Dr Nithiyaa

Article for pregnant moms during this summer

Hydronephrosis
Incidence 1-5/500 new borns

It’s a ultrasound diagnosis –dilatation of the collecting system of the kidney.
The risk of chromosomal anomalies is low as 1-3%

In the first two years of life ,spontaneous regression in approximately 40%-50% of cases and need for surgery in 20-30% of cases , according to the grade of hydronephrosis present during the prenatal period.

In bilateral forms associated with oligohydramnios , unfavourable prognosis with the possibility , in very selected cases of in uterotherapy.

Causes of hydronephrosis
Uretero-pelvic junction obstruction
Vesico-ureteric junction obstruction
Megaureter
Cloacal dysgenesis
Complicated duplex kidney
Bladder and urethral obstruction
Abdominal pelvic mass

Dr.nithya babukumar
Apollo hospitals omr,
Lotus clinic thoriapakkam
9566269224

What Do Squamous Metaplastic or Endocervical Cells on a Pap
Smear Indicate?

What are squamous metaplastic cells?

Squamous cells are types of cells found in various tissues throughout
your body, including:

 your skin
 the outer surface of the cervix (ectocervix)
 the linings of your organs

When changes occur within these thin, flat-shaped cells, they may be
described as metaplastic.

Squamous metaplasia is a noncancerous change in the cells that make up
the tissue lining for organs and glands (epithelium). Most people have
nonkeratinizing cervical squamous metaplasia.

This condition doesn’t increase cancer risk. Keratinizing squamous metaplasia can turn into dysplasia, which may lead to cancer.

Squamous cells that may be precancerous or more likely to turn into
cancer are described on a Pap test result as squamous intraepithelial
lesions (SIL). These may be further classified as low-grade (LSIL) or
high-grade (HSIL), indicating a low to high risk of cancer development.

If the pathologist finds

1. Atypical squamous cells of undetermined significance (ASC-US), this
usually means that the pathologist has found irregular cells and could not
determine why they were irregular. It can be due to other inflammatory
or noncancerous changes of the cervix that will likely resolve on their
own.

2. Low-grade squamous intraepithelial lesion (LSIL) indicates lower-
risk cervical cell change.

3. high-grade squamous intraepithelial lesion (HSIL) cervical cell
changes are present and may be at ahigher risk of turning into cancer.

4. atypical squamous cells (ASC-H) -changes were found within the
squamous cells of your cervix, and you may also have HSIL
5. atypical glandular cells (AGC) - changes within the glandular cells of
the endocervix exhibit possible signs of precancer or cancer
6. endocervical adenocarcinoma- indicates cancerous cells of the
endocervix
7. negative for intraepithelial lesions or malignancy (NILM)- no signs of
malignancy or lesions were noted
8. squamous metaplastic cells present- changes within cervical
squamous cells were seen but without any concerning irregularities
9. acute inflammation-this may indicate the presence infection and
white blood cells in your sample

10. atrophic changes- your cervix may be exhibiting signs of menopause

Takeaway

When it comes to reporting Pap smear test results, most medical
professionals will either tell you that your results were standard or that
you may need to undergo further testing to confirm possible
irregularities.
It’s important to discuss any concerns about your Pap smear results with
your doctor. Cervical cancer screenings are designed to detect possible
precancer and cancerous cells for the earliest possible treatment.

Dr.j.nithyababukumar
Lotus specialty clinic thoraipakkam
Apollo specialty hospitals omr
Apollo cradle karapakkam
9566269224

Single umbilical artery.

The umbilical cord forms between 13 and 38 days after conception and normally serves as the conduit for two umbilical arteries and one umbilical vein.

The normalumbilical cord contains 2 arteries and 1 vein (there vessel cord) single umbilical artery is characterized by the absence of either the left- or right umbilical artery. This malformation has a reported incidence of 0.5-6% in singleton pregnancies it increases of 3-4 times in twin pregnancies.

Single umbilical artery is of 3 types

TYPE 1– The entire length of the cord from baby to placenta ,
has just 2 vessels – one artery and one vein

TYPE 2– There are 3 vessel at the baby’s end of the cord but
at the placental side, 2cms from the surface of the placenta,
there are just 2 vessels .The cause is anagtomosis.

TYPE 3– The cord initially has 3 vessels but occlusion close
one artery of the cord .It is related to circulatory problems in the umbilical cord and
baby. Sometimes there can be persistence of the original single
allantoic artery of the baby stalk. Neonates with SUA are at a higher risk of congenital
anomalies and chromosomal abnormalities.

The most common congenital anomalies associated with SUA are renal,
hydrocephalus, thanatophoric dysplasia, gastroschisis, sacral agenesis hypospadias followed by cardiovascular and musculoskeletal.

There are three theories to explain how a SUA may form
during development.

The first is that a primary agenesis of one umbilical artery
results in a SUA. Another theory attributes the phenomenon to
a secondary atrophy or atresia of a previously normal
umbilical artery.

A third theory describes a persistence of the original allantoic artery of the body stalk as an explanation for SUA. Embryological considerations, as well as the detection of
occluded remnants of a second umbilical artery in some SUA fetuses, suggest that the second theory is the most likely explanation Diagnosis It can be detected in the first trimester of pregnancy with the use of 2D ultrasound. The sonographer is able to
identify a 2 vessel cord in an image with the bladder and color Doppler, which will show only one artery going around one side of the bladder. In a normal fetus, there
would be 2 arteries (one on each side of the bladder)

Management
When a 2 vessel cord is detected, a through search for other anomalies is required. A fetal 2D-ECHO is warranted. Invasive testing is not recommended in isolated single
umbilical artery. Invasive testing with chromoromal evalvation (Micro array) is
recommended if associated malformations are detected.

Serial growth scans with doppler indices are needed once a 2
vessel cord is seen For normal weight fetures with isolated single umbilical artery
and normal insertion of the cord, no particular precautions during labour are needed and induction can be performed Studies have shown a higher incidence of cesarean section in these women ( due to prematurity, fetal growth restriction and
oligohydramnios ) .

Dr.nithya babukumar
apollo cradle karapakkam,
apollospeciality perungudi.

For appointments call

Conservative management for stress urinary incontinence refers to non-surgical methods used to reduce and manage the symptoms of stress urinary incontinence. Some common conservative management techniques for stress urinary incontinence include:

Pelvic floor exercises (Kegels) - These exercises help to strengthen the muscles that support the bladder and urethra, reducing the risk of leakage.

Bladder training - This involves gradually increasing the time between bathroom visits, with the goal of training the bladder to hold more urine and reduce leaks.

Weight management - Losing weight can help to reduce the pressure on the bladder and reduce symptoms of stress urinary incontinence.

Lifestyle changes - Making changes to your lifestyle, such as avoiding bladder irritants and reducing fluid intake, can help to manage symptoms of stress urinary incontinence.

Medications - Some medications, such as antimuscarinics, can help to relax the bladder muscle and reduce symptoms of stress urinary incontinence.

It's important to consult with a healthcare professional to determine the best course of treatment for your specific needs and to monitor progress and side effects. In some cases, a combination of conservative treatments may be recommended for optimal results.

Basic Testing for Stress Urinary Incontinence

Stress urinary incontinence is a type of urinary incontinence that occurs when physical activity, such as coughing, laughing, or exercise, puts pressure on the bladder, causing accidental leakage.

There are a few basic tests that can be used to diagnose stress urinary incontinence:

The Couples Leakage Questionnaire (CLQ) - This is a self-assessment questionnaire that helps to determine the severity of stress urinary incontinence symptoms.

Pad test - This test involves using a special absorbent pad to measure the amount of urine leaked during a set period of time, such as a day or night.

Stress test - This test involves performing physical activities, such as coughing or jumping, to see if they trigger leakage.

Urodynamic test - This is a more advanced test that measures the pressure in the bladder and urethra during a filling and emptying cycle.

It's important to note that these tests are not definitive and should be interpreted in conjunction with a physical examination, medical history, and other diagnostic tests. An accurate diagnosis is essential for proper treatment and management of stress urinary incontinence

Risk Factors of stress urinary incontinence

Stress urinary incontinence (SUI) is a condition in which a person experiences leakage of urine during physical activity or movement that increases pressure on the bladder, such as coughing, sneezing, laughing, exercising, or lifting heavy objects. There are several factors that can increase the risk of developing SUI, including:

Age: As women age, the muscles in the pelvic region weaken, which can lead to SUI.

Pregnancy and childbirth: Pregnancy and childbirth can weaken the muscles that support the bladder and pelvic region, increasing the risk of SUI.

Obesity: Excess weight can increase the pressure on the bladder, leading to SUI.

Hysterectomy: Women who have had a hysterectomy, particularly those who had the surgery performed through the va**na, are at increased risk for SUI.

Menopause: As women go through menopause, the decrease in estrogen levels can lead to thinning and weakening of the tissues in the pelvic region, increasing the risk of SUI.

Neurological conditions: Certain neurological conditions, such as spinal cord injuries or multiple sclerosis, can weaken the muscles that control the bladder, increasing the risk of SUI.

Smoking: Smoking can weaken the muscles in the pelvic region and damage the tissues that support the bladder, increasing the risk of SUI.

It's important to note that these risk factors do not guarantee the development of SUI, and there are many women who experience SUI who do not have any of these risk factors. If you're concerned about SUI, it's best to speak with a doctor.

Leiomyoma of Uterus (Uterine Fibroid)
• What is a leiomyoma?
uterine leiomyomas , popularly known as fibroids are benign tumours that arise from smooth muscle cells of the uterus composed primarily of fibrous tissues
ETIOLOGY :Unknown Immature muscle cells present in myometrium , 30-50% women
Excessive growth depends on s*x steriod
Oestrogens and progesterone receptors are found on these myomas causing the growth
Risk factors
• Increasing age.
• Early menarche
• Low parity
• Obesity
• High fat diet and smoking
• Tamoxifen use
• Family history
Impact of uterine fibroid in women
• Symptomatic in only 35- 50 % of Patient
• Symptoms depend on location, size, changes &
1 Abnormal uterine bleeding
The most common30%Heavy / prolonged bleeding (menorrhagia) iron deficiency anaemia
Bleeding is due to interruption of blood supply to the endometrium, increase in area and blood flow ,distortion & congestion of surrounding vessels or ulceration of the overlying endometrium,
2.Dysmennorhea
3.PRESSURE EFFECTS
If large may distort or obstruct other organs like ureters, bladder causing urinary symptoms like frequency and retention. hydroureter, bowel symptoms like constipation, pelvic venous congestion & LL edema
4.PAIN
• Vascular occlusion necrosis, infection
• Torsion of a pedunculated fibroid -acute pain
• Myometrial contractions to expel the myoma
• Red degenration-acute pain
• Heaviness fullness in the pelvic area
• Feeling a mass
• If the tumor gets impacted in the pelvis pressure on nerves and back pain radiating to the lower extremities
• Dysparunea if it is protruding to va**na
5.DEGENERATION
Calcium deposits and liquefaction yellow colour in menopause
Red degeneration in pregnancy , oc pills,rapid growth
INFERTILITY
27-40% of women with multiple fibroids are infertile
Tubal block, tubal motility interfere with implantation , thinned endometrial bed Displacement of cervix from va**nal pool of semen feto maternal outcome in Pregnancy with fibroids:
Abortion, spontaneous miscarrige Preterm labour, dysfuntional labour , breech baby IUGR, placental abruption
PPH Causes: Defective implantation of placenta Poorly developed endometrium Reduced space for the growing fetus
Operative delivery , cervical fibrois cause c section
Torsion of fibroids, red degenerartion , enlargemnent
• Other symptoms like
• Iron deficient anaemia
• Polycythemia
• Uterine inversion
• Other possibilities of mass in the tummy mimicking fibroids are adenomyosis , ovarian tumours, endometriosis, Pid
• Modalities of managing a fibroid uterus
Patient planning for conservative option endometrial sampling and pap smear may be performed.70%are asymptomatic they should be followed up 6 monthly interval Current Medical mangement
First line management of uterine fibroids usually involves symptomatic treatment of heavy menstrual bleeding, with use of inexpensive non-steroidal anti-inflammatory drugs (NSAIDs), antifibrinolytic agents including tranexamic acid, or contraceptive steroids including the levonorgestrel intrauterine system (Mirena), the latter only suitable for patients in whom the uterine cavity is not distorted by fibroids Surgical . Laprascopic myomectomy, hysterescopic resection ,
lap hysterectomy
Newer tech.
Uterine artery embolisation
Dr.j.nithya babukumar
Apollo cradle karapakkam
9566269224

Weight, exercise, and nutrition
Planning pregnancy then watch out!!!
The prevalence of overweight young couples in the reproductive age of life is steadily increasing and there is now abundant evidence that female weight disorders, both underand
over-weight, impair spontaneous fertility Obesity has been linked to male fertility because of lifestyle changes, internal hormonal
environment alterations, and s***m genetic factors Either paternal or maternal obesity may negatively affect ART outcomes
Female obesity has been shown to be associated with poor pregnancy outcomes, including increased rates of congenital abnormalities, cesarean delivery, preeclampsia, gestational
diabetes, fetal macrosomia, stillbirth, and post-term pregnancy .
It has been reported that physical activity improves cardiovascular risk factors, hormonal profile, and reproductive function.
These improvements include decreases in abdominal fat, blood glucose, blood lipids and insulin resistance, as well as improvements in menstrual cyclicity, ovulation, and fertility,
decreases in testosterone levels and Free Androgen Index, and increases in s*x hormone binding globulin.
Recent datas also suggest that much more attention needs to be paid to optimization of male and female health and nutrition prior to pregnancy .
Diet
There are a number of dietary factors that have an impact on reproduction. Vitamins While there is little conclusive evidence on the effects of vitamins on fertility, more substantive evidence, particularly on folic acid, their effects on reducing congenital abnormalities.
It is therefore advised that women take up to 500 μg of folate for a minimum of one month prior to conception and, where there is a higher risk of abnormality, 5 mg should be taken.
It is recommended that women avoid the retinol form of vitamin A and foods containing this form of vitamin A while considering consuming vitamin D and achieving appropriate sunlight
exposure.
Iodine
Many women seeking pregnancy are iodine deficient and iodine is often added to prenatal supplements or foods.
All women who are pregnant, breastfeeding, or considering pregnancy should take an iodine supplement of 150 μg each day for a minimum of one month prior to conception.
Male antioxidants Oxidative stress is frequently described in infertile males and the role of antioxidants. While several commercial preparations exist, attention to increased fruit and
vegetables in the diet and avoidance of adverse lifestyle factors including environmental chemical exposure should be the first step.
Alcohol even low amounts of alcohol consumption during early pregnancy increased the risk of spontaneous abortion substantially . The role of alcohol in fetal alcohol syndrome is well known. It would therefore seem prudent for the woman to avoid alcohol during the periconception period.
Caffeine
Caffeine is the most popular neurostimulant and is found in drinks and foods across all cultures. A high consumption of caffeine may be associated with impaired fecundity,While a safe level of caffeine has not been defined, it seems reasonable to keep this below 200–300 mg per day (less than two cups of coffee per day) (84–86).
Fish Fish consumption Certain types of fish that are high in mercury should be avoided.
Smoking
Smoking can affect all stages of reproduction including folliculogenesis, steroidogenesis, embryo transport, endometrial receptivity, endometrial angiogenesis, uterine blood flow, and uterine myometrium For every one cigarette per day, there is a 1% increase in relative risk of miscarriage . S***m studies have shown increased oxidative stress, a lower s***m count, and abnormal
s***m fertilizing capacity, with a significantly reduced chance of pregnancy in a female partner . Passive smoking is also important in increasing complications in pregnancy as well as in IVF cycle
Stress There is growing evidence that psychosocial stress is as sociated with negative reproductive outcomes, including IVF therapies.
Appropriate counseling and lifestyle adjustments may ameliorate these effects. Environmental pollutants endocrine disrupting chemicals such as bisphenol A, phthalates, insecticides, and other
potentially dangerous products can affect fertility.
Vaccinations
There are few data on the impacts of vaccinations on fertility, but the serious consequences of becoming infected with rubella, herpes zoster, varicella zoster, and influenza indicate that
immunization prior to pregnancy is appropriate .
Sexually transmitted diseases
It is increasingly evident that bacterial and viral infections of the reproductive tissues can alter immune and inflammatory parameters in such a way as to impede periconception
events and reduce fertility Occupational factors
Evidence suggests that the circadian clock regulates each part of the reproductive axis from timing of neuronal activity in hypothalamic neurons to the day–night variation in the release
of pregnancy hormones. Dysregulation of circadian rhythms, as often occurs with shift work, results in increased risk of adverse consequences at each step of the reproductive pathway.
Other common workplace exposures such as prolonged working hours, lifting, standing, and heavy physical workload may also increase the risk of adverse obstetric and neonatal
outcomes .
Dr Nithya babukumar
Apollo Hospitals OMR
9566269224

Back pain during pregnancy.
Back pain during pregnancy is a common complaint — and it's no wonder. About 10 percent of the time the pain becomes so severe that it can interfere with the ability to work or carry out normal activities during pregnancy.
You're gaining weight, your center of gravity changes, and your hormones are relaxing the ligaments in the joints of your pelvis. Plus, the extra weight you’re carrying means more work for your muscles and increased stress on your joints. This is why your back may feel worse at the end of the day.
• The lumbar spine undergoes compensatory lordosis—an increase in the reverse C-shaped curvature—which causes excess strain on the lumbar joints, muscles, ligaments, and discs.
• The psoas muscle in the hip, which stabilizes the spine and helps in hip and leg movements, is shortened due to the compensatory lordosis, exacerbating the lower back pain symptoms.
• The concentration of the estrogen hormone also increases during pregnancy. The combined effects of relaxin and estrogen cause the pelvis to widen
Lower back pain symptoms may start at any time during pregnancy. These symptoms may feel like:
• A dull ache or sharp, burning pain in the lower back area
• One-sided pain in the right or left area of the lower and/or mid-back
• Pain that radiates into the back of the thigh and leg, and sometimes into the foot (similar to sciatica)
Sciatica symptoms typically occur if a lower lumbar and/or upper sacral nerve root is impinged in the lower spine due to disc herniation or spam muscles
Temporary compression, pulling, and/or loss of blood supply to a peripheral nerve may occur in the thigh during pregnancy. The swelling of soft tissues and pressure from the growing uterus may add additional pressure on these nerves.
Thigh pain may occur under these circumstances when the lateral femoral cutaneous nerve gets compressed.
Back Labor Pain
Pain during active labor is caused by contraction of the muscles of the uterus and is similar to an intense menstrual cramp. Labor pain typically comes-and-goes and gradually increases in intensity.
Lower Back and Abdominal Pain with Cramping
Sudden onset of severe abdominal pain and cramping may indicate a ruptured ectopic pregnancy in early weeks. The symptoms of a ruptured ectopic pregnancy may also include severe lower back and/or groin pain. This condition is a medical emergency and must be treated with surgical intervention on an urgent basis.
Obstetrical Conditions that May Cause Back Pain
While not common, certain obstetrical conditions, such as spontaneous abortion, ovarian cysts, pelvic or uterine adhesions, fibroids, or collection of fluid, may cause lower back pain in pregnancy

https://youtu.be/aehsacuTE0Y

You can travel when you are not less than 10 weeks or not more than 33 weeks of pregnancy.

Travelling is the main concern during pregnancy. You have to take health and safety precautions and consult your doctor before you book your tickets!

If its your first pregnancy at age 35 or above is not impossible. But it does have complications to conceive naturally and you might undergo a few treatments.

"Having a baby is every couple's dream and their family. To make it true never postpone conceiving until you settle down in life. Marriage, kids and work are all part of life. Don't wait till Tomorrow.
Are you in your 35 or above planning family-way? Consult a doctor for your doubts.

The left lateral position is ideal for you and your baby.

During pregnancy, you need a good and peaceful night's sleep more than anything. Know the suitable sleep position that's comfortable and safe for you and your baby.

Thoughts you have about not getting pregnant...

Myth Vs Fact

#

Let us break the MYTHS of PCOS

Confused and worried about not getting pregnant? Learn and understand cause of infertility.

Nutrition plays a vital role in adolescent age. As for teenagers the foundation to grow as healthier adults. An adolescent must eat three meals, 2-3 snacks everyday to meet her caloric.

Plant I'm healthy adolescents now, Gain healthier adults and also healthy future generations. It's a journey of life.

Making yourself a priority is not being selfish. We are for each other. Celebrate the spirit of womanhood with us for a healthier you today and tomorrow!

Taking tablets to postpone your periods ????

You must know this before taking pills to postpone your periods.

This page is exclusively made for sharing medical knowledge, Health tips and guiding the Women on adolescence, Fertility and Reproductive health. Lot many useful tips will be shared in this channel regularly.

Most of the time, irregular periods are part of the normal changes that can happen when you're a teen. As you get older, your cycle will probably settle into a recognizable pattern.

Here we have mentioned 8 Major causes of irregular periods in teenagers.