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असली लोग असली अनुभव- गर्भ में पानी कम होना और बच्चे की जान को खतरा-Oligohydramnios & It’s Complications

असली लोग असली अनुभव- गर्भ में पानी कम होना और बच्चे की जान को खतरा-Oligohydramnios & It’s Complications

एक 24 वर्षीया विवाहित औरत ,कलंबोली ,न्यू पनवेल की निवासी हमारे एक डॉक्टर के पास पिछले 9 महीने से अपनी पहली प्रेगनेंसी का इलाज कर रही थी।

उसकी डिलीवरी की तारीख भी नज़दीक ही थी।

नौवें महीने में हम एक सोनोग्राफी कर के बच्चे की सेहत के बारे में जानकारी करते हैं।

उसकी भी यह सोनोग्राफी की गई।

पर कुछ बात ऐसी सामने आई की एक नार्मल चलता हुआ केस तुरंत ही इमरजेंसी केस में बदल गया।

गर्भ में बच्चे के आस पास का जो पानी होता है वह बिलकुल ही सूख गया था।

सामान्यतः जो मात्रा 8 -10 सेंटीमीटर होती है ,वह घट कर सिर्फ 3 रह गयी थी।

यह चिंताजनक बात है क्योंकि वह पानी एक सुरक्षा कवच का काम करता है।

जब प्रसव का दर्द होता है तो यह पानी आँवल नाल को दबने से बचाता है और अजन्मे बच्चे को ऑक्सीजन मिलना जारी रहता है।

इस केस में हमें तुरंत सीज़ेरियन डिलीवरी का निर्णय लेना पड़ा ताकि आंवल नाल दबने के भयंकर परिणाम ना सामने आएं।

एक सुन्दर बेटी के जन्म से माँ और पिता दोनों ही बहुत खुश हो गए।

To know more log on to my website-

www.mygynaecworld.com

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


Email-mygynaecworld@gmail.com


List of our attachment hospitals-


Motherhood Hospital,Utasav Chowk, Plot -No-5, Sector -7, Kharghar, Navi`Mumbai


Kharghar Medicity Hospital,Aum Sai CHS, Plot NO – C/23 Sector 7, Kharghar, Navi Mumbai

Sanjeevan Hospital,Plot No. F/14, Opp. State Bank of Hyderabad,Sector-12, Kharghar,Navi Mumbai

Om Navjeevan Hospital,Plot No.2, Sector-21. Kharghar, Navi Mumbai



People from following locations of Navi Mumbai and Raigad can approach us for Gynaecology related advise

-Kharghar,Kamothe,Kalamboli,Panvel,Road Pali,CBD Belapur,Seawoods,Nerul,Vashi, Sanpada, Juinagar, Khanda Colony, Taloja

असली लोग असली अनुभव – क्या औरतों के कैरियर की कोई महत्ता नहीं

असली लोग असली अनुभव – क्या औरतों के कैरियर की कोई महत्ता नहीं 

एक 24 वर्षीया विवाहित कामकाजी  युवती जो रोड पाली पनवेल ,नवी मुंबई की निवासी थी ,  हमारे एक डॉक्टर से  सलाह लेने आई।

उसको गर्भ ठहर गया था और अभी ज़्यादा समय भी नहीं हुआ था।

गर्भपात की गोलियां उसपर असर कर सकती थीं।

पर पति तो साथ नहीं थे।

पूछने पर बताया की उन्होंने कलकत्ता शहर ट्रान्सफर लिया हुआ है क्योंकि उनकी कम्पनी ने उन्हें प्रमोशन दिया।

ये लो ! पत्नी के साथ रहना छोड़ दो प्रमोशन नहीं।

अब पत्नी का भी प्रमोशन होने वाला है पर गर्भधारण की अवस्था में वह उसे हाँ नहीं कह सकती।

उसे भी अपना कैरियर बहुत प्यारा है।

पर पति क्या और माँ बाप क्या सब उसे हैरान कर रहे हैं और प्रमोशन छोड़ सिर्फ गर्भ /बच्चा पैदा करने और माँ बनने की ही सलाह दे रहें हैं और मजबूर भी कर रहें हैं।

ये सही बात नहीं है – पति का कैरियर सब कुछ और पत्नी का कुछ नहीं।

उसकी बात भी नहीं सुनी जा रही।

उसके मानसिक तनाव का प्रेगनेंसी पर भी असर पड़  सकता है।

असली लोग असली अनुभव – क्या लोग लड़की भी पैदा करना चाहते हैं

असली लोग असली अनुभव – क्या लोग लड़की भी पैदा करना चाहते हैं 

एक कामोठे ,पनवेल की निवासी 32 वर्षीया औरत की कुछ दिनों पहले हमारे एक डॉक्टर के पास cesarean-(सीज़र ) डिलीवरी हो गयी और उसके यहां एक कन्या ने जन्म लिया।

उसको पहले एक लड़का है जो 9  वर्ष का है.

उसकी ख़ुशी का ठिकाना ना रहा  और उसके घर के लोग भी अत्यधिक खुश थे।

पूछने पर उन्होंने बताया की उस परिवार की तीन पुश्तों में कोई लड़की नहीं जन्मी थी।

दादा भी चार भाई।

पिता भी तीन भाई।

और इन तीनों भाइयों के पास भी बस लड़के ही लड़के।

काफी आश्चर्यजनक पर सत्य।

इस कन्या को कितना लाड- प्यार मिल रहा है और कितना आगे मिलेगा ,इसकी हम कल्पना भी नहीं कर सकते।

असली लोग -असली अनुभव – कम उम्र कामकाजी युवतियां और भयंकर मोटापा

असली लोग -असली अनुभव – कम उम्र कामकाजी युवतियां और भयंकर मोटापा 

 

खारघर, नवी मुंबई  निवासी एक अत्यधिक मोटापे से ग्रस्त एक युवती के बारे में आज बात करेंगे।

हमारी दिन भर की OPD में आजकल यह समस्या बहुत सामने आ रही है।

कम उम्र में ही लड़कियाँ अपनी पढ़ाई पूरी कर किसी दूसरे और बड़े  शहर में आ कर नौकरी करने लग जाती हैं।

रहने का ठिकाना अमूमन हॉस्टल होता है।

खाना पीना ज़्यादा करके बाहर।

वो भी तला भुना ,बर्गर ,पिज़्ज़ा ,वड़ा पाव जैसी चीज़ें।

काम का समय लम्बा ,दूरियाँ ऑफिस तक की ज़्यादा -नतीजा -अपनी सेहत पर देने को वक़्त ही नहीं।

कसरत -व्यायाम तो भूल ही जाओ।

वज़न तो बढ़ता ही जाता है।

साथ में आती हैं माहवारी से सम्बंधित समस्याएँ।

अभी कुछ ही दिन पहले की बात है , एक युवती का वज़न निकला -137 किलो।

उम्र लगभग 28 साल।

डॉक्टर्स भी हैरान और मरीज़ परेशान , करें तो क्या करें।

Real people -Real experiences- Fear of HIV in young sexually active adults with multiple partners

Real people -Real experiences- Fear of HIV in young sexually active adults with multiple partners 

A 24 year old male , resident of Kalamboli, New Panvel, a budding Physiotherapist ,son of a known patient was sent to us by that patient as she came to known that he has had unprotected sexual intercourse with his girl friend a couple of months back.

Why she was worried- as the son in question was not keeping well for sometime.

Contracting frequent bouts of Diarrhea and stomach upset over last few weeks.They could have been signs of early HIV-AIDS

Now the girlfriend also has changed, and he is worried that he may have transferred his infection to this new girlfriend.

To make the matters more entangled, this GF also comes with a history of having a boyfriend in the past.

Do you get the picture now.

Not only it is necessary that your current partner is disease free, also all the previous partners of current partner would need to be disease free for you to have safe sexual intercourse with this one.

What a whole lot of mess.

Stress on all levels- mental, physical, financial.

Lucky for both of them, upon testing, he is found to have no HIV

Real women- real experiences- Why do I want a second pregnancy

Real women- real experiences- Why do I want a second pregnancy

A 34 year old women, resident of CBD Belapur, sought consultation for early pregnancy.

She has had one living girl child of 9 years of age by Cesarean delivery for Breech presentation.

She is a working woman in Tourism sector.

Upon Ultrasound , this pregnancy was found to be of 8.5 weeks of duration/gestation age.

Her dilemma was whether she should keep this pregnancy.

She wanted a second child to keep company to her first one.

The question is does that really happen?

Are siblings really being a companion to each other in today’s time.

Her working profile more or less did not permit time for pregnancy care.

Leaving job in today’s job and financial scenario is not an option.

What she will decide finally , only time will tell.

Cervical Cancer Vaccination in Kharghar

http://cervicalcancervaccinationinkharghar.blogspot.in/

Reluctance to accept cervical cancer vaccine

This is our common experience that despite our detailed counselling of women who come to our OPD, the acceptance rate for vaccine is very low.

It may be related to high cost of vaccine, unawareness,denial that it could happen to me.

More campaigns need to be done to create awareness and acceptance.

 

 

SCREENING TESTS FOR GENETIC ABNORMALITIES IN IVF AND TWIN PREGNANCIES.

SCREENING TESTS FOR GENETIC ABNORMALITIES IN IVF AND TWIN PREGNANCIES.

Basis of Higher risk of genetic abnormalities in IVF Pregnancies: –

There is higher risk of having genetically abnormal fetus in IVF pregnancy as usually maternal age is advanced for IVF Pregnancy.

Formation of ova for the mother to be, happens for her when she herself was in her mother’s womb.

So, the age of ova in years is equivalent to her own in years while the age of sperm is only 90-120 days.

Precaution before starting testing:-

We must know that in this pregnancy, the ova (egg) used, was it hers or donor’s. All the calculations should be according to that. This rule is called “Risk Priori”.

How to determine Gestation age accurately:-

  1. Measuring CRL (Crown Rump Length) at NT (Nuchal Translucency) scan, at 11-13 weeks.
  2. Early Sonography in which heart beat(Cardiac activity) is seen.
  3. IVF Fresh cycle- egg retrieval date is taken or ET MINUS (-) 14 Days which means date of Embryo Transfer-14 days.
  4. In IVF Frozen Embryo cycle – Date of embryo transfer Minus (-) 17 days is taken to arrive at LMP( Date of last menstrual period ) as embryo is at least 3-5 days old.

Sonography markers like- NT-Nuchal Translucency and NB – Nasal Bone are not affected by mode of conception whether it is spontaneous on IVF

NIPT- Non Invasive Prenatal Testing –is also not affected by mode of conception .In this technique fragments of fetal DNA are extracted from mother’s blood sample.

This fraction is multiplied and analysed for chromosomal anomalies.

It is very good screening test but it is not diagnostic.

-Limitation is that it does not pick up structural abnormalities.

WHY SCREENING FOR GENETIC ABNORMALITIES IN IVF PATIENTS IS COMPLICATED?

  1. Advanced maternal age in itself is a high risk factor.
  2. If patient has undergone ICSI-Intra Cytoplasmic Sperm Injection The procedure itself has inherent increased risk of genetic abnormalities.
  3. Multiple pregnancies like twins or triplets may make the matter more complex.
  4. If clinical situation is of vanishing twin with empty sac –Double marker (Bio chemical test) can be done if correction factor is applied. If vanishing twin has measurable CRL and dead fetus- only ultrasound should be done for genetic abnormalities.
  5. As it is a precious pregnancy, acceptance on patient’s part for screening and invasive test is low.

Double marker measures two hormones

  • PAPP-A (Placenta Associated Plasma Protein- A)
  • Beta HCG

In down syndrome, the findings of double marker are :-

PAPP-A- Reduced

Beta HCG – High

IVF Pregnancies also show similar pattern-

The reasons are:

In IVF we use hyper stimulation protocols which results in some hormonal change like

Increased Inhibit A Level,

Decreased IGF- (Insulin like growth factors)

Increased Beta HCG Levels.

Because of interplay of these hormones even if pregnancy is normal, the values of PAPPA and HCG may mimic that of down’s syndrome.

To avoid that, a correction factor is applied while calculating value of double marker for an IVF Pregnancy.

In Twin Pregnancy there may be masking effect of abnormal twin hence double marker is not a good screening test for twins.

 

Genetic Sonogram (Ultrasound)- This mode of testing is not affected by type of conception whether it is a normal spontaneous conception or an IVF pregnancy.

TAKE HOME MESSEGE FOR SCREENING TESTS FOR TWINS :-

  • Chorionicity – whether there are two placental or one,should be determined by ultrasound.
  • NT, NB Scan along with DV-Ductus Venosus and TR-Tricuspid Regurgitation
  • NIPT may be done.

TAKE HOME MESSAGE FOR SCREENING TESTS FOR IVF PREGNANCY ARE: –

  • NT,NB along with DV,TR
  • NIPT

 

Double marker should be sent to only those labs that have sophisticated algorithms for correction factor for

-Type of conception

-Donor age

-Frozen or Fresh cycle

-Multiple pregnancies

-Chorionicity

 

 

Stress In PCOS and its Effects on Fertility Potential

 

Stress In PCOS and its Effects on Fertility Potential.

PCOS (Polycystic Ovarian Syndrome) or PCOD (Polycystic ovarian disorder) is a clinical situation of hormonal imbalance in young women of reproductive age group.

Its primary clinical presentation is menstrual irregularity and non- ovulation.

PCOS in general and its effect on ovulation can impair fertility.

Let us look at how stress in PCOS affects fertility.

Why PCOS causes Stress?

– Obesity

– Acne

– Hirsutism

– Difficulty in conceiving

– Constant reminder from doctor and relatives for lifestyle modifications

– Inability to find time and energy for exercising

– Food habits- very difficult to change and adapt

How does Stress Affect Fertility?

PCOS-

Chronic Stress Of Anovulation And Irregular Menses

Associated Factors:-

– Job

– Timings

– Family Support

– Junk Food

Leads to Release of Stress related hormones:-

– Adrenaline

– Catecholamines

– Corticosteroids

Inhibits release of Gonadotrophins hormones from Pituitary gland-

Leads to less secretion of sex hormones

Further Leads to:-

– Anovulation

– Less ovulation

– Poor Quality Ova

Associated Factors:-

– Poor Libido

WAYS TO OVERCOME STRESS:-

Exercise

For eg:

-Walking

-Jogging

-Swimming

Joyful Activities

Like- Dancing,

-Singing

-Art and Craft creativities

– Yoga

– Meditation

– Holiday

– Acupressure

– Foot reflexology

– Spa and Massage

– Subconscious Mind Training

– Visualization Techniques

– Attitude of Gratitude

– Break from Therapy for a few months

– Psychotherapy

– Pharmacotherapy –medicinal support

WILL REDUCED STRESS IMPROVE FERTILITY POTENTIAL?

– It is Scientifically proven fact that women who are relaxed and calm during the fertility treatment period stand higher chance of successful outcome.

CONCLUSION:-

– A mind full of positive energy will aid body in healing faster

THANK YOU

www.mygynaecworld.com