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Management of Abortion
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
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I got intimidated with my bf after 5 days of my periods. But I took ipill within 24 hours. It's been a week and yesterday I vomit and got lose motions. Is there any chance I am pregnant?
Good afternoon, I am Dr. Puneet Kocchar. I am a consultant gynecologist and a fertility specialist at Elixir Fertility Center, New Delhi. Today I will be talking about Recurrent miscarriages and abortions.
A positive pregnancy test is a very exciting news not only for the couple but for the entire family. However, sometimes there is a miscarriage and the chances of miscarriage in the normal pregnancy are about 10-15%. If you have had only one miscarriage, then the chances that you will carry on till term without requiring any medical extensive treatment in your next pregnancy are nearly 80% or more. For women who have had only one miscarriage, we will not recommend going for extensive testing or treatment.
What is recurrent abortion or recurrent miscarriage?
If a lady has had 3 or more repeated abortion, it is called recurrent abortions. Even these days we start doing test and treatment if a lady has had 2 abortions and we do not wait for third one to occur.
So, why does an abortion occur?
In simple terms, either it is a fetus, that is, an embryo is not normal or the womb which is going to carry the pregnancy has some problems in it. What happens to a fetus if you are carrying a genetically abnormal baby, that can lead to miscarriage. It is nature's way to take care of the pregnancy and not letting the abnormal baby come into life. So, we do tests called genetic tests to check the chromosomic make up of a baby. They can be done on the products of conception. We also recommend that we have complete parental care, that is the blood test of both mom and dad to check the both of the chromosomal content.
Sometimes, in2-5%of the cases, there is balanced chromosomal translocation. Now this translocation will not cause any problem to the person who is guiding translocation. But when you produce an egg or the sperm, the embryo can be abnormal and this will lead to a miscarriage.
What happens to a person carrying a translocation?
If you are carrying a translocation which is leading to repeated miscarriages, it is better to plan IVF cycle along with PGD or PGS rather than normal conception.
IVF is where we create an embryo using the eggs from the lady and sperm from the husband. When the embryo is ready, we take a small biopsy and we subject it to test and a complete chromosomal analysis. And once the results are back, the normal embryo is transferred back into the lady's womb resulting in healthy pregnancy. This is one factor that we just addressed.
The second factor that we talked about is abnormalities in the womb. Now, simple test to analyze hormonal balance from the blood taken from the lady will tell us about thyroid status, diabetes, abnormal prolactin. These are all hormones which if are elevated or below the range can lead to abortions. THis can all be treated by giving oral tablets. So, these are important to be tested for any women having recurrent abortions.
- Then we look into other factors such as autoimmune problems which are very common, occurring in about 20% of the patients. During pregnancy, we advise you to take low dose aspirin tablets and low molecular weight hampering injections for the entire duration of pregnancy. And this results in more than 60% successful pregnancies.
- Another important factor that leads to abortion, which is Thrombophilias. THese are inherited problem which increases the tendency of blood to clot. Since the blood flow to the uterus is not occurring properly, you might again need blood gain agents such as aspirin.
- Some of the other common factors are an anatomical factor. So, if the uterus or a womb is carrying a fibroid can also lead to abortions. Now, these can be easily diagnosed by doing an ultrasound either 2-dimensional or 3- dimensional. If such a problem is present, we can treat it by doing a hysteroscopic procedure.
- Another important factor that leads to Abortion, especially in our part of the country, that is North India, is Tuberculosis. This is one of the commonest cause of miscarriages especially in our part of the country. It can be tested by doing Biopsy. Take a small amount of tissue from the uterus and check whether the lady is carrying Tuberculosis or not. It can be treated by giving oral medication of tuberculosis that has to be taken for the period of 6-9 months.
- Another common cause is the imbalance of Th1 or Th2 cytokines. These are the cytokines present in the uterus which may not let the embryo or the pregnancy to grow. And if these are found to be positive, we recommend Immunomodulation.
So, these are the various causes due to which a lady can have an abortion. An important thing here is do not loose hope and do not give up treatment. If you have had 2-3 abortions, you need to get complete panel of tests done and with the help of a treatment, you have 60% of the chance to deliver a baby normally.
If you wish to consult me, please contact me through Lybrate or you can visit my clinic directly.
My mom have abdominal pain at the time of mensuration cycle. Please tell me its causes and treatment that should be taken to prevent it.
I am tasnim nahar. Age 25+. Married. Have some problem with my periods. Last time it was 16 day long. Bleeding heavily with cramps. N the texture of the blood was not normal, its slippery. N I was feeling my breast is enlarged. I have 2 medicines named clot xl 500 n syl forte. N finally ofloxacin ornidazole tablets n its stopped. Can you please tell me about this problem which I am facing. Is it any hormonal imbalance? Kindly suggest me. Thank you.
Hi Sir, Dear doctors I am asking this question on behalf of my wife, She need rubber penis medical grade ,to insert vagina due to vaginismus problem, as she having fear about anal dilator. Is rubber penis (sex toy) available in market or medical Shop. Is vagina getting to loosen with that for proper intercourse, as we are planed for baby And also hope no any infection in that to vagina. Please suggest.
Most women stay confused with the time of their ovulation. Couples who are sexually healthy and are in their 20s and 30s and are not using any birth control measures have 20% chances of getting pregnant. It is interesting to know that you have a high chance of getting pregnant at the time of ovulation. It is a small window period that comes each month. It is the time when your ovary produces ovum or egg and the egg is open for fertilisation. Even if you are having sex two or three days before ovulation, there is a high possibility of fertilisation. After ovulation is over, the window period gets shut for the next cycle. It is the safe period. Though doctors say that it cannot be considered 100% safe to have unprotected sex during this period, the chances of getting pregnant are considerably lower.
When does ovulation actually start?
It should be remembered that ovulation takes place at the middle of your menstrual cycle. It usually occurs halfway through the cycle. Commonly, the average time period of a cycle is 28 days. But, in some cases, women may have cycles as long as 23 to 35 days.
How will you know that you are ovulating?
- Check your calendar: It is a healthy habit to keep a menstrual calendar. You must maintain the dates for a few months. This will give you an idea as to when you actually ovulate.It is difficult to know the actual time of ovulation if you are having irregular periods.
- Carefully listen to your body: It is a common thing that your body spontaneously sends a memo to you before ovulation starts. You get cramps or feel pain in the lower abdomen before ovulation starts. This pain is called mittelschmerz. It is a reminder of the coming periods.
- Chart your body temperature: Well, you will need to keep a record of your basal body temperature. You can measure it after three to five hours of sleep. Your basal body temperature changes throughout the monthly ovulation cycle. Progesterone hormone is responsible for the increase in body temperature. In the first half of the month, the progesterone levels are low and hence the temperature remains low as compared to the second half of ovulation.
- You can go for saliva test: Your saliva contains the estrogen hormone. Its level changes throughout the cycle. You can also use an ovulation detector kit to know the dates.
- One can also track the timing when there is increase in vaginal discharge which starts just before the ovulation and is there for 24 to 48 hours. We can easily notice this as it is intermenstrual.
In case you have a concern or query you can always consult an expert & get answers to your questions!