Gynaecology

Painless Delivery

Giving birth to a baby is the greatest journey in a woman life that ends with God’s blessing with her child. But during these process she has to pass through tremendous physical and mental stress. These pain can now reduce with newer concept of painless delivery. We make pregnancy as an enjoyable experience with all the facilities of painless delivery in our modern labour room. Continous fetal monitoring also ensure safety to fetus.

Forceps Delivery

A forceps delivery is a type of assisted vaginal delivery. It's sometimes needed in the course of vaginal childbirth.

In a forceps delivery, a health care provider applies forceps — an instrument shaped like a pair of large spoons or salad tongs — to the baby's head to help guide the baby out of the birth canal. This is typically done during a contraction while the mother pushes.

Your health care provider might recommend a forceps delivery during the second stage of labor — when you're pushing — if labor isn't progressing or the baby's safety depends on an immediate delivery.

A forceps delivery poses a risk of injury for both mother and baby. If a forceps delivery fails, a cesarean delivery (C-section) might be needed.

Cesarean Section

A c-section, or cesarean section, is the delivery of a baby through a surgical incision in the mother's abdomen and uterus. In certain circumstances, a c-section is scheduled in advance. In others, it's done in response to an unforeseen complication.

Female Infertility

Female Infertility : A Complex System

Female infertility can be much more complex than male infertility for the simple reason that the female reproductive system is far more complex than the male reproductive system - and the woman has a much more important role to play in making babies than the man does. While the man's role is very simple - he just has to deposit a large number of good quality sperm in the vagina, the woman is

• Producing eggs
• Transporting the embryo to the uterus through the fallopian tube;
• Nurturing the embryo in the uterus.

This obviously means that there is much more which can go wrong as well !

Not only are the chances of medical problems much higher in the female reproductive tract, causing female infertility to be a more complex problem; to add insult to injury, treating infertility often means putting the woman through lots of medical procedures - some of which can be invasive. This is true, whether the problem is male infertility or female infertility !

To make matters even worse, since having a baby is usually the "woman's job"; infertile women suffer from many more personal and social stresses as a result of their infertility !

The commonest causes of female infertility include:

• Problems with egg production ( ovulation); and
• Tubal factor problems. Other areas of concern are:
• Endometriosis and
• Cervical mucus problems.

Male Infertility

Male partners with low sperm counts and/or low sperm motility and/or abnormally shaped sperm and/or who have antibodies against their own sperm, are classified as "male factor" patients.

Specialists in male fertility are called Andrologists and you may need to consult one prior to commencing IVF treatment.

Causes of Male Infertility

Male infertility is very common. About one in twenty men is sub fertile and a male factor is present in half of all infertile couples. About one third of all IVF procedures are performed for male factor infertility. For most men the discovery that they are infertile comes as a total surprise.

It must be remembered that the testis has two distinct roles. The first is to produce the male sex hormone, testosterone, which is important for providing sex drive, erections, strong muscles and basically giving a man a general feeling of well being. The second function of the testis is to produce millions of sperm every day, a process which occurs inside the approximately 150 metres of fine tubes in each testis. For most infertile men it is only this process which is at fault and a reduced number or poor quality of sperm are produced.

Why does this problem develop? We now believe that most cases are genetic. In other words, these men are born without the genetic information which would allow sperm production to occur normally. Small pieces of the Y, or so called male chromosome are often missing in men with severe infertility. Presumably these missing pieces of genetic information are the cause for the poor sperm production. But we need much more research before we can point to particular genes. Without that knowledge no treatment for men to improve sperm counts is likely to become available. IVF techniques offer hope now as they require very much fewer normal sperm than does Nature.

In the remaining one third of infertile men, we can find a likely cause for their infertility including:

• Obstruction to the passage of sperm from the back of the testis to the outside can result from blockage or absence of the vas deferens. Common causes include, obviously, vasectomy, but any history of injury, and other surgery or sexually transmitted disease may be important.
• Men can make antibodies to their sperm following vasectomy or other trauma or infection. These antibodies are a common cause of infertility and prevent sperm swimming or sticking to the egg. The testis can be damaged by a wide number of treatments including chemotherapy or X-Ray therapy.
• Some men have difficulties obtaining an erection, or in ejaculating due to a wide range of problems such as diabetes, MS, or previous prostate surgery. In these cases sperm can be found and used for IVF.
• Rarely, a deficiency in the brain pituitary hormones may result in low sperm counts. Its detection is important as it is readily treated with hormone injections.
• Finally there remains great controversy as to whether sperm counts have declined worldwide. The alleged change is quite small (about 15%) and no cause has been confidently identified.
• In conclusion while the causes of infertility are uncertain in many men, certain conditions can be identified and treated. These facts make it essential that all infertile men have their situation thoroughly investigated.

The basic male investigation begins with a detailed history and physical examination by our andrologist. Semen analysis and serum hormonal profile (FSH, LH, Testosterone, Prolactin and TSH) represent the first line investigations. History of hernia surgery or mumps in childhood, lifestyle (excessive exercise or steam/sauna), sexually transmitted infections or trauma will all be noted. Use of medication, alcohol, drugs and occupational and environmental exposure to toxins such as heat and other chemicals will also be recorded.

The semen analysis is the first basic investigation. The sample should be collected by masturbation after 2-7 days of abstinence (no sexual intercourse or masturbation). In exceptional circumstances, semen may be produced at home or during sexual intercourse using a special condom. The sample must be submitted within an hour after ejaculation.

Sperm counts of > 15 million/ml with >40% motility and > 4% normal morphology forms are considered normal.

The andrologist might suggest further investigations such as a color Doppler of the scrotum or certain dye tests such as vasography for accurate diagnosis.

Some conditions can be treated medically (such as hormone deficiencies) or surgically (varicocelectomy). If these fail to result in pregnancy you would be advised further treatment with IUI or finally ICSI which is the most successful treatment for almost all types of male factor infertility.

Very rarely, in some cases of primary testicular failure with elevated FSH levels where even microdissection TESA fails to yield sperm you might have to resort to a semen bank and avail of donor sperm for pregnancy.

Nonstress test

A nonstress test is a common prenatal test used to check on a baby's health. During a nonstress test, also known as fetal heart rate monitoring, a baby's heart rate is monitored to see how it responds to the baby's movements.

Typically, a nonstress test is recommended for women at increased risk of fetal death. A nonstress test is usually done after week 26 of pregnancy. Certain nonstress test results might indicate that you and your baby need further monitoring, testing or special care.

A nonstress test is a noninvasive test that doesn't pose any physical risks to you or your baby. Find out what a nonstress test involves and whether this prenatal test might benefit you or your baby.

MTP Centre

Abortion is a procedure that enables a woman to opt out of an unwanted pregnancy. Medical procedure for ending a pregnancy at any time before the foetus has attained the stage of viability is called Medical Termination of Pregnancy (MTP) or abortion. It is not a family planning method but it is a reliable method of terminating unplanned and unwanted pregnancy.

An abortion can be induced or spontaneous. A spontaneous abortion occurs when a pregnancy terminates without any medical or surgical intervention, as in the case of a miscarriage. Induced abortions involve surgical or medical procedures for termination of the pregnancy.

Family Planning

Babies are always welcome in our family but not to the extent of causing population explosion. “Ek Ya Do Bas” seems to be the tagline of today’s generation, and very truly so we cater to their needs with guaranteed contraceptive methods. Once their family is complete, we offer them sterilisation methods to provide a hassle-free lifestyle. Also unwanted pregnancies due to contraceptive failure are taken