Dr Pooja Choudhary

ANTENATAL CARE Antenatal care is the care you get from health professionals during your pregnancy also known as pregnancy care or maternity care. Antenatal appointments will allow your midwife and healthcare team to help both you and your baby stay healthy. You should start your antenatal care as soon as possible once you know you're pregnant. Its purpose is to provide optimal condition for the mother and her growing baby to achieve the best possible pregnancy outcome. Even if your pregnancy is going well and you’re feeling well, it’s important for you to attend your appointments so that any potential risks can be identified at the earliest and prevented or reduced. it is also the first and main opportunity to discuss all your queries concerning the pregnancy, like what’s happening during each trimester, physical changes in the body, birth plans etc. Usually, an uncomplicated pregnancy needs 8 to 10 visits with your doctor, but number of visits may vary if there is some complication in the pregnancy. Care during ante-natal visits- The antenatal care you get throughout your pregnancy depends on: • your stage of pregnancy • your pre- existing health condition • any present problems you may be experiencing There will be a number of checks, scans, tests and discussions, such as: • when the baby is due, what trimester you are in and what this means for you and your baby • finding out about your medical history, general health and how any previous pregnancies were • discussing any medication you are taking • ensuring you’ve had a recent pap test • making sure your mental health is OK, and supporting you if you have depression or anxiety • checking your blood pressure and weight and testing your urine • organizing blood tests and screening • providing advice on healthy eating and lifestyle changes • feeling and measuring your tummy, and listening to the baby’s heartbeat • checking about any physical symptoms that may be bothering you • running through your birth plan with you. A good ante-natal care has the best post-natal outcome. Some common types of antenatal care are antenatal clinic care, midwifery care, shared antenatal care, midwifery group practice (caseload midwifery), team midwifery care, and private care. FAQ What are antenatal risk factors? Smoking, drinking alcohol, and using illegal drugs can put your pregnancy at risk. Maternal health problems, high blood pressure, obesity, diabetes, epilepsy, thyroid disease, heart or blood disorders, poorly controlled asthma, and infections can also increase pregnancy risks. What is the period of antenatal? The period from conception till delivery is referred to as the antenatal period. How many visits in antenatal care? A minimum of eight contacts are recommended to reduce perinatal mortality and improve women's experience of care. Counselling about healthy eating and keeping physically active during pregnancy. What is antenatal care? Antenatal care is the care you get from your obstetrician during your pregnancy. It is also known as pregnancy care or maternity care. What is antenatal care, and how soon first antenatal visit be? And why it’s important? Care a woman receives during her pregnancy journey right from day 1, like advice on supplements, foods, exercise, tests etc. Plan your visit with the doctor as soon you know that you are pregnant. It is very important because it will help in finding out early health issues with mother and the developing baby, hence the problem can be tackled begore it becomes a big problem for both mother and baby.

OBSTETRICS SERVICES Obstetric services are routine services focused on caring for pregnant women and their unborn babies, assisting women through labour and delivery, and providing immediate care for mothers after childbirth. Obstetricians are medical professionals who specialize in obstetrics. An obstetrician looks after the health of both the mother and the unborn child throughout pregnancy by keeping an eye out for issues like ectopic pregnancies or congenital disorders like Down syndrome. FAQ What is included in obstetrics? Obstetrics is a large and diversified field of medicine that deals with a variety of issues, such as surgery, management of maternity care, gynaecological care, oncology, and women's primary healthcare. What are obstetric procedures? Obstetric procedures include vaginal birth with vacuum help, paracervical and pudendal blocks, and healing of perineal injuries caused by childbirth. Prenatal examination of foetus weight, gestational age, and delivery date are also included. How does obstetrics care support a healthy pregnancy? An obstetrician will be an irreplaceable help during pregnancy. Obstetricians are responsible for everything related to pregnancy, from regular check-ups to preparation for childbirth and aftercare.  

GENITAL CANCER SCREENING Vaginal cancer may be detected during a routine pelvic examination before signs or symptoms become apparent. Doctors may also do a Pap test to look for cervical cancer, but the Pap test may detect vaginal cancer cells. Once a doctor has made a diagnosis of vaginal cancer, steps are taken to determine how far cancer has spread. Your cancer stage helps your doctor decide which treatment is right for you. FAQ Is genital cancer curable? Vaginal cancer is treatable and the treatment you have will depend on the size and type of vaginal cancer you have. What is the most common genital cancer? The most common type is vaginal squamous cell carcinoma, which begins in the thin, squamous cells that line the surface of the vagina. What is the treatment for genital cancer? The usual treatment is radiation, which uses both brachytherapy and external beam radiation therapy. Radical surgery (radical vaginectomy or pelvic exenteration) is an option for some women with stage II squamous cell carcinoma of the vagina if it is small and in the upper part of the vagina.

POLYCYSTIC OVARIAN DISEASE Polycystic ovary syndrome (PCOS) is a medical condition that affects a woman’s hormone levels. This hormone imbalance causes the body to skip menstrual periods and makes it harder for them to get pregnant. It causes irregular menstrual periods, excess hair growth, acne, and infertility and contributes to long-term health problems like diabetes, high blood pressure, and heart disease. Birth control pills and diabetes medications can help fix the hormone imbalance and improve symptoms. PCOS treatment depends on several factors like age, how severe the symptoms are, and your overall health. The treatment also depends on whether you want to become pregnant in the future. FAQ How is PCOS diagnosed? Your doctor will ask about your medical history and symptoms. You will also undergo a physical examination. This probably includes a pelvic exam. This test checks the health of your internal and external reproductive organs. What happens when you have polycystic ovaries? PCOS is a very common hormonal problem. Women with PCOS do not ovulate, have high androgen levels, and have many small cysts in their ovaries. PCOS can lead to missing or irregular menstruation, excessive hair growth, acne, infertility, and weight gain. Is PCOS a serious problem? PCOS is a serious condition and requires proper medical care or surgical treatment. Can I prevent PCOS or its effects? There is no proven way to prevent PCOS, but you can take small steps to reduce your symptoms like eating nutritious foods, exercising regularly, and managing your weight.

UROGYNAECOLOGY The area of gynaecology known as urology diagnosis, investigates and treats pelvic floor issues in female patients. A gynaecologist who specializes in urology is a urologist. Urinary and pelvic floor incontinence are two typical issues that call for a consultation with a urogynaecology’s. The signs include an overactive bladder that necessitates frequent bathroom trips, urine leaks during routine activities like coughing, sneezing, and exercise, pressure, pelvic discomfort, feeling full or heavy, and pricking or pulling in the vagina that gets worse by evening. Urinary tract infection known as UTI is one of the most common urinary problems and is an infection that occurs in the urinary tract. This infection is most caused by microorganisms such as fungi, bacteria, and viruses. induced and affected the kidneys, ureters, urethra, or bladder. FAQ Why would your doctor send you to a urologist? Your healthcare physician could suggest a urologist if you require treatment for urine problems, pelvic discomfort, or sexual problems. The urologist can prescribe tests that will clearly define the diagnosis and indicate the best course of action. What can I expect during my first office visit? You will be required to fill out a questionnaire about your medical issues, including medical history, medicines, allergies, and social background, at your initial appointment visit. To allow for the analysis of a urine sample, you should arrive at the office with a full bladder.

LAPAROSCOPIC & HYSTEROSCOPIC SURGERIES Two of the most popular minimally invasive gynaecological surgical techniques to detect infertility in women or treat conditions that lead to infertility and miscarriage are laparoscopy and hysteroscopy. Laparoscopy and hysteroscopy are recommended procedures during infertility treatment. These procedures allow doctors to view structures and organs within the pelvis and perform certain corrective actions. A laparoscopy is done to view and access the exterior of the uterus, ovaries, fallopian tubes, and other structures in the pelvis. A hysteroscopy is done to look at the internal cavity of the uterus to identify abnormalities and take certain corrective actions. These procedures are best done immediately after menstruation when vision is unobstructed. Specialized laparoscopic and hysteroscopic surgeons ensure that treatments and operations are carried out with the appropriate supervision, care, and hygiene. FAQ What are the benefits of laparoscopy? The recovery in the immediate postoperative period is faster. Patients often go home the same day. Smaller incisions tend to be less painful, and as a result, patients often need less postoperative pain medication and there are fewer wound infections. What is the recovery period? Most patients are discharged within hours after surgery. Some patients require pain and nausea medication. Most women resume normal eating and activity within 48 hours. What are the risks of surgery? Complications from these procedures are rarely serious. Infection is possible and you may need antibiotics before and after surgery. Injury to the bladder, intestine, uterus, or blood vessels is possible and Laparoscopy may be needed for injuries.

AESTHETIC GYNAECOLOGY Aesthetic gynaecology is a fairly new branch of medicine that allows women to alter their intimate body parts, whether it is for sexual function or appearance. There are various aesthetic gynaecology procedures, which include labiaplasty, perineum and pelvic floor repair, vaginal rejuvenation, and vaginal tightening. There are new minimally invasive treatments available like Femi Lift that can be performed in an outpatient setting for various conditions such as stress urinary incontinence (SUI), vaginal tightening, post-menopause indications, post-delivery rehabilitation, vaginal dryness, recurring infections. FAQ Is the aesthetic treatment permanent? No, both Botox and dermal fillers last up to 6 months, so the treatment is not permanent. After that, the injection should be repeated. How long does aesthetic treatment last? The treatment works by injecting Botox into the skin. Botox then blocks nerve impulses to relax the muscles and reduce the appearance of wrinkles. Anti-wrinkle treatments last 4-6 months. What is the purpose of labiaplasty? The purpose of a labiaplasty is to remove excess tissue from the elongated labia minora (inner labia) to reduce physical and emotional discomfort.

HIGH RISK PREGNANCY A high-risk pregnancy is a pregnancy that involves increased health or life risks for the pregnant woman, fetus, or both. These pregnancies need to be monitored closely to reduce the chance of complications. Women with high-risk pregnancies may need special care before, during, and after childbirth. This can reduce the chance of complications. Certain health conditions and maternal age may increase the risk of pregnancy. A high-risk pregnancy may be the result of a medical condition that existed before pregnancy, such as diabetes or high blood pressure, or it may be due to a medical condition that develops in you or your baby during pregnancy, making the pregnancy a risk. FAQs What is high risk pregnancy? Not all pregnancies are the same. Some women may be labelled as high-risk pregnancy due to the certain conditions which may put both mother and her baby to face a higher-than-normal chance of complication during or after birth. These women need extra and special attention by the health care provider. This does not mean you shouldn’t get pregnant or enjoy your pregnancy. Who comes under high-risk pregnancy? Following cases come under high-risk pregnancy: • Anyone who is less than 17 or above 35 year or having high blood pressure, diabetes, thyroid problem, kidney disease, heart disease, lungs disorder or sexually transmitted disease or chronic infection comes under high risk. • Medical condition that occurs during pregnancy such as preeclampsia, Gestational diabetes, multi fatal pregnancy, ectopic pregnancy, previous c-section etc is also a possible cause of high-risk pregnancy. • Other condition such as premature delivery or multiple births. How can I best take care of myself during pregnancy? Taking care of yourself and getting early and regular prenatal care from your healthcare provider can reduce your risk of pregnancy. What are the worrisome signs that need to report during a high-risk pregnancy? Consult your physician if you experience vaginal bleeding, unusual vaginal discharge, constant headache, pain or cramping in the lower abdomen, decreased activity in children, fever, dizziness, vomiting, pain when urinating, or swelling of the face, hands, or fingers

OVARIAN CYST An ovarian cyst is a fluid-filled sac within the ovary. They are common and usually form during ovulation. Ovulation occurs when the ovaries release one egg each month. Many women with ovarian cysts have no symptoms. Cysts are usually harmless. Most ovarian cysts cause no symptoms and heal on their own, but large ovarian cysts can cause pelvic pain that comes and goes. Pain may be felt in the area below the navel on one side. FAQ What happens when a woman has an ovarian cyst? pelvic discomfort that occurs during movement or sexual activity. Nausea and vomiting are frequently accompanied by sudden, acute pelvic discomfort. What are the 3 types of ovarian cysts? Ovarian cysts can take many different forms, including dermoid cysts and endometrioma cysts. But functioning cysts are the most typical kind. Follicle and corpus luteum cysts are the two categories of functional cysts. Is ovarian cyst a serious problem? In most cases, there is little, or no discomfort and the cyst is harmless. Most cysts disappear within months without treatment. However, ovarian cysts can twist or rupture and can cause serious symptoms.

UTERINE PROLAPSE Uterine prolapse is a condition in which the muscles and tissues surrounding the uterus become weak. This causes the uterus to drop into the vagina. It can occur in any woman who gives birth but is most common after menopause and in women who’ve had more than one vaginal delivery. Prolapse occurs when your pelvic floor muscles are damaged or become weak to the point that they can no longer provide support and cause your pelvic organs to drop in or out of your vagina. Uterine prolapse can be mild or severe, depending on how weak the muscles supporting the uterus have become. FAQ What makes a prolapsed uterus worse? Repetitive hard lifting, chronic constipation, persistent coughing, and weak or poor tissue are also linked to prolapse. Prolapse symptoms can worsen at different times of the day. I have. Some women find that they feel more pressure after walking or standing for long periods. How serious is a prolapsed uterus? Although a prolapse is rarely life-threatening, it can nevertheless be painful and uncomfortable. Pelvic floor exercises and lifestyle changes can improve symptoms, but treatment may be needed. How common is uterine prolapse? Uterine prolapse is a common condition. The risk of developing this condition increases with age.

Healthy and safe pregnancies start with prenatal care. Prenatal care is when you get check-ups from a doctor, nurse, or midwife in your pregnancy to keep you and your baby healthy and continue for the next nine months or until birth. They will give you a visit schedule to follow based on your age, any medical conditions you may have, and whether you are at high risk for complications. It is important because it helps in reducing complications during pregnancy and delivery. There are numerous benefits of prenatal care for both mother and baby. Women who attend regular prenatal care appointments have babies at a healthier birth weight. This also reduces the chance the baby dies in the womb. FAQ What is prenatal care? It’s a care given to any woman planning to conceive in near future. What can I expect at my prenatal visit? I will take your proper history, give folic acid supplement and advice few important bloods test to know your current health status, to help you to deliver a healthy baby. Why is Prenatal Care Important? The success of pregnancy is significantly influenced by receiving quality prenatal care. The optimal time to begin prenatal treatment is as soon as possible. The risk of pregnancy and delivery issues is decreased by receiving regular prenatal care throughout your pregnancy. Why do I need prenatal care? Prenatal care promotes your and your unborn child's health. Low birth weight is more frequent in babies of moms who do not receive prenatal treatment. Doctors can detect health problems early during mothers' regular visits, and this allows many problems to be treated early. What happens during prenatal care? The doctor, nurse, or midwife will check your blood pressure, weight, and height, and calculate your due date based on your last menstrual cycle and an ultrasound scan. They will ask about your health, including previous conditions, surgeries, pregnancies, and genetic history.

MENOPAUSE SUPPORT Menopause occurs when a woman has not had a period for 12 consecutive months and is no longer able to conceive naturally. It usually begins between the ages of 45 and 55 but can occur before or after this age range. Menopause can cause unpleasant symptoms such as hot flashes and weight gain. Other common symptoms of menopause include insomnia, vaginal dryness, weight gain, depression, anxiety, headaches, etc. Most menopausal women do not need treatment. Each woman is affected by the menopausal transition differently. Women may put on weight more quickly due to changes in fat cells and how the body uses energy. You may experience changes in your bone or heart health, body shape, and composition, or physical activity. FAQ How to avoid menopause? You can't prevent menopause, but you can manage many common symptoms and prevent possible complications by making changes to lifestyle like, eating a healthy diet, exercising regularly, getting enough sleep, maintaining bone strength, and managing blood pressure. What comes after menopause? Post-menopause is defined as the absence of menstruation for at least one year after menopause. Can a woman get pregnant after menopause? When you reach post menopause, your hormone levels are no longer suitable for ovulation and natural pregnancy, and contraception is no longer necessary, but it is still possible to get pregnant through in vitro fertilization (IVF). IVF after menopause is successful in many cases.

HYSTERECTOMY Hysterectomy is a surgical procedure that removes the uterus(womb) and cervix. The uterus or womb is where a foetus grows during pregnancy. The doctor can also remove the fallopian tubes and ovaries. You can’t become pregnant and no longer menstruate after this surgery. This surgery may be done for different reasons, including, Uterine fibroids that cause pain, abnormal bleeding, cancer, or other problems. Hysterectomies are performed mostly between the ages of 40 and 50. A hysterectomy is a major surgical procedure and can also be performed through an incision in the vagina or by a laparoscopic or robotic surgical approach which uses long, thin instruments passed through small abdominal incisions. FAQ What are the signs you need a hysterectomy? Some of the most common reasons your doctor might recommend a hysterectomy include Uterine fibroids, benign (non-cancerous) tumours in the uterus, and consistent, abnormally heavy periods. Is hysterectomy a major surgery? Hysterectomy is a major surgery with a long recovery, risks, and side effects. Depending on the type of surgery, you may experience symptoms of menopause and you may not be able to conceive after surgery. What changes can I expect after a hysterectomy? For most women, the biggest change is an improved quality of life. You should be free from symptoms that made the surgery necessary.

FERTILITY ENHANCING SURGERIES Fertility-enhancing surgery can help improve or restore fertility in women with infertility complications. Many infertility complications such as fibroids, endometriosis, dermoid, adhesions, and PCOD disturb the normal function of the women’s reproductive system and affect the chances of getting pregnant naturally. With the help of these surgeries and procedures, female infertility problems can be treated. An experienced gynaecological surgeon selects the appropriate surgery based on the patient's problem and general health. to treat and cure such conditions. The significance of these fertility-enhancing surgeries has grown as more individuals nowadays struggle with infertility. FAQ What is Fertility Enhancing Surgeries? Fertility-enhancing surgeries treat problems like endometriosis, PCOD, blocked fallopian tubes, fibroids, etc, and help in enhancing fertility in women. What is the success rate of fertility treatments? Aside from age and health, the success rate also depends on the type of treatment. 85 to 90% of infertility cases are treatable. What percent after surgery improves fertility? 45 to 75% of women who have undergone the surgery can conceive after healing and many of these pregnancies are even achieved naturally without assisted reproductive technologies.

CONTACEPTIVE ADVICE Contraception, also called birth control, is the use of drugs, devices, or surgery to prevent pregnancy. There are different types, some are reversible, and some are permanent. Choosing a contraceptive method is a complex decision. Healthcare providers play an important role in providing information about contraceptive methods through contraceptive counselling and in supporting patient decision-making. FAQ How do the different birth control options work? Different birth control methods function in various ways. Birth control methods change the uterine lining to prevent a fertilized egg from adhering to it, inactivate or harm sperm, prevent an egg from being released each month, and thicken cervical mucus to hinder sperm movement. Are birth control methods reversible? Which contraceptive method you choose depends on your reproductive goals. If you're planning a pregnancy shortly, you may want an easy way to stop or quickly reverse it, such as short-acting hormonal or barrier methods. If you want long-term contraception, you can consider a long-acting method, such as an IUD. What is the best method of birth control? No birth control technique works best for all women. The best form of birth control for you and your partner may depend on a variety of factors and may vary over time.

OVULATION INDUCTION Ovulation induction uses fertility medications to stimulate ovulation in women who have irregular or absent ovulation or increase the number of eggs produced during a cycle, by increasing the opportunity for pregnancy. Treatments include either oral medications or injectable medications. The medicine is taken at the beginning of the menstrual cycle, and the body's reaction is monitored during the menstrual cycle by ultrasound. Ovulation induction is done for a range of medical conditions, but it is most beneficial for individuals who don't naturally ovulate regularly, including those with polycystic ovarian syndrome or other irregular menstrual cycles. To enhance the number of eggs produced each month and hence the likelihood of becoming pregnant, ovulation induction can also be used on women who ovulate frequently. FAQ Who could benefit from ovulation induction? Ovulation induction is a common treatment for women who do not ovulate or who ovulate infrequently. Women with disorders that prevent ovulation, such as PCOS, can also benefit from ovulation induction. How long ovulation induction can be done? Pregnancy might take longer than expected for some people. Your age and the length of your infertility are factors in how long the treatment will last. How is ovulation induction achieved? The medications and doses used to trigger ovulation are personalized for you. When you should start taking medications to stimulate the ovaries will be suggested by your doctor, who will also suggest a regimen of monitoring using ultrasound scans and maybe blood testing.