Ovarian Cyst

Dr Deepika Tiwari, Consultant Obstetrician & Gynaecologist
Sohna Road, Gurgaon Ph: 09911821669
Ovarian cysts are fluid-filled sacs within or on the surface of an ovary. Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months. Ovarian cysts — especially those that have ruptured — sometimes produce serious symptoms. 

The symptoms of ovarian cysts, if present, may include:

• Menstrual irregularities
• Pelvic pain — a constant or intermittent dull ache that may radiate to your lower back and thighs
• Pelvic pain shortly before your period begins or just before it ends
• Pelvic pain during intercourse (dyspareunia)
• Pain during bowel movements or pressure on your bowels
• Nausea, vomiting or breast tenderness similar to that experienced during pregnancy
• Fullness or heaviness in your abdomen
• Pressure on your rectum or bladder that causes a need to urinate more frequently or difficulty emptying your bladder completely.

Infrequent complications associated with ovarian cysts include:

• Ovarian torsion. Cysts that become large may cause the ovary to move out of its usual position in the pelvis. This increases the chance of painful twisting of your ovary, called ovarian torsion.
• Rupture. A cyst that ruptures may cause severe pain and lead to internal bleeding.

To identify the type of cyst, your doctor may perform the following procedures:

Pregnancy test

Pelvic ultrasound

Laparoscopy

CA 125 blood test

The treatment depends upon the type/ stage of the cyst; or the presence of complications.

Female Infertility : Causes & Treatment

  Generally, infertility results from female infertility factors about one-third of the time and male infertility factors about one-third of the time. In the rest, the cause is either unknown or a combination of male and female factors.

When to see a doctor
If you're in your early 30s or younger, most doctors recommend trying to get pregnant for at least a year before having any testing or treatment.

If you're age 30 to 35, discuss your concerns with your doctor after six months of trying.

If you're over 35 or have a history of irregular or painful periods, pelvic inflammatory disease (PID), repeated miscarriages, prior cancer treatment or endometriosis, your doctor may want to begin testing or treatment right away.

1. Ovulation disorders account for infertility in 25 percent of infertile couples

Abnormal FSH and LH secretion, Polycystic ovary syndrome (PCOS), Luteal phase defect, Premature ovarian failure, Premature ovarian failure.

2. Damage to fallopian tubes (tubal infertility)

3. Endometriosis

4. Cervical narrowing or blockage

5. Uterine causes

6. Unexplained infertility

Treatments can either attempt to restore fertility — by means of medication or surgery — or assist in reproduction with sophisticated techniques.

Fertility restoration: Stimulating ovulation with fertility drugs
Fertility drugs, which regulate or induce ovulation, are the main treatment for women who are infertile due to ovulation disorders. In general, they work like the natural hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation.

Reproductive assistance: In vitro fertilization
This effective technique involves retrieving mature eggs from a woman, fertilizing them with a man's sperm in a dish in a laboratory and transferring the embryos in the uterus three to five days after fertilization. In vitro fertilization (IVF) often is recommended when both fallopian tubes are blocked. It's also widely used for a number of other conditions, such as endometriosis, unexplained infertility, cervical factor infertility, male infertility and ovulation disorders.

Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669
www.gurgaongynae.in
http://www.drdeepikatiwari.blogspot.com/
http://www.gurgaongynecologist.webs.com/

Anemia among Pregnant Women in India

Dr Deepika Tiwari, Consultant Obstetrician & Gynaecologist, Sohna Road, Gurgaon      9911821669

According to WHO, the prevalence of Anaemia in pregnancy in south East Asia is around

56%. In India incidence of anaemia pregnancy has been noted as high as 40-80%.

Maternal risk due to Anemia : Poor weight gain. Pre term labours, Pregnancy Induced 

Hypertension , placenta previa,  eclampsia, premature rupture of membrane (PROM)  Postnatal 

sepsis, sub involution, embolism etc.

Risk to Foetus and Newborn : Complications include Prematurity, low birth weight, poor

Apgar score, fetal distress,  neonatal distress requiring prolonged resuscitation, and neonatal anemia due to poor reserve. Infants with anemia have higher prevalence of failure to thrive, poorer intellectual developmental milestones, and higher rates of morbidities and neonatal mortalities than infants without anemia.

Studies carried out in India and elsewhere have shown that iron deficiency is the major cause of anaemia followed by folate deficiency. In recent years, the contribution of B12 deficiency has been highlighted.

Anaemia and iron deficiency in the mother are not  associated with significant degree of anaemia in the children during neonatal period. However, iron stores in these neonates are low, iron content in breast milk in anaemic women is low and because of these factors substantial proportion of infants become anaemic by six months.

Unless effective screening of pregnant women is done for detection of anemic status, substantial 
reduction in maternal mortality and morbidity may not be lowered.

Ref : Indian J Med Res;