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Clinical Facts


  • 1. What is Endometriosis?
    • It's a common condition where cells of lining of the womb (endometrium) are found elsewhere, usually in the pelvis, ovaries, fallopian tubes & around uterus. It is not cancer. It is not an infection.

      What symptoms will I have?

      The main symptoms include

      * Pelvic pain

      * Pain during or after sex

      * Painful, Heavy periods

      * Problems with getting pregnant


  • 1. What are Polycystic ovaries(PCOS)?
    • Polycystic ovaries are slightly larger than normal ovaries & have twice the number of follicles (small cysts).It is very common affecting 20 in 100 women(20%)

  • 2. What are the symptoms of PCOS?
    • Having Polycystic ovaries doesn't mean that you have polycystic ovarian syndrome. The incidence is 6 or 7 in 100 women (6%-7%).

      The symptoms include

      * irregular periods or no periods

      * difficulty becoming pregnant

      * having excessive body/facial hair than usual

      * loss of hair on head (excessive hair fall)

      * overweight, rapid increase in weight or difficulty losing weight

      What are the long term health issues if I have pcos?

      * Insulin resistance & Diabetes

      * High Blood pressure

      * Heart disease in later life

      * With fewer periods, risk of Endometrial cancer is increased

      Pcos doesn't increase your chance of Breast, Cervical or ovarian cancer


  • 1. What is menopause?
    • It is the point when a woman's periods stop permanently. The average age of menopause is 51, but ranges between 40 t0 55.

  • 2. What are the common symptoms of menopause?
    • The most common symptom of menopause is "HOT FLUSHES". It is the sudden feeling of heat that rushes to the upper body &face. Skin may redden & last for few seconds to several minutes. You might have sleep disturbances, mood changes, pain during sex, vaginal & frequent urinary problems.


  • 1. What is a Pap smear?
    • It is a screening test done in the OPD .It helps to check for changes in the cells of your cervix like infection, abnormal cells or cancer.

  • 2. What will be the schedule for PAP smear screening?
    • Usually ,we start screening few years after you enter into sexually active life. The guidelines in general would be

      * start screening at 20-25 until 50 or 60

      * every 2 yrs if more than 30 yrs of age.

      * screen every 3-5 yrs until normal results

      * stop screening at 65,unless results recent abnormal results.

      * no need to screen after a complete hysterectomy done for benign disease

      The frequency depends on the individual patient & her risk and so consult your gynecologist.

  • 3. Do I need pap test if I get vaccinated?
    • Yes. Pap smear test is compulsory even if already vaccinated!

  • 4. What is the advantage of doing Pap test?
    • Since Pap test is a screening test ,we intend to pick up abnormalities of cervix at the preclinical stage. A regular pap screen with follow up can reduce cancer cervix by about 80%.

  • 5. What are the fallacies with pap test?
    • Pap test is a screening test and hence there could be false positives & false negatives. Adeno carcinoma of cervix has not been shown to be prevented by pap test.

  • 6. How should I get a Pap smear test done?
    • Usually it's done by your Gynecologist at her office. Fix up an appointment about 10-15 days after your periods . Avoid vaginal douching, sprays, deodorants & sex for at least 1-2 days before the procedure.


    • Failure to conceive after regular unprotected intercour Yes. Female fertility declines with age, but the effect of age on male fertility is less clear


      * If after 1 year of trying, no pregnancy occurred.

      * If female partner more than 35 yrs, earlier investigation needed.

      * If h/o menstrual irregularities, Pelvic infection, coital difficulties, undescended testis, couple need to consult early.

    • Yes. Counseling is very important since it involves a lot of psychological stress.

    • The basic investigations needed before starting any infertility treatment are semen analysis, confirmation of ovulation & documentation of tubal patency.

  • 4. WHAT IS IUI?
    • IUI means placing the prepared sperm inside the uterine cavity.

    • The overall success rate is about 20%-40%

    • Referral for IVF is recommended in case of failure to achieve a pregnancy in 4 to 6 cycles.


Preterm Labour

  • 1. What is preterm labour and What will happen to my Baby?
    • There's chance of many health problems especially with eyes, ears, breathing &nervous system. They tend to grow more slowly. There may be learning & behavioral problems as they grow

  • 2. How will I know that I've got preterm labour?
    • If you have symptoms like

      increased vaginal discharge(watery, mucus ,blood)

      pelvic or low abdominal pain

      constant low dull back ache

      mild abdominal cramps

      regular, frequent uterine contractions

  • 3. What is PPROM?
    • If there's leakage of Amniotic fluid before 37 weeks, it's PPROM - 2 in 100 (2%)

  • 4. How will I suspect?
    • You will feel wet/damp. Amniotic fluid will be clear or pinkish in color, green-brown or blood stained.

  • 5. What should I do?
    • Leakage of urine is common during pregnancy. So, keep an under pad to note the color & amount of fluid leaking. If u think it's amniotic fluid, contact your obstetrician immediately.

  • 6. What kind of treatment can I expect?
    • Treatment is aimed to reduce the complications Depending on the duration of pregnancy, you may need to have ..Antibiotics to reduce chance of infection ..Course of steroid injections to help baby's lung development ..Medication to stop contraction if you need to be transferred to a tertiary care center with good NICU

  • 7. How will this affect a future pregnancy?
    • Having had preterm delivery means that you are at increased risk of preterm labour (PTL) in the next pregnancy also ! ( depending on the cause of previous PTL)

Cervical Incompetence

  • 1. What is cervical incompetence?
    • Normally, changes in cervix (mouth of womb) should begin at the beginning of labour, after about 9 months of pregnancy. But, in some women, due to pressure from growing fetus on the uterus, the Cervix opens prematurely leading to delivery, which may happen between 16 to 24 weeks of pregnancy. A h/O 2nd or early 3rd trimester fetal loss, after painless cervical dilatation , prolapse or Rupture of membranes & expulsion of a live fetus despite minimal uterine activity, is characteristic of cervical insufficiency.

  • 2. What is cervical encerclage?
    • Cervical encerclage is a stitch made in the cervix to provide structural support to the weak cervix.

      If prophylactic cerclage (past obstetric history indicated) planned, you may need it around 12 to 14 weeks .But it can be done when Usg (scan) shows cervical shortening , usually around 14 to 24 weeks.

  • 3. Who need ultrasound monitoring of cervical length?
    • Pregnant women with a h/o spontaneous 2nd trimester loss or preterm birth who have not undergone a history indicated cerclage may be offered serial sonagraphic surveillance which is an alternative option to prophylactic cerclage. If patient shows cervical shortening , they are at increased risk of preterm birth & may need cerclage. If cervix remains long, they have a low risk of 2nd trimester loss/preterm birth.

Low Lying Placenta(PLACENTA PRAEVIA)

  • 1. What is Placenta Praevia?
    • If placenta attaches too low in the womb and covers a part or whole of the entrance to the womb(cervix),it's called as low lying placenta

  • 2. What does this mean to my pregnancy?
    • In most cases, placenta is carried upwards as the womb stretches over the growing baby & so not a problem. If it continues to lie in the lower part in the last months of pregnancy, this is placenta praevia and you may anticipate some problems before or during delivery.

  • 3. What extra Antenatal care should I expect?
    • You need to have one extra scan at around 8 months of pregnancy to check if placenta is still low lying. If you continue to have low lying placenta, then depending on the severity of the condition, the management is individualized & carefully follow your Doctor's advice

Antepartum Monitoring of Fetal Wellbeing

  • 1. What are the special fetal tests?
    • The special fetal tests include fetal(baby) movement count, Ultrasound, Doppler Ultrasound of Umbilical artery & other arteries, Non stress test (NST),Biophysical profile(BPP).

  • 2. Why do I need special fetal testing?
    • If the pregnancy is at risk, special fetal testing at frequent intervals may be needed to assess the health of the baby.. (eg) Blood disorder ,Thyroid disorder ,Heart disease, Kidney disease, Diabetes, High BP during pregnancy, Decreased Baby movement, Too much (or) too little Amniotic fluid, prior fetal death, postdated pregnancy etc..

  • 3. What is a NST?
    • NST is the most common special fetal test .It measures the baby's heart rate in response baby's own movements. It is done to assess the health of the baby inside the womb.

Ectopic Pregnancy

Pelvic Inflammatory Disease(PID)

UTI(Urinary Tract Infection) In Pregnancy



Gallstone Disease