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Heavy period – how to manage it?

What is menorrhagia?

Menorrhagia is a heavy or prolonged menstrual bleeding. Many women have this type of abnormal uterine bleeding. It can be related to a number of conditions including problems with the uterus, hormone problems, or other rare conditions. While heavy bleeding can make it tough to take part in normal daily life at times, there are treatments to help.

What causes menorrhagia?

During your menstrual cycle, if an egg is not fertilized, the uterine lining breaks down, and bleeds. The egg and the uterine lining are then shed during your period.

Hormone problems or conditions that affect the uterus can result in heavy bleeding. Other diseases or bleeding disorders can also cause it.

Hormone problems include:

  • Imbalance of estrogen and progesterone or other hormones

Problems with the uterus include:

  • Fibroids (non cancerous)
  • Cancer
  • Pregnancy problems (such as a miscarriage or ectopic pregnancy)
  • Use of an intrauterine device (IUD)

Other conditions such as thyroid, kidney or liver disease, cancer or bleeding disorders can also cause heavy bleeding.

What are the symptoms of menorrhagia?

If you have to change your pad or tampon every 1 to 2 hours because it is soaked, or bleed longer than 7 days, see your doctor. Spotting or bleeding between periods is also a sign of a problem.

The symptoms of menorrhagia may look like other conditions or medical problems. Always consult your healthcare provider for a diagnosis.

How is menorrhagia diagnosed?

Your healthcare provider will ask you about your medical history and about your periods. You will also have a physical exam including a pelvic exam. You may be asked to keep track of your periods and how many pads or tampons you use for a few months if you haven’t already done so.

  • Blood tests. These check for anemia and test how fast your blood clots.
  • Pap test. For this test, cells are collected from the cervix and examined. It’s used to check for cancerous changes, infection, or inflammation.
  • Ultrasound. Using sound waves and a computer, your healthcare provider can check for fibroids or other problems inside the uterus.
  • Biopsy. Examining a tissue sample from the uterine lining can help your healthcare provider find cancer or other abnormal tissue.

Other tests include:

  • Hysteroscopy. Using a viewing instrument inserted through the vagina, your healthcare provider can see the cervix and the inside of the uterus.
  • Dilation and curettage (D&C).This procedure involves scraping and then examining the uterine cavity.

Treatment

Treatment of menorrhagia depends on the individual case.

Drug therapy includes:

  • Iron supplements to treat anemia
  • Tranexamic acid, or Lysteda, taken at the time of bleeding to help reduce blood loss
  • Oral contraceptives to regulate the menstrual cycle and decrease bleeding duration and quantity
  • Oral progesterone to treat hormonal imbalance and reduce bleeding
  • Hormonal IUD to thin the lining of the uterus, reducing bleeding and cramping

In women who have a bleeding disorder, such as von Willebrand’s disease or mild hemophilia, Desmopressin nasal spray, or Stimate can boost the levels of blood-clotting proteins.

Nonsteroidal anti-inflammatories, such as ibuprofen, or Advil, can be used to treat dysmenorrhea, or painful menstrual cramps, and they can help reduce blood loss. However, NSAIDS can also increase the risk of bleeding.

Surgical interventions

A number of surgical procedures are available to treat or relieve the symptoms of menorrhagia.

  • Dilation and curettage (D&C) is a surgical procedure for scraping the lining of the uterus
  • Uterine artery embolization treats fibroids, a cause of menorrhagia, by blocking arteries that feed them
  • Hysteroscopy involves inserting a camera into the uterus to evaluate the lining, assisting in the removal of fibroids, polyps, and the uterine lining.
  • Focused ultrasound ablation uses ultrasonic waves to kill fibroid tissue.
  • Myomectomy is a surgical intervention to remove uterine fibroids through several small abdominal incisions, an open abdominal incision, or through the vagina.
  • Endometrial ablation permanently destroys the lining of the uterus.
  • Endometrial resection uses an electrosurgical wire loop to remove the uterine lining.
  • Hysterectomy removes the uterus and cervix, and, sometimes, the ovaries.

The choice of intervention will take into account the cause and extent of the condition, the age and health of the patient, and their personal preference and expectations.

Dr.Ruchi Tandon is a Gynecologist practicing in leading hospitals in South Delhi and Greater Kailash.

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PCOS in your 30’s, how it can affect you?

Polycystic ovary syndrome (PCOS) is a common condition that affects how a woman’s ovaries work.

The 3 main features of PCOS are:

  • Irregular periods – which means your ovaries do not regularly release eggs (anovulation)
  • excess androgen – high levels of “male” hormones in your body, which may cause physical signs such as excess facial or body hair
  • polycystic ovaries – your ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs (but despite the name, you do not actually have cysts if you have PCOS)

If you have at least 2 of these features, you may be diagnosed with PCOS.

What are polycystic ovaries?

Polycystic ovaries contain a large number of harmless follicles that are up to 8mm (approximately 0.3in) in size. 

The follicles are under-developed sacs in which eggs develop. In PCOS, these sacs are often unable to release an egg, which means ovulation does not take place.

It’s difficult to know exactly how many women have PCOS, but it’s thought to be very common, affecting about 1 in every 5 women in the UK.

More than half of these women do not have any symptoms.

Symptoms of polycystic ovary syndrome (PCOS)

If you have symptoms of PCOS, they’ll usually become apparent during your late teens or early 20s.

They can include:

  • irregular periods or absent periods
  • difficulty getting pregnant as a result of irregular ovulation or failure to ovulate
  • The excessive hair growth or hirsutism – usually on the face, chest, back or buttocks
  • weight gain
  • thinning hair and hair loss from the head
  • oily skin or acne

PCOS is also associated with an increased risk of developing health problems in later life, such as type 2 diabetes and high cholesterol levels.

What causes polycystic ovary syndrome (PCOS)?

The exact cause of PCOS is unknown, but it often runs in families.

It’s related to abnormal hormone levels in the body, including high levels of insulin.

Insulin is a hormone that controls sugar levels in the body.

Many women with PCOS are resistant to the action of insulin in their bodies and produce higher levels of insulin to overcome this.

This contributes to the increased production and activity of hormones like testosterone.

Being overweight or obese also increases the amount of insulin your body produces.

What causes it?

Doctors don’t know exactly what causes PCOS. They believe that high levels of male hormones prevent the ovaries from producing hormones and making eggs normally.

Genes, insulin resistance, and inflammation have all been linked to excess androgen production.

Genes

Studies show that PCOS runs in families.

It’s likely that many genes — not just one — contribute to the condition.

Insulin resistance

Up to 70 percent of women with PCOS have insulin resistance, meaning that their cells can’t use insulin properly.

Insulin is a hormone the pancreas produces to help the body use sugar from foods for energy.

When cells can’t use insulin properly, the body’s demand for insulin increases. The pancreas makes more insulin to compensate. Extra insulin triggers the ovaries to produce more male hormones.

Obesity is a major cause of insulin resistance. Both obesity and insulin resistance can increase your risk for type 2 Diabetes.

Inflammation

Women with PCOS often have increased levels of inflammation in their bodies. Being overweight can also contribute to inflammation. Studies have linked excess inflammation to higher androgen levels.

How PCOS affects your body

Having higher-than-normal androgen levels can affect your fertility and other aspects of your health.

Infertility

To get pregnant, you have to ovulate. Women who don’t ovulate regularly don’t release as many eggs to be fertilized. PCOS is one of the leading causes of infertility in women.

Metabolic syndrome

Up to 80 percent of women with PCOS are overweight or obese. Both obesity and PCOS increase your risk for high blood sugar, high BP, low HDL (“good”) cholesterol, and high LDL (“bad”) cholesterol.

Together, these factors are called metabolic syndrome, and they increase the risk for heart disease, diabetes, stroke.

Sleep apnea

This condition causes repeated pauses in breathing during the night, which interrupts sleep.

Sleep apnea is more common in women who are overweight — especially if they also have PCOS. The risk for sleep apnea is 5 to 10 times higher in obese women with PCOS than in those without PCOS.

Endometrial cancer

During ovulation, the uterine lining sheds. If you don’t ovulate every month, the lining can build up.

A thickened uterine lining can increase your risk for endometrial cancer. 

Depression

Both hormonal changes and symptoms like unwanted hair growth can negatively affect your emotions. Many with PCOS end up experiencing depression and anxiety.

Dr.Ruch Tandon, the Gynecologist, specializes in PCOS and is available at leading hospitals in South Delhi

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Urinary leakage in women, why does it happen?

What is stress incontinence?

Stress incontinence is the inability to control your urge to urinate in certain circumstances. It’s a serious and embarrassing disorder and can lead to social isolation. Any pressure placed on the abdomen and bladder can lead to the involuntary loss of urine.

It’s important to remember that the term “stress” is used in a strictly physical sense when describing stress incontinence. It refers to excessive pressure on the bladder and not emotional stress.

An overactive bladder is a separate condition. In some cases, both overactive bladder and stress incontinence can occur, which is called mixed incontinence. Your Gynecologist can do tests to determine which is causing your incontinence.

Anatomy of the bladder

Your bladder is supported by a varied system of muscles:

  • The sphincter encircles the urethra, the tube that carries urine outside of your body.
  • The detrusor is the muscle of the bladder wall, which allows it to expand.
  • The pelvic floor muscles help support the bladder and the urethra.

To hold urine inside your bladder without leakage, you need to be able to contract your sphincter. When your sphincter and pelvic muscles are weak, it’s more difficult to contract these muscles and the result is called as stress incontinence.

Stress incontinence symptoms

The main symptom of stress incontinence is the loss of bladder control during physical activity. You may experience a few drops of urine or a large, involuntary flow. This can happen while you are:

  • laughing
  • sneezing
  • coughing
  • jumping
  • exercising
  • doing heavy lifting
  • engaging in sexual intercourse

Sometimes even standing up from a seated or reclining position can put additional pressure on your bladder and cause a leakage. Stress incontinence is unique for every individual. You may not show symptoms every time you participate in an activity, and the same activities that cause leakage for you may not affect another person with stress incontinence.

Who suffers from stress incontinence?

Women are twice as likely as men to suffer from involuntary leakage. The most common causes of stress incontinence among women are pregnancy and childbirth, especially having multiple vaginal deliveries. During pregnancy and childbirth, the sphincter and pelvic muscles stretch out and are weakened.

Older age and conditions that cause a chronic cough can also cause stress incontinence. This condition can also be a side effect of pelvic surgery.

Some women only suffer from stress incontinence during the week before they get their period. Various studies explain that estrogen drops during this phase of the menstrual cycle, which can weaken the urethra. This is not common though.

Other risk factors for stress incontinence include:

  • smoking due to chronic cough
  • any other condition associated with chronic cough
  • excessive caffeine and alcohol use
  • obesity
  • constipation
  • long-term participation in high-impact activities

Treatment

Your Gynecologist may recommend a combination of treatment strategies to end or lessen the number of incontinence episodes. If an underlying cause or contributing factor, such as a urinary tract infection, is identified, you’ll also receive treatment for the condition.

Behavior therapies

Behavior therapies may help you eliminate or lessen episodes of stress incontinence. The treatments your doctor recommends may include:

  • Pelvic floor muscle exercises. Called Kegel exercises, these movements strengthen your pelvic floor muscles and urinary sphincter. Your doctor or a physical therapist can help you learn how to do them correctly. Just like any other exercise routine, how well Kegel exercises work for you depends on whether you perform them regularly.

A technique called biofeedback can be used along with Kegel exercises to make them more effective. Biofeedback involves the use of pressure sensors or electrical stimulation to reinforce the proper muscle contractions.

  • Fluid consumption.Your doctor might recommend the amount and timing of fluids you consume during the day and evening. However, don’t limit what you drink so much that you become dehydrated.

Your Gynecologist may also suggest that you avoid caffeinated and alcoholic beverages because it’s believed that in some people these dietary irritants affect your bladder function. But, new research suggests that coffee and caffeine may not increase stress incontinence. If you find that using fluid schedules and avoiding dietary irritants significantly improves leakage, you’ll have to decide whether these changes are worth the improvement in leakage.

  • Healthy lifestyle changes.Quitting smoking, losing excess weight or treating a chronic cough will lessen your risk of stress incontinence as well as improve your symptoms.
  • Bladder training.Your doctor might recommend a schedule for toileting (bladder training) if you have mixed incontinence. More frequent voiding of the bladder may reduce the number or severity of urge incontinence episodes.

Medications

There are various approved medications to specifically treat stress incontinence.The antidepressant duloxetine (Cymbalta) is used for the treatment of stress incontinence.

Devices

Certain devices designed for women may help control stress incontinence, including:

  • Vaginal pessary. A specialized urinary incontinence pessary, shaped like a ring with two bumps that sit on each side of the urethra, is fitted and put into place by your doctor or nurse. It helps support your bladder base to prevent urine leakage during activity, especially if your bladder has dropped (prolapsed).

This is a good choice if you wish to avoid surgery. A pessary will require routine removal and cleaning. Pessaries are used mostly in people who also have pelvic organ prolapse.

Surgeries

Laparoscopic bladder neck repair, Kelly’s repair, sling operations,  burch colposuspensipn, TVT tape colposuspensipn are some of the surgical options.

Recently transvaginal RF LASER treatment is giving good results in stress and mixed incontinence.

Dr.Ruchi Tandon is a Gynecologist with 13 years experience in all cases of urinary leakage and urinary incontinence. She is practicing in leading hospitals in South Delhi.

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What could possibly be the cause of your miscarriage and how to avoid it?

A miscarriage, also called a spontaneous abortion, is the spontaneous ending of a pregnancy. About 1/3 to 1/2 of all pregnancies end in miscarriage before a woman misses a menstrual period or even knows she is pregnant. About 10 to 20% of women who know they are pregnant will miscarry , mostly in the first three months.

A miscarriage is most likely to occur within the first 3 months of pregnancy, before 20 weeks gestation. Very few of miscarriages occur after 20 weeks’ gestation. These are termed late miscarriages.

What causes miscarriage?

About half of all miscarriages that occur in the first trimester are caused by chromosomal abnormalities, which might be hereditary or spontaneous , in the father’s sperm or the mother’s egg. Chromosomes are tiny structures inside the cells of the body that carry many genes, the basic units of heredity.

Genes determine all of a person’s physical attributes, such as sex, hair and eye color and blood type. Most chromosomal problems occur by chance and are not related to the mother’s or father’s health.

Miscarriages are also caused by a variety of unknown and known factors, such as:

  1. Infection
  2. Exposure to environmental and workplace hazards such as high levels of radiation or toxic agents.
  3. Hormonal irregularities.
  4. Improper inplantation of fertilized egg in the uterine lining.
  5. Maternal age.
  6. Uterine abnormalities.
  7. Incompetent cervix. (The cervix begins to widen and open too early, in the middle of pregnancy, without signs of pain or labor.)
  8. Lifestyle factors such as smoking, drinking alcohol, or using illegal drugs.
  9. Disorders of the immune system including lupus, an autoimmune disease.
  10. Severe kidney disease.
  11. Congenital heart disease.
  12. Diabetes that is not controlled.
  13. Thyroid disease.
  14. Radiation
  15. Certain medicines, such as the acne drug isotretinoin .
  16. Severe malnutrition.
  17. Infections

What are the symptoms of a miscarriage?

Symptoms of a miscarriage include:

If you are experiencing the symptoms listed above, contact your Gynecologist right away. She will tell you to come in to the office or go to the labor room.

How Is a Miscarriage Diagnosed and Treated?

Your Gynecologist will perform a pelvic exam, an ultrasound test and bloodwork to confirm a miscarriage. If the miscarriage is complete and the uterus is empty, then no further treatment is usually required. Occasionally, the uterus is not completely emptied, so a dilatation and curettage (D&C) procedure is performed. During this procedure, the cervix is dilated and any remaining fetal or placental tissue is gently removed from the uterus. As an alternative to a D&C, certain medicines can be given to cause your body to expel the contents in the uterus. This option may be more ideal in someone who wants to avoid surgery and whose condition is otherwise stable.

Blood work to determine the amount of a pregnancy hormone (hCG) is checked to monitor the progress of the miscarriage.

When the bleeding stops, usually you will be able to continue with your normal activities. If the cervix is dilated, you may be diagnosed with an incompetent cervix and a procedure to close the cervix (called cerclage) may be performed if the pregnancy is still viable. If your blood group is Rh negative, your doctor may give you a blood product called Rh immune globulin (Rhogam). This prevents you from developing antibodies that could harm your baby as well as any of your future pregnancies.

Blood tests, genetic tests, or medication may be necessary if a woman has more than two miscarriages in a row (called recurrent miscarriage). Some diagnostic procedures used to evaluate the cause of repeated miscarriage include ultrasound, hysterosalpingogram (an X-ray of the uterus and fallopian tubes), and hysteroscopy (a test in which the doctor views the inside of the uterus with a thin, telescope-like device inserted through the vagina and cervix).

Can I Get Pregnant Following a Miscarriage?

Yes. At least 85% of women who have miscarriages have subsequent normal pregnancies and births. Having a miscarriage does not necessarily mean you have a fertility problem. On the other hand, about 1%-2% of women may have repeated miscarriages (three or more). Some researchers believe this is related to an autoimmune response.

If you’ve had two miscarriages in a row, you should stop trying to conceive, use a form of birth control, and ask your Gynecologist to perform diagnostic tests to determine the cause of the miscarriages.

Dr. Ruchi Tandon, is a Gynecologist with over 13 years experience in obstetrics and Gynecology, practicing in leading hospitals in South Delhi. She is approachable, experienced and highly competent in handling all types of pregnancies.

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Endometrial polyp in your 40’s

Uterine or endometrial polyps are growths attached to the inner wall of the uterus that extend into the uterine cavity. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of ensdometrial polyps, also known as uterine polyps. These polyps are usually noncancerous (benign), although some can be cancerous or can eventually turn into cancer. They can range from few millimetres to few centimeters and can be endometrial, endocervical or cervical polyps depending on the origin of the tissue.

Symptoms

Signs and symptoms of uterine polyps include:

  • Irregular menstrual bleeding — for example, having continuous, unpredictable periods of variable length and heaviness
  • Bleeding between 2 menstrual periods
  • Excessively heavy menstrual periods
  • Vaginal bleeding after menopause
  • Infertility

Some women have only light bleeding or spotting; others are without symptoms.

Causes

Doctors don’t know exactly why women get uterine polyps, but it may be related to changes in hormone levels. Each month, your estrogen levels rise and fall, directing the lining of the uterus to thicken and then shed during your period. It’s an overgrowth of that uterine lining that makes a polyp.

Some things make you more likely to have polyps. One is age ,they’re more common in your 40s or 50s. That may be due to the changes in estrogen levels that happen right before and during your menopause.

Obesity, high blood pressure and taking the breast cancer drug tamoxifene can also raise your chances for uterine polyps.

Diagnosis

Transvaginal ultrasound

Hysteroscopy

Endometrial biopsy

Treatment modalities

Watch and wait

Medication :Some studies have shown polyps less than 5 mm can be treated with course of progesterones for upto 3 cycles, polys might regress or be she’d out in next  menstrual cycle.

Hysteroscopy:

Hysteroscopy had been accepted as the gold standard in diagnosis and treatment of all types of polyps. It is usually done as a daycare procedure and the obtained tissue is sent for histopathology diagnosis.

What to expect with hysteroscopic removal of endometrial polyp

Prior to surgery

  • You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), Clopidogrel (Plavix), warfarin (Coumadin), and other blood thinners.
  • You will be scheduled to undergo the procedure after menstrual bleeding has ended and before ovulation (if you are still ovulating).
  • Ask your doctor which drugs you should still take on the day of the surgery.
  • Discuss any possible bleeding disorders or other medical conditions that you may have.
  • You will have blood samples taken in case you need a blood transfusion.
  • Do not smoke. This will help you to recover quicker.

On the Day of the Surgery

  • If you are to have general anesthesia, you will usually be asked not to drink or eat anything after midnight the night before the surgery.
  • Take the drugs your doctor told you to take with a small sip of water.
  • Your doctor or nurse will tell you when to arrive at the hospital.

After Surgery

  • Most patients can go home the same day.
  • You may have increased cramping and vaginal bleeding for a day or two after the procedure.
  • You may experience gas pains for about a day or so due to gas administered during the procedure. This may extend into your upper abdomen and shoulder. Walking will help relieve this pressure.
  • This surgery has a quick recovery with most patients feeling much better within the first few days.

Recovery: what to expect in the next few weeks

  • Some women have some water discharge with some blood for a few weeks expect the flow to be heavy at first and then diminishing over time.
  • Most women feel better within the first week following surgery; however, do not lift, push or pull any heavy objects for a couple of weeks.
  • Do not resume sexual intercourse or douche until your doctor says it is OK.
  • Full recovery takes about two weeks to allow for internal healing.

Dr.Ruchi Tandon is a trained hysteroscopic surgeon with over 13 years of clinical experience. At present, she is providing her services in leading hospitals in South Delhi namely, Apollo Spectra, Apollo Cradle Royale and Max Smart super speciality hospital, Saket.

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High Risk Pregnancy – How to manage it

Any pregnancy that poses a risk to the mother or baby, or is different from normal is considered as high-risk pregnancy.

What are the risk factors for high-risk pregnancies?

Sometimes a high-risk pregnancy is the result of a medical condition or disease present before pregnancy. In other cases, a medical condition that develops during pregnancy for either you or your baby causes a pregnancy to become high risk pregnancy.

Specific factors that might contribute to a high-risk pregnancy include:

  • Advanced maternal age.Pregnancy risks are higher for mothers older than age 35 years.
  • Lifestyle choices. Smoking cigarettes, drinking alcohol and using certain drugs can put a pregnancy at risk.
  • Medical history. A history of hypertension, diabetes, heart disorders, breathing problems such as poorly controlled asthma, infections, and blood-clotting disorders such as deep vein thrombosis can increase pregnancy risks.
  • Surgical history. A history of surgery on your uterus, including  C-sections, multiple abdominal surgeries or surgery for uterine tumors (fibroids), can increase pregnancy risks.
  • Pregnancy complications. Various complications that develop during pregnancy can pose risks. Examples include an abnormal placenta position, bleeding during pregnancy, fetal growth less than the 10th percentile for gestational age (fetal growth restriction) and Rh (rhesus) sensitization — a potentially serious condition that can occur when your blood group is Rh negative and your baby’s blood group is Rh-positive.
  • Multiple pregnancy. Pregnancy risks are higher for women carrying twins or higher-order multiple fetuses.

What steps can you take to promote a healthy pregnancy?

Whether you know ahead of time that you’ll have a high-risk pregnancy or you simply want to do whatever you can to prevent a high-risk pregnancy, follow the instructions by your Gynecologist. For example:

  • Schedule a preconception appointment.If you’re thinking about becoming pregnant, consult your Gynecologist. She might counsel you to start taking a daily prenatal vitamin with folic acid and reach a healthy weight before you become pregnant. If you have a medical condition, your treatment might need to be adjusted to prepare for pregnancy. Your health care provider might also discuss your risk of having a baby with a genetic condition.
  • Seek regular prenatal care. Prenatal visits can help your health care provider monitor your health and your baby’s health. Depending on the circumstances, you might be referred to a specialist in maternal-fetal medicine, genetics, pediatrics or other areas.
  • Eat a healthy diet. During pregnancy, you’ll need more folic acid, protein, calcium and iron. A daily prenatal vitamin can help fill any gaps. Talk to your Gynecologist if you have special nutrition needs due to a health condition, such as diabetes.
  • Gain weight wisely. Gaining the right amount of weight can support your baby’s health — and make it easier to shed the extra pounds after delivery. Work with your Gynecologist to determine what’s right for you.
  • Avoid risky substances. If you smoke, quit. Alcohol and illegal drugs are off-limits, too. Get your health care provider’s OK before you start — or stop — taking any medications or supplements.

Do you need special tests?

If you have a high-risk pregnancy, you might consider various tests or procedures in addition to routine prenatal screening tests. Depending on the circumstances, your Gynecologist might recommend:

  • Specialized or targeted ultrasound.This type of fetal ultrasound, an imaging technique that uses high-frequency sound waves to produce images of a baby in the uterus  targets a suspected problem, such as abnormal development.
  • During this procedure, a sample of the fluid that surrounds and protects a baby during pregnancy (amniotic fluid) is withdrawn from the uterus. Typically done after week 14 of pregnancy, amniocentesis can identify certain genetic conditions, as well as neural tube defects — serious abnormalities of the brain or spinal cord.
  • Chorionic villus sampling (CVS).During this procedure, a sample of cells is removed from the placenta. Usually done between weeks 10 and 12 of pregnancy, CVS can identify certain genetic conditions.
  • Also known as percutaneous umbilical blood sampling, this is a diagnostic prenatal test in which a sample of the baby’s blood is removed from the umbilical cord for testing. The test can identify certain genetic disorders,  conditions and infections.
  • Ultrasound for cervical length. Your health care provider might use an ultrasound to measure the length of your cervix at prenatal appointments to determine if you are at risk of preterm labor.
  • Laboratory tests. Your health care provider will test your urine for urinary tract infections and screen you for infectious diseases such as HIV and syphilis.
  • Biophysical profile. 2This prenatal test is used to check on a baby’s well-being. It might involve only an ultrasound to evaluate fetal well-being or, depending on the results of the ultrasound, also fetal heart rate monitoring (nonstress test).

Some prenatal diagnostic tests — such as amniocentesis and chorionic villus sampling — carry a small risk of pregnancy loss. The decision to pursue prenatal testing is up to you and your partner. Discuss the risks and benefits with your Gynecologist.

Dr. Ruchi Tandon is a gynecologist specialising in high risk pregnancy, with over 14 years of clinical experience. She is currently associated with leading hospitals of South Delhi such as Max Smart Superspeciality Hospital, saket, Apollo Cradle Royale, Nehru Place and Apollo Spectra, Kailash Colony.