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MODERN HEALTH CARE for WOMEN
- Dr Ruby
Every woman
deserves optimal primary care before, during and after her reproductive years.
This site has been designed to aid in the treatment of outpatient problems and
queries. It is meant to emphasize the office diagnosis and treatment for the
most frequently encountered problems, as well as sensitive subjects encountered
in office medicine.
This site will serve as a quick reference with a wide scope,
covering most aspects of obstetrical and gynecological outpatient care.
FEATURES:
- Provides an incisive look at areas of rapid change in women’s health
care to stay abreast of changes in how health care is being delivered with
the new advances in various aspects of women’s health care.
- Practical information on commonly encountered health problems.
- Evaluation and management of common clinical problems.
- Encompasses a wide range of topics, progressing from the basics of health
care for women to complicated subspecialty problems:
-
Obstetric care of pregnant women ( ante-, intra- and postnatal care)
Infertility
- Gynecological problems related to different age groups:
adolescence, reproductive age and issues pertaining to the mature woman
- Uro-gynecology
- Gynec-oncology
- Genetic counselling and risk management
- Recent trends evolving in the field
- Guidance and recommendation to expert faculty and clinicians in respective
subspeciality fileds.
As approaches to common clinical conditions continue to
evolve and change overtime, the information provided will be from a review of
current literature, technical bulletins of OB/GYN, peer review literature,
discussions with respected colleagues and own clinical impression.
This site has been envisioned to be a rapid and informative
source in the area of women’s health care and it is hoped that it will
complement and foster the development of health care to women.
It is our hope here at www.kulal.com
that the practical material contained within will help the women who place their
deepest trust in the skill and wisdom of their obstetricians and gynecologists.
PRELIMINARY
DEFINITIONS:
Obstetrics:
deals with pregnancy, labor and puerperium (period immediately following
delivery up to 45 days after)
Gynecology: deals
with diseases of the female genital tract
Amenorrhoea:
1. No periods by age 14 in the absence of growth or development of
secondary sexual characteristics.
2.
No periods by age 16 regardless of the presence of normal growth and development with the appearance of secondary sexual characteristics.
3. In a woman who has been menstruating, the absence of
periods for a length of time equivalent to a total of at least 3 of the
previous cycle intervals or 6 months of amennorhoea (absence of menses).
Primigravida: a woman pregnant
for the first time
Colostrum:
the thin, yellow, milky
fluid secreted by the mammary gland before or after
parturition ®
contains up to 20% protein (predominantly among which are immunoglobulins),
more minerals and less fat and carbohydrates than does milk.
Antenatal
(or prenatal):
existing or occurring before birth, with reference to fetus
Intranatal:
occurring
during birth
Postnatal:
occurring after birth, with reference to the newborn
Puerperium:
the period following delivery up to 6 weeks after
Parturition:
the act or process of giving birth to a child
DID
YOU KNOW?
OBSTETRICS:
FAMILY PLANNING: CONTRACEPTION AND PREGNANCY TERMINATION
·
It has been estimated by WHO (world health organization) that 50
million unwanted pregnancies are terminated every year, of which 40% are
performed unsafely (represents 1 in 10 pregnancies or 1 unsafe abortion in every
7 births).
90% of these
unsafe abortions take place in developing countries.
·
In India, 15 - 24 unsafe abortions take place per 1000 women (
aged between 15 – 45 years). They are performed 15 – 20 times more often
than safe legal abortion in India at present.
·
Illegal abortion is 10 – 250 times more dangerous than any kind
of contraceptive measure.
·
Death rate from illegal abortion is estimated to range from 50 –
100 per 100,000 procedures.
In India, 70 - 89 women per 100,000 live births die from unsafe abortion.
The risk of death is 1 in 250 procedures.
·
It is safer to avoid a pregnancy than to terminate one………so
if you aren’t prepared to have a baby yet ®
seek CONTRACEPTIVE ADVICE.
·
EARLY
PREGNANCY (less than 2 months) TERMINATION can now be carried out
using medical
methods….. you can now choose between a medical method and a
surgical intervention like D & C (dilatation and curettage).
PREGNANCY RELATED:
·
The
total duration of pregnancy is 40 weeks. A “term pregnancy” is one that has
completed 37 weeks. Any duration of pregnancy before that is considered “preterm”. Duration of pregnancy
lasting 2 weeks beyond the expected date is considered “postterm”.
·
Only
40% of pregnant women actually deliver on their Expected
Date of Delivery (EDD) / Confinement (EDC). One in 10 gets prolonged beyond 40
weeks. 10% of pregnancies go
postterm. 10% of pregnancies
terminate as preterm.
·
Regular check ups antenatally (during pregnancy), after confirmation,
with your doctor, can ensure a safer pregnancy outcome.
·
Smoking and
alcohol consumption in pregnancy can have a detrimental
effect on pregnancy.
·
Having your first baby after 30
years of age (especially after 35
years)? You are what obtetricians call an Elderly primigravida and you need to ensure your medical
evaluation (especially in terms of Blood pressure and Blood sugars) and regular
antenatal check ups!
·
Are you aware of the importance of Breast Feeding and colostrum?
·
Vaginal
infection in early pregnany is
significantly associated with preterm
labour and preterm birth. The earlier in pregnancy at which the infection is
treated for the specific type, the more likely the decrease in incidence of
preterm labor/ birth.
GYNECOLOGY:
·
The most common cancer
affecting the Indian woman is that of the uterine cervix, followed by that of
the Breast.
Every
sexually active woman should have herself screened by the PAP
Test.
·
Non-itching and non-foul smelling vaginal discharge a woman gets
in the middle of her cycles may only be a normal physiological discharge called leucorrhoea.
Persistent and or foul smelling, itchy vaginal discharge needs to be
evaluated and treated!
·
Daily calcium supplement intake
after 30 years of age significantly decreases the risk of osteoporosis an
drelated fractures in the mature woman.
·
Your ultrasound scan report shows you have a FIBROID
–
but you have no complaints (asymptomatic). NEEDEN’T PANIC: you need not have it removed!!
A fibroid is the most common benign (non-cancerous) lesion/ tumor
affecting women of reproductive age group.
·
In an infertile
couple, the prevelance of women
related factors responsible for infertility accounts for 40%, that
of male factors also accounts for
40%, both: 10%, and unexplained factors account for 10%.
so, it is equally important to have the husband evaluated for the cause of
infertility.
·
Any woman, in the reproductive age group, with amenorrhoea
needs be evaluated.
OTHER SUBJECTS YOU CAN ENQUIRE ON
Place of HRT
(hormone replacement therapy)
Menopause
Menstrual
problems
Hirsuitism
(excesive male pattern of bodily hair growth)
Abnormal
sexual development
Incontinence
of urine
Recurrent
early pregnancy loss
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