to surgery of the lower abdomen
5. Pelvic inflammatory disease (PID)
6. Uterine fibroids (benign growths that occur in the uterus)
7. Endometriosis (development of uterine tissue outside of the organ)

These disorders can lead to the development of scar tissue, adhesions, polyps or tumors to form inside the pathway. Additionally, the tubes can also get stuck to other body parts such as the ovaries, bladder, uterus and bowels. Two things can happen to the fallopian tubes, either they can become twisted or the tubes walls may stick together, leading to complete blockage. Moreover, even if the fallopian tubes are partially damaged, they can remain open so as to enable pregnancy to occur, while increasing your risk for ectopic pregnancy.
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Know the After Affects Of Hysterectomy Surgery

Masters In Counselling & Psychotherapy, DGO, MBBS Bachelor of Medicine and Bachelor of Surgery
Gynaecologist, Mumbai
Know the After Affects Of Hysterectomy Surgery
What is a hysterectomy? This is a surgery that is used to remove the ovaries or even the uterus. This surgery is usually conducted in order to deal with the extreme conditions that may be caused by the severe onset of various conditions related to the reproductive system of women. Read on to find out why this surgery carried out and what are the after effects?

Causes: This surgery can be carried out for a variety of reasons. One of the main reason is the manifestation of uterine fibroids that can cause severe pain and bleeding. These fibroids will have to be removed surgically and in case they have spread, the uterus will have to be removed entirely. Also, if the condition has spread to the ovaries, it may be imperative to remove the ovaries as well. Furthermore, if the patient is suffering from endometriosis, where the tissue has spread too much and cannot be contained merely by medication or other forms of treatment, then the doctor will have to conduct a hysterectomy surgery in order to remove the affected areas of the reproductive area. Also, other conditions for which this surgery may be required include adenomyosis, chronic pain in the pelvic area, cancer of the uterus, cervical cancer and uterine prolapse.

Procedure: A hysterectomy is performed under anesthesia, and the doctor makes a five to seven inch incision in the abdomen for an open surgery. The doctor will then continue to remove the uterus through this incision. Also, usually, the patient will have to spend about three to four days in the hospital following this surgery. A vaginal hysterectomy may also be conducted for certain cases, depending on the type and severity of the condition that has led to this form of treatment. For this kind of surgery, the incisions will be made in the vaginal area.

After effects: Starting from hormonal imbalances to early menopause, this surgery can leave significant after effects in its trail. The patients who have been through this surgery will be asked to abstain from heavy physical work that involves lifting heavy objects and bending. Also, the doctor will recommend abstinence from sex. One will have to avoid these things for a period of at least six weeks after the surgery. In many cases, the patient may also go through heavy menstrual bleeding.

Doctor visits: In case the bleeding and hot flashes are excessive, then the patient will have to see a doctor and take further appointments so that the condition may not reoccur. Also, the doctor will usually prescribe supplements like vitamins, which must be taken on a regular basis after the surgery to avoid any complications at a later date.

Fibroid Tumours - 8 Signs You Should Never Ignore!

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Obstetrics & Gynaecology
Gynaecologist, Bangalore
Fibroid Tumours - 8 Signs You Should Never Ignore!
Fibroid tumour is the abnormal cell growth in the uterus and they are mostly benign. Fibroids usually affect women in the age bracket of 30 - 40. Fibroid tumours are of three types, depending on their location:

Submucosal fibroids: The tumour develops under the lining of the uterus
Intramural fibroids: The growth is found amongst the muscles in the wall of the uterus
Subserosal fibroids: The growth develops on the wall of the uterus right in the pelvic cavity
Causes behind it:

The exact cause of fibroids in not known clearly. But certain factors have been discovered that might influence their formation. These factors include:

Hormones: Progesterone and estrogen are the hormones responsible for recreating the uterine lining during every menstrual cycle. These hormones might trigger the formation of tumour.
Family history: If any member in your family; your mother, grandmother or sister has/had fibroids in their uterus, you may also develop it.
Pregnancy: Your body produces excessive progesterone and estrogen when you are pregnant, which may cause an increase in the size of a pre-existing small fibroid. Myomectomy can be done by giving incision on the abdomen or by laparoscopy depending on the size and location of the fibroids.
Signs You are suffering from it:

Heavy bleeding along with blood clots during or between your periods
Lower back or pelvic pain
Elevated menstrual cramping
Frequent urination
Pain during sex
Longer than normal periods
Bloating or pressure in lower abdomen
Enlargement or swelling of the abdomen
How it can be treated?

Your doctor will formulate the right treatment depending on your age, the mass of the fibroids and your overall health. Your doctor may choose a combination of treatment to cure your fibroids, and they include:

Medication: Gonadotropin releasing hormones (GnRH) agonists, birth control pills and ibuprofen (anti-inflammatory medicine) are prescribed. GnRH agonists reduce the level of progesterone and estrogen in your uterus.
Surgery: Myomectomy and hysterectomy are two common surgical procedures to treat fibroids. Myomectomy is performed by removing the fibroids only by making an incision on the abdomen. But hysterectomy completely removes the uterus. The latter is reserved for serious cases.
Non-invasive surgery: Forced ultrasound surgery, myolysis (shrinking fibroids with laser or electric current), cryomyolysis (fibroids are frozen) and endometrial ablation (an instrument uses heat, hot water, microwaves or electric current to destroy fibroids) are some non-invasive surgical procedures.

My wife is having fibroid in her uterus and the doctor suggested ovral l for her. What is the use of this tablet for fibroid? Will it stop or shrink the size of the fibroid?

MS - Obstetrics and Gynaecology
Gynaecologist, Delhi
Ovral - l is an orsl contraceptive pill ,it will preven unwanted pregnancy,will regularize her cycles,if bleeding is excessive will reduce bleeding . But it will have no effect on the size of fibroid
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Hi, I am aged 31. Married 3 months before. Expecting a baby. My period cycle is 25 for past 3 months. Need details when will egg fertilize. And sex after egg fertilize is safe.

BAMS
Ayurveda, Ahmedabad
Hi, I am aged 31. Married 3 months before. Expecting a baby. My period cycle is 25 for past 3 months. Need details wh...
Menses ke day 1 se 10 days tak ka period he fertilization period so you should do intercourse in this time.
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Infertility - Know Women's Side Of It!

MBBS, MS - Obstetrics and Gynaecology, Fellowship in Day care Gynaecological Endoscopy
Gynaecologist, Kolkata
Infertility - Know Women's Side Of It!
Infertility is a condition that affects approximately 1 out of every 6 couples. An infertility diagnosis is given to a couple that has been unsuccessful in efforts to conceive over the course of one full year. When the cause of infertility exists within the female partner, it is referred to as female infertility. Female infertility factors contribute to approximately 50% of all infertility cases and female infertility alone accounts for approximately one-third of all infertility cases.

What causes infertility in Women?

1. Damage to your Fallopian tubes: These structures carry eggs from your ovaries, which produce eggs, to the uterus, where the baby develops. They can get damaged when scars form after pelvic infections, endometriosis, and pelvic surgery. That can prevent sperm from reaching an egg.
2. Hormonal problems: You may not be getting pregnant because your body isn't going through the usual hormone changes that lead to the release of an egg from the ovary and the thickening of the lining of the uterus.
3. Cervical issues: Some women have a condition that prevents sperm from passing through the cervical canal.
4. Uterine trouble: You may have polyps and fibroids that interfere with getting pregnant. Uterine polyps and fibroids happen when too many cells grow in the endometrium, the lining of the uterus.
5. Ovulation disorders: Ovulation disorders, meaning you ovulate infrequently or not at all, account for infertility in about 25 percent of infertile couples. These can be one of the following:

Polycystic ovary syndrome (PCOS): In PCOS, complex changes occur in the hypothalamus, pituitary gland and ovaries, resulting in a hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body and acne. It's the most common cause of female infertility.
Hypothalamic dysfunction. The two hormones responsible for stimulating ovulation each month, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are produced by the pituitary gland in a specific pattern during the menstrual cycle.
Premature ovarian insufficiency. This disorder is usually caused by an autoimmune response where your body mistakenly attacks ovarian tissues or by the premature loss of eggs from your ovary due to genetic problems or environmental insults such as chemotherapy. It results in the loss of the ability to produce eggs by the ovary, as well as a decreased oestrogen production under the age of 40.
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