From gynaecologists and obstetricians to neonatologists and paediatricians, Medcare Girls & Kids Hospital is a one-stop resolution supplier for all health-related wants of ladies and youngsters. As well as, the hospital gives the entire gamut of medical providers to sufferers by way of different departments equivalent to endocrinology, household drugs, gastroenterology, common surgical procedure, dentistry, dermatology, weight loss plan and vitamin, and cosmetic surgery.
GN Focus speaks to 3 medical doctors on the hospital to be taught extra in regards to the gynaecological and pregnancy-related points ladies within the UAE face and the way the hospital tackles them.
What are the most typical gynaecological issues seen in ladies within the UAE?
Dr Sura Alwan, Specialist Obstetrics & Gynaecology: The commonest gynaecological dysfunction within the UAE is vaginal infections, that are often triggered when there’s an imbalance within the regular vaginal micro organism. What’s vital with vaginal an infection is correct analysis, which is able to information the remedy. Seek the advice of a health care provider instantly when you have vaginal discharge, irritation, ache or itching. It’s extra widespread right here within the UAE due to the new and humid local weather. Comply with good hygiene and drink lots of water to forestall infections. Cut back the quantity of sugar in weight loss plan as a result of that may typically set off sure sorts of yeast an infection.
One other gynaecological drawback that we see principally within the UAE is irregular menstruation, which may be resulting from pathological points in addition to way of life issues equivalent to weight achieve or weight reduction. One of many pathological causes is fibroids. A fibroid is a benign progress that develop from the cells that make up the muscle mass of the uterus, inflicting bleeding and pelvic ache beneath strain. Endometriosis, which causes painful menstruation or pelvic ache, can also be seen within the UAE.
Polycystic ovarian syndrome is extensively seen within the UAE. Why? Ought to ladies fear about it?
Dr Sura Alwan: Polycystic ovarian syndrome, or PCOS, is extra widespread these days. There are such a lot of causes, however principally it’s associated to sedentary way of life – an increasing number of ladies have gotten chubby – and likewise publicity to extra stress, industrial air pollution, extra toxins and radicals.
PCOS could cause many signs equivalent to irregular menstruation, infertility, extreme hair progress on the face, pimples, and many others. Its remedy relies on the signs in addition to the long-term impact of the syndrome.
PCOS is an endocrinological drawback, a hormonal imbalance. One of the crucial widespread hormones that disturb is the insulin.
The primary line of remedy for PCOS is way of life modification. We advise sufferers to not improve their weight and attempt to observe a nutritious diet and a wholesome degree of train.
If chubby ladies lose 5-10 per cent of their physique mass index or weight, they are going to have a lot enchancment of their signs.
Treatment equivalent to metformin may be given to cut back weight or preserve degree of insulin and sugar.
Some hormonal therapies will also be given to manage irregular menstruation attributable to PCOS.
If a lady develops fertility points resulting from PCOS, she is going to want particular remedy for that.
General, PCOS isn’t harmful. It won’t have an effect on a lady so long as she manages her signs by way of common train, a nutritious diet and observe medical doctors’ instructions.
Can you’re taking us by way of the significance of maternal foetal drugs?
Dr Shiva Harikrishnan, Senior Advisor, Obstetrics & Gynaecology: For the very best being pregnant consequence, each mom’s and the foetus’ well being is vital. We’ve to rigorously monitor and establish any issues in each mom and the foetus. We’ve foetal drugs specialists who handle foetal well being from the start of being pregnant. That is achieved by way of an in depth scan at 12 weeks to establish foetal abnormalities in addition to chromosomal or gene abnormalities. We’ve Down Syndrome screening, double marker, NT scan (to test the neck thickness of the infant) by excessive decision ultrasound, and a few blood assessments equivalent to BHCG and PAPPA from the maternal blood from which we will calculate whether or not the affected person is at excessive danger for Down Syndrome or some other chromosomal anomalies.
The obstetrician and the foetal drugs specialist work hand in hand to present the very best remedy for intra-uterine progress restriction, if the infant could be very small, when the water across the child could be very much less or when the blood stream for the infant is diminished.
At our hospital, we now have inner drugs medical doctors and endocrinologists who work along with obstetricians to ship constructive outcomes for each the infant and mom.
Is endometriosis underdiagnosed and undertreated within the UAE too? What are the challenges?
Dr Shiva Harikrishnan: Sure. Over the previous few years, there’s been a rise in consciousness amongst sufferers in addition to medical doctors, however there’s nonetheless an extended method to go as a result of often ladies really feel painful interval is wholesome and there’s nothing to fret. When there’s interval ache you don’t have to fret, however you need to know the distinction between the standard ache, which happens on the primary day of the interval, and congestive dysmenorrhea, the ache that comes earlier than the interval, doesn’t go down after the beginning of the interval and will final even after the interval is over. When sufferers with dysmenorrhea or painful interval come to our hospital, we use ache rating and signs to establish whether or not it’s endometriosis. We’ve an endometriosis centre, the place we do lots of work upfront laparoscopy and particular scan known as dynamic scan to test deep infiltrating endometriosis. We’ve radiology medical doctors who’re effectively versed with dynamic pelvic scanning to establish endometriosis and deep-infiltrating endometriosis into the uterosacral ligaments or the ligaments of the uterus or the womb and likewise to the bowel.
At Medcare Girls & Kids Hospital, we concentrate on endometriotic surgical procedure the place we now have a workforce of medical doctors together with a colorectal surgeon, urologist and gynaecologist who’s skilled in superior laparoscopic surgical procedure, which is the very best remedy for endometriosis and deep-infiltrating endometriosis. We’ve medical doctors who’re accredited as Grasp Surgeon in Minimal Invasive Surgical procedure from the Surgical Evaluate Company, USA. For many who aren’t keen to go for surgical therapies, we provide Dienogest, an oral progestogen that reduces the scale of endometriosis and offers short-term aid, along with injections that can produce a menopause-like state known as GnRh.
Who’re susceptible to high-risk pregnancies? What can ladies do to mitigate the dangers?
Dr Mansi Joneja, Inside Medication Specialist: Some pregnancies turn into excessive danger as they progress, nevertheless some ladies are at excessive danger even earlier than their being pregnant. Girls older than 35 and adolescent age; very skinny ladies (with BMI lower than 19.8) and chubby (BMI- 25-29.9) earlier than being pregnant; shorter ladies
(top lower than 5 toes); structural abnormalities of reproductive tract (uterus or cervix); persistent illnesses equivalent to hypertension, diabetes, kidney issues, autoimmune illnesses, thyroid issues, coronary heart illness, blood issues equivalent to sickle cell illness; and infections like HIV predispose them to dangers throughout being pregnant.
Nonetheless, typically wholesome ladies develop problems throughout being pregnant equivalent to raised blood strain, an infection in fluid surrounding the foetus, a number of births, and excessive sugars throughout being pregnant in non-diabetic ladies, which make their current being pregnant excessive danger.
Publicity to sure medication, chemical compounds, radiation, infections like herpes, cytomegalovirus, rubella, rooster pox, consumption of alcohol, cocaine, smoking additionally add to the danger.
So, it’s important to plan being pregnant on the proper age. Pre-existing situations should be managed with remedy. Wholesome way of life measures should be adopted, with the beginning of prenatal dietary supplements. Attaining the optimum weight, abstinence from alcohol and smoking, with prior essential immunisation assist mitigate the dangers.
It’s wiser to work on controlling as many danger components as doable quite than worrying about them. Seek the advice of the maternity workforce earlier than planning being pregnant in order that dangers may be assessed and handled earlier than conception. As soon as the danger components are recognized, a multidisciplinary strategy to the affected person with involvement of involved specialty together with the maternity workforce on the very onset helps to handle high-risk pregnancies effectively.
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