Dr.Rekha Agrawal

High-risk pregnancy: Know what to expect A high-risk pregnancy can be stressful. Know what kind of prenatal care you might need and how to cope. A high-risk pregnancy might pose challenges before, during or after delivery. If you have a high-risk pregnancy, you and your baby might need special monitoring or care throughout your pregnancy. Understand what causes a high-risk pregnancy, and what you can do to take care of yourself and your baby. What are the risk factors for a high-risk pregnancy? Sometimes a high-risk pregnancy is the result of a medical condition present before pregnancy. In other cases, a medical condition that develops during pregnancy for either mom or baby causes a pregnancy to become high risk. Specific factors that might contribute to a high-risk pregnancy include: Advanced maternal age. Pregnancy risks are higher for mothers age 35 and older. Lifestyle choices. Smoking cigarettes, drinking alcohol and using illegal drugs can put a pregnancy at risk. Medical history. A prior C-section, low birth weight baby or preterm birth — birth before 37 weeks of pregnancy — might increase the risks for subsequent pregnancies. Other risk factors include a fetal genetic condition, a family history of genetic conditions, a history of pregnancy loss or the death of a baby shortly after birth. Underlying conditions

Pregnancy is a dream come true of all couples. The first time mothers are filled with apprehension and innumerable questions. They get their queries solved by consulting their elders and peers and now newsgroups. They develop misconceptions and fears regarding pregnancy and labor.The perception of pain during labor and delivery varies between individuals. Specially, the first-time mothers need a proper antenatal counselling regarding good nutritious diet, antenatal exercises and physiology of labor pains. Here we shall only be dealing with labor & delivery. Epidural anaesthesia is an advance in pain management during labor, which ensures that a pregnant woman has a comfortable labor. It is a regional anaesthesia in which an anaesthetic drug is injected near the spinal cord in the spinal canal. Areas affected :- It numbs the body below the waist, but the movements are not impaired. Time of anaesthesia It is administered when the patient is in active labor. It can be given as a single injection or in multiple doses through a special epidural catheter by a skilled anaesthetist. Advantages :- Almost complete relief from pain with the patient being mobile No postpartum headache as in spinal anaesthesia Mother is conscious and alert throughout the labor An instrumental delivery can be performed under the same anaesthesia, if need arises If the patient has to be taken for caesarean section, the effect can be topped up through the epidural catheter.

Vaginal Hysterectomy is a surgical procedure to remove the uterus through the vagina. During a vaginal hysterectomy, the surgeon detaches the uterus from the ovaries, fallopian tubes and upper vagina, as well as from the blood vessels and connective tissue that support it. The uterus is then removed through the vagina.Vaginal hysterectomy involves a shorter time in the hospital, lower cost and faster recovery than an abdominal hysterectomy, which requires an incision in your lower abdomen. However, if your uterus is enlarged, vaginal hysterectomy may not be possible. Hysterectomy often includes removal of the cervix as well as the uterus. When the surgeon also removes one or both ovaries and fallopian tubes, it’s called a total hysterectomy with salpingo-oophorectomy (sal-ping-go-o-of-uh-REK-tuh-me). Located in your pelvis, all these organs are part of your reproductive system.

Laparoscopy is the most common procedure used to diagnose and remove mild to moderate endometriosis. Instead of using a large abdominal incision, the surgeon inserts a lighted viewing instrument called a laparoscope through a small incision. If the surgeon needs better access,she makes one or two more small incisions for inserting other surgical instruments.If your doctor recommends a laparoscopy, it will be to: • View the internal organs to look for signs of endometriosis and other possible problems. This is the only way that endometriosis can be diagnosed with certainty. But a “no endometriosis” diagnosis is never certain. Growths (implants) can be tiny or hidden from the surgeon’s view. • Remove any visible endometriosis implants and scar tissue that may be causing pain or infertility. If an endometriosis cyst is found growing on an ovary (endometrioma), it is likely to be removed. Laparoscopy procedure You will be advised not to eat or drink for at least 8 hours before a laparoscopy. Laparoscopy is usually done under general anesthesia, although you can stay awake if you have local or spinal anesthetic. A gynecologist or surgeon performs the procedure. For a laparoscopy, the abdomen is inflated with gas (carbon dioxide or nitrous oxide). The gas, which is injected with a needle, pushes the abdominal wall away from the organs so that the surgeon can see them clearly. The surgeon then inserts a laparoscope through a small incision and examines the internal organs. Additional incisions may be used to insert instruments to move internal organs and structures for better viewing. The procedure usually takes 30 to 45 minutes.

Infertility is fundamentally the inability to conceive a baby. Infertility also refers to the state of a woman who is unable to carry a pregnancy to full term. There are many biological causes of infertility, including some that medical intervention can treat. Infertility has increased by 4 percent since the 1980s, mostly from problems withfecundity due to an increase in age. About 40 percent of the issues involved with infertility are due to the man, another 40 percent due to the woman, and 20 percent result from complications with both partners.Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile during the rest of the menstrual cycle. Fertility awarenessmethods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature.