Unawareness and Skipping A Pap Smear Test Can Increase Cervical Cancer Rates

By Dr Manisha Ranjan, Consultant, Obstetrics & Gynecology, Motherhood Hospital, Noida

Cervix of a woman is the mouth of the uterus which is examined through vagina. Cervical cancer occurs when abnormal or pre-cancerous cells start to develop. The human cervix has two parts ectocervix which is of a healthy pink color and is covered in flat thin squamous cells as well as endocervix which is the cervical canal and is made up of columnar cells. The area where endocervix and ectocervix meet is the transformation zone which is the most likely region where abnormal and pre-cancerous cells can develop.

HPV is the leading cause of cervical cancer

The leading cause of cervical cancer is Human Papillomavirus (HPV) is responsible in about 70-80% of cervical cancer cases. There are over 100 different types of HPV which are considered low risk and do not result in cervical cancer. Nonetheless the high-risk cancer types are HPV-16 and HPV-18 and if a woman has persistent HPV infection then she must see a doctor immediately as they are at a greater risk of developing cervical cell abnormalities

Significance of Pap Test

Precancerous cervical cell do not cause any prominent symptoms which is why regular screening through Pap and HPV tests is recommended. They can catch precancerous cells early and prevent the development of cervical cancer.

Look for these signs to know if you have cervical cancer or not

The possible symptoms of advanced cervical cancer are:

  • Abnormal bleeding that includes bleeding between regular menstrual periods, bleeding after sexual intercourse, bleeding after menopause, bleeding after douching and bleeding after a pelvic exam
  • Pelvic pain that is not related to menstrual cycle
  • Unusual or heavy discharge that is watery, thick or foul smelling
  • Pain during urination as well as increased urinary frequency

These symptoms can also be a result of some other condition than cancer so please see your doctor to know what it is.

Risk Factors

  • Women who do these following things are at a higher risk of cervical cancer than others.
  • Girls who started having early sex
  • Take birth control pills for more than 10yrs increases about fourfold chances of cervical cancer only in women who are HPV positive
  • Have a weak immune system
  • Women who are sexually active with more than one partner
  • Women who have been diagnosed with STD’s (Sexually Transmitted Disease)

 

Cervical Cancer Exams and Diagnosis

Papinicolaou test (Pap Smear) is an advanced form of cervical cancer screening which is a part of woman’s regular screening exam. The procedure is as follows as the doctor collects cells from the surface of your cervix and looks at them under the microscope. After this if anything unusual is spotted then they will extract a bit of cervical tissue for biopsy which will help in further examination.

Another method is colposcopy in which the doctor will stain your cervix with a harmless dye or acetic acid to improve visibility of abnormal cells. After that the doctor will use a colposcope to magnify your cervix by 8 to 15 times to look for unusual cells.

One more method is the Loop electrosurgical excision procedure (LEEP) wherein the doctor uses an electrified loop of wire to take a sample tissue of your cervix for a biopsy  Long standing HPV infection may cause the cells to turn into cancer by forming into a tumor over time. Regular Pap smear will help in early detection of cervical cancer so that it can be diagnosed and treated

The Importance OF Getting Vaccinated for Cervical Cancer

Prioritize health: Cervical cancer vaccination insights - Motherhood Hospital India

Dr Surabhi Siddhartha, Consultant Obstetrician & Gynaecologist, Motherhood Hospital Kharghar

Cervical cancer is ranked as the fourth common cancer all over the world. One of the main risk factors of it is the human papilloma virus. This type of cancer originates in females at the entrance to the womb from the vagina, the cervix. Although the condition mostly seen in women after 30 years. Currently, you will be shocked to know even girls at a younger age can get cervical cancer. Thus, cervical cancer will not only occur in the sexually active women belonging to the age group of 30-45 but before that too. The reason behind this can be the increasing number of girls have become sexually active at a younger age.

The human papillloma virus can be transmitted during sexual intercourse from one person to another. But this does not suggest that every sexually active woman will get cervical cancer. Did you know? HPV-16 and HPV-18 are known to cause this cancer while abnormal vaginal bleeding during or after sexual intercourse, pain during intercourse, abnormal vaginal discharge, and pelvic pain are some of the common symptoms of cervical cancer in the advanced stages of the condition. Thus, taking cervical cancer vaccination is the need of the hour, and can save many lives.

Importance of cervical cancer vaccinations

Awareness about cervical cancer is extremely low in India, mainly in rural areas. Women are often shy and do not want to discuss their symptoms openly. Though, the vaccines are available still women are not aware of them. Basically, they are not okay with the idea of taking a vaccination. It is recommended for girls at the age of 9 to make sure that they do not skip the cervical cancer vaccination, and no booster is required. Prevention is possible via HPV vaccination which is routinely advised to girls between 12 and 13 years. The cost of the vaccine is around 3,000 per vaccine, and one will require 3 doses 0, 2- and 6-months Gardasil and Cervarix at 0, 1 and 6 months. Every girl should take a cervical cancer vaccine before she gets sexually active as this can increase her risk of cervical cancer. The benefits of taking vaccination are they act as a shield against cervical cancer by preventing the two strains of HPV like 16 and 18. Many hospitals give vaccination mandatorily after delivery. 

Screening about cervical cancer

Cervical cancer is preventable if it is detected at an early stage. Screening tests for cervical cancer that is a Pap smear and HPV test must be advised in every young woman above 25 years, every 3 years or early if sexually active. 

Awareness regarding cervical cancer

When it comes to awareness regarding cervical cancer in every 10 women only 2 may be aware of it. While speaking about the rural areas, there is a lack of knowledge and education regarding this. This can increase morbidity and mortality as women-only visit the doctors in an advanced stage where saving lives becomes difficult. 

For awareness amongst rural area, annual pap smear camps be conducted. Vaccine charges should be made affordable for rural women by Govt health schemes or at least early detection measures like pap smear camps be organized regularly. Thus, to improve the outcome and efficacy, women should be educated at the primary level regarding the condition (in schools) to create awareness about cervical cancer. They should be taught about the benefits of taking a vaccination and ways to prevent this cancer should be discussed. 

Health for all women be given priority.

Pregnancy and COVID-19: What are the risks?

We are distanced from many day-to-day habits. We are distancing ourselves from almost everyone around us. We no longer freely get along with anyone. That’s right! The wave of COVID-19 left us all in shambles. The discomforts and plights are plaguing various walks of our life. Most of our answers are unclear due to the unknown levels of COVID-19 infectivity. The scientific literature on similar pandemics in the past may help discover the effects of COVID-19 in pregnancy. COVID 19 and pregnancy risks remains a regularly explorable subject in obstetrics and gynaecology. 

How does COVID-19 affect pregnancy?

Pregnant womenmay be less likely to contract COVID-19. However, pregnancy is a phase that alters various mechanisms of the body. It modifies many systems of the body including the immune system. The way a body responds to a virulent strain of microbes including viruses may change. Therefore, alterations in the immune system may relate themselves to more complexities. The symptoms of COVID-19 in pregnancy can often become severe.

Some cases reported of COVID-19 pneumonia in pregnancy are less severe and show a good rate of recovery. Most pregnant women develop mild flulike symptoms if they contract COVID-19. A few cases involving chest pain that worsens day-by-day, however, may require immediate clinical attention. Here we explore the topic of COVID-19 and pregnancy risks in detail.

Effect of COVID-19 on foetal health

Concrete data is unavailable to cite the risk of miscarriage in the event of COVID-19 infection. The risk of miscarriage may increase in the second trimester. Foetal Growth Restriction (FGR) may be a possibility in COVID-19 infection. There’s no concrete evidence that shows that COVID-19 exposure in pregnancy may pass on the infection to the unborn. Nine women in China were tested positive for COVID-19 infection. Their nine babies, however, went on to be tested negative for the virus. A case in London contradicted the previous scenario. A pregnant lady in London tested positive for COVID-19. Her baby tested positive for the virus too.

The healthcare providers assisting the events are unable to establish the mode of transmission. It’s not clear whether the unborn falls victim to the virus in utero or shortly after he or she is born. Opinions worldwide vary as to what comes next after a pregnant lady contract the virus. A few opinions hold that the baby may not contract the virus during pregnancy. Nor may the baby fall prey to any developmental delays or defects. No persuasive evidence is available to establish a correlation between COVID-19 and its interferences in overall pregnancy. 

Effects of COVID-19 in the first trimester

Studies denote that the infection of COVID-19 may not predispose the first trimester of pregnancy to early pregnancy loss. Data on pregnant women to test positive for COVID-19 in the first trimester is still unavailable. Some anecdotes suggest that the patients infected with high fever may raise the risk of birth defects or developmental defects. Evidence to demonstrate such impacts, however, is unavailable. 

Coronavirus and pregnancy

No data suggests an increase in the risk of spontaneous abortion due to COVID-19. Evidence is still unavailable to prove the status of Coronavirus as teratogenic. The healthcare fraternity may need extensive data to demonstrate how coronavirus influences pregnancy. The infection of COVID-19 doesn’t associate itself with the clinical end of pregnancy. However, pregnant women with COVID-19 may be at increased risk of severe COVID-19. It might be prevalent especially if those infected people hail from ethnic minority backgrounds. Pre-existent conditions like Diabetes, Blood Pressure and obesity may complicate the health of pregnant women with COVID-19. 

What kinds of symptoms of COVID-19 may prevail in pregnant women?

Cough and fever may be the two most common symptoms of COVID-19 in pregnant women. In comparison with non-pregnant women in their fertility age, the pregnant and newly conceived women infected with COVID-19 may remain asymptomatic. Pregnancy during COVID 19 comes with dozens of medical responsibilities.

What are the risk factors that associate themselves with COVID-19 in pregnant women?

High body mass index is one of the most significant risk factors in pregnant women with COVID-19. Conditions that existed before their conception including diabetes and chronic hypertension may lead to developing severe symptoms of COVID-19. Studies even impute the severe symptoms of COVID-19 to advanced maternal age. Many studies warn that preeclampsia and gestational diabetes are two of the important risk factors that may occur in pregnant women.

No persuasive evidence exists to substantiate how these risk factors influence the outcomes of pregnancy with COVID-19. Women who have conceived should take care of themselves, specifically if they have pre-existent health conditions. Obstetricians should take the initiatives and educate pregnant women about risk factors and precautionary measures against them. There may be additional risk factors if you have a pregnancy-specific condition.

How should obstetric staff observe precautions during the pandemics like COVID-19?

  1. Medical facilities should generate substantial space and staff to help prevent the viruses like COVID-19 from going awry. 
  2. Help pregnant women and new mothers to observe proper precautions and protocols.
  3. Staff members should use every safety protocol and follow the guidelines as they proceed to meet pregnant women at Maternity Unit.
  4. If a staff member finds that someone has COVID-19 or someone is a PUI, he/she should initiate the most suitable infection control techniques. 

Precautions to observe by pregnant women

  1. Start practising social distancing from your home. 
  2. Stay at least 2 meters or 6 feet away from others including your family members if they have a high risk of infection.
  3. Take vaccinations and immunize yourselves against COVID-19 or other opportunistic ailments.
  4. Take even flu vaccination if your obstetrician guides you.
  5. It may not protect you from COVID-19, but it will safeguard you from flu which may complicate your pregnancy. 
  6. Use tissue each time you feel like sneezing or coughing or do so.
  7. Call your General Physician or obstetrician immediately if you encounter respiratory issues.
  8. Prefer video consultations over every other mode of clinical support. 

How can I breastfeed if I am suspected to carry COVID-19?

  1. Sanitize yourself regularly as your immediate supervisor suggests.
  2. Make sure you are using the mask each time you are around your baby. 
  3. Avoid sneezing or coughing while you carry your baby.
  4.  Sterilize the breast pump as your immediate supervisor/attendant directs.

Everything you possibly could need to know about finding the right Gynecologists in Noida?

The journey of bringing a new life into the world is one where you need some help, and the doctor who can care for you before, during and after your pregnancy is a Gynaecologist

A Gynaecologist is a person who is specializes in female genital tract and women’s overall health condition. All the disorders related to vagina, ovaries, cervix, and womb are examined and treated by a Gynaecologist. The gynaecologist is the one who is certified to deliver babies are the obstetrician.

Gynaecologists play a very significant role in a woman’s life, especially when she is expecting. Your gynaecologist can help you plan a family, screen you for diseases and treat the same and a lot of other things. A lot of women find it difficult to find the right gynaecologist. Inability to do so can affect you in more ways than one. So here you ll understand on how to find or choose a gynaecologist.  

How to Find the Right & best Gynaecologist in Noida?

It is important to feel comfortable and confident about your gynaecologist. So special care must be taken to find the best gynaecologist in Noida for yourself.

Here are major points that you must keep in mind while finding one.

  1. Most important, he/she should be someone with whom you feel comfortable with.
  2. The gynaecologist should have a good reputation as they are doctors who will know the most intimate and personal facets of a female’s life.
  3. Ideally, look for a Gynaecologist, who is also an Obstetrician if you are planning a baby.
  4. Consult your friends and relatives or find reviews online. It is important that the doctor lives close to your house if you are planning a pregnancy.
  5. Only friendly, caring and responsive gynaecologist makes their patient comfortable. They should be willing to answer all your queries accurately and precisely.

Remember Gynaecologist would be the part of your life in the most important phases and so choosing the right one is critical.

A Gynaecologist will be a part of one of the most important phases of your life. So make sure you trust your gynaecologist completely. Unless you are satisfied, never settle for less!

Blog on Mental Health During Covid Crisis

Do’s and don’ t during the current covid crisis

How to maintain good mental heath during the current crisis.

1. stay positive

2. remember 97% recover ( there are many who have put up their stories on the net)

3. listen and follow the instructions given from authentic sources. ( doctors, govt, health care workers)

4. if you have self quarentined follow a routine at home, do not spend time lying down on the bed  watching tv. Try to be as active as possible at home.

5. stay in contact with the world digitally

6. look at what you can achieve by being at home. Enjoy it

7. Remember you are not the only one going through the crisis, the whole world is.

you are not alone

8. if you are feeling overwhelmed seek help from mental health care professionals. many are available online.

9. keep in touch with extended family members digitally

10. Humour is a good way to handle crisis.

watch movies which can make you laugh and read books if you are an avid reader.

11. Do not watch information which causes you anxiety. Avoid 24×7 watching and discussing about covid ( twice a day information from reliable sources should be enough)

12. Check the well being of near and dear ones digitally

13. Do not drink alcohol or smoke tobacco as a coping stratergy , it only worsens the situations

14. Do not sigmatise people whom have contacted the virus be supportive .

15. Bravado does not help , follow instructions given from authentic sources.

16. Do not focus on the number of cases focus on what you should do to keep safe.

Dr Vijayakumar D R

MBBS, DPM, DNB
(NIMHANS), CCST(UK),
CCMDT

Consultant Psychiatrist 

Motherhood Hospital Hebbal 

How to find the right gynaecologist for your pregnancy?

Maternity healthcare guide: Best gynecologist for your pregnancy - Motherhood Hospital India

Finding a gynecologist for your pregnancy can feel like a huge task. However, itŸ??s of paramount importance as your health, and your babyŸ??s health depends on it.

Get referrals: Consult your primary care doctor and friends for recommendations for a referral list. Research the doctorsŸ?? credentials and experience and ask for a consultation before finalizing the gynecologist.

Check the credentials: Check for any special certification that shows the doctor has the necessary training, skills, and experience to provide gynecologic care.

Consider the experience: Experience matters. The more experience a doctor has with a condition or procedure, the better your results are likely to be.

Research hospital quality: Your gynecologistŸ??s hospital is going to be your hospital. Therefore, consider the quality of care at the hospital because patients at top-rated hospitals have fewer complications.

Read reviews: Reading reviews about the gynecologist on what other people have to say can sometimes provide insight into how a doctor practices and how he/she delivers care.

Book an appointment at Motherhood Hospitals. It offers a complete birthing experience to couples by hand-holding them through their journey towards parenthood. We have a team of obstetricians/gynecologists who are highly experienced in pregnancy care and birthing. With the highest standards of clinical competency, backed by state-of-art technology and proven protocols, Motherhood is committed to offering the best outcomes for the mother and child.

Services we offer include:

Comprehensive pregnancy care, preconception care, pregnancy care, high-risk pregnancy care, 3D/4D ultrasound, early pregnancy scan, NT scan, anomaly scan, growth scan, maternal-foetal medicine, vaccination, antenatal classes, diet and nutrition plan by clinical dietician, exercise during pregnancy designed by highly experienced physiotherapist, antenatal workshops, Lamaze, lactation counseling, postnatal nutrition, postnatal fitness, 24×7 emergency care

How to calculate your due date?

There are multiple ways to calculate your date, as follows:

First day of last period: The best way to estimate your due date is to count 40 weeks, or 280 days, from the first day of your last menstrual period (LMP). Another useful way is to subtract three months from the first day of your last period and add seven days.

Conception date: If your cycle is irregular, the LMP method may not work for you. Just add 266 days to get your estimated due date.

IVF transfer date: If youŸ??ve gone throughassisted reproductive technology cycles, you can calculate your due date more precisely using your IVF transfer date.

If you are already pregnant, then book an appointment at Motherhood Hospitals. It offers a complete birthing experience to couples by hand-holding them through their journey towards parenthood. With the highest standards of clinical competency, backed by state-of-art technology and proven protocols, Motherhood is committed to offering the best outcomes for the mother and child.

Services we offerinclude:

Comprehensive pregnancy care, preconception care, pregnancy care, high-risk pregnancy care, 3D/4D ultrasound, early pregnancy scan, NT scan, anomaly scan, growth scan, maternal-foetal medicine, vaccination, antenatal classes, diet and nutrition plan by clinical dietician, physiotherapy, antenatal workshops, Lamaze, lactation counselling, postnatal nutrition, postnatal fitness, 24×7 emergency care

If you have failed IUI, IVF treatment, then book an appointment at Motherhood Fertility. We are a renowned fertility and reproductive centre, well-equipped with expert doctors (male andrologists), female fertility doctors, skilled team of nurses, counsellors, physiotherapists, and clinical dieticians. The team of experts provides comprehensive fertility services like IUI treatment, ICSI, artificial insemination and IVF treatment backed by our state-of-the-art andrology lab.The team conducts all fertility tests for men, women and advanced laparoscopic and surgical treatments for all fertility issues.

When do you need to see a doctor immediately during the initial days of pregnancy?

Essential Pregnancy Care: Early Pregnancy Health Tips - Motherhood Hospital India

The initial days of pregnancy are very crucial for the well-being of the mother and the overall health of the baby. See your doctor immediately if you notice:

  • Vaginal Bleeding: Some spotting is normal, but heavy bleeding could be a sign of miscarriage or ectopic pregnancy.
  • Excessive nausea and vomiting
  • High Fever: A fever greater than 101 degrees Fahrenheit during pregnancy may be serious.
  • Pain or burning during urination
  • Leg or calf pain, or swelling on one side/severe headache
  • Recurrence of chronic diseases: Women who have certain pre-existing medical conditions such as thyroid disease, diabetes, high blood pressure, asthma, and/or lupus should note any changes in their condition during pregnancy.

If you face any of the above conditions, book an appointment with Motherhood Hospitals. We have a team of obstetricians/gynaecologists who are highly experienced in pregnancy care and birthing. With the highest standards of clinical competency, backed by state-of-art technology and proven protocols, Motherhood is committed to offering the best outcomes for the mother and child.

We also have 24*7 obstetricians/gynaecologists for emergency care, 24*7 well-equipped ambulance services,  pregnancy care, high-risk pregnancy care, early pregnancy scan, NT scan, anomaly scan, growth scan, 3D/4D ultrasound, maternal-foetal medicine, vaccination, antenatal classes, diet and nutrition plan by clinical dietician, exercise during pregnancy designed by highly experienced physiotherapist, antenatal workshops, Lamaze, lactation counselling, postnatal nutrition, postnatal fitness, 24×7 emergency care.

How much weight should you gain during pregnancy? Is it safe to exercise during pregnancy ?

A woman who was of average weight before getting pregnant should gain 12 to 15 kg after becoming pregnant. Underweight women should gain 13 to 18 kg. Overweight women may need to gain only 7 to 12 kg during pregnancy.

In general, you should gain about 1 to 2 kg during the first three months youŸ??re pregnant and 1 kg a week during the rest of your pregnancy.

It is safe to exercise during pregnancy if you exercise with caution and don’t overdo it. A regular exercise routine throughout your pregnancy can help you stay healthy. It can improve your posture and decrease some common discomforts such as backaches and fatigue.

The safest and most productive exercises include swimming, brisk walking, indoor cycling and low-impact aerobics. These activities carry little risk of injury, benefit your entire body and can be continued until birth.

If you have never exercised regularly before, you can safely begin an exercise program during pregnancy after consulting with your gynaecologist. If you have asthma, heart disease or diabetes, exercise may not be advisable. Exercise may also be harmful if you have a pregnancy-related condition such as bleeding or spotting, low placenta, recurrent miscarriage etc.

At Motherhood hospitals, we offer exercises during pregnancy designed by highly experienced clinical physiotherapists who organise weekly Lamaze classes to keep you fit and active during your pregnancy. Book an appointment with Motherhood Hospitals. We have a team of obstetricians/gynaecologists who are highly experienced in pregnancy care and birthing. With the highest standards of clinical competency, backed by state-of-art technology and proven protocols, Motherhood is committed to offering the best outcomes for the mother and child.

We also have 24*7 obstetricians/gynaecologists for emergency care, 24*7 well-equipped ambulance services,  pregnancy care, high-risk pregnancy care, 3D/4D ultrasound, early pregnancy scan, NT scan, anomaly scan, growth scan, maternal-foetal medicine, vaccination, antenatal classes, diet and nutrition plan by clinical dietician, exercise during pregnancy designed by highly experienced physiotherapist, antenatal workshops, Lamaze, lactation counselling, postnatal nutrition, postnatal fitness, 24×7 emergency care.

Dos and don’ts of nutrition during first few weeks of pregnancy

A healthy and balanced diet during pregnancy requires fine-tuning your eating habits to ensure you are receiving enough nutrition for your own health and that of your baby. You must eat from a variety of food groups including fruits, vegetables, bread grains, protein sources and dairy products.

Fruits and Vegetables: Fruits and vegetables contain many important nutrients for pregnancy especially, vitamin C and folic acid.

Bread and Grains: A woman needs energy during pregnancy and it comes from carbohydrates. These essential ingredients are found in bread and grains. One can also get the required amount of folic acid from fortified bread and cereal.

Protein: Meat, poultry, fish, eggs and beans contain the protein, B vitamins and iron needed during pregnancy.

Dairy Products: Calcium is needed to support pregnancy as it helps build strong teeth and bones, normal blood clotting and muscle and nerve function.

Prenatal Vitamins: A daily prenatal vitamin can help fill small gaps, just in case you unintentionally do not get enough key nutrients. Consult your gynaecologist about which supplement is best for you.

Can you drink alcohol if you are pregnant?

The straightforward answer is Ÿ??noŸ??. ItŸ??s safest not to drink alcohol at all during pregnancy. Drinking alcohol during pregnancy can pose a long-term risk to your unborn baby and the more you drink, the higher the risks. ItŸ??s especially important to stay off alcohol in the first trimester, because of the risk of miscarriage.

However, if you do decide to drink while youŸ??re pregnant, limit it to one or two units of alcohol, no more than once or twice a week and never enough to get drunk.

Book an appointment with Motherhood hospitals. We have clinical dieticians highly experienced in planning a balanced diet and nutrition plan for women and their special needs during pregnancy and after pregnancy. We also have 24*7 obstetricians/gynaecologists for emergency care, 24*7 well-equipped ambulance services,?˜ pregnancy care, high-risk pregnancy care, 3D/4D ultrasound, early pregnancy scan, NT scan, anomaly scan, growth scan, maternal-foetal medicine, vaccination, antenatal classes, diet and nutrition plan by clinical dietician, exercise during pregnancy designed by highly experienced physiotherapist, antenatal workshops, Lamaze, lactation counselling, postnatal nutrition, postnatal fitness, 24×7 emergency care.