Marriage is considered a remarkable event in the individuals' lives, as
they work on starting a family, and through which the individual ushers a
new stage in terms of building the emotional, social, familial, and healthy
relationships. And it also guarantees preventing the couple from the
hereditary and infectious diseases; in order to build a happy, stable
family, getting along well.
PREMARITAL SCREENING CONSISTS OF conducting examination for couples intending to marry; in order to identify if there is any injury with genetic blood diseases such as sickle-cell anemia (SCA) and Thalassemia, and some infectious diseases such as hepatitis B, C and HIV "Aids". This is in order to provide medical consultation on the odds of transmitting these diseases to the other marriage partner or the children in the future, and to give options and alternatives before soon-to-be married with the aim of helping them plan for a hea;thy,sound family.
Objectives of Premarital Screening:- Limiting the spread of some genetic blood diseases: sickle-cell anemia (SCA) and thalassemia, and some infectious diseases: hepatitis B, C and AIDS/HIV.
Caring for your health before you become pregnant
If you are thinking about pregnancy visit our OB-GYN doctor for a preconceptional consult. They will provide you with expert advice on planning your pregnancy
Preexisting maternal condition can lead to unfavorable maternal and fetal outcomes which can be avoided by pre-pregnancy interventions
Identifying family history of any hereditary disorders and counselling couple and risk of the child getting affected .
Weight - obesity and underweight is associated with prenatal and intrapartum complication.
In Prakriya we do assessment and counselling regarding weight status. Over weight or obese and underweight women - counselling about optimum weight and exercise and dietary advice.
Preexisting medical chronic medical conditions if any and optimizing the medicines used for the same before conception.
Diabetes - preexisting diabetes with uncontrolled sugars can lead to increased incidence of congenital anomalies and macrosomia , growth retardation and intrauterine death
Patient should have cardiac and renal and ophthalmic evaluation preconceptionally
Carefull control of sugar and monitoring of fetus improves the outcome of both the mother and the fetus
Hypertension- patient needs to have cardiac and renal evaluation and optimising antihyp[ertensive medicines prior to conception
Epilepsy- fetus of an epileptic mother has an increased risk of congenital anomaly. Optimising antiepileptic medicines preconception and folic acid supplementation is very important
Cardiac disease, renal disease- medicines need to be optimised preconceptionally
Councelling regarding smoking and alcohol intake
Preconceptional supplementation with folic acid which helps prevent neural tube defects in the child
Pre-conceptional lab tests
VDRL, HIV, HBSAG,
Blood group and Rh typing
unwanted pregnancies and miscarriages in early pregnancy can be managed with medications .
Surgical management- D&C will be done where the medical management has failed or where the pregnancy is advanced and doctor feels surgical management is the preferred method
Medical management of ectopic pregnancy
Ectopic pregnancy- when the pregnancy has implanted outside the uterine cavity . doctor will decide if the ectopic pregnancy can be managed by medication alone depending on the ultrasound and blood reports . patient needs to follow up till the blood reports become normal.
Surgical management of ectopic
If the ectopic pregnancy has ruptured and bleeding or if it doesnt full fill the ultrasound and blood report criteria then patient needs to be operated to remove the ectopic either laproscopically or by a small suprapubic incision
Care of the women through out pregnancy by experienced obstetrician
Why antenatal appointments with doctor are important?
These appointments will allow both you and your baby stay healthy. Even if your pregnancy is going well and you are feeling well, it is important for you to attent your appointments so that any potential risks can be identified and prevented or reduced. And its an opportunity to know your doctor and ask any questions about pregnancy and birth
What will happen during the appointments?
There will be number of checks, scans , and tests depending on the individual needs.
Provide you advice on healthy eating and lifestyle
Talking to your doictor about the birth plan
Preparing your for the major event of you life - birthing process(delivery)
How many antenatal appointments will I have ?
you may have to attend 8-10 appointments till delivery. The number of visits can change depending on weather pregnancy becomes complicated
Can my husband come along?
Its a good idea to get your husband to come with you for the appointments when discussing your birthing plan and if you want them to support during the birth.
Also called birth and parenting classes
It helps you and your husband get ready for labour , birth , breastfeeding and caring for newborn baby
Talk by obstetrician about signs of labour, when to call hospital, Stages of labour, what to expect during labour
Talk by anaesthetist about different methods of pain relief available during labour and about epidural analgesia(painless labour)
Talk by dietitian about the diet to follow during all the trimesters
Talk by neonatologist about baby care
Talk by lactational nurse about breast feeding and newborn care
You can ask questions , and you get to meet groups of parents who like you are expecting ababy and get to share share your experiences
Please refer to pre-marital counselling
You baby’s heart rate will be continuously monitored during labour to make sure your baby is coping .
It is important to check your baby’s heart beat during labour as a change in heart beta pattern is a sign that the baby is not getting enough oxygen. This is called ‘fetal distress’
Intermittent auscultation with Doppler
Continuous monitoring with CTG machine - electronic monitor is attached to a belt arround your abdomen. This continuously records the baby’s heart beat and your contractions on a paper printout
Child birth can be pain full and you may be offered and epidural to help relieve pain during labour
Epidurals relieve labour pain more than any forms of pain relief
It is an injection given in your back to numb nerves that carry pain feelings from birth canal to your brain.
Procedure- a local anesthetic is given in your back and a needle inserted at the back and a small plastic tube in inserted inside and left in situ to give the medicine continuously till delivery
Occasional complication of epidural - bad headache which occasionally affects women after 24-48 hrs of procedure
Myth- If I take epidural I will get backache in future- it is a myth , it doesn't cause any back pain
You will be admitted in hospital once labour is confirmed by taking a heart bet trace , checking for fetal heart and vaginal examination
Labour will be continuously monitored by well trained nurse and duty registrars round the clock . Doctor will asses for the progress of labour by vaginal examination . once the cervix is fully dilated the women is encouraged to push during the contractions . A small cut may need to be given at the vagina(episiotomy ) to make way for the baby which will be sutured after the delivery. If any difficulty in delivering the baby it may be assisted withvacuum/forceps .after the delivery of the baby placenta will be delivered . Baby will be attended by the pediatrician .
Vaginal birth remains the safest birth option for delivery. Mothers recover quickly and will be able to take care of the baby.
Cesarean is an operation whereby the surgeon removes the baby directly from
Who will do the procedure ?
Your obstetrician will perform the procedure assisted by one more doctor and a nurse with the help of anaesthetist
Type of anaesthesia with be decided by the anaesthetist - spinal or general anaesthesia after discussing with the patient
A pediatrician will be present to received the baby
Under anaesthesia. Transverse incision is made above the pubis and baby is delivered after incising the uterus . baby will be handed over to the pediatrician and uterus up to skin will be closed in layers with absorbable sutures.
Part of or the entire placenta is inserted into the lower segment of the uterus
Diagnosed by ultrasound
It can cause painless and unprovoked bleeding
if the bleeding is minimal mother and baby need to be monitored until bleeding stops
If bleeding is excessive anytime during pregnancy , mother is stabilized and baby needs to be delivered immediately and mother may require blood transfusion
At full term if the placenta is low lying and covering the os . baby needs to be delivered by cesarean and mother has risk of excessive bleeding during surgery . she may need blood transfusion and if the bleeding is not getting controlled uterine artery embolisation will be done by interventional radiologist where the main blood vessels supplying the uterus will be blocked so the blood supply to uterus is reduced and bleeding will be controlled
In Prakriya we have adequate blood storage facility and interventional radiologist available round the clock
What is postpartum haemorrhage ?
Vaginal blood loss >500ml following child birth. Causes can be uterine atony , trauma to the birth canal, retained placenta, blood clotting problems . Management
Uterine massage , monitoring the pulse BP, saturation,
Uterine or vaginal tamponade where a balloon like device is inserted and filled with fluid to exert pressure on the walls of uterus
Surgeries- B-Lynch sutures to compress the uterus
Postnatal period is critical phase in the lives of mothers and newborn
Post delivery mother and baby will be monitored until discharge that is approximately 48 hrs
Postnatal checkups will be after 2 weeks and 6 weeks from delivery where you can discuss any issues like pain in the episiotomy, back pain , incontinence and discuss about contraception before you start having sex again
Pelvic floor exercises to strengthen the pelvic muscles will help for incontinence of urinebr>
Pelvic floor exercises can be done anywhere and anytime
Squeeze and draw your back passage at the same time close up and draw your vagina upwards . do it quickly , tightening and releasing the muscles immediately, then do it slowly . repeat each exercise 10 times 4-6 to 6 times a day
Deep stomach exercises -- will help firm your stomach
Lie on your sides with your knees slightly bent, let your tummy sag and breathe in gently. As you breathe out, gently draw in lower part of your stomach like a corset, narrowing your waist line . squeeze your pelvic floor at the same time . hold for a count of ten and gently release. Repeat 10 times
While feeding always sit with your back well supported and straight. Place a cushion behind your waist. Kneel or squat to do low knee level jobs(avoid bending your back)
See new born care for information
scan done for pregnant ladies between 11-14 wks. - to identify any anomalies in the foetus and double marker test - to identify any risk of chromosomal anomalies in the baby
Anomaly scan between 18-20 wks. - to identify and major anomalies in the foetus
And regular growth scans
Is the use of hormones or devices or surgery to prevent a women from becoming pregnant. It allows couples to choose if and when they want to have baby
Contraception to avoid pregnancy is recommended from the time you start to become sexually active until at least 1 or 2 yrs after menopause
There are different methods of contraception which include - oral contraceptive pill, minipill, condom, intrauterine device like mirena , cu-T and permanent measures like tubal ligation for female and vasectomy for male
oral contraceptive pill, minipill, the doctor will decide after assessing the patient which contraceptive is best for the patient
They prevent the sperm from reaching the and fertilising the egg. They also help to protect against sexually transmitted infection including HIV .
It contains female hormones estrogen and progesterone , it is 99% effective if taken as per instructions . with typical use it is 91% effective
Doctor will examine you and take your past history and medical history before prescribing the pill as it can cause serious side effects if there is any past history of clots or few medical conditions
It contains only progesterone it must be taken at the same time every day. This is prescribed for patients for whom combined pills cannot be prescribed
To prevent pregnancy after having an unprotected intercourse. There are 2 things , emergency contraceptive pill and cu-T
Cu-t copper releasing device.
Mirena or hormone releasing device
Male sterilisation- it is a quick and relatively painless surgery that blocks the tubes that carry the sperm
The operation involves cutting or blocking the tubes that carry eggs from ovaries to womb.
Infertility can be a stressful and frustrating experience for every one involved . there is plenty you can do
If a women is not able to conceive after 12 months of regular and unprotected intercourse
For couples trying for a baby , it is normal to have feeling of uncertainty, dissapointment and anxiety. It is good to talk through any problem with your doctor
There are many options
You may increase your chances of fertility if you know the most fertile days
You can treat any underlying causes of infertility like endometriosis and sexually transmitted infections
You can use artificial insemination or you can seek a fertility treatment like in vitro fertilisation (IVF)
If you are under 35 you should think about seeing your doctor if you have been trying unsuccessfully for 12 months or more
If you are more than 35 you should think about seeing your doctor if you have been trying for 6 months
Hysterosalphingogram -- a test done to check if the tubes are patent
Adolescent girls are prone to poor food choices and eating habits ---skipping meals , eating high fat food, consuming few fruits and vegetables , engaging in chronic dieting
It can be a symptom of PCOS , high level of androgens and excess insulin can disrupt the monthly cycle of ovulation and menstruation.
The average menstrual cycles is 28 days , but any where between 21-35 days is normal
Long gap between periods can lead to abnormal cells building up inside the womb. It is important for you to have at least 4 cycles per year to avoid a build up that may include abnormal cells
A low dose oral contraceptive pill,
Metformin or insulin sensitising drug - improves menstrual regularity and ovulation
To make a decision on the best therapy for you to help with irregular periods discuss your options with your doctor and seek the best quality healthcare you can . prioritise what is important to you and communicate his with your doctor
A healthy lifestyle is one of the most important aspects of managing PCOS successfully . loss of excess weight, even a 5-10% weight loss can have significant health benefits
Fibroids are non cancerous growths or lumps of muscle tissue that for within the walls of uterus.
Exact cause is not known , female hormones play a significant role in stimulating the growth
Fibroids occur in 50% of the women by the time they are 50
Majority don’t have symptoms , few may have heavy and prolonged bleeding , anemia , pressure on the bowel, bladder, low back ache
Fibroids are diagnosed by pelvic examination and ultrasound Less than 3% of patients can have fertility problems
Fibroids in pregnancy can increase the risk of miscarriage , premature labour and delivery, severe bleeding after child birth
Management and treatment
Most fibroids will not require treatment unless they cause problems
Treatment will depend on the symptoms , position and size of fibroid
Treatment include - conservative- intrauterine hormonal device- mirena- placed inside the uterus
Uterine artery embolization- a substance is injected into the uterine artery to reduce the blood supply to the fibroid causing it to shrink
Myomectomy complete removal of fibroid either by laparoscopy or by laparotomy
Hysterectomy- removal of uterus which will permanently prevent the fibroid from growing
It is a condition that can cause pain scarring and trouble getting pregnant. It affects 1 in 10 women
What is endometriosis
The cells which line the uterus grow in other parts of body usually in the pelvis
Symptoms are- painful periods , pain during sex ,
It can affect fertility
Diagnosis is by ultrasound , laparoscopy
In mild cases , pain killers during periods help
In severe cases hormone treatment with oral contraceptive pills , progestin's, gonadotropin releasing hormone agonists
Surgical treatment when medical management fails - laparoscopy /laparotomy and excision and burning of the endometriotic tissues . hysterectomy may be an option if endometriosis is significantly impacting the quality of life
The uterus slipping or dropping down into the vagina or outside the vagina due to weakening of the muscles and ligaments supporting it
Felling heaviness in the vagina
Bulge protruding out of the vagina
Difficult vaginal delivery, Multiple births, obesity, straining on the toilet to pass motion, severe coughing
Pelvic floor exercises
Vaginal pessary- a device fitted into the vagina to support the uterus
Vaginal surgery- vaginal hysterectomy where the uterus is removed through the vaginal
Conditions which require d&c
Laparoscopy used to examine the interior of the abdominal or pelvic cavities for the diagnosis or treatment (or both) of a number of different diseases and conditions. The advantage of laparoscopy is that only a small incision is required; this is why laparoscopy is also known as 'keyhole surgery'.
Laparoscopy examines the interior of the abdominal or pelvic cavity using a slender tube (laparoscope) inserted through a small incision. The laparoscope contains fibre-optic camera heads or surgical heads (or both). Laparoscopy greatly reduces the patient's recovery time.
Some of the many problems that may be diagnosed or treated by laparoscopy include:
Hysteroscopy can be defined as an inspection of the cavity in the uterus with the help of endoscopy. It is accessed through the cervix. It is done for the diagnosis of the intrauterine pathology and serves as a way of surgical intervention as well.
The diagnostic hysteroscopy is the most accepted and the most preferred way of diagnosing the problems present in the uterus
There are two variants of hysteroscopy- one is operative, and the other is diagnostic
Hysteroscopy is done if you have fibroids and polyps in the uterus, adhesions, septum's and abnormal bleeding. The hysteroscopy can be used for the removal of a non-cancerous growth in the uterus
Hysterectomy is the surgical removal of the womb (uterus), with or without the cervix. The operation may also be with or without the removal of the ovaries and the fallopian tubes. If a woman has a hysterectomy, she will no longer have menstrual periods or be able to have a child,
Reasons for a hysterectomy
Conditions that may be treated by hysterectomy include:
Vaccine to prevent cervical cancer !!!
Get it now before its too late !
Things you need to know about cervical cancer and vaccination to prevent cervical cancer
Cervical cancer is one of the leading causes of cancer and mortality –17% of all cancer deaths in women aged between 30-69 yrs
Facts about cervical cancer
Cervical cancer screening is done by regular pap smears Sexually active women should start getting the screening done after 25 yrs every 3 yrs until 65 yrs
Most cervical cell changes have no symptoms. The only way to know if there are abnormal cells in the cervix is to have a Cervical Screening Test (PAP SMEAR). Sometimes abnormal bleeding, discharge or pain may be a sign of cervical cancer. If you have these symptoms, see your doctor as soon as possible.
Various tests are used to detect cervical cancer including:
Uterine cancer is also known as cancer of the womb, cancer of the uterus, endometrial cancer most common symptom of cancer of the uterus is unusual vaginal bleeding, particularly if it occurs after menopause
tests used to diagnose cancer of the uterus include:
Ovarian cancer can be difficult to diagnose at an early stage, largely because symptoms can be vague and similar to those of other common illnesses.
Some of the symptoms of later stage ovarian cancer include:
The Department of Obstetrics and Gynecology at Prakriya Hospitals offers a full spectrum of
women’s health care services. Prakriya Hospitals is a one stop maternity care center for a
pregnancy and delivery. We have high quality birthing facilities to ensure comfort and
for both the mother and the baby. Our team consists of qualified and experienced
gynecologists, neonatologists and birthing experts. Our team, backed by state of the art
medical equipment and well-trained supportive staff are ready to tackle any emergencies.
maternity unit is ably support by the multispecialty team and tertiary care facilities.
We understand the physical and emotional feelings and the requirements of the entire family, right from providing solutions to the couples who are eagerly waiting complete their family to the expectant mothers and newborns.
In addition to giving the best medical care, we also ensure that both the mother and baby get a warm and caring environment to celebrate the special occasion. We aim to create an unforgettable experience for the mother and the family in welcoming their bundle of joy into the world.
You may go to the website and find a doctor.
Please call the number +91 9513733334 and take and appointment
Please get all the medical reports and all the medications to be taken
Please go to the website and look at the services provided
Yes, pediatrician /neonatologist will be present at the time of delivery.
Phone support is available 24 hrs a day and seven day a week for emergencies . you can call the number +91 9513733334 and ask them to connect to labour room. Labour room nurse or the duty registrar will answer your call . if they have any doubt they will consult the respective physician
Yes husband is allowed to stay with the delivering mother. If you have a instrumental delivery your husband will be asked to stay outside .
Husband is allowed for an elective cesarean after the spinal anesthesia until delivery of the baby. But for emergency procedures no relatives are allowed.
loose cells are scraped from the opening of the cervix and are tested for cervical and vaginal cancer
adult females who are sexually active .
during health checks breast examination will be performed by doctors to check for any lumps or other breast problems and suggest for ultrasound or mammogram depending on the findings.