Author: mygynaec

Gestational Trophoblastic Disease-a Strangely Abnormal Pregnancy,Update-24.2.19,Cancerous subset-GTN

Gestational Trophoblastic Disease-a Strangely Abnormal Pregnancy,Update-24.2.19,Cancerous subset-GTN

Hello friends,

As promised, we will continue our discussion and talk about Gestational Trophoblastic Neoplasia or GTN which is the malignant or cancerous subset of spectrum of Gestational Trophoblastic Diseases or GTD.

-GTN responds to chemotherapy and are routinely cured even in the presence of widespread metastases.

-In GTN, the chances for preservation of fertility and subsequent successful pregnancy are also good.

-Most commonly GTN develops from Molar pregnancy but may follow any kind of pregnancy.

– So, friends, in next update of this series will discuss in detail about some other aspect of this topic.

By

Dr Himani Gupta

Gynaecologist & Obstetrician

Director-My Gynaec World

Official Head Quarter

Mother ‘n’ Care Clinic

Row House F 44/32

First Floor

Near Shivaji Chowk

Sector 12-Kharghar, Navi Mumbai

Ph  +91-7506027299

+91- 9820193283

Medical Investigations of Couple Seeking Fertility-Update-24.2.19-What is sub-fertility & when to investigate

Medical Investigations of Couple Seeking Fertility-Update-24.2.19-What is sub-fertility & when to investigate

Hello friends,

As promised, we will continue our discussion on evaluation of couple seeking fertility.

-Today we will seek deeper understanding of what is infertility and population dynamics.

-It is said that most couples are said to be subfertile as they will ultimately conceive if given enough time.

-The decision to start investigations in the couple depend on many factors like age of woman, for how long they have been married, ovulation status and so on.

– Generally, investigations are started if couple has failed to conceive in one year.

Fecundability, which by definition is ability of woman to conceive, is highly age related and declines with advancing age.

-Women in age group 35-40 years will require more frequent evaluation than younger woman.

– So, friends, in next update of this series will discuss in detail about some other aspect of this topic.

By

Dr Himani Gupta

Gynaecologist & Obstetrician

Director-My Gynaec World

Official Head Quarter

Mother ‘n’ Care Clinic

Row House F 44/32

First Floor

Near Shivaji Chowk

Sector 12-Kharghar, Navi Mumbai

Ph  +91-7506027299

+91- 9820193283

Endometriosis-a Medical Dilemma in Women-Update-24.2.19-How it happens & spreads

Endometriosis-a Medical Dilemma in Women-Update-24.2.19-How it happens & spreads

Hello friends,

-As promised, we are back with more discussion on Endometriosis.

-Today, we will discuss several theories that propose cause of endometriosis.

Retrograde menstruation theory states that here is back flow of menstrual blood through Fallopian tubes into peritoneal cavity. These endometrial fragments get implanted there,survive,grow and give rise to endometrial lesions.

-Endometriosis also spreads through vascular or lymphatic channels to unusual locations like groin, perineum and retro-peritoneum.

-There is another theory of coelomic metaplasia which proposes that the lining of abdomen known as peritoneum is capable of turning into endometriotic lesions.

– So, friends, in next update of this series, we will discuss some more aspect of Endometriosis.

-Keep a watch on this space as next update will arrive soon

By

Dr Himani Gupta

Gynaecologist & Obstetrician

Director-My Gynaec World

Official Head Quarter

Mother ‘n’ Care Clinic

Row House F 44/32

First Floor

Near Shivaji Chowk

Sector 12-Kharghar, Navi Mumbai

Ph  +91-7506027299

+91- 9820193283

Ectopic Pregnancy-a Devastating Outcome of Pregnancy,Update-24.2.19,Why it happens

Ectopic Pregnancy-a Devastating Outcome of Pregnancy,Update-24.2.19,Why it happens

Hello friends,

-As promised, we are back with more discussion on Ectopic pregnancy.

-Today, we will discuss various risk factors which are responsible for increased incidence of ectopic pregnancies.

-More people are suffering from sexually transmitted diseases which may lead to damage of the Fallopian tubes.

– This on one hand can cause infertility and on other hand ectopic pregnancy.

-If a surgery is done on Fallopian tube, either to correct its pathology or to reverse permanent family planning operation, it will leave the tube more prone for developing ectopic pregnancy.

– Women who become pregnant in later years of life or who require assisted reproductive techniques like IUI or IVF etc are at increased risk of developing ectopic pregnancy.

-Family planning methods like copper-T and permanent operation of female, when they fail, they lead to increased risk of ectopic pregnancy.

– So, friends, in next update of this series, we will discuss some more aspect of Ectopic Pregnancy.

-Keep a watch on this space as next update will arrive soon

By

Dr Himani Gupta

Gynaecologist & Obstetrician

Director-My Gynaec World

Official Head Quarter

Mother ‘n’ Care Clinic

Row House F 44/32

First Floor

Near Shivaji Chowk

Sector 12-Kharghar, Navi Mumbai

Ph  +91-7506027299

+91- 9820193283

Cervical Cancer-Most Common Gynecological Cancer- Update-24.2.19,Population and Age Dynamics

Cervical Cancer-Most Common Gynecological Cancer- Update-2.2.19,Population and Age Dynamics

Hello friends,
-As promised, we are back with more discussion on Cervical Cancer.

-Today, we will discuss incidence of cervical cancer i.e. the rate at which it occurs in population.

-Cervical cancer is common worldwide. Higher incidence is found in developing countries & contribute 85% of reported cases annually.

-Developed countries have much less incidence of cervical cancer owing to cervical cancer screening programs like Pap’s smear and availability and affordability of cervical cancer vaccine.

– The age at which cervical cancer develops is in general earlier than that of other gynecologic conditions and the median age at diagnosis is 48 years.

– So, friends, in next update of this series, we will discuss some more aspect of Cervical Cancer.

-Keep a watch on this space as next update will arrive soon

By

Dr Himani Gupta

Gynaecologist & Obstetrician

Director-My Gynaec World

Official Head Quarter

Mother ‘n’ Care Clinic

Row House F 44/32

First Floor

Near Shivaji Chowk

Sector 12-Kharghar, Navi Mumbai

Ph  +91-7506027299

+91- 9820193283

Abnormal Uterine Bleeding-Definitions, Update Article-24.2.19

Abnormal Uterine Bleeding-Definitions, Update Article-24.2.19

Hello friends,

As promised, we will continue our discussion on Abnormal Uterine Bleeding & will discuss a few definitions today.

-Menorrhagia is defined as prolonged or heavy cyclic menstruation with menses lasting for more than 7 days & blood loss exceeding more than 80 ml.

-Metrorrhagia or intermenstrual bleeding is also commonly referred to as breakthrough bleeding

-Frequently women complain of both patterns menorrhagia as well as metrorrhagia.

-Hypomenorrhea is defined as diminished flow or shortening of menses.

-Normal menstruation typically occurs every 28 days  7 days.

-Cycles with interval longer than 35 days are described as Oligomenorrhoea.

-Withdrawal bleeding refers to predictable bleeding that results from an abrupt decline in progesterone levels.

– So friends , in next update of this series will discuss in detail about some other aspect of this topic.

By

Dr Himani Gupta

Gynaecologist & Obstetrician

Director-My Gynaec World

Official Head Quarter

Mother ‘n’ Care Clinic

Row House F 44/32

First Floor

Near Shivaji Chowk

Sector 12-Kharghar, Navi Mumbai

Ph  +91-7506027299

+91- 9820193283

Endometriosis-a Medical Dilemma in Women

18.12.18

Hello friends,

As this topic ‘Endometriosis-A Medical Dilemma’ is a vast topic and we want to bring understanding to this topic in as simple a language as possible such that it can be easily understood by everyone,we are starting an article series.

The introductory article will give you a glimpse about how will we go about it.

Let’s start

-Endometriosis is a common benign gynecologic disorder defined as the presence of endometrial glands and stroma outside of the normal location.

– The word endometrium means- inner lining of the uterus which gets shed every month during menstruation.

– Endometriosis gives rise to variety of symptoms in women of chiefly reproductive age group.

– In simple language we will explain the causes of endometriosis, its hormone dependence and role of the immune system.

– We will discuss   risk factors of endometriosis.

– We will discuss its classification system and anatomic sites where it is present.

– Patient may present with pain of various origins, infertility of various degrees and in advanced cases- intestinal and ureteral obstruction.

– In diagnosis of endometriosis, we will discuss physical examination, lab testing, role of sonography, CT scan, MRI, importance of diagnostic laparoscopy and histopathologic analysis.

– Treatment of endometriosis depends on many factors like severity of symptoms, location of endometriotic lesions and desire to conserve future fertility.

– Medical management of endometriosis requires giving non-steroidal anti-inflammatory drugs, hormones, GnRH agonists and GnRH antagonists.

– The route of surgical treatment can be either laparoscopy or laparotomy. it can include lesion removal and adhesiolysis, endometrioma resection and hysterectomy with bilateral salpingo-oophorectomy-

So, friends you do get an idea of what all things we will cover under this topic ‘Endometriosis’.

-In next update of article of this series we will take one of the above listed  topics and bring more clarity on that

-Keep a watch on this article itself as a dated update will arrive soon

Ectopic Pregnancy-a Devastating Outcome of Pregnancy

18.12.18

Hello friends,

As this topic ‘Ectopic Pregnancy’ is a vast topic and we want to bring understanding to this topic in as simple a language as possible such that it can be easily understood by everyone,we are starting an article series.

The introductory article will give you a glimpse about how will we go about it.

Let’s start

-An ectopic or extra uterine pregnancy is one in which the blastocyst implants anywhere other than the endometrial lining of the uterine cavity.

-We will discuss the factors that will help in explaining the increased incidence of ectopic pregnancy.

-There are consequences of ectopic pregnancy like tubal rupture and tubal damage which are associated with maternal morbidity and in rare cases with mortality too. We will have a discussion on that.

-We will discuss clinical symptoms and signs of ectopic pregnancy.

-Certain blood tests and sonography or ultrasound aid in arriving at a diagnosis. We will have discussion on these findings.

-Ectopic pregnancy can be managed either medically or surgically.

-There are certain criteria to be met during medical management, we will discuss that.

-Surgical treatment is either by laparotomy or laparoscopy.

-Surgery done is either salpingectomy or salpingostomy.

-So, friends you do get an idea of what all things we will cover under this topic ‘Ectopic Pregnancy’

-In next update of article of this series we will take one of the above listed  topics and bring more clarity on that-Keep a watch on this article itself as a dated update will arrive soon.

 

Abnormal Uterine Bleeding in Women

 

18.12,18

Hello friends,

As this topic  ‘Abnormal Uterine Bleeding in Women’ is a vast topic and we want to bring understanding to this topic in as simple a language as possible such that it can be easily understood by everyone, we are starting an article series. The introductory article will give you a glimpse of how will we go about it.

Let’s start

We will first discuss the definitions and the terms used to describe abnormal uterine bleeding like menorrhagia, metrorrhagia and oligomenorrhea.

We will discuss normal cycle duration and interval.

The incidence of abnormal uterine bleeding and the most common reasons that are there in childhood, adolescence, reproductive age, perimenopause and menopause age group will be discussed.

We will also talk about other symptoms of AUB like post-coital bleeding and pelvic pain.

Diagnosis is done by physical examination of the patient, lab investigations include blood tests and cytologic examination.

Endometrial biopsy, sonography, colour Doppler and hysteroscopy are also done to arrive at a diagnosis.

Management options depend on the cause of the problem, like surgical treatment in cases of the endometrial and endocervical polyp.

Hormone-releasing intrauterine devices and oral tablets which can be hormonal or non-hormonal are used.

Other medicines like antifibrinolytic drugs, haemostatic agents and iron therapy are also used

So, friends, you do get an idea of what all things we will cover under this topic ‘Abnormal Uterine Bleeding in Women’ or AUB

In next update of the article of this series, we will take one of the above-listed topics and bring more clarity on that

Keep a watch on this article itself as a dated update will arrive soon.

 

 

 

Ruptured Ovarian Ectopic Pregnancy- A Rare & Real Life Threatening Case

Ruptured Ovarian Ectopic Pregnancy- A Rare & Real Life Threatening Case

-A 24 year old woman, resident of Kamothe (Panvel)- Sector 11, came to OPD for consultation for Abortion tablets, 

-She had a living female child of 2.5 years of age by normal delivery. ( G-2,P-1,L-1)

-She had missed her menses and her UPT- Urine Pregnancy Test was positive.

-She has been complaining of on & off menstrual like lower abdomen cramps, which on some moments were severe.

-But she did not start with menses.

-On examination- her lower abdomen was slightly distended.

– Pulse rate was 92/min and BP- 100/70 mm Hg

– As a routine test and precaution before giving abortion pills , Trans-Vaginal ultra sound was performed.

-The findings suggested intra-abdominal free fluid amounting to 700-800 ml

-There was G-Sac ( Gestational sac ) like structure near left ovary which was surrounded by a mass of tissue , which seemed to be attached to left ovary.

-Diagnosis of Ovarian ruptured ectopic pregnancy was suspected as there was a breach in the outer lining of ovary too and adnexal mass was lying just close to that, along with echogenic mass lesion in the ovary (Trophoblastic Tissue).

– She was immediately posted for Laparoscopy by Dr Santosh Jaybhaye , Om Sai Hospital, Kamothe.

– On putting the scope, the first finding that we noted was Haemoperitoneum ( Blood in peritoneal cavity)

– Upon suctioning and cleaning it up, it was then possible to locate ruptured Left ovarian ruptured ectopic pregnancy.

– Mass lesion was resected ( surgically cut ) and Haemostasis ( There is no longer bleeding ) was achieved.

– She required one unit of packed cells blood transfusion intra-operatively and her recovery post operatively was uneventful.

-Following routine safety protocols, timely intervention and availability of blood products saved the life of the woman

-You Can watch the video too by clicking on the following link-