Maternity Diet Tips

Great maternity begins with great diet. Eating well is extremely important. Did you know that eating can determine C-section operation or natural birth! Yes! It can help you have a healthy pregnancy and a healthy baby. Here are some diet tips from the best maternity hospital in Bangalore, Read:

1. Never skip breakfast.

  • Include cooked breakfast cereals with fruit in your first meal of the day. Fortified cereals have added nutrients that benefit your health.
  • Eat more food later in the morning.

 

2. Eat meals with fiber.

  • A variety of vegetables and fruits, like carrots, cooked greens, bananas, and melon keep you full for longer
  • Eat plenty of beans and whole grains along with brown rice & oatmeal.

 

3. Binge on healthy snacks.

  • Try fat-free yogurt with fresh fruits.
  • Eat grain crackers with low-fat cheese

 

4. Regularly take prenatal vitamin with iron and folic acid every day.

Never skip prenatal vitamins as they ensure a smooth and comfortable pregnancy. Iron and folic acid helps prevent birth defects.

  • Avoid Mercury-rich meals
  • Avoid fish and shellfish with high levels of mercury along with shark, swordfish, king mackerel, or tilefish.
  • Eat low mercury fishes like shrimp, salmon, and catfish.

 

6. Stay away from soft cheeses and lunch meat.

There may be foods which might not be easy on the guts. Avoid bacteria prone foods like:

  • Soft cheeses like feta and goat cheese
  • Uncooked or undercooked meats or fish (like sushi)

 

7. Avoid alcohol and caffeine

  • Drink decaffeinated coffee or tea.
  • Drink water instead of soda.
  • Don’t drink alcohol.

Follow these tips and make sure that you get all your medical tests and scans on time. If you are looking for the best maternity hospital in Indiranagar, Visit Motherhood Hospital.

Cord Complications By Dr. Anu Vinod Vij

Cord Complications: Expert Insights on Maternal-Fetal Health Guidance - Motherhood Hospital India

?˜ ?˜ ?˜ ?˜ ?˜ ?˜ ?˜ The umbilical cord is the lifeline of an unborn child from the mother. It?˜usually contains three blood vessels and is about 21Ÿ? long and is?˜responsible for supplying nutrients and oxygen from the motherŸ??s bloodstream to the infantŸ??s bloodstream, as well as supplying a blood supply to the infant and eliminating wastes. Without it, an infant cannot survive during the gestational period.?˜

Once an infant is delivered, the umbilical cord is clamped and cut, and babies begin to breathe on their own.

                However, there are several umbilical cord problems that can arise and put infants at risk for serious health problems. This article is intended to allay the anxiety which arises from certain ultrasound reports mentioning various cord positions. Some mothers are terrified by the thought of the umbilical cord wrapping around the babyŸ??s neck and the possibility of problems during delivery or even a stillbirth.

Common Umbilical Cord Problems

Umbilical Cord Prolapse

Umbilical cord prolapse is a problem that occurs when the umbilical cord drops through a motherŸ??s open cervix during labor and delivery and sometimes even before the onset of labor. This can cause the cord to get compressed between the babyŸ??s body and the rim of the cervix and hence occlude the blood supply of the baby. 

The most common risk factors for umbilical cord prolapse include:

  • Premature rupture of membranes: If the motherŸ??s water breaks too early, when the baby is still positioned high in the uterus, the umbilical cord may make its way into the birth canal before the baby can descend.
  • Long umbilical cord length
  • Low birth weight
  • Pelvic deformities
  • Low lying placenta
  • Malpresentation (e.g. breech)
  • Multiples sharing an amniotic sac: The first baby to be born may drag the cord of another through the birth canal.
  • Premature delivery
  • Uterine malformations
  • Unengaged presenting part
  • Excessive amniotic fluid (polyhydramnios): This may push the cord down before the baby.

The clearest sign of a cord prolapse is the emergence of the cord prior to the baby. However, this does not always happen, as the cord can also come down the canal alongside the baby. Signs of foetal distress, such as heart rate deceleration, also clue medical professionals into the possibility of cord prolapse.

Treatment/management of cord prolapse

Sometimes, it is possible for a physician to move the baby away from the cord, possibly with the help of forceps or a vacuum extractor (which can also be dangerous for the baby). However, this often fails, and then an emergency C-section delivery is necessary. While preparing the mother for surgery, medical professionals will often opt to push the presenting part of the baby back into the pelvis.

If Obstetricians donŸ??t detect and treat an umbilical cord prolapse quickly, the infant may be deprived of oxygen, leading to a host of medical issues, including long-term cognitive problems, cerebral palsy, and in severe instances, a stillbirth.

Short cord 

The average umbilical cord length is between 55 and 60 cm. An umbilical cord is considered short if it is 35 cm or less in length. Short umbilical cords occur in roughly 6% of pregnancies. They are risky because they can affect the growth and development of the baby as well as the outcome of the pregnancy. Short umbilical cords can lead to many complications, including:

  • Prolonged labor
  • Placental abruption
  • Hypoxic-ischemic encephalopathy (HIE)
  • Cerebral palsy
  • Intrauterine growth restriction (IUGR)
  • Umbilical cord rupture

Risk factors for short cord

Some of the risk factors for short umbilical cord include :

  • Gestational diabetes
  • Maternal low body mass index (BMI)
  • Oligohydramnios (decreased amniotic fluid)
  • Polyhydramnios (excessing amniotic fluid)
  • History of smoking during pregnancy

Signs and diagnosis of short cord

Short cord should be suspected if there is low foetal movement; this could both cause and be caused by short cord. Signs of foetal distress should also prompt medical professionals to check for short cord.

Treatment/management of short cord

If the cord is extremely short, or there are signs of foetal distress, the mother may be admitted to the hospital for inpatient monitoring prior to delivery. If she is diagnosed with placental abruption or the baby is in foetal distress, then the medical team should quickly prepare the mother for emergency C-section.

Nuchal Cord

A nuchal cord occurs when the umbilical cord becomes coiled around an infantŸ??s neck, most often in a single coil but in some cases, multiple coils. Nuchal cords occur in around 10% to 30% of all births. And a 2018 study in the American Journal of Obstetrics and Gynaecology reports that, the majority of time, babies do just fine when one is present. 

What causes nuchal cords?

Random foetal movement is the primary cause of a nuchal cord. Other factors that might increase the risk of the umbilical cord winding around a babyŸ??s neck include an extra-long umbilical cord or excess amniotic fluid that allows more foetal movement.

Nuchal cords typically are discovered at birth. Occasionally, patients ask if we can see them on ultrasound, which sometimes we can. ThereŸ??s no way yet to prevent nuchal cords or unwind them from a babyŸ??s neck in the uterus. 

When is a nuchal cord dangerous?

If the cord is looped around the neck or another body part, blood flow through the entangled cord may be decreased during contractions. This can cause the babyŸ??s heart rate to fall during contractions. Prior to delivery, if blood flow is completely cut off, a stillbirth can occur. This is however very rare, as complete occlusion of the umbilical vessels seldom occurs as they are adequately protected by the presence of a jelly like substance around them in the umbilical cord, called WhartonŸ??s Jelly. 

In the 2018 study, 12 percent of deliveries had a nuchal cord. Most babies with a nuchal cord had just a single loop around the neck. Fortunately, there was no increased risk for growth problems, stillbirth, or lower Apgar scores in this group. 

What is the possibility of stillbirth in cases of nuchal cord?

Research has found little or no connection between stillbirth and nuchal cords, although there has been some speculation about the relationship by researchers in Timisoara, Romania.

Their results were noted in the journal?˜Clinical and Experimental Obstetrics and Gynaecology and suggested nuchal cord incidents needed to be given more attention. They recommended thorough monitoring of foetal heart rates, during delivery once ultrasounds had revealed nuchal cords. They also suggested cesarean delivery when any distress was noted.

What happens during delivery?

Since the vast majority of time we donŸ??t know if a baby will have a nuchal cord, it is routine that the doctor will check the babyŸ??s neck for a nuchal cord after the babyŸ??s head is delivered. Usually the cord is loose and can be slipped over the babyŸ??s head. At times it might be too tight to easily slip over the head, and the doctor or midwife will clamp and cut the cord before the babyŸ??s shoulders are delivered. This keeps the cord from tearing away from the placenta when the rest of the babyŸ??s body is delivered. 

Umbilical Cord Knots: True Knots

Umbilical cord knots occur when a fetus maneuvers around in amniotic fluid and moves through the umbilical cord loop, creating a knot. The knot usually remains loose but can constrict and tighten during delivery. While the knot is loose, there generally isnŸ??t a need to worry, but if the knot becomes too tight and not detected and treated immediately, the infant may experience oxygen loss, decreased blood flow, and in some instances, death. During labor it can be reflected in abnormal CTG tracings or decreased or increased Foetal heart rates. 

Cord Stricture

According to the National Institutes of Health (NIH), cord stricture is a common cause of foetal death, typically during the 2nd trimester, before birth. The cause of cord stricture is unknown, yet it occurs in around 19% of foetal deaths. 

Since this type of umbilical problem is difficult to detect during the prenatal period, risk of foetal death is increased. 

Umbilical Cord Cysts

Umbilical cord cysts occur when an abnormal growth appears on the umbilical cord. The growths are classified as either false cysts (filled with fluid), or true cysts (remaining cells from foetal development). Can be detected during first trimester on USG. These are sometimes associated with chromosomal problems and anatomical defects. 

Single umbilical artery

The umbilical cord normally contains two umbilical arteries and one umbilical vein, which carry blood between the placenta and the unborn baby. Some unborn babies have only one umbilical artery. While this usually does not pose a problem to the developing baby, about 30% of infants with only one umbilical artery have some sort of congenital abnormality such as cleft lip, heart conditions, or chromosomal abnormalities if associated with other markers. If isolated, this finding is innocuous and does not warrant further testing. These babies are more prone for growth restriction in pregnancy and hence periodic growth monitoring by serial scans is necessary. 

Velamentous insertion and vasa previa

Usually the umbilical blood vessels run from the placenta, protected within the umbilical cord, to the baby. However, in 1% to 2% of pregnancies, a condition called velamentous insertion of the umbilical cord can occur. In this condition, the blood vessels travel, unprotected, across the foetal membranes before they come together into the umbilical cord. This condition may be associated with low birth weight, premature birth, and various congenital abnormalities. Velamentous insertion can cause haemorrhage from the baby during childbirth, after the foetal membranes have ruptured. If velamentous insertion is suspected, you may be advised to have a caesarean section to avoid the chance of rupture. 

Vasa previa is a complication of velamentous insertion where the umbilical blood vessels cross the foetal membranes and pass through the space between the unborn baby and the cervix. This is a very serious condition because once the foetal membranes rupture, the exposed blood vessels can tear, causing massive bleeding from the baby. This causes the babyŸ??s heart rate to slow down and puts them in grave danger. If you have vasa previa with significant vaginal bleeding, you will need to have a caesarean section in an effort to save the babyŸ??s life. 

Is SEX during pregnancy is safe? – Dr Madhuri Laha

Very common question in pregnant female mind. Most patient feels that sex may harm the baby in uterus though answer is not totally yes or no overall it is safe through out the pregnancy in uncomplicated low risk case.

Trimester Wise Guide

First Trimester – Most of the pregnant female have low libido due to associated nausea, vomiting and weakness in first trimester. Or maybe due to unplanned pregnancy patient may feel a loss of libido.

Second trimester – Most of the pregnant female are comfortable in their second trimester as they are free of nausea. Also there is an increase in libido due to engorgement of genital organs. Also, risk of abortions are low and placenta is localised in ultrasonography so doctor is more confident to allow sex during the second trimester of pregnancy.

Third trimester-Though safe, but uncomfortable for females due to the large tummy of the patient. Risk of premature labour pains are still there. The couple may try other positions during sex like a female on the top or side positions.

Conditions where sex during pregnancy to be avoided –

  • H/O abortion and miscarriages, preterm labour pain , 2nd trimester abortion due to incompetent os.
  • Cases with low lying placenta reaching or covering os, premature rupture of membranes.
  • Post coital bleeding, vaginal or cervical infection with purulent white discharge.
  • Some cases have swollen blood vessels at cervical mouth which may get ruptured during intercourse, needs doctors advice before going ahead.

When to rejoin sex after child’s birth?

  • Generally after normal vaginal delivery there is bleeding followed by lochia discharge(white and yellow) which last for more than a month. During this period sex should be avoided due to the risk of infection.

*Also there is episiotomy stitch and vaginal mucosa injury which needs time to heal of at least 20-25 days.

*Female may feel low libido during this period because of new responsibility of newborn and disturbed sleep cycle. 

*Important point to keep in mind is about the contraception because a female may get pregnant before even getting her first period after delivery.

* Barrier methods like condoms or IUCD should be used to avoid pregnancy. Barrier method also protects the female from a sexually transmitted disease so should be seriously considered in pregnancy and puerperal period.

Ultimately it is a couple’s decision and choice about the sex during and after pregnancy. Any couple can enjoy the intimacy after taking advice from the doctor.

Excessive or abnormal vaginal discharge: What can be the reasons?

Vaginal discharge is quite common, and thereŸ??s usually no reason to worry too much about it. However, thereŸ??s a sense of uncertainty involved in it which causes confusion and doubt for the person who is facing this problem.

While vaginal discharge is the way a womanŸ??s body manages fluid and cells, it can also indicate vaginal infections and whether you have a potential health issue which needs the attention of a gynaecologist. The reason for white discharge varies from woman to woman, and can change depending on multiple factors such as potential infections, menstrual cycle, hormones and pregnancy.

Excessive vaginal discharge or leukorrhea is often caused by an infection. Some commonwhite discharge causing infections include bacterial vaginosis, trichomoniasis, yeast infection, vaginal atrophy, vaginitis, gonorrhoea, chlamydia, pelvic inflammatory disease (PID) and human papilloma virus (HPV) or cervical cancer.

Bacterial vaginosis is likely to affect women who receive oral sex or who have multiple sexual partners. It has a strong, foul and sometimes fishy odour. Trichomoniasis results ina yellow or green discharge that has a foul odour. Pain, inflammation, and itching are also common symptoms. A yeast candida infection causes white, cottage cheese-like discharge in addition to burning and sometimes no discharge, just itching sensations.

Vaginal atrophy is the thinning and drying out of the vaginal walls during menopause while Vaginitis is characterised by irritation in or around the vagina.

Gonorrhoea and chlamydia are sexually transmitted infections (STIs) that can produce an abnormal discharge. PID occurs when bacteria spread up the vagina and into other reproductive organs. HPV or cervical cancer spreads through sexual contact. Cervical cancer can easily be screened with yearly Pap smears and HPV testing.

Stay aware of normal and abnormal changes in vaginal discharge. This allows you to identify infections and other health problems. You should contact your doctor if you notice your vaginal discharge has changed from its typical consistency, colour and smell or if you have other symptoms in your vaginal area. You should discuss your white discharge reason with your doctor if:

  • It has changed in consistency and appears yellow, green or even gray
  • It resembles cottage cheese in colour and consistency
  • It looks foamy or frothy and has a strong smell of fish, yeast or another odour
  • It is brown or blood-stained
  • You experience vaginal itching, swelling burning, or pain

If you have any questions about the vaginal discharge youŸ??re experiencing, contact Motherhood Hospitals which has a team of highly experienced gynaecologistŸ??s for white discharge treatment and quick relief from the problem. Older women should see a doctor promptly if they have a discharge, particularly if the discharge contains blood or is brown or pink (possibly indicating a small amount of blood). A discharge that occurs after menopause can be a warning sign of a precancerous disorder (such as thickening of the lining of the uterus) or cancer and should not be ignored. Our experts mitigate risk and suggest you thorough options, medicinal as well as highly advanced minimally invasive procedures like endometriosis surgery (hysteroscopy, laparoscopy).

 

Endometrial Cancer

Supportive care and treatment options for endometrial cancer - Motherhood Hospital India

Safe Surgical Treatment For Every Woman

Many conditions affecting the reproductive organs may go unnoticed till the patients suffer severe symptoms like bleeding and pain. Advanced gynaecological surgeries can help women get back to normal. So, Motherhood hospital’s gynaecological programme ensures that women get the advantage of a timely diagnosis and effective treatment that includes advanced gynaecological surgeries wherever necessary.

Dr Suhasini Inamdar, Consultant, Obstetrics and Gynaecology at Motherhood hospitals, Indiranagar talks about a few conditions and the advanced treatment for them:

Endometrial Cancer

Endometrial cancer arises from the cells that make up the endometrium, which is the lining of the uterus. This type of cancer is known to affect 3-4 per 100, 000 women in India, according to a study published in the US-based Journal of the National Cancer Institute in October 2017. The 15-year study, across 43 countries, conducted by researchers from the American Cancer Society and International Agency for Research on Cancer found that endometrial cancer was more common among postmenopausal women. One of the most common signs of cancer of the endometrium is bleeding after menopause.

Symptoms

  1. Vaginal bleeding/post-menopausal bleeding
  2. Pelvic pain
  3. Irregular menstruation
  4. Bleeding between periods

The condition can be diagnosed through a hysteroscopy. One of the patients who presented with endometrial cancer at Motherhood Hospital was a 50-year-old woman with a history of breast cancer.

Around 15 years ago, the patient had undergone a procedure to remove a lump in her breast. At that time, doctors had also performed an oopherectomy (a surgical procedure to remove the ovaries) on her to prevent cancer from recurring. Later, she was diagnosed with hyperthyroidism and was taking radioactive iodine as treatment. As a result, she became hypothyroid.

Treatment

When she consulted us this year, she had severe post-menopausal bleeding. Because of the hypothyroidism, the patient had become obese. We did a hysteroscopy and found that the endometrial lining was thickened considerably. The best option is to do a laparoscopic hysterectomy. The risk was high because of the patient’s weight and her earlier procedures, said Dr Inamdar.

Laparoscopic hysterectomy is a minimally-invasive procedure to remove the uterus. It is carried out with the help of a laparoscope, a thin lighted tube with a camera at the end. Small incisions are made near the navel and the lower abdomen; the device is inserted through one of them and the surgeon performs the procedure by seeing the images beamed from the camera on a screen.

In this case, the expertise of the doctors at Motherhood ensured that the surgery had a successful outcome. The patient also made a quick recovery as blood loss and pain was minimal.

Vaginal Vault Prolapses – Dr Suhasini

Dr. Suhasini Explains Vaginal Vault Prolapses and Causes and Treatment Options - Motherhood Hospital India

Advanced Gynae Surgeries for Women

Certain gynaecological conditions can make day-to-day life miserable for many women. These specialised procedures give them much-needed relief.

Every year, thousands of women in India are diagnosed with serious gynaecological conditions. Of these, some may seek timely treatment while many may not be aware of the dangers of these problems.

Dr Sireesha Reddy, Consultant, Obstetrics and Gynaecology, Motherhood Hospital, Hebbal talks about some of the complex conditions and their advanced gynaecological surgery solutions which are being conducted at the hospital on a regular basis.

Vaginal Vault Prolapses

A pelvic prolapse is a condition wherein one of the organs in the pelvic region starts coming down abnormally, causing a lot of discomfort. This could happen because of age-related causes including wear and tear of tissues over time, pregnancy and childbirth or due to congenital factors. When the tissues supporting the top part of the vagina become weak, resulting in that part of the vagina to sag or drop down into the vaginal canal, it is called vaginal vault prolapse. Sometimes, the sagging part of the vaginal wall may even be visible through the vaginal opening. Some women, who have undergone hysterectomy, may experience this condition because of the pelvic support tissues becoming weakened over the years.

Symptoms

  1. Discomfort and pressure in the pelvic region
  2. Back pain
  3. Difficulty in urinating/passing motion
  4. Urinary incontinenceTreatment

Apart from being a birthing centre, Motherhood Hospital is well-equipped and has an envious line-up of medical experts to carry out advanced surgical procedures for complicated gynaecological conditions. This includes minimally-invasive procedures to correct prolapse.

Advanced surgery to repair a vaginal vault prolapse will prevent the sagging and give relief from the symptoms, helping an affected woman lead a normal life without discomfort. We had a 65-year-old woman who came to us with symptoms of pressure and difficulty in passing urine. She had undergone a hysterectomy about 20 years ago. Investigations revealed that she was suffering from a vaginal vault prolapse. We performed a laparoscopic sacrocolposuspension procedure, which gave her much-needed relief from her symptoms, said Dr Sireesha Reddy.

In this minimally-invasive procedure, the surgeon makes tiny incisions on the lower abdomen and the top part of the vagina is connected to the tail bone through a graft. As in all laparoscopic procedures, scarring and blood loss is minimal and the patient makes a quick recovery.

Large Fibroids – Dr Sireesha Reddy

Advanced gynae surgeries for women

Diagnosing the condition early and giving the right treatment can help in alleviating the pain of the affected woman. That is what sets Motherhood Hospital apart Ÿ?? as medical experts who have the know-how and experience to deal effectively with complicated conditions including multiple fibroids, cysts, endometrial cancers, pelvic prolapse and other problems. State-of-the-art technology and medical prowess of the doctors at Motherhood ensure the patients make a speedy recovery.

Dr Sireesha Reddy, Consultant, Obstetrics and Gynaecology, Motherhood Hospital, Hebbal talks about some of the complex conditions and their advanced gynaecological surgery solutions which are being conducted at the hospital on a regular basis.

?˜Large Fibroids?˜?˜

In most instancesŸ?? fibroids may not pose any major problems or show marked symptoms. But, when they grow large and cause debilitating pain and bleeding, thus interfering with day-to-day activities Ÿ?? it is time to act.

Gynaecological surgery is a good option, yet many women continue to suffer and refuse surgery, as they are scared to go undergo them. That is what happened with 40-year-old Seema (name changed) who was diagnosed with large fibroids.

Ÿ??The patient had heavy bleeding and was extremely anaemic. She was on hormone therapy to regulate her periods and a host of other medications, when she came to us. Even though none of them were working, she was reluctant to have surgery, as she was scared, she would have a huge scar on her abdomen and that she would be bedridden for long. But at Motherhood, we convinced her to undergo a laparoscopic hysterectomy to remove the uterus, as the incisions would be tiny and she would make a quick recovery,Ÿ? informed Dr Sireesha Reddy, who conducted the surgery.

Treatment

Despite the patient having large fibroids, the doctor was able to successfully remove the uterus through the minimally-invasive procedure. In fact, upon removal, the uterus weighed 1.2 kg. The patient was thrilled with the outcome, as the tiny incisions were hardly visible, and the blood loss was also minimal. She did not have to endure much pain and got back to a normal lifestyle shortly.

Investigation of Infertility- The Despondent Woman

ItŸ??s very heartening when I see women are subjected to all the pressure and treatment for pregnancy. The problem may be either related to the man or women. But most often only women have to bear the challenges of the treatment, such as Regular vaginal scans, hormonal blood tests and of all regular medication and injections.

Today I saw a young women who was 24 years old coming for consultation to my OPD.

So I started my series of Questions which are a part of the usual history taking process.

The answers, however, came as a shock to me.

I asked her what the issue was. She said she had not yet conceived

How long has she been married for? —- 4 months!!

She has already done all the blood test as part of the Infertility workup.

And had already seen two consultants

Okay, I thought there must be some issue.

So I went through the reports and previous consultations and found nothing medically wrong.

So what is it?

Then I asked for her husband to come in, as he was not present, thinking that he must be waiting to be called.

But she had come with her Ÿ??Ÿ??Ÿ??Ÿ??Ÿ??.. Mother. And the Husband was not present for the consultation.

So I again repeated my question, but this time differently.

I asked her Ÿ??Why such an urgencyŸ?.

With tears in her eyes, she said that her mother in law was forcing her to get pregnant since the first month of marriage. When asked if semen analysis was done as part of the work-up, She answered in a very unassuming tone that. IT WAS NOT DONE.

After more than 2 decades of being in practice What I still fail to understand is why is it always it the women who has to undergo the brunt of bearing the blame for not getting pregnant. When the male partner is not even available with wife during the first consultation.

ItŸ??s very well-known that both men and women are equally responsible for conceiving and also for not conceiving.

When do we investigate couple for fertility issues?

We advise investigation only after one year of unprotected intercourse, where the women is less than 30 years of age and 6 months unprotected intercourse, for women more than 30 years of age.

Do couple need any investigation before conceiving at all?

As routine preconception counselling we do advice few investigation which would prevent complications during pregnancy like haemoglobin test, thyroid function test, and rubella screening.

Who has to be investigated first husband or wife?

As both are equally responsible both have to be investigated together. There are the battery of test to be done to investigate a woman but for a man, itŸ??s just one simple test Ÿ?? semen analysis.

Why is there a prejudice when it comes to women being subjected to infertility treatment?

The general conception in many house hold is that if the couple has not conceived after trying for many months, the blame is usually put on the wife. This is not always the case and in such circumstances, the couple need to support each other rather than point fingers and play the blame game.

Why does the male partner shy away from getting tested?

In my personal experience, I have seen that many Men think that revealing that they have a low sperm count or low motility is like questioning their manhood. This is a very damaging misconception and can lead to lot of issues among the couple if not sorted out. The male partner needs to be counselled regarding the need to get tested for complete evaluation of infertility, and that the reports are completely confidential.

 

How does laparoscopy help in infertility?

Laparoscopy plays a very important role in the management of subfertility. Its suggested for women where after the basic investigation like hysterosalpingogram for tube assessment, ultrasound for assessment of uterus and ovary, and hormone analysis for the female partner and semen analysis in a male partner have not yielded any reason for subfertility or when on ultrasound in female partner has shown certain abnormality .

Laparoscopy is a very simple procedure. In subfertility usually it a day care procedure.it is done under anaesthesia but hysteroscopy can be done without anaesthesia which we call it as office hysteroscopy. Like women is admitted in the morning and discharged by evening, as it being diagnostic in nature most of the time. Even if we have do some corrective procedure like adhesiolysis, drilling, cystectomy, tubal cannulation, polypectomy or septal resection

Usually in a diagnostic lap with create 2 small incision of 5mm on the abdomen through which lap instruments are passed through and the procedure completed. If we need to do some operative procedure like cystectomy or adhesiolysis we create one more incision. As the cut are very small the problems associated with surgery is very minimal. Patient generally do not complain of pain and usually can go back to normal routine work in a daysŸ?? time.

Although there are many scientific methods to treat infertility such as in vitro fertilization (IVF) assisted reproductive technologies (ART), laparoscopy is inevitable in conditions where the reasons for infertility remain unknown.

When is diagnostic laparoscopy for infertility recommended?

After the initial work up of the couple if we find that thereŸ??s no obvious reason for subfertility then we recommend further investigation with diagnostic hystero- laparoscopy. And also when there are certain indications like

  • In case of an previous pelvic surgery
  • In case of suspected mild to moderate endometriosis.
  • In case of suspected pelvic inflammatory disease or tuberculosis.
  • In case of severe pain and cramps during menstrual cycles.

When is laparoscopic surgery recommended?

Is indicated when on initial investigation reveals certain correctable causes of subfertility.

  • In case of polycystic ovarian syndrome
  • In case of an endometrial deposits
  • If the fallopian tubes are blocked
  • If Hydrosalpinx is suspected
  • If ovarian cysts block fallopian tubes

Benefits of Laparoscopy:

  • Helps in having a comprehensive and detailed look inside the abdominal region
  • Helps in getting rid of pelvic pain
  • Helps in removing scar tissues, fibroids, and endometrial deposits

Why should you see a doctor if you surfer from pregnancy loss?

Expert guidance for pregnancy loss: Consult a doctor for personalized care - Motherhood Hospital India

ItŸ??s believed that 75percent of all pregnancies end in miscarriage. However, most miscarriages go unnoticed because they happen so early. The victim might feel it like a normal period, slightly delayed though says Dr.Mirudhubashini Govindarajan, Clinical Director, WomenŸ??s Center by Motherhood. Experts believe that 15 to 20 percent of women will experience a miscarriage which is clinically recognized. Ÿ??This happens due to genetic, infective, immunological, endocrine or environmental causes or structural defects,Ÿ? she adds. According to her, 50 percent of early miscarriages could be attributed to genetic causes when fetus cannot survive due to genetic or chromosomal defect.

This miscarriage is a random event. Ÿ??But, most such women will achieve normal pregnancy subsequently,Ÿ? avers Dr.Mirudhubashini. As for immunological causes, it is finally the clots in blood which result in the demise of the fetus. Ÿ??Antibodies which some women carry in their blood may attack their own cells,Ÿ? informs Dr.Mirudhubashini, adding Ÿ??some of these antibodies may attack the placenta or promote formation of blood clots in the placentaŸ?. The clots can slow down the fetal growth leading to eventual miscarriage.

Miscarriage can also occur due to anatomic causes because some women may have a septum (wall) within the uterus. It could come in the form of a double or half uterine cavity or a similar defect which leads to miscarriage. Presence of large fibroids, particularly, those encroaching upon the uterine cavity can also preclude a successful pregnancy outcome.

Miscarriage can also occur due to infections. Many types of bacteria, viruses or parasites can cause pregnancy loss. But, this is not very common.

Elaborating on endocrine causes, Dr.Mirudhubashini says that women with irregular periods or Polycystic Ovarian Syndrome (PCOS) run a higher risk of early pregnancy loss because the multiple maternal hormones fail to provide an ideal environment to the developing embryo.

We canŸ??t do much about many of these causes. But, miscarriages occurring due to certain environmental causes like intake of harmful substances like drugs, alcohol, smoking or excessive caffeine can definitely be prevented to a great through abstention.

Miscarriage is never a pleasant experience. The agony could have a prolonged effect. Bleeding is the first symptom of a miscarriage. It could range from spotting to heavy bleeding (haemorrhage). A miscarriage resulting in haemorrhage is generally not life-threatening if good medical help is available. Ÿ??But, in the long run, a woman could become anaemic due to blood loss. She needs to be given adequate iron supplements and vitamin-rich diet to take care of nutritional deficitŸ? advises Dr.Mirudhubashini.

A woman suffering from miscarriage must get adequate rest and if she is working, it is advisable to take a few days off thus allowing the bleeding to taper off in a week. But, persistent bleeding or heavier than normal period is a definite indication that you should visit a doctor, says

Dr.Mirudhubashini. Ÿ??You should also avoid intercourse during this time. This is not good because the uterus is still healing. One should remember that infection might occur at any point because the mouth of the uterus is open from a few hours to days making it vulnerable to bacterial attack. Frequent change of sanitary napkins should be strictly followed. This along with adequate rest prevents infection in most casesŸ? she explains.

So, how would one know in the case of infection?
Ÿ??ItŸ??s a good question. ThereŸ??re a few symptoms which include pelvic pain, fever, foul-smelling discharge, burning and/or pain while passing urine besides vomiting, body ache or lethargy,Ÿ? she confirms.

So, how long one should wait before attempting the next pregnancy after a miscarriage?
Experts says a couple should plan their next pregnancy from the third month after the miscarriage since it takes about six weeks for a womanŸ??s body to come back to normal after the miscarriage. Ÿ??But before that the couple should undergo a thorough medical investigation to rule out any possible causes of repeated miscarriages,Ÿ? cautions Dr.Mirudhubashini. In the event of detecting the cause, it should be treated before attempting another pregnancy. In the case of a first miscarriage, basic testing is done to rule out infection or endocrine causes. A second miscarriage, however, will need a detailed testing while a third miscarriage warrants detailed counselling including genetic counselling and detailed probe to detect possible causes.

A woman who has suffered from miscarriage in the past should undergo pre-pregnancy counselling and start on folic acid supplements. The physician treating her should also need to correct her nutritional and mental health as the situation demands. In essence, any woman with a past history of miscarriage would do better in her next pregnancy with extra medical monitoring.

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