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gynaecology

Vaccines help the body develop immunity against a specific pathogen: Dr Manju Puri

by Medically Speaking Team July 26, 2021

The Union Health Ministry recently stated that pregnant women are eligible to get vaccinated against COVID-19. However, there are certain women who are unaware of the benefits of getting vaccinated during their pregnancy and the steps they should follow to protect their child and themselves from the infection.

In an interview posted by the Ministry of Health and Family Welfare, Dr. Manju Puri, Head of Department, Obstetrics & Gynecology, Lady Hardinge Medical College, New Delhi, talks about the recent decision to introduce COVID-19 vaccine for women during pregnancy and the precautions that they should take to protect themselves and their baby from COVID-19.

Question: It has now been approved that woman can take COVID-19 vaccines even during pregnancy. How will it help?

Dr Manju Puri: During the second wave, many women contracted COVID-19 during pregnancy compared to the first wave. This can lead to serious complications during pregnancy as the uterus is enlarged and presses on the diaphragm. Vaccines will help prevent severe diseases in pregnant women. Also, vaccinating a mother is likely to give some degree of protection to the new-born as the antibodies developed in the mother’s body post-vaccination will pass on to the developing foetus through her blood.

Question: Some people believe that vaccines can cause infertility among women. Is it true?

Dr Manju Puri: The Covid-19 vaccines do not cause infertility and there is no scientific data or studies that show that vaccines can cause infertility. The vaccine does not affect the reproductive organs in any way. Vaccines help the body develop immunity against a specific pathogen and do not affect any other body tissue.

Question: What precautions should a pregnant woman take to protect herself from catching COVID?

Dr Manju Puri: Women should use all Covid-appropriate precautions during pregnancy and after childbirth as it can prevent them from catching the infection and related complications. An expectant mother should wear a mask and maintain physical distance even when at home, amongst her family members. It is because she may not be going out, but her husband or family members could be going to work and she can contract the infection from them.

Question: What should a pregnant woman do if she shows symptoms of Covid-19?

Dr Manju Puri: If a woman has any symptoms of COVID, she should get herself tested at the earliest. She should drink plenty of fluids, check her temperature and oxygen saturation every 4-6 hours. If there is a fall in oxygen concentration or if it is decreasing, she needs to get in touch with her doctor. Women who have illnesses such as diabetes, high blood pressure, cardiovascular disease, obesity, need to be more careful, as they may need hospitalization.

Question: Can a foetus contract Covid-19 from the mother?

Dr Manju Puri: There is no evidence to support claims that the placenta acts as a protective barrier against Covid-19 infection. There are a few cases where the new-born were found infected but we are not sure whether those babies got the infection inside the mother’s womb or soon after the birth. Having said that, as I have explained earlier, pregnant women must take all the possible precautions to prevent the infection as Covid-19 can affect her and her child in many other ways.

Question: What precautions should a COVID positive mother take to protect her newborn?

Dr Manju Puri: A mother should continue to breastfeed the baby but is advised to keep the baby at a distance of 6 feet from her when she is not breastfeeding. A caregiver who is tested negative can also help in taking care of the newborn. Before breastfeeding the newborn, she should wash her hands, wear protective gear such as a mask, face shield. She should also sanitize her surroundings frequently.

Question: Postpartum depression and anxiety are common among women. Do you see an increase in mental health issues among women during the pandemic?

Dr Manju Puri: There is an increase in mental health problems among women during pregnancy and post-childbirth. Isolation for 15-days is difficult for everyone, but more so for pregnant women and postnatal mothers. Doctors, as well as family members, need to watch a woman’s behavior carefully during this time. The family should stay in touch through video calls, and observe any change in her mood and seek medical help if she looks and feels depressed.

Question: What advice would you like to give to your women patients?

Dr Manju Puri: Women with symptoms suggestive of COVID need to seek medical help immediately and should not delay the diagnosis. They are advised to take vaccine as and when it is available to them and avoid meeting many people. All pregnant women should be counselled about various contraceptive methods during pregnancy. Postpartum Intra-Uterine Device (Cu T) can be inserted immediately after childbirth or caesarean delivery. It saves them of an unnecessary visit to the hospital after childbirth and reduces the risk of an unplanned pregnancy.

July 26, 2021 0 comment

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Yoga in Pregnancy – An effective and safe fitness option for Mothers-to-be

by Medically Speaking Team June 18, 2021

written by Medically Speaking Team

By: Dr. Aruna Kalra – Senior Gynaecologist and Obstetrician at CK Birla Hospital, Gurugram

In order to stay healthy and active during pregnancy, a woman can opt for yoga for best results. Yoga helps pregnant women and their babies in a number of ways. It reduces anxiety and help the mom-to-be stay calm during pregnancy and in labour. During pregnancy, a number of women go through mood swings, breathing problems, fatigue and sickness. Yoga exercises reduce all such problems resulting in an easy and smooth delivery.

Women who regularly perform yoga would only need to make minor modifications to their yoga routine during their pregnancy when the body is undergoing hormonal changes. The main aim of yoga during pregnancy is to help moms-to-be bring their little ones into the world with minimum risks and no health complications. Positions and exercises practiced differ with every phase of pregnancy. So, you should perform yoga under the supervision of an expert and after consulting your doctor.

A happy, healthy pregnancy through yoga

Yoga is a great way to relieve pain during pregnancy. Women who perform yoga during pregnant can experience reductions in:

Back pain
Leg pain
High blood pressure or Preeclampsia risk during pregnancy
Labour pain, potentially due to improved core strength

Yoga also offers many psychological benefits for mothers-to-be, such as lowered levels of anxiety and depression, which can result in a happier, more balanced pregnancy. Even in the delivery room, the breathing and relaxation techniques can help relieve pain during labour.

After delivery, yoga also helps in reducing postpartum depression, which is a serious concern for many women. Yoga can help in re-gaining core strength, which can lower the risks of pelvic floor disorders related to childbirth.

Yoga Poses for Pregnant Women

Following are some yoga poses that can help ease pregnancy symptoms or help you build strength:

Cat to cow: This back-arching technique is great for relieving back pain.

Garland: This deep squat is thought to help turn a breech baby to the proper head-down position.

Jac Prenatal 4 Supported Garland or Squat Pose Malasana from Dolphin Method

Happy baby: Aptly named for pregnant yoga practitioners, this pose can help release tense lower back muscles. This is an inversion pose, so Check with your doctor and yoga instructor before trying this as it is an .

Legs up the wall: This inversion pose can help reduce swelling in your feet and ankles. Check with your doctor and instructor first.

Planks: Planks help in building abdominal strength, which is important for labour and recovery. As your pregnancy progresses, you may find planks difficult to perform, so don’t put much pressure on yourself.

Warriors: These standing poses are some of the most commonly practiced to help build overall strength. You can also do double duty by performing Kegel exercises at the same time, which aid in delivery and recovery after childbirth.

Basic Precautions to keep in mind

Inform your yoga instructor about your pregnancy if you are attending a yoga class that is not specifically designed for pregnant women.
Any kind of yoga poses that works on the back should be avoided after the first trimester. These exercises may reduce the flow of blood to the uterus.
Avoid stretching your muscles to the extreme.
Practice yoga poses only to the extent to which you are comfortable. Do not exert yourself too much. Do not over exert your body, listen to it carefully and stop exercising if you feel any discomfort.
Be aware of your knees. Do not strain them too much.
Practice yoga during pregnancy under the guidance of an expert only. Avoid copying videos or DVDs, because it can be dangerous to your health as you will not be able to judge if you are doing any mistake.
Don’t exert yourself too much and know when you should take a rest. Observe the signs your body is trying to give and if you feel tired, take breaks in between.

June 18, 2021 0 comment

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Important Health Screening Tests Every Woman Needs

by Medically Speaking Team June 18, 2021

written by Medically Speaking Team

By: Mr. Sameer Bhati – Director of Star Imaging & Path Lab

A Woman is considered as the backbone of a family as she works day and night to fulfill every
need and take care of everything and everyone, that others might forget. They work twenty four
into seven (24*7) to cater to every need and request. Many a times, due to this, they overlook
their own health. Therefore, a woman needs special care and timely tests and screenings to
ensure that they are in the pink of their health. Below mentioned are five important health
screening tests with periodicity that a women must undergo in order to lead a healthy and happy
life.

Routine Blood Test: Regular blood examinations can help in finding potential health
problems before they become major concerns and these tests are one of the most
important ways to keep a check on a woman’s overall physical well-being. Getting tested
at regular intervals allows them to observe the way their body changes over a period of
time and aware them to make informed decisions regarding their health. Regular blood
test generally includes blood pressure screening, Anemia test, Blood Glucose test,
cholesterol check-up, Vitamin D along with others. A woman can undergo these blood
tests twice a year.
Mammogram: A mammogram is basically an X-ray of the breasts of the women. A
mammogram helps in finding signs of breast cancer – it is the second most cause of
cancer-related deaths in women. A woman should usually start getting her mammograms
done around the age of 40 years and then repeat the same after every 1 or 2 years. Some
doctors may also suggest you to start getting the mammograms done by the age of 50
years. This test is done to in order to identify skeptical changes occurring in a woman’s
breast like lumps, breast pain, unusual skin color or any other. Pregnant ladies should not
undergo this test.
Pelvic examination: A pelvic test is an examination of the reproductive organs of a
female in order to check for cancer, infections, and other health conditions. A Pap test is
a common test performed during a pelvic exam that helps in detecting cervical cancer.
Diagnosing cervical cancer at an early stage using a Pap smear provides a greater chance
for cure. This test also helps in detecting changes in cervical cells that show the chances
of development of cancer in the future. Diagnosing such abnormal cells at an early stage
with a Pap smear test is the first step in stopping the possible development of cervical
cancer. A pelvic test should be done once in a year starting around the age of 21 years.
Bone Density Test (BMD): A bone density examination measures bone mass in the key
areas of a woman’s body, such as the hip, heel and wrist. BMD is one of the important
tests to detect osteoporosis. Osteoporosis is a health condition in women in which their
bones become brittle and weak, and become more susceptible to breaking. A bone
density examination can be performed using different machines. One of the most
common technique is dual-energy X-ray absorptiometry (DEXA) scan. This test
enhances the accuracy of calculation of the risks of bones breakage. BMD test uses X-ray
images to measure the grams of calcium and other bone minerals that are packed into a
segment of bone. Spine bones, hip bones and sometimes the bones of the forearm are
most commonly tested. A woman can undergo a bone density test twice in a year.
Female Hormonal Profile: In females, hormonal imbalances are common to occur these
days due to the changes in their lifestyles. Hormone blood tests help to know the
abundance of key information about a woman’s well being. Blood tests performed to
measure the female hormone levels also play an important role in diagnosing medical
conditions such as thyroid disease, diabetes or PCOD or PCOS. Hormonal profile test
generally includes Progesterone, Estrogen, Follicle-stimulating hormone (FSH), Thyroid
hormones, and Testosterone or DHEA.

June 18, 2021 0 comment

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Punjab: Hospital and gynae directed to compensate Rs. 10 lakh to patient for failed surgery

by Medically Speaking Team April 22, 2021

written by Medically Speaking Team

Punjab State Consumer Disputes Redressal Commission has directed a hospital and its doctor to pay a lump sum of Rs 10 Lakh as compensation to a patient for failing in operation and providing post-operative care to the her. The patient was suffering a cut in her intestine during an operation for ectopic pregnancy.

The judgement dated that the treating doctor should have opted for CT scan to understand the reason for suffering by the patient. It held the hospital and the gynaecologist guilty of deficiency in service and medical negligence.

Thus, the commission directed the treating doctor and the hospital:

To pay lump sum of Rs. 10,00,000/- to the complainant, as compensation, along with interest at the rate 7% per annum from the date of filing of the complaint till realization, on account of deficiency in service and medical negligence on the part of the opposite parties No. 1 & 2 and resultant loss, mental agony, harassment, avoidable pain, suffering caused to her, including medical expenses, and;
To pay Rs. 11,000 as litigation costs.

April 22, 2021 0 comment

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Pregnancy adversely affected by Covid? Know cure

by Medically Speaking Team April 12, 2021

written by Medically Speaking Team

According to latest findings, COVID-19 is less likely to show symptoms in pregnant women as compared to non-pregnant, but more likely to need extensive care if severely ill.

The new research findings published in the BMJ highlight the risks of COVID for pregnant women and their babies. It says that pregnant women seen at the hospital with suspected or confirmed COVID-19 are less likely to experience a fever or muscle pain. However if they develop severe disease they are more likely to need intensive care than non pregnant women with COViD-19.

These results are based on a ‘living systematic review’; ongoing, global, research which is collecting and synthesising data on the situation for pregnant women with COVID-19 in countries worldwide. It has been led by researchers at the University of Birmingham, UK, the World Health Organization, and the Special Programme HRP alongside other collaborators.

Pre-existing medical conditions

Currently evidence suggests that people who are non-white, are older, who are overweight and/or have a pre-existing medical condition, are more vulnerable to severe disease due to COVID-19. According to the latest findings of this review, pregnant women with COVID-19, who have pre-existing medical conditions, such as diabetes or chronic high blood pressure, or those who are non-white, older or overweight, are also more likely to suffer severe health complications due to COVID-19.

Risks for newborn babies and women

Pregnant women with COVID-19 were also more likely to give birth prematurely. The findings also show that 1 in 4 of all babies born to women with COVID-19, were admitted to a neonatal unit but data on causes of preterm births or indications for admission to neonatal units among these babies is lacking. Stillbirth and newborn death rates however were low.

The research findings show that pregnant or recently pregnant women with COVID-19 are more likely to be admitted to the intensive care unit or need respiratory support when compared with non-pregnant women of reproductive age.

Implications for healthcare

It is important healthcare providers are aware that pregnant women with COVID-19 and their newborn babies may be more likely to need specialist care, and that women and their babies have access to this care. This is particularly true for pregnant women with COVID-19 alongside other co-morbidities or risk factors.

In addition it is crucial to stress that whether or not a woman has COVID-19, her right to a positive pregnancy and childbirth experience must be ensured.

It is also important to recognise the increased stress and anxiety caused by COVID-19 which may be particularly felt by pregnant women, recently-pregnant women, and their partners, children, and families; healthcare providers have a role in responding to pregnant women in an appropriate and compassionate way.

Source – WHO

April 12, 2021 0 comment

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Covid 19 may severely affect Pregnancy; know cure

by Medically Speaking Team March 27, 2021

written by Medically Speaking Team

March 27, 2021 0 comment

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Guilt and Shame Risk Sexual Health Problems in Women

by Medically Speaking Team March 25, 2021

written by Medically Speaking Team

By: Padmashree Dr Alka Kriplani, Director & Head – Centre for Minimally Invasive Gynaecology, Obstetrics & ART, Paras Hospitals, Gurgaon

The lack of clear approach to sexual health and reproductive concepts have caused many problems in this part of the country for a long time now. However, the general lack of awareness about sexual health in girls who have attained puberty is more telling as sex is still a taboo subject in conservative societies. The cost of it is severe as these girls are dependent on unverified sources of information, mainly hearsay, and experience of older girls and women. Sex is presented as a means to fulfill an end as not as an experience. As a result, anyone who is exposed to it outside the approved pattern is filled with guilt. They are not likely to come out and seek help. This guilt and shame around sexual health increases the risk of these girls and women increasing their risk of sexual health problems.

Common sexual health problems

Female sexual dysfunction (FSD) is a fact of life and many women face it at some or the other point of their lives. Some of the common sexual health problem women encounter include:

Pain during sex: This is one of the most well-known sexual health concerns among women. Pain during sex, known as dyspareunia, can be the result of vaginismus. Vaginismus is a condition when the vagina suddenly tightens up just as something is inserted into it. The condition can be caused by a vaginal trauma, such as an episiotomy during childbirth, the guilt of having sex being a ‘wrong’ doing, fear of pregnancy or relationship problems, and can be treated.
Low libido: Stress is a major reason for low sex drive. Besides, diabetes – both type 1 and type 2 diabetes; hormone disorders such as that of thyroid gland; depression; tiredness; and mental or physical trauma, among others can cause low sex drive. Women after menopause may experience a drop in sexual drive due to lower levels of estrogen.
Orgasm issues: A woman may have never experienced orgasm or has had an orgasm in the past, but not any longer. One may have this due to fear or lack of knowledge about sex; not enough stimulation before sex; feeling depressed or stressed; relationship problems; or previous traumatic sexual experience.
Trauma and sexually transmitted infections: Women who have undergone the trauma of female genital mutilation (FGM), as practiced in some communities, can find it painful to have sex. The process deliberately cuts or changes female genitals. Lack of sexual knowledge increases the risk of sexually-transmitted infections such as chlamydia or gonorrhoea or more serious HIV (human immunodeficiency virus) causing AIDS (acquired immune deficiency syndrome).

Knowledge is important

Sexual health problems can be addressed with knowledge and awareness. The most important is knowledge of contraception that will prevent both STI and unwanted pregnancy. Psychosexual therapy aims to help the woman to understand and change feelings about her body and sex. Physical contractions during sex can be addressed with relaxation techniques such as mindfulness and breathing while gentle touching exercises will help learn the vaginal muscles to relax. One can also do pelvic floor exercises to gain control of these muscles. Sensate focus exercises can help one relax during sex and increase sex drive.

March 25, 2021 0 comment

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