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Cervical Insufficiency & Cerclage- A Reason For Mid Term Pregnancy Loss & It’s Treatment

Cervical Insufficiency & Cerclage- A Reason For Mid Term Pregnancy Loss & It’s Treatment

-Cervix is the lower part of the uterus which opens in the vagina.
-During the entire duration of 9 months of normal pregnancy it stays closed and when labour pains start it opens up and dilates and let the baby be born.
-You can say say that it is like a closed door .When fetus in uterus is increasing in size and weight , it is very important that this door stays closed else, baby will be born prematurely.
Cervical insufficiency is a distinct clinical entity
It is characterized by painless cervical dilatation in second trimester of pregnancy ( 13-28 weeks of pregnancy ). It is also associated with decreased length of cervix- Short Cervix
It results in prolapse (bulging out ) and ballooning of membranes around fetus (Amniotic Sac/Amniotic Membranes-these membranes make a sac around fetus and protect the pregnancy ) into vagina and ultimately expulsion of an immature fetus.

Unless effectively treated this sequence of events may get repeated in subsequent pregnancies.

1) Ultrasonography- Inadequate Cervical length is an indicator along with funneling of cervix which is ballooning of membranes into the dilated internal os but with a closed external os.
2) Clinical internal examination by the Gynaecologist

Risk Factors
Previous cervical trauma caused by surgeries like
-D & C- Dilatation & Curettage
-Conization- Removal of a diseased tissue of cervix in manner of a cone
-Cauterization- Electric current application to cervical tissue for purpose burning the diseased tissue and stimulate generation of new and healthy tissue
-Amputation- Removal of protruding part of cervix
-Abnormal cervical development

Precautions before treatment of Cervical Incompetence
– Ultrasound is done to check for fetal well being.
-Sexual intercourse is prohibited one week before and after the surgery.

Contraindications to treatment
-Bleeding from vagina
-Uterine contractions and pain
-Rupture of bag of membranes- leaking of fluid

Treatment of Cervical Incompetence
Classic Cervical Incompetence is treated surgically with ‘Cerclage ‘ operation which reinforces a weak cervix by a purse string suture ( Stitching of mouth of uterus). The suture material used is strong, thick and non absorbent. These sutures will now provide strength to the cervix to stay closed even though the weight of the fetus will keep on increasing.
This procedure is done as prophylaxis ( prevention ).
At times ‘Rescue Cerclage’ is needed as patient presents with symptoms in emergency.
This suture is removed at a selected date when the pregnancy has attained a mature state and the newborn will be healthy.
At times the suture needs to be removed in emergency if the patient goes in labour prematurely.


When to do the Cervical Cerclage Surgery
-Most medical text books recommend surgery at 12-14 weeks of gestation- A sonography at this stage will rule out majority of congenital malformations ( Birth Defects )
-If there is previous loss of pregnancy, surgery should be done a couple of weeks prior to gestation age( pregnancy duration) at which the loss occurred.
– If pregnancy is at a later stage- there is risk that Cervical Cerclage operation might induce contractions of the uterus and in turn will lead to loss of pregnancy .

Success of Cerclage surgery
Many medical studies have been conducted and it is found out that the success of this surgery is unpredictable.

Many Gynaecologists will opt for alternative method of managing patients with cervical incompetence- like bed rest, abstinence, Progesterone hormone support , Tocolytics ( Uterine relaxants medicines)

After a thorough counselling of patient and relatives, a treatment option is chosen for that particular woman.The pros and cons of doing the surgery vs conservative approach is discussed.

Name of Cervical Cerclage Surgery
McDonald Cervical Cerclage ( Most commonly done surgery )

Procedure-How it is done
After giving anaesthesia , patient is put in lithotomy position ( Legs spread and supported, patients buttocks reaching the edge of the operation table )

It is a trans vaginal procedure
With the help of instruments ( Sim’s Speculum)- Cervix is exposed.
With the help of non traumatic instruments ( Sponge holder/ Ring forceps )- Cervix is held
Non-Traumatic needle ( Round body ) is used along with non absorbent , thick suture ( Thread ) and purse string sutures are placed as high as possible on Cervix.


Uterine contractions
Rupture of membranes

To summarize- Cervical Incompetence is one of the causes of recurrent pregnancy loss. Timely treatment may reduce further losses. It is very important that Gynaecologist and patient have a detailed conversation . Then only treatment protocol should be decided.

Hysteroscopic Myomectomy

Hysteroscopic Myomectomy -A Novel Approach to Removing Fibroids of Uterus


In a case of uterine fibroids and in that too particularly intramural fibroids, alternative conservative surgeries are now available to suitable patients vs more radical operation of uterus removal- Hysterectomy

Dr Santosh Jaybhaye is an expert Gynaecologist of Kamothe, Panvel has performed this surgery of removing fibroids through Hysteroscopy. This surgery is an attempt to prevent surgery of removal of Uterus ( Hysterectomy ) in a patient who complains of irregular menstrual periods.
Admin- My Gynaec World
Dr Himani Gupta

Adverse Effects Of High BP on Pregnant Woman And The Newborn

Adverse Effects Of High BP on Pregnant Woman And The newborn



-High blood pressure –BP ( PIH- Pregnancy Induced Hypertension)s  affects  the health of both pregnant  mother and the unborn child adversely.

-Medical management like medicines, rest, hospitalization and regular visit to the Gynaecologist will  help in controlling PIH- pregnancy related high BP in most of the cases.

-This article will provide an insight into the complications that are associated with this clinical condition     which happen if medical advice is not followed and hypertension becomes uncontrolled.

-One needs to understand that in severe disease, unfortunately complications occur in spite of best and regular medical treatment of PIH- Pregnancy Induced Hypertension.

-Another pointer to understand is that in any one particular patient only one of the following or a  combination of the complications may be present.

The topic is written in easy language and terminology is such that the information provided will be useful to a large number of people. However medical terminology is inseparable part of this article. To make understanding simpler (  ) are used for medical terminology


The organs and systems get affected in many ways


 Swelling of the brain( Cerebral edema)

Clinically the symptoms are

-Headache- which will not get OK by taking painkiller tablets



-Blurred vision

In late stages


-Fits(Eclampsia)- This is a dangerous clinical situation. It may be associated with significant brain injury and dysfunction.

Changes in brain at structural level include bleeding (Hemorrhage), Blockage of blood supply (Infarction), Decreased blood flow (Ischemia), shrinkage of blood vessels (Vasospasm)

These patients are prone to sudden increase in BP which may worsen their condition further

Investigations like CT Scan or MRI will show following features

-Swelling (Edema) of the brain

-Fluid channels of brain get blocked (Obliteration of central ventricles)

-Brain matter will come out( herniate)   through its coverings-life threatening (Transtentorial herniation)


Woman will complain of

-Seeing black spots before eyes (Scotomata)

-Seeing things as double (Diplopia)

Blindness– in most cases it will last for 4 hours to up to 8 days. It is reversible. The dysfunction occurs in brain where centre for vision lies.

In some cases partial or total blindness persists.

Eyeball changes

-Inner lining of eyeball gets disrupted (Retinal detachment)-one more reason of blindness

-Blood supply to eyeball is stopped  retinal artery occlusion)- causes permanent blindness


 -There may be bleeding inside the liver (Periportal haemorrhage)

-Blood may collect below its capsule( Subcapsular hematoma)

-There may be rupture of liver with dire consequences

Clinically patient presents as

-Pain in upper abdomen

Blood investigation for liver function will reveal raised liver enzymes ( SGOT,SGPT)

Liver complications are associated with higher death rate of pregnant woman (maternal mortality)

In rare cases liver transplantation only will save the life of the woman

HELLP syndrome is associated with liver disorders (Hepatocellular necrosis)

H (Hemolysis) EL ( Elevated Liver enzymes) ,LP (Low Platelets count)

Patient suffering from this complication will require intensive care and may have prolonged recovery time


 -Blood supply to the kidneys ( Renal perfusion ) and its filtration process , both are reduced

-Factors like  blood loss, redirection of the blood to more vital organs like brain, increased blood pressure leading to widespread contraction of blood vessels ( Vasospasm) are responsible for it.

-On microscopic level basic functional units of kidney like Glomeruli and Tubules are damaged.

Kidneys secrete many harmful substances of body through urine. Consequences of decreased kidney functions are many –

-Urine output is decreased

-Blood levels of Creatinine, Uric acid and Calcium rise

The accumulated toxic substances in blood will eventually affect the mental status of the patient and she will appear dull and lethargic


Decreased platelet count (Thrombocytopenia-Platelet is a component of blood)

-The normal platelet count is 1.5-4-5 Lakh / ml.

-Platelets play a very important role in stopping the flow of blood at the site of injury or bleeding.

-During delivery or Caesarean section the amount of bleeding is more if platelet count is less and it puts the life of mother in danger.

-If serial monitoring of blood shows decreasing trend of platelet count, it becomes an indication for delivery

-After delivery recovery of platelets will take 2-5 days

Destruction of blood (Hemolysis)

 -In high BP pregnant  patients the lining of small blood vessels gets damaged.

-Platelets and fibrin (blood component) get deposited on these sites to seal these sites.

-Blood corpuscles get damaged while passing through these vessels.

-Destruction of blood will lead to fall in Hemoglobin level (Anemia)

-Microscopic slide examination of blood will show abnormal Red Blood Corpuscles (RBC) like (Schizocytosis,Spherocytosis,Reticulocytosis).

Blood clotting (Coagulation) changes

-There is widespread blood clotting and blood destruction happening at multi-organ level in these patients.

-As a result blood levels of clotting factors are deranged .

-The tests which are abnormal include- PT- Prothronbin Time, PTT-Partial Thromboplastin Time,Fibronectin, D-Dimers, Factor VIII, Fibrinogen etc


Heart is made up of two types of chambers

  • Contractile chambers to push blood out into the system-Ventricles –They are two in numbers, left and right
  • Receptive chambers to receive blood from the system- Atrium- They are also two in numbers, left and right

When BP is high the ventricles will need to work against more resistance. As a result their muscle mass increases (Ventricular hypertrophy). Their lumen gets diminished in size. The final result is that fluid accumulates in lungs( Pulmonary Edema)-leading to difficulty in breathing( Respiratory distress). It also results in accumulation of fluid in the body (Edema)

There are other factors too which will lead to accumulation of fluid in the lungs like injury to the lining of breathing units (Alveoli)


There may be accumulation of fluid in lungs (Pulmonary edema)

Patient may have difficulty in breathing and at times may require ventilator support ( ARDS-Acute Respiratory Distress Syndrome)


Uterus-Placenta unit’s blood supply

(Utero-placental perfusion)

-Uterine artery is the main blood vessel supplying uterus and in turn to placenta and growing baby(fetus)

-In normal pregnancy the uterus and placenta allow uterine artery to supply extra blood to it for healthy growth of baby (fetus)

-In cases of high BP, both uterus and placenta will resist this extra supply, resulting in less blood available to baby (utero-placental insufficiency) which will lead to low birth weight of newborn (IUGR- Intra Uterine Growth Retardation)

-At times water around baby also becomes less (Oligohydramnios)

-This compromised placenta sometimes separates from its attachment to uterus prematurely, even when patient is not in labor (Abruptio Placentae). This will lead to bleeding (Ante Partum Hemorrhage) putting life of both mother and baby in danger (Maternal mortality and IUFD-Intra Uterine Fetal Death)

Preterm birth– at times it becomes necessary to deliver the pregnant woman even before her 9 months are not complete. This kind of decision is taken if all the medical management including tablets to control the BP, rest at home or even hospitalizations are failing to control the high BP of pregnancy (PIH-Pregnancy Induced Hypertension )

Note From Author:

Expert and timely medical care and patient’s compliance towards taking medicines and regular check up with prescribed investigations has improved the outlook  in most of the cases . In urban settings  where the facility for ICU- Intensive Care Unit,NICU-Neonatal Intensive Care Unit for the newborn and blood banks are available, both mother and child have a good outcome.

Rural areas which are yet to have these facilities have a scope for improvement towards ‘Healthy Mother-Healthy Child’ initiative




5 Reasons – Why Your Wife May Seem Cranky During Pregnancy and Why You Should Just Smile

5 Reasons – Why Your Wife May Seem Cranky During Pregnancy and Why You Should Just Smile


The fact that you’re here means you have been through or are currently in a similar situation. During pregnancy, your partner will change, as I’m sure most of you have already noticed by now. Coming home from work and opening that main door has become a game of potluck, you do not know what’s on the other side of it. And I’m sure you have heard this from a lot of people but here it is- it’s not her fault, it’s the hormones!

Hormones are chemicals our glands secrete into our body that get to control things, all kinds of things. When a woman becomes pregnant, these hormones go into hyper drive to create the perfect environment for the baby. And while they are at it, they also cause the following changes-


  1. Nausea and vomiting
    This is the earliest symptom of pregnancy. Hormonal changes of pregnancy are again responsible for it. It usually subsides by the 4th month. At times it may be prolonged due to which women will require to take medicines for many months.
    Word to the Husband
    Remember the last time you had to take an antacid as you were having nausea and vomiting as a result of eating outside? Now imagine your wife having the same feeling for a period of 2-3 months.
  2. Pain
    ‘No pain, no gain.’  This age old saying is absolutely true for pregnancy. Whether delivery is normal or Cesarean some amount of pain will be experienced even with our newest medicines. She needs to undergo repeated blood tests, gynecological check ups, and has to get numerous vaccinations.
    Word to the Husband
    How many of us keep postponing health check ups, dental treatment for fear of pain?
  3. Change in Eating and Sleeping Habits
    When a woman gets married, she may enter a new realm of eating and cultural habits. What is eaten, the way it is cooked, eating time table, all may be entirely different from what she is used to since her birth. Add to that the increasing demands of pregnancy. She may experience craving for odd food items at times. Her sleeping habits may also change. Increasing abdominal girth makes it difficult for her to adopt a comfortable posture. Baby movements may keep her awake or wake her up frequently during sleep.
    All these things will overwhelm her.
    Word to the Husband
    You can start by acknowledging the fact that she still keeps smiling despite all these changes. Get her one meal per day of her choice. The way she has always liked and share it with her. Make sure you do whatever you can to get her comfortable when she wants to sleep.
  4. Weight gain
    As pregnancy advances she is bound to gain weight. Growing fetus, placenta, uterus and many other factors are responsible for this. During each doctor visit, first thing that will be asked of her ‘Have you gained weight?’ Healthy weight gain is necessary for a healthy pregnancy. Then again it comes with its own discomforts. Feeling of bloating, backache, swelling in legs, all are part of the package. Even after delivery, returning to pre-pregnancy weight may not be easily achievable for many women.
    Word to the Husband
    Empathy, sympathy and understanding will work for you. Accept the changes in her and help her do the same.


  1. Pregnancy Marks
    Pregnancy is going to leave its tell tale signs behind. Things like loss of hair will recover, pigmentation on face will also disappear with time and treatment. But stretch marks is the main concern. With our newer skin treatments it is possible that they appear less and can be made to go away to a certain extent. But even for a short period, her appearance and way of dressing may change.
    Word to the Husband
    Inner beauty and qualities of a person matter most in journey with your life partner. Tell her that she is the most beautiful woman that has walked in to your life at every opportunity that you get.

Put all this together & you’ve got someone who needs your help & support, however difficult it might be for you at times. So you’ll have to bite your lip, do a lot of agreeing & apologising, and keep telling yourself that she’s literally out of control. This is a hard time for her too. Things will get less confusing once you slowly learn to gauge her mood. Remember to always ask her what she needs.

Talk to her. Be with her. Support and love her.


3 Simple Ways to Avoid Unwanted Pregnancy

Unwanted pregnancy

1) Use protection
-Prevention is always better than cure
-Indian social scenario is changing
-Pre- marital, extra-marital and living in relationships are on a rise.
-At times these relationships are casual and will lead to unwanted pregnancy
-At the end of it,  it is the female’s body which will bear the brunt of physical discomfort of abortion
-There are many myths in people’s minds regarding use of regular contraceptive methods like oral contraceptive pills, condoms or Copper -T
-Whether a couple is married or unmarried when these regular contraceptive methods are used, unwanted pregnancy can be avoided.
-A consultation with the Gynaecologist for check up and to understand their correct use is a must and will allay your anxieties and concerns

A word of caution here about Emergency Contraceptive Pill
-It is clear that these pills are for emergency situations
-Couples in steady relationship should adopt regular contraceptive method
-These emergency pills have very high content of hormones
-Using them can make your next menses irregular,  delayed and heavy
-They should be taken ONLY on advise of a Gynaecologist

2) Be alert – For early diagnosis of unwanted pregnancy
-As soon as you have missed your periods, check yourself for pregnancy
-Easiest method is to do a urine pregnancy test done at home in a kit easily available at Chemist.
-The instructions to do the tests are also clearly written on packet
-Advanced tests for diagnosis of pregnancy can be done on your Gynaecologist ‘s advice like a test in blood known as Serum Beta HCG and sonography

3) Timely treatment – See a Gynaecologist at earliest
-When we talk about unwanted pregnancy, it is clear that couple wants termination.
-Government of India has made guidelines to offer safe abortion to all who seek it, regardless of marital status
-There are two ways of undergoing abortion
A) Surgical D&C
-This is traditional way and will require a day time hospitalization.
-If done in Govt approved MTP ( Medical Termination of Pregnancy)  center,  it is safe
B) Abortion by pills
-If clinical situation is of early pregnancy and within the limit set by Govt of India,  oral abortion pills can be taken on advise of a Gynaecologist
-There are no risks of anesthesia and surgical instrumentation in this method and no hospitalization is required

6 Steps for Healthy Recovery after Hysterectomy


1) Eat healthy
– Simple wholesome home cooked food should be eaten .
– Avoid fried , spicy , fatty and outside food .
– Take plenty of oral liquids.

2) Rest at home
– Resting will lead to peace of body & mind .
-Operative area will heal faster

3) Take medicines on time
– Antibiotics will prevent infection
– Iron & vitamin tablets will improve your general well being

4)Go slow on work and exercise
-Work should be resumed gradually.
-Heavy work is to be avoided for at least six weeks
-Breathing exercises & Praanayam is good and wil improve oxygenation of blood.
-Walking can be started next and later on other exercises can be done

5)Delay having intercourse
-Intercourse can be resumed after six weeks.
-Visit to your gynecologist and check up to know if healing is complete is necessary

6) Visit your doctor on time
-Keep in touch with your doctor, consult and get yourself checked as per schedule.
-This will keep a tab on your recovery,  diagnose any complication at earliest for timely treatment.

Complications of D & C ( Dilatation & Curettage )

Complications of D & C ( Dilatation & Curettage )

-D & C is a very common gynaecological procedure to manage menstrual problems, to offer surgical abortion ( MTP- Medical termination of pregnancy ) & as a part of infertility work up -Every procedure has its inherent risks and complications-These complications can be minimized by using advanced technology like Hysteroscopy and Ultrasonud assisted procedures, use of good antibiotics and use of newer medications for cervical dilatation.

– Lower abdominal, menstrual like cramping is expected for a couple of days after procedure
– Normal pain killers are adequate to manage

-Vaginal bleeding to some extent is expected.
-If quantity is more or duration is prolonged it is abnormal
-Management requires ultrasound for diagnosis & repeat D & C

– May occur of uterus and other pelvic organs
-It presents as pain abdomen , fever and foul smelling discharge from vagina
-Management require course of antibiotics

 Injury to cervix
-Access to uterine cavity for the purpose of procedure is gained by dilatation of cervix ( mouth of uterus)
-This at times may lead to laceration (tearing ) and bleeding
– Management requires taking stitches on cervixs

-It can occur with any instrument that is put inside uterus.
– Uterus, Bowel (Intestines and rectum), Urinary bladder, Blood Vessels are most commonly injured organs.
-There are more chances of injury if there has been a previous operation like Caesarean delivery, myomectomy ( operation for removal of fibroids) etc.
-Management depends on the organ involved, extent of injury and general condition of patient.
– Laparoscopy – (Key hole surgery) can be performed to diagnose the site of perforation as well as repair of damaged organ.
-Laparatomy – ( Open abdominal surgery ) is required in cases where extent of damage is more.
-Blood transfusion, Intervention by general surgeon , ICU care – all of them are rare but known clinical situations

-Scar tissue developing inside uterus-known as Asherman’s syndrome
-Repeated D& C procedures may lead to this condition.
-The anterior and posterior walls of the uterus get stuck to each other.
-It will result in scanty or no menstruation subsequently
-Management requires- Hysteroscopy ( Looking inside cavity of uterus through instruments) and cutting of fibrous tissue.
– Further pregnancies may be complicated by miscarriage or ectopic pregnancy ( Pregnancy occurring at sites other than uterus) etc.

Anaesthesia complications 
Allergic reactions to medications

Protecting from Cervical Cancer


  • Cervical Cancer is the most common cancer affecting Indian women
  • It is a preventable disease
  • You can protect yourselves and your daughters and be almost 100% safe with a combination of vaccination and screening

  • Normal cells multiply all the time
  • Old cells die and fall off
  • New, completely formed, mature cells replace them
  • They take over the regular functionCancer…..normal gone berserk:
    » Normal mechanism can be disturbed by many factors (ex: virus, chemicals in Tobacco, repeated damage)
    » Cancer cells are abnormal cells which multiply too fast
    » Old cells refuse to die
    » New cells don’t mature but keep growing – become a bulk called “Tumour”
    » Cannot function normally and start competing with the normal cells
    » Can spread and grow anywhere else in the body and choke off the normal cells Normal mechanism can be disturbed by many factors (Ex : virus, chemicals in Tobacco, repeated damage)A virus
    HPV  -Human Papilloma Virus)HPV 16
    HPV 18
    >75% of Cervical Cancer5,6

    » Large number of women get HPV infection sometime during life time (80% by the age of 50).
    » There are no symptoms – you may not know you have it
    » Majority would clear infection without developing any disease.
    » Few women develop precancerous lesions and cervical cancer over a period of time (few months to 9 years).
    We don’t know which ones will!

    Cervical Cancer is the commonest cancer in Indian Women

    200 women die every day in India
    8 women die every hour
    1 woman every 7 minutes

    India makes up only 16% of the world’s population
    But has 27% of the world’s total cervical cancer cases and deaths every year

    India : 1,32,082
    World : 4,93,243
    Deaths due to cervical cancer annually
    India : 74,118
    World : 2,73,505

  • Usually no symptoms in early stage
  • When advanced, there can be the following symptoms:
    • A little bleeding between periods
    • Bleeding after sexual intercourse
    • Abnormal vaginal discharge
    • Sometimes – pain
      • During intercourse
      • Continuous
      • Low back-ache
  • Unexplained loss of weight
    Pail face and nails (anemia)
  • Treatment options depend on the following:
    • The stage of the cancer.
    • The size of the tumor.
    • Your age.
    • Your desire to have children.
  • Conservative treatment
    (save the uterus and part of the cervix)
  • Burn the abnormal part of cervix with electric current
  • Destroy the abnormal area by freezing it
    (cold co-agulation)
  • Surgery
    • Medium spread of cancer – remove uterus with cervix, tubes and ovary
      • Good chance of survival
      • Can’t have babies
  • Late Stage
    • Extensive surgery removing other parts of the body as well
    • Needs radiation therapy and chemotherapy
    • Chances of survival vary

How can you protect yourself?

A smooth, sterilized instrument is gently inserted to see the cervix

A small spatula or brush is swiped across the cervix to loosen cells
The brush is smeared on a clean glass slide
The slide is later examined by an expert to spot abnormal cells

What you should know about vaccination

  • Vaccination is the only true form of “prevention” – stops the disease from happening in the first place
  • There are two vaccines available today:
    • Quadrivalent (“four type”)
      • Protects from 6,11,16,18
      • Partial protection from 33, 35, 41 and 7 other types
  • Bivalent (“two type”)
    • Protects from 16, 18
  • Partial protection from 33, 35 and 41

How does the vaccine work?
It gets your body to produce antibodies against the HPV virus. These antibodies protect your body from an HPV infection by fighting the virus when it tries to attack the cervix.

Who should take the vaccine and when?
Ideally, the vaccine should be taken as early as possible after the age of 9 years but girls and women of any age up to 45 can benefit from this vaccine.  Expectant mothers should not take the vaccine during their pregnancy.

How does the vaccine work?
It gets your body to produce antibodies against the HPV virus. These antibodies protect your body from an HPV infection by fighting the virus when it tries to attack the cervix.

Who should take the vaccine and when?
Ideally, the vaccine should be taken as early as possible after the age of 9 years but girls and women of any age up to 45 can benefit from this vaccine.  Expectant mothers should not take the vaccine during their pregnancy.


Routine blood tests during pregnancy


When the good news of pregnancy is first confirmed and the lady consults a gynaecologist, she is advised to take certain blood tests.

In the eye of the commoner, the list may be overwhelming as it goes like this:-

CBC-Complete blood count including hemoglobin
Blood group and Rh Factor
Blood sugar levels in fasting and PP-Post Prandial state (two hours after food)
HIV testing- Infection screen from Human Immunodeficiency Virus
HBsAg testing-Infection screen from Hepatitis B Virus
VDRL testing- Infection screen from syphilis disease
TSH– screening tests for thyroid disorder

Let’s take each test one by one and try to solve the mystery behind the question-“Why should I do so many tests? I am perfectly healthy.”

First, get that straight that the sub-section of female population who become pregnant are essentially healthy. Why, because the age group 20-35 years enjoys good health naturally.

These tests are done on all pregnant females and are aimed at picking out those cases in which it is not so.

Abortion by pills vs Traditional D&C



  • No hospital admission is required
  • No risk of anesthesia complications Only thing required of you is to take the oral tablets as instructed
  • No instrument inserted in the uterus, hence less complications
  • Privacy Assurance-To carry out abortion,signature of the woman only is sufficient,If the woman is of age 18 years and above, regardless of marital status


  • It is a safer approach when the duration of pregnancy is 45 days or less corresponding to within 15 days of missed periods



  • One day stay in hospital is mandatory
  • Inherent anesthesia risk present
  • You are required to undergo surgical procedure
  • Inherent risk of surgical instrumentation present
  • In case of hospitalization, due formalities need to be carried out


  • Termination is permitted till 20 weeks , corresponding to 4.5 months of pregnancy,with due precaution and considering indications

-Performing of basic blood investigations like-Hemoglobin, Blood Sugar, Urine analysis
-An ultrasonography to determine the duration and site of pregnancy is advisable
-A repeat ultrasonography after few days of taking the pills, to check whether the procedure is complete