Tag Archives: Best Gynecologist in South Delhi

Breast Cancer Detection and Treatment

The first recorded case of an inflammatory breast cancer: Persian empress Atossa (550 BC to 475 BC), daughter of Cyrus the Great, wife of two Achamenian kings, Cambyses and Darius.

“Cancer may have started the fight, but I will finish it.” 

Introduction

Since cancer-prevention is not possible, the saying, “prevention is the cure” is amended to “early detection is the cure.”

Only about 10% of cancer deaths are because of primary tumour. Most of the deaths are because of metastasis – spreading of the cancer to other parts of the body. Once metastasis happens, it is difficult to treat the cancer. Early detection of cancer is therefore of utmost importance.

Early Detection

Several ways of early detection:

  1. Self-examination of Breasts

More than 80% cancers are detected by women doing self-examination of breasts. The examination should be done every month, 5-7 days after menorrhoea. Look for the following:

  • Lumps in breast (less than 20% are cancer) or in lymph nodes in armpits.
  • Thickening of breasts
  • One breast becoming larger than other
  • A nipple changing position or shape or becoming inverted
  • Discharge from nipple
  • Constant pain in part of breast or armpit
  • Swelling beneath the armpit or around the collarbone

‘Breast cancer self-check’ images and videos are available on internet. In case of palpated anomaly, consult your gynecologist.

The limitations of self-examination are:

  • Only 20% women do self-examination of breasts.
  • The tumour/changes are large by the time they are felt and this delay in detection can adversely affect the treatment outcome.
  1. Imaging Techniques

Early detection of cancer is required and is possible by using Imaging Techniques. Six Imaging Techniques are available:

  • X-rays examination. Small neoplasmatic tissue formations can be seen.
  • Sonography (Ultrasound)

Sonography is done in addition to Mammography to rule out possible cysts and to estimate the size of the tumour. However, tumours smaller than 5 mm cannot be detected.

  • MRI

MRI is used to detect if the breast has been affected by more than one tumour.

  • Computer Assisted Detection (CAD)

CAD is used to point out possibly diseased regions. It is used mainly as a second opinion to the report of the doctor.

  • CT-scan

CT-scan is most often used to see if breast cancer has spread to other organs.

  • PET

A PET scan is used to detect the cancer cells in the body. It is often combined with a CT scan (known as a PET/CT scan).

Limitations of Imaging

  • Imaging techniques magnify the tumour much as the magnifying glass magnifies the letters in a book. If the font size is very small, a letter cannot be identified even with the magnifying glass. In a similar way, the imaging techniques cannot identify tumours that are very small.
  • The QUALITY of cancer is more important than the QUANTITY. A small tumour can be more dangerous than a large tumour.  Imaging can tell the quantity of the tumour, that is, its size, but cannot tell the quality of the tumour.
  • Most of the time, Imaging cannot even tell whether a tumour is cancerous or not.

Confirming Cancer

The only absolute way to confirm cancer is by biopsy: a small tissue from the tumour is taken and microscopically examined to check for cancer.

Types of Biopsy

  • Punching Biopsy. Done in a locally sedated state.
  • Needle Biopsy. Done with a syringe and a special needle. As painful as venepuncture.
  • Advanced Breast Biopsy Instrumentation (ABBI). Done with X-ray to ensure localisation of target. Only a few doctors are experienced in this technique.

Microscopic examination of biopsy is sufficient; but in a few rare cases specialized lab tests are required.

Treatment

Even small localised tumours have the potential of metastasis and therefore need to be treated. The treatment is surgery, medications (hormonal therapy and chemotherapy), radiation and immunotherapy.

Surgery offers the single largest benefit. Used along with chemotherapy and radiation, the local relapse rate is reduced, and the overall survival rate may increase.

Surgery

  • Mastectomy:  remove whole breast.
  • Quadrantectomy: remove quarter breast.
  • Lumpectomy: remove small part of breast.
  • Endoscopy-assisted breast-conserving surgery (EBCS), which has the advantage of a less noticeable scar, was developed more than ten years ago.
  • Breast Reconstruction Surgery or breast prostheses: to simulate breast.

Neo-adjuvant, that is prior to surgery, and Adjuvant that is after and in addition to surgery, medication is used as part of treatment. For example, Neo-adjuvant use of aspirin may reduce the mortality from Breast Cancer.

Adjuvant Therapies

Radiation (negative effect on normal cells) to kill cancer cells in tumour bed and regional lymph nodes that may have escaped surgery. It reduces the risk by 50 – 66 % (i.e., 1/2 to 2/3 reduction of risk). It is confined to region being treated. But only solid tumour can be treated.

Therapies using drugs/agents etc.

  • Chemotherapy (negative effect on normal cells). Uses drugs, usually two or more drugs in combination, to destroy cancer cells.
  • Targeted Therapy that became available in 1990s that uses drugs that inhibit enzymes.
  • Monoclonal Antibody Therapy in which the agent is an antibody
  • Immunotherapy that uses patient’s immune systems to fight cancer using drugs.
  • Hormone Blocking Therapy. Uses Estrogen Receptors (ER +) Tamoxifen and Progesterone Receptors (PR +) Anastrozole that block the receptors.

Experimental Cancer Treatment

  1. Gene Therapy
  2. Ultrasound Energy.

Complementary and Alternative Cancer Treatments

Alternative cancer treatments do not cure cancer. But they may lessen signs and symptoms – such as anxiety, fatigue, nausea and vomiting, pain, difficulty sleeping, and stress  – caused by cancer and cancer treatments. Hypnosis, massage, meditation, relaxation techniques, yoga, acupuncture, aromatherapy, music therapy, and Tai chi – alone or in combination may be beneficial.

But many alternative cancer treatments are unproved, and some may even be dangerous.

Type of Treatment Given

Patients with good prognosis are offered less invasive treatment – e.g. lumpectomy + radiation + hormone.

Patients with poor prognosis are offered more aggressive treatment – extensive mastectomy + radiation + chemotherapy + adjuvant medication.

Treatment Success Rate

If the cancer is detected early, that is at Stage 1, prognosis is excellent and usually chemotherapy is not required.

If detected in Stage 2 & 3 prognosis is progressively poorer with a greater risk of recurrence.  Surgery, chemotherapy, and radiation are required.

If detected in Stage 4, that is metastatic cancer (spread to distant sites), prognosis is poor.  Surgery, radiation, chemotherapy, and targeted therapies are used. But the 10-year survival rate is 5% without treatment and 10 % with optimal treatment.

In India, more than 60% of the BC’s are diagnosed at stage III or IV. Hence the low survival rate.

Psychological and Emotional Aspects

Cancer patients need psychological and emotional support. Besides the family, such support can be given by support groups who are trained and experienced in giving such support. ‘Cancer Sahyog’ is one such support group in India.

Conclusion

Cancer is a 3200-year-old disease. It is endogenous, a part of life-process. So, it can neither be eradicated, nor prevented, nor cured. As yet.

Late detection of cancer is fatal. The causes for late detection are many but lack of awareness is the principal cause. Other main causes are patient being shy, social stigma and doctors’ ignorance because of which the treatment is delayed. An awareness program will address all these issues.

Will some radical discovery in the future make cancer prevention and cure possible? We do not know. But we can always hope.

Because as Richard Causer, Director, NCI, USA, says about the future of cancer cure, “There are far more good historians than there are prophets.”

Depression in Pregnancy

Depression, suffering and anger are all part of being human. – Janet Fitch

Depression is the inability to construct a future. – Rollo May

SYNOPSIS

Depression is a mood disorder, a biological illness, which affects 14-23% of women during pregnancy. Depression makes a woman feel sad, bleak, helpless, anxious, irritable, fatigued and lacking in energy.

Depression can be treated. Left untreated, it can lead the woman to poor nutrition, drinking and smoking causing the babies to be born premature, less active, and have developmental problems. Antenatal depression is a strong precursor to Postpartum Depression.

Depression treatment is psychotherapy, medication, and self-care. Cognitive behavioural therapy (CBT) is the often used psychotherapy. A woman can do it herself after suitable instructions. Medication is antidepressants. These pose a very small risk to fetus. A few supplements are also claimed to help. But these should not be taken without doctor’s advice. Self-care involves proper diet, adequate sleep, exercise, and pregnancy-yoga.

Several women have depression during pregnancy. So, you are not alone. Do not therefore hesitate to speak to your doctor at the first appearance of the symptoms of depression.

INTRODUCTION

Pregnancy is a joyous period for women. But for a few the joy is clouded by mood swings. We all have transitory mood swings. But if these last a few weeks or a few months, then these signal depression.

DEPRESSION

Depressions are biological illnesses caused by changes in brain chemistry. Such changes may be triggered by the hormonal changes during pregnancy. This is called antenatal depression. But except in name, it is similar to clinical depression.

SYMPTONS

Symptoms of depression vary from person to person. But if you have one or more (usually five) of the following symptoms for most of the day, nearly every day, for two weeks or more, it signals depression:
• feelings of sadness, bleakness, hopelessness, and anxiety;
• lack of interest or pleasure in doing anything;
• feeling tired or having little energy;
• difficulty concentrating;
• difficulty remembering.
• feeling emotionally numb.
• extreme irritability.
• sense of dread about everything, including the pregnancy.
• feelings of failure, or guilt.
• trouble getting to sleep, waking up in the night or sleeping too much;
• overeating or decreased appetite.
• weight loss/gain unrelated to pregnancy
• low self-esteem, or feelings of guilt or failure
• fidgeting a lot, or moving and speaking very slowly
• loss of interest in sex.
• thoughts of suicide or self-harm may occur.
• inability to get excited about the pregnancy, and/or baby
• feeling of disconnection with the baby, and an inability to form/feel a bond with the developing baby.

RISK

Anyone can have depression. But the following factors, or a combination of these, increases the risk of getting depression:

• Family history of depression. Risk of suicide also goes up.
• Personal history of depression or anxiety in the past – like during an earlier pregnancy or after the birth of a previous child. Also the risk of postpartum psychosis, a rare but very serious condition that involves hallucinations, increases.
• Life stress events, such as financial problems, the end of a relationship, the death of a close friend or family member, or a job loss.
• Lack of support like having relationship problems or an unsupportive partner or having your baby on your own, or if you feel isolated from friends or family
• Unplanned pregnancy finding out you’re pregnant when you didn’t plan to be.
• Domestic violence and emotional abuse that tend to get worse when you’re pregnant.
• Infertility treatments
• Complications in pregnancy

TREATMENT

Antenatal depression is treatable with psychotherapy, medication and self-care.

Psychotherapy

• Cognitive behavioural therapy (CBT) is the often used psychotherapy. It helps the mother recognise her emotions and counter her negative thoughts. She is encouraged to do CBT herself after step by step instructions in CBT through books and talks; or she may be advised do it in sessions with a therapist.

Medication

• She may also need antidepressants. Not enough evidence is available that these are completely safe to take in pregnancy. A few of these pose a very small risk of birth defects that include fetal heart and skull abnormalities. Doctor weighs the risks and benefits to the mother and to the baby to decide on antidepressants. If the mother was on mental health medication before pregnancy, she should not stop these without asking the doctor. Also, she should not start any medication, including herbal medication, without asking the doctor.
• Supplements. Several supplements such as St. John’s wort, SAMe, Saffron extract, 5-HTP and DHEA are being marketed as being helpful in depression. These seem to help some people but sufficient evidence is not available for their efficacy. A few of these can interfere with prescription medications or cause dangerous interactions and may be unsafe. Consult your doctor before taking any supplements or herbal medication.

Acupuncture

Acupuncture is claimed to help relieve depression. But the evidence for its effectiveness is ambiguous or outright contradictory. The World Health Organization has recognized acupuncture as effective in treating mild to moderate depression. – Dr Andrew Weil in ‘Depression, Health, World, Organization.’

Self-care

Diet, sleep, and physical activity are just as important as medication and therapy — sometimes more so.

Diet and nutrition.

Diet is so important to mental health that a new field of medicine called nutritional psychiatry has grown around it. Many foods have been linked to mood changes, the ability to handle stress and mental clarity.

• Foods to avoid are:

o Alcohol: it depletes serotonin, which makes people prone to anxiety, depression and panic attack.
o Caffeine: It lowers serotonin and increases the risk for anxiety, depression, and poor sleep. Reduce intake of coffee, tea, and hot cocoa.

• Foods to take are those rich in:

o B12 and folate. These prevent mood disorders and dementias. Sources: beetroot, lentils, almonds, spinach, liver (folate); liver, chicken, fish (B12)
o Vitamin D. Its deficiency is associated with different mood disorders. Sources: sun exposure; breakfast cereals, breads, juices, milk; high-quality supplements.
o Selenium. It decreases depression. Sources: cod, Brazil nuts, walnuts, poultry.
o Omega-3 fatty acids. These improve cognitive and behavioral function. Low levels of omega-3 fats leads to mood swings and depression. Sources: cod, haddock, salmon, halibut, nut oils, seeds, walnuts, and algae; high-quality supplements
o Endorphins. These enhance mood and promote a sense of well-being. Source: dark chocolate

Sleep

Lack of sleep (insomnia), or disturbed/obstructive sleep (apnea) are linked to depression. People with insomnia are 10 times more likely to have clinical depression and 17 times more likely to have clinical anxiety, and people with apnea are five times more likely to have clinical depression, than people who sleep normally. To help get sleep, lower room temperature, follow a schedule, avoid naps during the day, listen to relaxing music, try a low carb/high fat diet and eat 3-4 hours before sleep time, exercise, and practice yoga and meditation.

Exercise

Exercise releases endorphins, natural cannabis-like brain chemicals, and other natural brain chemicals, that enhance your sense of well-being. Depression causes tiredness and lack of energy. It may therefore be difficult to begin exercising. So begin with a walk for five or ten minutes and gradually increase to 30-45 minutes a day for three to five days a week. Results will appear after a few weeks because exercise is a long term treatment. Therefore pick up an exercise – walking, cycling, swimming – that you enjoy.so you will continue to do it

YOGA

Yoga focuses on the balance between your mind, body and breath. This balance is created through:

• physical exercises and postures (asanas)
• breathing exercises (pranayama)
• relaxation
• meditation

Yoga improves your physical, mental and emotional wellbeing. It helps you to:

• Improve your circulation, muscle tone and flexibility; to keep the body supple and relieve tension around the cervix by opening up the pelvic region. This prepares to-be-mothers for labor and delivery.
• Alleviate the effect of common symptoms such as morning sickness, painful leg cramps, swollen ankles, lower-back pain and constipation.
• Stay mentally agile through relaxation, breathing and meditation.
• Train you to breathe deeply and relax consciously, helping you to face the demands of labor and childbirth.
• Feel calm, and ease muscle tension.
• Recover faster post-delivery.

If you are already doing Yoga, you may continue to do pregnancy yoga during pregnancy. Since most miscarriages happen during the first trimester, you may, as a precaution, decide not to do Yoga during that period. Although there is no evidence that doing yoga, or any other exercise, during the first trimester will harm your pregnancy.

If you have never before done Yoga, then do not begin it in the first trimester. Begin in the second trimester, after 14 weeks of pregnancy. Join a pregnancy Yoga class. Your instructor will start you gently and slowly and modify the posture to suit the stage of your pregnancy.

Avoid these:

• Lying on your back after 16 weeks.
• Breathing exercises that involve holding your breath or taking short, forceful breaths.
• Strong stretches or difficult positions that put you under strain.
• Lying on your tummy (prone).
• Upside-down postures (inversions).
• Back bends.
• Strong twists.

A study published in Obstetrics & Gynecology in December 2015 found no evidence of fetal distress in any of the 26 postures attempted. These included downward facing dog and savasana. But avoid any poses that feel uncomfortable.

The Art of Living recommends only nine asanas (postures) for pregnancy Yoga. These include Shavasana (Corpse Pose) and Yoga Nidra (Yogic sleep).

You may restart postpartum yoga six weeks after a vaginal delivery; and a longer period after a Caesarean section as advised by your doctor. The postpartum asanas help combat back and neck aches and also help breastfeeding mothers.

ADDITIONAL

To help yourself handle depression:

• Talk about your concerns with your partner, family and friends. They may offer you a proper perspective or practical help. And simply talking about your problems makes these seem more manageable.
• Take time to relax. Give yourself some “me time.” Read, take a calming bath, lunch out with friends, watch an entertaining movie or play. In short do anything that takes your mind away from your concerns and gives you physical and mental relaxation.

DOWNSIDE

Untreated depression can lead to poor nutrition, drinking and smoking. These can cause premature birth, low birth weight, and developmental problems. Babies of ‘depressed’ mothers may be less active, have lower attention span, be more agitated, have behavioral problems and delayed cognitive and language development as compared to babies born to normal mothers.

Antenatal depression is a strong precursor to Postpartum Depression: a major depression in the weeks and months after childbirth. It affects mother’s health and quality of life and also the well-being of the baby. It can cause bonding issues with the baby and can contribute to sleeping and feeding problems for the baby.

CONCLUSION

If you have symptoms of depression, remember, you are not alone. Between 14-23% of women struggle with some symptoms of depression during pregnancy. Antenatal depression can be treated and managed. Most women recover with a few weeks, or a few months, of treatment.

So do not feel shy. Speak to your doctor at the first appearance of the symptoms of depression.

REFERENCES

1. Depression During pregnancy
https://www.babycenter.com/0_depression-during-pregnancy_9179.bc#articlesection1
2. Depression In pregnancy

Depression in Pregnancy


3. Facing Depression During Pregnancy
https://www.webmd.com/baby/features/facing-depression-during-pregnancy#1
4. Depression during pregnancy: You’re not alone
https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by- Antenatal depression
5. Antenatal depression
https://en.wikipedia.org/wiki/Antenatal_depression
6. Prenatal Yoga for women to do during pregnancy | The Art of Living …https://www.artofliving.org/in-en/yoga/yoga-for-women/yoga-and-pregnancy
7. Introduction to Pregnancy Yoga – Verywell Fit
https://www.verywellfit.com › Fitness › Yoga › Yoga and Your Health
8. Pregnancy yoga for beginners – BabyCentre UK
https://www.babycentre.co.uk/a1033238/pregnancy-yoga-for-beginners
9. The Complex Relationship Between Sleep, Depression & Anxiety …
https://sleepfoundation.org/excessivesleepiness/…/the-complex-relationship-between-sl…
10. Depression & Sleep – National Sleep Foundation
https://sleepfoundation.org/sleep-disorders-problems/depression-and-sleep
11. Can Acupuncture Treat Depression? – Scientific American
https://www.scientificamerican.com/article/can-acupuncture-treat-depression/
12. Natural remedies for depression: Are they effective? – Mayo Clinic
https://www.mayoclinic.org/…/depression/…/natural-remedies-for-depression/faq-200.
13. Depression and anxiety: Exercise eases symptoms – Mayo Clinic
https://www.mayoclinic.org/diseases…/depression/in…/depression…exercise/art-20046.
14. Exercise is an all-natural treatment to fight depression – Harvard Health
https://www.health.harvard.edu/…/exercise-is-an-all-natural-treatment-to-fight-depress..
15. 20 Simple Ways to Fall Asleep as Fast as Possible – Healthline
https://www.healthline.com/nutrition/ways-to-fall-asleep

Painless Childbirth

The pain of childbirth is not remembered. It’s the child that’s remembered.

Words cannot express the joy of new life.

SYNOPSIS

Labor pain can be excruciating. Many women have low pain thresholds and are unable to bear such pain. For them, painless delivery may be a need. In this procedure, once the active labor begins, an injection of epidural is given. Epidural makes the delivery almost painless. But epidural has certain side effects. Also, it often results in forceps or vacuum delivery. And both these pose risks of injury to the mother and the baby. But natural birth is also not without risks. For example, unrelieved labor-pain is associated with postpartum depression, post-traumatic stress disorder, and chronic pain. Your gynecologist in Delhi looks at many factors, including the health and emotional well-being of the mother, and then recommends the optimum childbirth procedure for you. Follow her advice.

Labor Pains

Childbirth is a joyous but painful experience for women. Labor pain is the mother of all pains, it is said. But labor pain is different for each woman; and different for each pregnancy of the same woman. And no one can predict what your labor will be like. It can range from mild to extreme. For some women, labor may be almost painless, or mild, or just irritating, or a dull or mild hurt. For others, pain may be excruciating, all-encompassing, cramps going from the top of the stomach down to pubic area, radiating to lower back and rectum, each contraction like a punch in the stomach that knocks all the air out; pain may be burning, and in stabs; pain may be in legs and hips.

Keeping fit during pregnancy and learning relaxation techniques – rhythmic breathing, visualization, meditation, and self-hypnosis – can help handle the pain. HypnoBirthing – practice, and use of a combination of music, visualization, positive thinking and words to relax the body and control sensations during labor – may help keep you keep calm and keep the muscles loose. Changing positions may help reduce the pain. Massage and walking may also help.

Total natural Birth

Many women believe that pain cements the bond between them and the baby. They also fear the side effects of medicated births and epidurals and decline even the painkiller injections that are usually given during labor. That is, they opt for ‘total natural birth (tnb).’ It, ‘tnb,’ is the worldwide trend these days.

But unrelieved childbirth pain is associated with postpartum depression, post-traumatic stress disorder, and chronic pain. Women should be aware of this when opting for tnb. And if during tnb, or natural birth, the pain becomes unbearable, they should not hesitate to opt for pain relief medication. They should ‘differentiate between pain and suffering. Pain can be managed, but if it becomes overwhelming, medication may prevent suffering.’

The stages in childbirth are:

  • Early labor (up to eight hours or longer): cervix dilates, or opens to 3 to 4 centimeters, and begins to efface (thin). Mild-to-moderate contractions, 30 to 60 seconds long, occur every five to 20 minutes and progressively become stronger and more frequent.
  • Active labor (approximately two to eight hours): Contractions continue to become longer, stronger and closer together; the cervix dilates to 7 centimeters. This is when most women request pain medication, though sometimes it’s given earlier.
  • Transition (up to an hour): Cervix dilates to about 10 centimeters, pain is strongest, contractions are intense and closely spaced, you may feel pain in your back, groin, even your sides or thighs, as well as nausea.
  • Pushing (a few minutes to three hours). Intense pain is eclipsed by major pressure as you feel a great urge to bear down and push your baby out—some women describe it as “like pooping a watermelon or bowling ball.” Although pain continues, many women say it’s a relief to push because it helps relieve the pressure. When the baby’s head crowns, or becomes visible, you may experience a burning, stinging sensation around the vaginal opening as it stretches.
  • Placenta delivery (up to 30 minutes): This stage tends to be relatively easy, as mild, crampy contractions ease the placenta out. At this point, you’re focused on your new-born anyway.’

Painless Delivery

Several women have low pain-threshold. And in a few women, anticipated pain and discomfort may cause anxiety. These women may opt for ‘painless delivery.’ A few others may opt for it because it is the flavor of the month.

In painless delivery, the woman has to bear the ‘early labor’ pain which can be mild to acute depending on the individual. These ‘early labor’ pains can be managed with warm showers, massages, and exercises.

When labor reaches the ‘Active labor’ stage, an injection of epidural is given in the spinal cord by the anesthetist. He tops up the epidural from time to time as the labor progresses. Epidural takes 10 minutes to place and another 10 to 15 minutes to begin to work. Epidural greatly reduces the pain during the ‘Transition’ and ‘Pushing’ stages and makes ‘Placenta delivery’ nearly painless.

Disadvantages of Epidural

The disadvantages of epidural are that labor is prolonged, the woman is unable to self-help, and the chances of delivery through forceps or vacuum increase. In one study, these chances increased from 16.4% in non-epidural to 37.9% in epidural delivery. Forceps or vacuum delivery has certain risks of injury. These are explained to the patient at length before she opts for natural or painless delivery.

Common side effects of epidural are:

  • Itching
  • Nausea and vomiting
  • Fever
  • Soreness
  • Low blood pressure
  • Difficulty urinating

A few rare side effects of epidural are:

  • Breathing problems
  • Severe headache (1%)
  • Infection
  • Seizure
  • Nerve damage (extremely rare, 1 in 4,000 to 1 in 200,000)

But gynecologist in South Delhi says that ‘there’s lots of misinformation [about epidural etc] — the risks and complications are overblown, and women suffer unnecessarily.’ And that epidurals and other pain-relief drugs are quite safe.

Forceps Delivery Risks

The risks to the baby from forceps delivery, though rare, are:

  • Minor facial injuries due to the pressure of the forceps
  • Temporary weakness in the facial muscles (facial palsy)
  • Minor external eye trauma
  • Skull fracture
  • Bleeding within the skull
  • Seizures

 Forceps delivery risks to mother are:

  • Pain in the perineum — the tissue between your vagina and your anus — after delivery
  • Lower genital tract tears
  • Difficulty urinating or emptying your bladder
  • Short-term or long-term urinary or fecal incontinence (involuntary urination or defecation) if a severe tear occurs
  • Injuries to the bladder or urethra — the tube that connects the bladder to the outside of the body
  • Uterine rupture — when the uterine wall is torn, which could allow the baby or placenta to be pushed into the mother’s abdominal cavity
  • The weakening of the muscles and ligaments supporting your pelvic organs, causing pelvic organs to drop lower in the pelvis (pelvic organ prolapse)

Most of these risks are also associated with vaginal deliveries, but these are more likely with forceps delivery.

Vacuum Extraction Risks

The risks of vacuum extraction to the mother are:

  • Tears and damage to the tissue in the lower genital tract
  • Pain after labor and delivery
  • Blood loss and subsequent anemia
  • Muscle and ligament weakness around the pelvic organs
  • Urinary or fecal incontinence, which may be temporary or permanent

Risks to the baby are:

  • Bleeding and wounds on the scalp.
  • Stretching of the nerves along the neck, which can cause Erb’s palsy or a brachial plexus injury.
  • Bleeding under the skin or in the brain.
  • Bleeding in the eyes.
  • A skull fracture.
  • Neonatal jaundice.
  • Brain damage, which may lead to permanent disability.

Natural Birth Risks

Natural births have risks too. Especially if the mother has a medical problem, or if an issue prevents the baby from naturally moving through the birth canal. Other concerns are:

  • tears in the perineum (area behind the vaginal wall)
  • increased pain
  • hemorrhoids
  • bowel issues
  • urinary incontinence
  • psychological trauma

Labor and delivery during natural birth can be eased with:

  • massages
  • acupressure
  • taking a warm bath or using a hot pack
  • breathing techniques
  • frequent changes in position to compensate for changes in the pelvis

The optimum method of childbirth for You

When advising you about the optimum method of labor and delivery for you, the Obstetrician will consider:

  • overall health and emotional well-being of the mother
  • the size of the mother’s pelvis
  • the mother’s pain tolerance level
  • the intensity level of contractions
  • size or position of the baby

Conclusion

Hopefully, the information in this write-up will help you make an informed decision, in consultation with your obstetrician, about the optimum method of childbirth for you:  total natural birth, natural delivery, painless delivery, or a caesarean section.

References:

  1. Natural vs. Epidural: What to Expect

https://www.healthline.com/health/pregnancy/natural-birth-vs-epidural

2. Pros and Cons of Painless Delivery

https://medium.com/health-care-for-women/pros-and-cons-of-painless-delivery-2c25e5d82e11

3. 8 Ways to Manage Labor Pain

https://www.parents.com/pregnancy/giving-birth/pain-relief/manage-labor-pain/

4. Painless Normal Delivery: Watch You Tube https://www.youtube.com/watch?v=zgcUvdEOMb

5. Pregnancy and birth: Epidurals and painkillers for labor pain relief

https://www.ncbi.nlm.nih.gov/books/NBK279567

6. Using Epidural Anesthesia During Labor: Benefits and Risks

https://americanpregnancy.org/labor-and-birth/epidural/

7. Side effects – Epidural

https://www.nhs.uk/conditions/epidural/side-effects/

8. Risks of Epidurals During Delivery

https://www.healthline.com/health/pregnancy/pain-risks-epidurals

9. Natural Childbirth V: Epidural Side Effects and Risks

https://chriskresser.com/natural-childbirth-v-epidural-side-effects-and-risks/

10. Labor Pain Explained: Stages, Symptoms and Pain Relief

https://www.parents.com/pregnancy/giving-birth/labor-and-delivery/understanding-labor-pain/

11.Women’s experience of pain during childbirth

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093177/

12. Methods of Childbirth

https://www.webmd.com/baby/guide/delivery-method

13. Forceps delivery

https://www.mayoclinic.org/tests-procedures/forceps-delivery/about/pac-20394207

14. What moms should know about forceps and vacuum deliveries

https://utswmed.org/medblog/forceps-vacuum-delivery/

15. The long term effects of forceps delivery on a baby

https://www.teeslaw.com/article/long-term-effects-forceps-delivery-baby

15. Forceps or vacuum delivery

https://www.nhs.uk/conditions/pregnancy-and-baby/ventouse-forceps-delivery/

16. Does Pain After Childbirth Increase Postpartum Depression Risk?

https://www.healthline.com/health-news/does-painful-childbirth-increase-post-partum-depression-risk

17. Less Labor Pain, Lower Postpartum Depression Risk?

https://www.webmd.com/depression/postpartum-depression/news/20161026/less-labor-pain-lower-postpartum-depression-risk#1

18. Feeling depressed after childbirth

https://www.nhs.uk/conditions/pregnancy-and-baby/feeling-depressed-after-birth/

19. Vacuum extraction

https://www.mayoclinic.org/tests-procedures/vacuum-extraction/about/pac-20395232

20. Vacuum-Assisted Vaginal Delivery

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672989/

21. Vacuum-Assisted Delivery: Do You Know the Risks?

https://www.healthline.com/health/pregnancy/risks-vacuum-assisted-delivery

22. Vacuum Extractor Injuries

https://www.cerebralpalsyguidance.com/cerebral-palsy/causes/vacuum-extractor-injuries/

Infertility Treatments Offered by the Best Gynecologist in South Extension

Today, witnessing the infertility concerns are very common the couples. 3 out of 10 couples are looking for the infertility treatment near their local area. And if you are among those couples, then wait, you don’t have to worry more about getting pregnant. Dr. Sadhana Kala is the best Gynecologist in South Extension, holding the degrees of MS, FIAMS, and FACS from USA, FICOG, MAAGL. She is an expert in the field of Gynecology and Obstetrician. She says that “I have come across many patients are facing complications with conceiving a child, such couples start feeling frustrated just after the few attempts of unprotected sex. But, having patience is the key and our team of doctors has successfully given the gift parenthood to many couples”.

best Gynecologist in South Extension Delhi

Infertility is the inability of getting pregnant even after having a year of unprotected intercourse. Both the partners can be responsible for infertility. Discussing female infertility, Dr. Sadhana Kala says that undergoing the treatment at right time is really vital for the couple that is planning to expand their family. She is trusted as leading Gynecologist in South Extension Delhi and many couples have undergone the medical assistance of her and her team and attained the delights of parenthood.

Infertility treatment:

Fertility drugs – These drugs are useful in balancing the fertility hormones in both male and female. These drugs are helpful even in the case when the actual causes are not known. The fertility drugs can be taken with a combination of other treatments like Intrauterine Insemination (IUI).

What is Intrauterine Insemination (IUI)? When the male’s sperm need help to get to the female partner’s egg, then a concentrated sample of sperm is placed directly into the uterus of the female partner at the proper time that can improve the chances of getting pregnant.

Surgery – As the best Gynecologist in South Extension, she states that the surgery is conducted if a female partner is having blocked fallopian tubes, fibroids, endometriosis, anatomic problems with reproductive organs, or ovarian cysts.

Dysmenorrhea : Affect Most Of The Ladies

Numerous ladies know how agonizing their period can be. This is alleged essential dysmenorrhea and it is common to the point that can even be considered as should be expected. Not at all like this, auxiliary dysmenorrhea happens later in lady’s life, which beforehand didn’t experience menstrual torment and this is typically neurotic.

Best Gynecologist in Delhi

This implies auxiliary dysmenorrhea happens later in life (usually in the 20s or 30s) and in the event that you encounter your first menstrual spasms in this age, you ought to visit a  Best Gynecologist in Delhi Dr. Sadhana Kala. You shouldn’t overlook it in light of the fact that there are numerous reasons for auxiliary dysmenorrhea, for example,

  • Endometriosis,
  • Pelvic provocative ailment,
  • Leiomyoma
  • Much tumor

Then again, a few ladies may have exorbitant seeping amid monthly cycle however possibly they are reluctant to discuss it or they don’t know about it. On the off chance that you need to change the cushions or tampons each hour, or if your period keeps going longer than usual (seven days or more), you ought to instantly visit a Gynecologist in Delhi.

This can happen in each age, so it can be brought on by numerous reasons, for example,

  • Hormone lopsidedness,
  • Ovarian cysts,
  • Uterine polyps,
  • Adenomyosis,
  • Uterine tumor

In more youthful patients this substantial draining is normally brought about by hormone lopsidedness, yet in ladies in their 50s, the most widely recognized cause is the endometrial malignancy. What’s more, this likewise something that you shouldn’t disregard.

Contemplates have demonstrated that 80 percent of ladies don’t request specialists help about issues amid their cycle.

This substantial or delayed draining happens in around 25 percent of ladies, however, they once in a while choose to look for help and to put a conclusion to this issue. They typically call a specialist when they get to be pale (the most well-known confusion from menorrhagia).

How to stop or avoid uterine spasms actually?

A standout amongst the most critical approaches to stop uterine spasms is to get thinner. This will likewise avert endometrial disease in later age since weight is the most vital danger variable in charge of this sort of tumor.

Best Gynecologist South Delhi To Help Women Away From Various Health Related Dangers

Ladies may have complex health issues, frequently beginning from their adolescents. Significant concerns a lady may confront amid her life can be connected with the period, pregnancy, hormonal irregularity and numerous other well-being issues. These conditions on occasion may definitely prompt bargain a personal satisfaction, disposition swings, thyroid lopsidedness, osteoporosis, pallor, stress and so on. These well-being issues may not be obvious at a case in a lady. Subsequently, it is vital to hold fast to convenient checkups to recognize any physical signs and indications, so that the important examinations and a viable administration arrangement can be taken after.

gynecologist in Delhi

With innovation progressing in each field, there are numerous offices, treatments and compelling methodologies accessible that guarantees lightening of these conditions. Nutritious and natural medication close by a coordinated therapeutic methodology can be of awesome advantage to a significant number of these female afflictions. On the off chance that you are looking forward to those clinics for treatment of various sicknesses or issues connected with female gainful parts, you can contact with best gynecologist in south Delhi to get their optimum services.

Sometimes there will be issues taking after the introduction of your child. A decent clinic will see to it that you have entry to a few medicinal administrations including nutritionist and dietitian help for your recuperation to perfect wellbeing. The best doctor’s facilities in South Delhi for conveyance ought to likewise incorporate a pediatrician’s administrations. He will be observing your child guarantee that nourishment and end are working as they ought to and the infant is keeping up a consistent weight pick up. The gynecologist will be observing you with blood tests, weight reduction or increase and womb condition.

Healing facilities with best ladies care administrations are normally favored by the patients searching for best treatment for infections connected with female beneficial parts. Patients regularly search for exceptionally successful doctor’s facilities with very viable birthing administrations. Birthing administrations, for example, an easy conveyance makes the clinics very requested in patients. In a pizzazz to accomplish an amazing position in this area, healing centers likewise offer precise administration of high hazard pregnancy cases. These medical centers also offer people with modern instruments as to enable great health to their patients with putting excessive pressure on their pocket.

The best gynecologist in south Delhi gives viable cervical malignancy screening to a location of the cervical tumor in the most methodical way. Discovery methodologies are utilized with the end goal of compelling identification of cervical tumor screening. For screening systems to be viably done, these healing centers have created howdy tech lab. Every one of these techniques is performed by first class specialists of industry which have substantial experience of working in the same field.

Booking Appointment with Best Gynecologist, Obstetrician in Delhi

A gynecology is a sub-branch of the medical science which deals with or analysis the problems occurring in the reproductive organs of a female. An adolescent young girl or a woman of old age face any fertility problems or monthly reproductive cycle system then they would need a specialist who can treat it. The problem of reproductive cycle system of a woman is not a general thing, it can be critical during on cycling period eggs are produced in the ovarian ones it imbalance then difficult to control and come back on routine. It can control with the help of gynecologist in Delhi they can treat it with the help of medicines. Females ovarian is a gland type organ if it infected then there is most of the chance to be occurring cancer disease.

gynecologist in Delhi

Not only women need a gynecology clinic but also a man can need it, the man that has lack of sperms or abnormal sperms, unable to conceive a kid. Medical science says that man sperms fertilize with the woman eggs and a mixture of these helps to born a kid. Medical science has been advanced and discovered new technology. IVF is a technology in which male sperms and woman sperms mix in the laboratory tube and after fertilizing it return to the woman ovaries. Couples who are not able to conceive a child may be experiencing strain, sadness, and nervousness which clarifies why it is important that these individuals be mentally ready to go through this procedure. It is a safe and successful treatment procedure. IVF treatment procedure is also known as test tube baby procedure. The adolescent girl or woman always aware of their cycling period if they are suffering now continue cycling reproductive system then without any embarrassment. Best gynecologist in Delhi offers all kind of treatment they are able to treatment by medicine or can provide IVF treatment.

Know Your Gynecologist in Delhi Before Getting Consultation

Numerous ladies imagine that a gynecology assessment is an exceptionally startling methodology, some even recount others the run of the mill story of when the specialists cut out your pubic parts and utilize it for unspecified reasons, which is all made out to terrify you clearly and obviously it’s not genuine. In all genuineness, the assessment is an extremely basic, straightforward system which you will probably expect amid the assessment. On the off chance that you have come here in light of the fact that your companion is going to experience this assessment yet you yourself have no clues what this exam comprises of. All things considered, you are in fortunes to see well about the nuts and bolts of a gynecology assessment.

gynecologist in Delhi

A gynecology test is a full assessment of a ladies’ vaginal locale by a specialist. A gynecology test helps your specialist on deciding the size and arrangement of your vagina’s primary parts like the uterus and ovaries. It is critical that all females by the age of fifteen finish this test. This test is likewise performed to pinpoint particular growths in their starting stages.

Before going to get administrations of any gynecologist, you ought to realize that when you appear for the assessment, as a rule, you will be given a structure in where you need to round out your therapeutic history. Return this structure to the colleague at the work area; now sit tight for your name to be gotten out by the aide. You will then be coordinated to the specialist; they will then sit you down in his office and make inquiries for the most part identifying with your therapeutic history. Then again, there is in no way like holding you under dull yet best Gynecologist in South Delhi may be work best you are coming into this range. The best thing is their top of the line learning and dedication to keep their patients free from dangers. You can get great results within couple of days once being counseled by the specialists living in south Delhi.

Know Your Doctor Better Before Contacing For Child Birth Cases

Gynecologists are the individual who takes great consideration of ladies. From the issues in the regenerative framework to labor, everything is taken great consideration and consideration with the goal that ladies can survive well and draw out the best result in wellbeing. A gynecologist in Delhi investigates the welfare of ladies greatly with the goal that they can get great consideration of their wellbeing and stay upbeat and solid. In the restorative field, they have an awesome obligation to conceive an offspring of an infant from the normal mother and bring an incredible grin on the substance of the mother.

best gynecologist south delhi

A gynecologist is a person who assumes the liability for labor and all other related issues of ladies. On the off chance that you are expecting a kid, then you ought to legitimately look into the best specialist around the city so that your child comes into this world in a sheltered way. Research and audits can demonstrate to you right way on the conception of your child. These audits taxicab certainly help you sooner rather than later and give you a positive result. After you are fulfilled by your examination, then just you take the choice of picking a decent specialist.

A gynecologist amid the season of pregnancy is exceptionally crucial and vital. He or she ought to need to take appropriate consideration of the mother and of the tyke. The authority is enjoying a major obligation in taking care of both of the mother and of tyke with extraordinary consideration and consideration. Authority dependably needs to update herself with legitimate information on the issues of pregnancy so one can give great consideration to ladies and result in better. The master is resolved with their obligation so that he or she can bring the best result for a mother. At the point when considering best gynecologist in South Delhi, it is important to investigate every single related amenity where you don’t have to confront any kind of outcomes and you can discover everything good.

Hormonal Disorder and Solutions by Gynecologist

Man and woman, both of them almost have the same kind of body organs and organ system. But there are some basic organs and organ systems which makes the difference between male and female. Not only a woman but also man can be need of gynecologist because hormonal disorder can happen for anyone.

gynecologist in delhi

Gynecology is a branch or part of medical science that deals with the health of female reproductive system that is very subtle. Furthermore that it is like any other part of the body as it requires detailed research and knowledge. Considering that, there are lots of aliments which are looked into by any gynecologist like urine problem, cancer problem with menstruation etc. So, whenever you search a gynecologist you need to take care of loads of things like; to consult a gynecologist who has an experience in obstetrician as well. To consult female gynecologist because women have hesitation they cannot share their internal body problems with a male gynecologist. Mostly a gynecologist in Delhi resolves infertility problem with the help of medicines or drugs. They always strive for making corrections to unbalance hormonal organs.

Gynecology clinics in Delhi have brought up the wonderful infertility treatment in Delhi through In Vitro Fertilization. These clinics are characterized as the technique that is utilized to consider a child outside the body of a female. By this technique, men’s sperms and women’s eggs are set together in a plastic tube for fertilization. Once the eggs are fertilized, consequential embryos are placed into the woman’s uterus through the glass tube or plastic tube for resulting in pregnancy. This treatment method is known as test tube baby technique.

There are many hospitals and clinic in the Delhi city, but you have to opt one best gynecologist in Delhi then visit www.drsadhanakala.com through the internet and consult our clinic address in Delhi has remedies that can cure any infertility issues easily. The concept of having test tube baby is a blessing to those couples who cannot become parents due to some of their unbalance organs anyhow this modern technology gives them a chance to live the blissful moments of parenthood. It’s proven successful technique of medical science, millions of parents in the world have adopted this treatment and got the successful living their parenthood life.