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Gynaecology OP

Fetal Medicine

Gynaecology is the clinical area focused on the health of the female reproductive system and covers a wide range of different conditions and age groups.

The common problems include issues related to irregular periods, menstrual pain, heavy menstrual bleeding, endometriosis, fibroids, pelvic pain, infertility and pelvic floor problems causing incontinence or prolapse. Beginning from problems in pre-puberty to post-menopause, we offer care to women through Out Patient, day care surgery and inpatient services. The Out Patient services are offered at Units 3, 4 and 5 and inpatient care including surgeries at Units 2 and 5 (details on schedules and appointments can be accessed at the call centre).

Our team of gynaecologists are well-versed in diagnosing and treating a wide range of medical conditions that affect women. The doctors bring with them expertise, experience and compassion. They are also well versed with the latest technologies (surgical and non surgical) and current trends. Many conditions can be addressed through medication and lifestyle changes instead of a surgery. Our main aim is to provide the most up-to-date care in the complete range of gynaecological problems. This care is provided by a team of specialists who have expertise in their particular field of interest, and includes doctors and nurses who strive to provide the best care in a clean and comfortable environment. All doctors are competent and offer counselling to enable women make the right choices. We also have an active ongoing programme for research and development.

We undertake consultation, investigation and treatment of a wide range of gynaecological conditions including:

  • General gynaecology: including screening for genital cancers, cervical cancer vaccination, etc.
  • Emergency gynaecology round-the-clock: ectopic pregnancy, twisted ovarian cyst, etc.
  • Reproductive medicine services: ovulation induction and intrauterine insemination
  • Abnormal vaginal bleeding
  • Urogynaecology
  • Preventive gynaecology and Well Woman checks incorporating clinical examination, Pap smear, laboratory investigations, pelvic ultrasonography and mammography.

The team specializes in modern minimally invasive techniques for surgery, enabling a shorter stay in hospital and a quicker recovery to normal activities. The gynaecological service has well equipped operation theatres in units 2 and 5 with the latest anaesthetic and surgical equipment. We have a dedicated post operative ICU for high risk cases and well-trained nurses who offer excellent post operative care.

Some of the surgeries offered are:

  • Keyhole surgery: diagnostic hysteroscopy and laparoscopy for infertility, irregular bleeding, bleeding after menopause
  • Operative hysteroscopy for endometrial polyps, uterine abnormalities, submucous fibroids
  • Operative laparoscopy for endometriosis, fibroids (myomectomy) and ovarian cysts
  • Scarless vaginal hysterectomy for abnormal uterine bleeding
  • Vaginal surgeries for prolapse and urinary incontinence
  • Total laparoscopic hysterectomy
  • Abdominal hysterectomy for large abdominal masses and huge fibroids

One-stop clinic

Our gynaecology service offers an initial consultation and diagnostic test in a single visit. An ultrasound scan can also be carried out simultaneously if required, enabling treatment plan to be drawn up immediately. This includes a 2D / 3D transabdominal and transvaginal ultrasound scan (internal scan only in sexually active women). The abdominal scan is done with an optimally full bladder and subsequently the bladder needs to be emptied for the transvaginal scan. By doing an internal scan, the doctor obtains a clear picture of your pelvic organs. Saline infusion sonography permits more detailed evaluation of the interior of the uterus and the fallopian tubes and may be recommended in certain situations.

Full time access to scan services is a great support to the management of subfertility and early pregnancy problems. We provide a one-stop clinic for conditions such as abnormal bleeding wherein scan, consultation and surgical procedures (endometrial biopsy, levonorgestrel IUCD insertion) under local anaesthesia can take place during one outpatient visit. This reduces the anxiety and inconvenience of multiple hospital visits.

Subfertility evaluation and management

Infertility is the inability of a sexually active non-contracepting couple to achieve pregnancy in one year. It is a common problem with a global prevalence of approximately 9%. The contribution to infertility by problems in either the male or female partner ranges from 30-40% each, with the remaining 10-20% being unexplained. Baseline investigations include semen analysis, tests for egg development and ovulation, and patency of the fallopian tubes. Other necessary hormonal assays may be requested as clinically indicated.

The initial treatment strategy incorporates nutritionist consultation and lifestyle modifications for women who are obese or underweight, and endocrinology referral for those with hormone problems. Broadly, the treatment of subfertility in the female partner may be categorized into ovulation induction (medicines for stimulation and release of mature egg(s) from the ovary), intrauterine insemination (transfer of motile sperms processed from the husband’s semen into the uterus at the expected time of ovulation or egg release) and in vitro fertilization or IVF (test tube baby wherein the fertilization of eggs by the sperm is carried out in the IVF lab and the embryo transferred into the womb). A dedicated Andrology Clinic by Dr Krishna Chaitanya at unit 3 on Thursdays caters to the needs of men with fertility problems. Both infertility and its treatment can lead to emotional and psychological stress and significantly impact the quality of life of these couples. Catering to the emotional needs is an integral part of the treatment plan and psychological counselling by experts can be solicited when needed.

Dr Manjula P. with long-standing experience in the management of subfertility spearheads the Infertility division and has been instrumental in the formulation of management protocols and streamlining of the infertility services. After evaluation of both partners, the treatment plan is decided by the treating consultant based on standard international guidelines. Evaluation by hysteroscopy and laparoscopy, and surgical correction of tubal blocks and malformed uteri, removal of fibroids and cysts are some of the fertility-related procedures that are performed by consultants trained and experienced in endoscopic surgery. The team strives to achieve success rates in comparison with international standards by keeping abreast with recent scientific advances and offering evidence-based treatment.

Fetal Medicine

Urogynaecology Clinic

Urogynaecology involves assessment, investigations and treatment of women with urinary incontinence (leakage of urine), prolapse (mass or lump in vagina), recurrent urinary tract infections, bladder pain and problems following pelvic floor injury at childbirth such as vaginal pain. Urogynaecology Clinic is a one-stop clinic to evaluate and treat women presenting with urinary incontinence, frequent urination, sudden urge to pass urine, painful urination, difficulty in emptying the bladder and recurrent infections. We work with physiotherapists to provide comprehensive care towards achieving control of the bladder function (continence). Some women might need a special test called Urodynamics to evaluate bladder function.

Pelvic organ prolapse is a condition characterized by descent of the uterus through the vagina leading to a feeling of heaviness, fullness and dragging or aching in the pelvis. The symptoms often get worse towards the end of the day or during a bowel movement and women might see or feel a bulge outside the vagina. These symptoms, although not life-threatening, can significantly affect the quality of life of the individual. We offer a variety of treatment options ranging from non-surgical methods such as pelvic floor exercises and pessaries to advanced surgical options like mesh repairs for recurrent and complicated prolapse.

These services are provided by Dr Vinatha Puli, a senior urogynaecologist trained in the UK, at the Urogynaecology Clinic every Tuesday from 9 am to 2 pm at unit 4.

Perineal Clinic

Childbirth trauma can sometimes cause damage (tears) to the muscles surrounding the anal canal (motion passage) known as the sphincter muscles. These tears are called 3rd and 4th degree perineal tears or obstetric anal sphincter injuries. They can cause distressing symptoms such as anal incontinence (leakage of motion), urgency to pass motion, dyspareunia (pain during intercourse) and perineal pain (pain at suture site near vagina and anal region) which are reported in 30–50% of women with a clinically recognized anal sphincter injury.

This is an area where good management can make a difference. This begins with identification and adequate repair of the torn muscles by an experienced doctor (OBGYN) after delivery. It is recommended to follow up these women at 6 to 12 weeks post delivery. The Perineal Clinic provides a dedicated setting where all women with such injuries can be examined by clinicians with expertise in this field. This helps to standardize follow up care and provides an opportunity for debriefing and clarification of any doubts about the events surrounding the delivery process. Counselling can also be provided about the mode of delivery in future pregnancies. Women with poor outcomes despite adequate repair are managed in consultation with a colorectal surgeon.

The Perineal Clinic is run every Tuesday at Unit 4 from 9 am to 2 pm by Dr Kameswari S. and Dr Vinatha Puli, who have been trained in the UK in the management and follow up of these injuries.

What we do not offer at Fernandez hospital

 

  • Contraception facilities such as IUCD insertion and tubectomy
  • Medical termination of pregnancy
  • In vitro fertilization (IVF)

Treating Headaches During Pregnancy

Pregnancy is a phase during which you get ready to welcome your little bundle of joy. It is also a time when women undergo physical changes and experience some discomforts. Headache during pregnancy is quite common, especially in the first trimester. Though most frequent in the first and third trimester, pregnancy headache may occur at any time during the gestation period.
Nov
2018

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