These days pills are available for abortion in all chemist shops for Abortion in Early Pregnanc...
Planning a baby after 35 means first of all you may face difficulty in concieving naturally. There are two ovaries in a woman’s body close to the uterus. These form eggs which are fertilised with sperms to form pregnancy. With age the Ovarian reserve of eggs continues to decrease , especially after 35 years. Also post 35 the quality of your eggs may not be as good as at a younger age. Due to these reasons getting pregnant naturally may be difficult especially after 35 years of age.
Secondly post 35 the pregnancy may not be as smooth as at a younger age as incidence of genetic disorders like Down’s Syndrome is seen to increase with advancing age. We need to do special blood tests for this.
With advancing age there are more chances of getting high Bp or deranged blood sugars during pregnancy as compared to younger woman. So the pregnancy may fall into the high risk group requiring frequent and close monitoring. And sometimes premature delivery may also have to be done if these medical conditions get serious.
But there is no need to panic. If you plan pregnancy post 35 years it can be managed under the guidance of an expert and experienced Obstetrician.
With technical advances these days there is trend of minimal invasive or Laparoscopic surgery performed for various gynaecological problems by a laparoscopic surgeon. A more advanced method is Robotic surgery performed by many laparoscopic surgeon in delhi and other bigger cities in India.
In these type of surgeries the cuts given are very small, usually less than one centimetre, so the post operative recovery is very good. Many times patient is discharged even on the same day. In these surgeries usually blood loss is also less. So where ever possible minimal invasive surgery done by a gynae laparoscopic surgeon is recommended.
Abortion is a very common medical situation needing management under qualified medical personnel.
It is safe when carried out using a method appropriate to the pregnancy duration and under the guidance of a gynaecologist at a good medical centre.
Unsafe abortion can lead to maternal morbidity. It can lead to not only physical but also mental health problems.
Abortion may be done by choice when its an unplanned and unwanted pregnancy or it may be needed due to some medical problem in the pregnancy leading to missed or incomplete abortion.
Abortion can be performed using medication or a surgical procedure. In the first seven weeks of pregnancy, a medical abortion can be done using medicines. But it’s important to do it under proper guidance of a qualified gynaecologist after doing an ultrasound for pregnancy.
Post seven weeks usually a surgical method is performed which requires admission and the procedure in safer when done in an operation theatre under anaesthesia taking care of all aseptic measures and sometimes under ultrasound guidance.
If the abortion is done due to some medical issue or due to missed or incomplete miscarriage, it may lead to some mental issues, as it may have to be done suddenly as an emergency case. And in such cases the woman has the feeling of loosing her baby. They may have some depression for some but usually not requiring medication.
If the abortion is done by choice then usually it does not affect the mental status of the woman as she is well prepared for it.
By Dr. Anita Gupta
Obstetrics & Gynaecology
Fortis La Femme
There are many methods for contraception but commonly used are Oral contraceptive pills, Intra uterine devices, Vaginal ring, Condom, Contraceptive injection, Contraceptive implant.
Oral contraceptive pills are of many types, all having hormones. Most effective are the combination pills with low dose hormones. The low dose ensures less side effects and the combination of hormones ensures regular menses and less chances of inter menstrual irregular bleeding or spotting per vaginum. These pills can be taken for many months/years. But it is better to start these after visiting a gynaecologist. One caution! Smoking and oral contraceptive pills is a very bad combination!!
The safer contraceptive with very very less failure rate are the various intra-uterine devices. There are two type of these devices; copper and hormonal. These have to be inserted in the uterus by a gynaecologist as a OPD procedure. Of these the hormonal ones are better, available by the name of Mirena which can be used for five years and then replaced with a new one. The copper devices are of two types which have to be replaced after every three or five years depending on the one used.
Then there are hormone loaded rings which are placed in the vagina every month and the lady can insert it on her own every time. This is also a safe contraceptive method with less failure rate. Only issue is using a new one every month.
Injectable contraceptives are also available with an efficacy of three months. This is also a very effective method but sometimes there is a side effect leading to irregular bleeding in those three months.
Very commonly used method is the barrier method where the male partner uses condoms. But this has the highest failure rate.
Pregnant woman fall in the category of higher risk when we talk of Covid 19. As During pregnancy you are more vulnerable to get infected with any disease as compared to a non pregnant woman because your immune system is comparatively more sensitive during pregnancy and post delivery. So pregnant ladies are considered to be in the high risk group just like aged people, children and also persons having co morbidity like diabetes or high BP, in this Covid pandemic.
So you need to be extra careful in this Covid-19 pandemic. So you need to take extra precautions. Take care of yourself by maintaining proper social distancing and good hand hygiene. Cover your nose and mouth properly with a mask when stepping out. In fact avoid unnecessary movements outside your home. Eat healthy food. Have lot of fruits and vegetables. Keep yourself well hydrated by taking plenty of water and other liquids like nimbu pani and coconut water. Try to do small walks inside your house. Keep your rooms well ventilated.
Avoid going out unnecessarily. Try to get most of the things home delivered. Use a mask when receiving your groceries and other stuff. If you are visiting the Gynecologist or Hospital for your routine checkup then wear the Mask properly and maintain social distancing. Carry your own water bottle and a small snack. Before taking an appointment for a physical checkup ask your Gynecologist for Online consultation if it can be done.
Tele consultation is usually possible in the first four months of pregnancy. Try to avoid unnecessary hospital visits.
Continue taking all your vitamins, iron, calcium and protein supplements. Follow all your doctors instructions. If any doubt do tele consultation. Be aware of baby movements. Report to hospital if you experience any fever, lethargy or muscle pains. Don’t be afraid if you are told to get yourself tested for Covid.
Live healthy. Eat healthy. Sleep healthy. God forbid if inspite of all precautions you still get Covid positive, then follow Gynecologist’s instructions carefully. Many pregnant women have recovered and have had healthy babies.
Author: Dr. Anita Gupta, Gynecologist in Delhi
The ovaries are a very important part of a female body. They (Ovarian Cysts) are in a pair in the female reproductive system and are located one on each side of the uterus. Each ovary is about the size and shape of an almond. The ovaries produce eggs and are also the main source of the female hormones estrogen and progesterone. They influence the development of a woman’s breasts, body shape, and body hair. They also regulate the menstrual cycle and pregnancy.
Ovarian Cysts Symptoms
A cyst is a fluid-filled sac and can be located anywhere in the body. Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. Different types of cysts can form in the ovary. Many cysts are completely normal. These are called functional cysts and these are very commonly found. They occur during egg formation. Functional cysts normally shrink over time, usually in a few months.
If you have a functional cyst, you may need a check-up once again in 1 to 2 months to make sure that the cyst has become smaller or has completely resolved. These cysts are almost never associated with cancer. But if you are menopausal and are not having periods, you will not have functional cysts.
The other types of cysts are chocolate cysts, Simple cysts, or dermoid cysts. Many women have ovarian cysts without having any symptoms it is advisable to meet a gynecologist in Delhi. In some the cyst will cause these problems:
- Pressure, fullness, or pain in the abdomen
- Pain during sexual intercourse
- Painful menstrual periods and abnormal bleeding
- Nausea or vomiting
To identify the type of cyst, the following tests are needed:
- Pelvic ultrasound
- CA 125 blood test- It is a tumor marker and is often elevated in ovarian cancer.
The ovarian cysts can be treated in the following ways:-
- Wait and watch: The patient waits and gets re-examined in one to three months to see if the cyst has changed in size. This is a common treatment option for women who are in their childbearing years, have no symptoms, and have a simple cyst less than 5 cm size.
- Surgery: If the cyst does not go away after few menstrual cycles, has become larger, or looks unusual on the ultrasound, causes pain, or the woman is postmenopausal, then there is a need to remove it.
There are two surgical methods:
- Laparoscopy- if the cyst looks non-cancerous on the ultrasound, CA-125 is normal then laparoscopy can be done. This procedure is done under general anesthesia. Very small incisions of 0.5 to 1.0 cm are needed in this surgery.
- Open Surgery- if the cyst is solid and looks suspicious, then open surgery is needed. The incision in open surgery is sometimes quite big.
This type of situation is not very common
Early Signs of Pregnancy Symptoms
If you miss your menses date by more than a week, the first thing to check should be pregnancy, do a home test. You get many types of pregnancy checking kits in chemist shops. Buy one and check with the first urine early morning. If positive see a Gynecologist (obstetrician in Delhi) at the earliest.
If your age is more than 35 years (which is quite common these days as women are now career-oriented) then you are a candidate whose pregnancy falls into the high-risk pregnancy group as with advancing age there are more chances of problems for the mother and the baby both. Similarly, if you have got your pregnancy after treatment for infertility or through IVF (test tube baby) then also you come into this group.
Follow the advice of your Gynaecologist sincerely and carefully. Go for regular check-ups. Do all the tests asked for as in these pregnancies some extra tests are needed most of the time. Take all the prescribed medicines regularly
It is important to maintain a healthy diet during pregnancy.
Your body needs additional nutrients, vitamins, minerals, and some 300-350 extra calories each day during pregnancy. You should talk to your gynecology doctor during pregnancy.
A diet lacking in nutrients, poor eating habits may lead to some pregnancy problems. Similarly over eating or eating all the wrong things may lead to excess weight gain and may also increase your risk of gestational diabetes.
So choosing a healthy, nutritious diet will help ensure that you and your baby both are healthy.
When A non-medical friend’s daughter, who was eight weeks pregnant ordered spring rolls at a restaurant, another one of my friends reacted as if she had ordered a double whiskey. “You can’t have Chinese food when you’re pregnant!” she shouted! When I asked her why she thinks so, she said she thought that one cannot have Chinese food during pregnancy. Well, then what do Chinese women eat during their pregnancy! Actually, it is ajinomoto in big quantity which cannot be taken, and Chinese food is safe.
Yes, certain foods can lead to pregnancy problems and one should know about them.
From conception onwards, it is very important to have folic acid.
Vitamin D is another important thing needed during pregnancy.
Iron and Calcium along with some minerals is also needed. Protein and fibre in diet is also important.
Legumes are great sources of folate (folic acid), fiber and many other nutrients. Folate is a vitamin that reduces the risk of neural tube defects in the growing baby.
Fruits are a good source of many vitamins and fibre. Fibre helps in reducing the problem of constipation often bothering a pregnant lady.
Green leafy vegetables are a good source of iron. Avocados contain high amounts of fibre, folate and potassium. Potassium helps to relieve leg cramps that are common in pregnant women.
Sweet potatoes are an excellent source of beta-carotene, which is important for the growing fetus.
Whole eggs are a good source of protein (the white part) along with many nutrients in the yellow part. You can have two eggs daily. Chicken and fish give you a lot of protein as does paneer for vegetarians.
Dairy products like milk, yoghurt should be consumed in sufficient quantity as it is a good source of protein and calcium..
Dry fruits like almonds and walnut are good for pregnant women but make sure to limit your portions.
Drinking water is very important during pregnancy. It may also help prevent constipation and urinary tract infections which are comparatively more common during pregnancy.
Some foods are to be avoided during pregnancy.
Raw fish and shell fish, Raw or undercooked meat, and raw eggs must be avoided as they may lead to infection if contaminated.
Pregnant women should limit their caffeine intake to one or two cups of coffee. High caffeine intake during pregnancy is bad. Try to have decaffeinated coffee. Also, reduce tea intake to two to three cups. Green tea should not be taken during pregnancy.
Pregnant women should not drink alcohol as it increases the risk of miscarriage, stillbirth.
In the second and third trimesters the nutrients, iron, and calcium are given in tablet form also along with the good diet.
During pregnancy, a lady gains about 9-12 kg weight. Loosing the extra gained weight is very important for her mental and physical health. If the lady remains overweight she can suffer from Diabetes or high blood pressure later on in life.
Post-delivery she looses 3-5 kg immediately. It is important to try to reduce the rest of your weight gradually after she has recovered physically post-delivery, she should take advice from Gynecologist in Delhi. Post-delivery it takes about six weeks for this recovery. Try to lose weight over the next several months with the help of a healthy diet and daily exercise. Breastfeeding also helps with post-pregnancy weight loss.
If the lady is unable to reduce the pregnancy weight then she may develop heart problems later on in life. She may develop diabetes or hypertension. Due to excess weight, she may develop depression. Next pregnancy and delivery will also be difficult.
With the excess weight, She may also develop polycystic ovarian disease, which will lead to hormonal imbalance and difficulty in conceiving later on. Fibroids are also more common in overweight women.