Normal & Caesarean Delivery
Caesarean is a medical operation. It is percieved as a pain-free procedure. Operation is carried out under anaesthesia and therefore no pains of labour to be endured.
Horizontal cut of about 5-6 inches is made just below the pubic hair line or vaginal birth involves an invasion of privacy.
It is generally painful.
Normal , straight forward, intervention free, healthy natural birth is still the safest, most practical and advantageous way for a baby to be born.
MTP( Medical termination of pregnancy)
Also called as induced abortion. It is a medical way of getting rid of unwanted pregnancy.
It is legally permitted upto 20 weeks of gestation.
Pregnancy termination performed in 1st trimester is safer than in 2nd trimester since has fewer complications.
Myomectomy and Hysterectomy
Myomectomy: It is a surgical procedure to remove uterine fibroids- also called as leiomyomas.
They are common non- cancerous growth and that appear in uterus usually during child
bearing years.
Depending upon size, number and location of fibroids – one may be eligible for :
- Abdominal myomectomy
- Laparoscopic myomectomy
- Hysteroscopic myomectomy
- Hysterectomy: It is surgical removal of uterus and sometimes the cervix and supporting tissue. It ends menstruation and ability to become pregnant.
Types :
- Supra cervical hysterectomy
- Total hysterectomy
- Total hysterectomy with bilateral salpingo-oophorectomy
- Radiacal hysterectomy
- Procedure lasts for 1-3 hrs.
Cervical & Vaginal Operations
Surgery are performed for cervical cancers and pre cancers.
a) Cryosurgery: in this metal probe cooled with liquid nitrogen is placed directly on the cervix.
b) LASER surgery: a focussed laser beam directed through the vagina , is used to vaporize abnormal cells or to remove a small piece of tissue.
c) Conization: cone shaped piece of tissue is removed from cervix.
d) Hysterectomy
e) Trachelectomy: removal of cervix and upper part of vagina but not body of uterus.
f) Pelvic exenteration: used to treat recurrent cervical cancer.
Vaginal surgeries depends on the size and stage of cancer:
- local excision
- vaginectomy
- Trachelectomy
- Hysterectomy
- Vaginal reconstruction
- Pelvic excenteration
All diagnostic and therapeutic laparoscopic procedure
Diagnostic laparoscopy is minimally invasive surgery for diagnosis of intra- abdominal diseases.
Laparoscopic ultrasound can be used to evalute deep organ parts that may not amenable to inspection.
Minimally invasive technique of laparoscopic surgery was successfully introduced for gynaecological procedure in early 1970’s
Laparoscopy typically entails four incisions of 5-10mm
Follicular monitoring(TVS)
It is the procedure of serial ultrasonic monitoring of the ovarian follicles used to identify maturation status of eggs.
It is used for assessing size of follicle that supports the growing egg and for determining the thickness of uterine lining.
Infertility:
It means not being able to become pregnant .It can be due to woman, man or due to unknown problems.
Infertility in men is due to varicocele, low or absent sperm count, or sperm damage.
Women’s infertility include ovulation problem, blocked fallopian tubes, uterine problem, uterine fibroids , age , stress etc…
Treatment:
-Medicines
-Surgery
-Artificial insemination
-Assisted reproductive technology
Intra uterine insemination(IUI):
It is a procedure that involves placing sperm inside a woman’s uterus to facilitate fertilization .
Ultrasound will be used to monitor the size of follicules. The hormone – human chorionic gonadotropin
(HCG) is administered to stimulate the release of eggs from follicles.
Irregular and heavy bleeding:
A change in hormone level is a common cause of abnormal menstrual bleeding. This is called Dysfunctional uterine bleeding.
Other causes:
- Endometrial hyperplasia
- Cancer of uterus
- Uterine fibroids
- Pregnancy complications
- Change in birth control pills
- Use of steroids, blood thinners
- Use of intra uterine device
Treatment:
Medicines: tranexamic acid
NSAIDS- mefenamic acid
Naproxen
Ibuprofen
Oral northisterone
Surgeries- uterine artery embolisation
Myomectomy
Endometriosis:
It is a condition where endometrial tissueis found outside the uterus. It is trapped in the pelvic areas and lower tummy.
It can cause painful periods, persistent pain in pelvic areas, infertility and other symptoms.
Treatment:
Medicines- pain killers
Hormone treatment
Surgery.
Adenomyosis:
It is the condition in which the inner lining of uterus breaks through the muscle wall of uterus.
It can cause menstual cramps, lower abdominal pressure, bloating, heavy periods.
Treatment:
NSAIDS
Hormone therapy( levonorgestrel-releasing GnRH analogs)
Treatment of cysts/ tumors of any kind:
Birth controlling pills may relieve pain from ovarian cysts. They prevent ovulation.
Surgeries:
- Laparoscopy
- Laparotomy
- Chemotherapy
- Radiation
PID( pelvic inflammatory diseases):
It is an infection of the female reproductive organ .
It is a serious complications of a sexually transmitted disease in wounds.
Treatment:
a) Antibiotics
b) Surgery – laparoscopy
- Nerve ablation surgery.
Excessive menstrual blood loss treatment by balon therapy:
Treatment aims to remove the inner linning of uterus and reduce excessive menstrual bleeding.
Ballon therapy:
A flexible soft ballon attached to a thin tube is inserted into vagina and up into the uterus through cervix .This is achieved with out any cut or incision. Once positioned ballon is inflated with sterile fluid which is then heated to 87 degree centigrade and then left in uterus for 8minutes , until linning is treated. After this time ballon is removed. After treatment nothing will remain in uterus and the treated lining will come away like a period over 7-10 days afterwards.
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