Dr. Fakhra Masroor

M.B.B.S, DNB (Obs & Gyn), FIAOG

Consultant Gynaecologist and Laparoscopic Surgeon

Advanced Treatment


When should you contact a Gynaecologist?


  • If patient has reached nearly 40 yrs and menses has stopped but after 6 months she starts having menses again.
  • Or near the age of menopause when she is having irregular menses
  • Or the amount of blood flow has increased from before or there are increased days of menses and if there is severe pain during menses.
  • Or if there is post coital (after intercourse) bleeding
  • First, we try to find the cause.
  • Then manage it.
  • Most cases, it is genetic problem of the baby.
  • Some case, it is uterine problem, hormonal problem or infection
  • Couple who try to conceive we screen them for any problem that can lead to miscarriage or complicated pregnancy.
  • Some blood tests are done.
  • Lady is given folic acid that is very important to avoid miscarriage and neural tube defect in baby.
  • Please report as soon as you miss the dates as coming later on you miss very important folic acid tab that helps for the nerve development of the baby.
  • Do not neglect symptoms like pain abdomen, loss of appetite and weight loss.
  • Consult for Cancer prevention and vaccination – Prevent cancer cervix by GARDASIL vaccination. Best time to give GARDASIL vaccination is at young age and it provide high rate of protection.
  • How to keep women fit especially after age 40.
  • Screening after 40 years is required as chances of developing hypertension, increased blood pressure, diabetes, heart disease are high, that may lead to severe problem later on.
  • PCOS problems – need consultation for treatment, need to bring change in life style and food habits.
  • Vitamin D deficiency – diagnosis and treatment. Vitamin D deficiency can lead to a loss of bone density, which can contribute to osteoporosis and fractures (broken bones). Severe vitamin D deficiency can also lead to other diseases.
  • As soon as you miss the period the you can do the pregnancy test by UPT KIT available in the market and if there are two lines then it means you are pregnant and immediately you should consult the me.
  • Reason for early consultation is that baby need important vitamin that is folic acid that is needed for the nerve and brain development of the baby as the brain development is maximum in the first three months and deficit of that leads to problem to the baby.
  • Some of the patients which are high risk groups such as diabetes, hypertension, heart disease, hypothyroidism, B Thalassemia carrier need to be prior evaluated. They may need to change the drugs as some of the drugs are strictly contraindicated in pregnancy.
  • Some of the patient who are B Thalassemia carrier, their husband blood group is also evaluated and if both are found to be carrier then urgent diagnosis of the baby status has to be done using special technique such as CVS or amniocentesis.
  • The main drug given to mother is Iron and calcium and that is continued till the delivery and thereafter for three months at least.
  • Important Investigations are done as early as possible in the first trimester -ABO/Rh CBC, PPBS 2 hr, urine RE / ME, Thalassemia screening, thyroid profile, HIV, HBsAg, Anti HCV, VDRL and ultrasound.
  • Those recently married and don’t want to have babies.
  • Those who recently has given birth to a child by Caesarean or normal delivery.
  • Those who are having some medical problem and can’t carry pregnancy for some medical implication.

NEED AND ADVANTAGE OF LAPAROSCOPY SURGERY


  • Laparoscopy for infertility
  • Removal of cyst or tumour
  • Removal of uterus for indicated cases- Hysterectomy
  • To find tubal block and its correction
  • Removal of ovarian cyst
  • 1 cm port around umbilicus is made for telescope.
  • 0.5 cm two side ports are made for instruments.
  • Whole surgery is done through this by seeing on screen through telescope put in the abdominal cavity.
  • No pain, no blood loss, no scar.
  • No infection of wound
  • Less stay in hospital
  • Less use of antibiotics
  • Least post-operative complication such as pain, adhesion.
  • Efficient surgery as large view is provided through big screen monitor.
  • Early normal life activity.

INFERTILITY RELATED ISSUES AND TREATMENT


  • Age - before 30 years.
  • Having regular periods
  • Normal weight
  • No uterine infection
  • No egg formation, PCOS
  • Tubal block
  • Sperm problem
  • Problem in uterus
  • But almost all the problems can be solved
  • Treatment though medicine
  • Some cases may need surgery
  • Some cases may need IUI, IVF