Coping with Anxiety and Stress during a High-Risk Pregnancy

Coping with Anxiety and Stress during a High-Risk Pregnancy

Bringing new life into the world is a beautiful and transformative experience, but it can also be a time of heightened anxiety and stress, especially if you are navigating a high-risk pregnancy. High-risk pregnancies can be challenging due to potential complications, making it crucial to prioritize emotional well-being and stress management throughout this journey. Consulting high-risk pregnancy doctors in Greater Kailash can help cope and manage stress.

Tips to Manage Stress and Anxiety During High-Risk Pregnancy

Communication and Education

Open communication with the Best Gynecologist in Greater Kailash is the cornerstone of managing anxiety during a high-risk pregnancy. Ensure you have a clear understanding of your condition, potential risks, and the steps needed to monitor and manage your health. Knowledge alleviates fear and helps you take proactive measures to ensure a healthy pregnancy.

Build a Support Network

Surround yourself with a strong support system that includes your partner, family, friends, and healthcare professionals. Having a network of individuals who understand and empathize with your situation can provide immense emotional support. Share your concerns and fears openly, allowing your loved ones to offer encouragement and reassurance.

Practice Relaxation Techniques

Add relaxation techniques to your daily routine. This will help manage stress. Techniques such as deep breathing, progressive muscle relaxation, guided imagery, and meditation can help reduce anxiety levels. These practices can be done at any time and in any place, giving you a sense of control over your emotional well-being.

Stay Active within Limits

Regular, gentle exercises can help reduce stress and anxiety during a high-risk pregnancy. Consult your high-risk pregnancy doctors in Greater Kailash to determine suitable exercises for your condition. Activities like prenatal yoga, walking, and swimming can improve circulation, reduce tension, and enhance your overall mood.

Mindfulness and Mindful Eating

Practice mindfulness to stay present and reduce anxiety. Pay attention to your thoughts and feelings without judgment, and engage in activities that ground you in the moment. Mindful eating, focusing on nourishing foods and enjoying each bite, can promote a sense of calm and improve your overall well-being.

Seek Professional Help

If anxiety and stress become overwhelming, consider consulting a mental health professional specializing in perinatal care. Therapy, counseling, or support groups can provide a safe space to express your emotions and receive guidance on managing anxiety and stress effectively.

Prioritize Self-Care

Make self-care a non-negotiable part of your routine. Take proper sleep, maintain a balanced diet, and engage in activities that make you happy and relaxed. Taking care of yourself physically and emotionally is vital for a healthy pregnancy and managing anxiety.

Dr. Ruchi Tandon, the Best Gynecologist in Greater Kailash can guide you with some tips on maintaining stress and anxiety levels to the minimum during high-risk pregnancy.

How to Maintain a Healthy Pregnancy?

Tips for Healthy Pregnancy - A Quick Guide

Pregnancy is a remarkable journey filled with anticipation, joy, and change. The well-being of both the expectant mother and the growing baby is of paramount importance during this transformative time. To ensure a healthy pregnancy, the first should be to find the best pregnancy doctor in South Delhi. Besides that, there are several key tips to keep in mind that encompass physical, emotional, and lifestyle aspects.

How to Maintain a Healthy Pregnancy?

Preconception Planning

Begin your journey to a healthy pregnancy by planning ahead. Schedule a preconception checkup with your healthcare provider to discuss any medical conditions, medications, or vaccinations that might need adjustment before conception.

Nutrient-Rich Diet

A balanced and nutrient-rich diet is crucial for the well-being of both mother and baby. Add a variety of food items like fruits, vegetables, whole grains, lean proteins, and dairy products to your diet. Adequate folic acid, iron, calcium, and omega-3 fatty acids are especially important. Do consult the best gynecologist in Greater Kailash to confirm what you should eat.

Regular Prenatal Care

Attending regular prenatal checkups at a good gynecologist in South Delhi is essential for monitoring the progress of your pregnancy. These appointments allow your pregnancy doctor to track the baby’s growth, address any concerns, and provide guidance on a healthy lifestyle.

Stay Hydrated

Proper hydration is vital for maintaining amniotic fluid levels and supporting the body’s increased blood volume during pregnancy. Drink enough water throughout the day.

Exercise Mindfully

Engaging in regular, moderate exercise can help alleviate discomfort, boost mood, and improve overall health during pregnancy. Consult your healthcare provider for safe exercise options that suit your individual needs.

Adequate Rest

Your body is working hard to support the growth of your baby. Prioritize adequate sleep and rest to ensure both you and your baby receive the rejuvenation you need.

Emotional Well-being

Pregnancy brings about a range of emotions. Practice stress-reduction techniques such as meditation, deep breathing, or prenatal yoga to foster emotional well-being.

Avoid Harmful Substances

Say no to alcohol, tobacco, recreational drugs, and excessive caffeine. These substances can pose risks to your baby’s development and overall health.

Safe Medication Use

Always consult your healthcare provider before taking any medication, including over-the-counter drugs and supplements, to ensure they are safe for pregnancy.

Maintain a Healthy Weight

Strive to gain a healthy amount of weight throughout pregnancy. This supports your baby’s growth while minimizing the risk of complications. Your pregnancy doctor in South Delhi can guide you on how to manage a healthy weight during pregnancy.

Hygiene and Food Safety

Pay attention to hygiene and food safety to prevent infections. Avoid undercooked meats, unpasteurized dairy products, and foods that carry a higher risk of contamination.

Endometriosis in Adolescents – An Expert Guide

Endometriosis is a condition often associated with adult women, but, can also affect adolescents, and its impact can be profound. A good endometriosis doctor in South Delhi must be consulted for better diagnosis and treatment. Despite its prevalence, endometriosis in adolescents is frequently overlooked or misdiagnosed, leading to delayed treatment and potential long-term consequences.

In this blog, we will explore the significance of recognizing endometriosis in adolescents, its symptoms, diagnostic challenges, and the importance of early intervention.

What is Endometriosis?

Endometriosis is a chronic condition characterized by the presence of endometrial-like tissue outside the uterus, typically in the pelvic area. When adolescents are affected, this tissue can grow on the ovaries, fallopian tubes, and other pelvic organs. As the menstrual cycle progresses, the tissue responds to hormonal changes which can lead to painful symptoms and inflammation. It is always advised to seek the guidance of the best gynecologist in Greater Kailash.

Symptoms and Diagnostic Challenges

Identifying endometriosis in adolescents can be challenging due to several factors. Firstly, it is often mistaken as severe menstrual pain, leading to dismissals of the pain as a natural part of growing up.

Secondly, adolescents may be hesitant or embarrassed to discuss their symptoms, making it difficult for endometriosis doctors in South Delhi to get a comprehensive understanding of their condition. Common symptoms of endometriosis in adolescents include:

  • Severe pelvic pain, especially during menstruation
  • Heavy and irregular menstrual bleeding
  • Gastrointestinal issues like diarrhea, constipation, or bloating
  • Fatigue and general malaise
  • Pain during intercourse
  • Chronic lower back pain

The Importance of Early Intervention

Recognizing endometriosis in adolescents is crucial for several reasons. Firstly, early intervention can alleviate pain and improve their quality of life during a time of physical and emotional growth. Secondly, identifying the condition early may prevent the progression of endometriosis and its potential complications, such as infertility.

Lastly, early diagnosis allows for the initiation of appropriate treatment plans, which can include hormonal therapies or minimally invasive surgical options. This can only be achieved if one connects with the best gynecologist in Greater Kailash.

Encouraging Open Communication

Addressing endometriosis in adolescents requires an open and supportive environment. Parents, caregivers, and endometriosis doctor in South Delhi must encourage open communication with teenagers about their menstrual health. By fostering a safe space for discussing symptoms and concerns, adolescents may feel more comfortable seeking medical advice and sharing their experiences.

Raising Awareness and Education

To combat the lack of awareness surrounding endometriosis in adolescents, it is essential to raise awareness and promote education about the condition. Schools, healthcare providers, and community organizations can collaborate to implement educational programs that inform adolescents, parents, and educators about the symptoms, treatment options, and available resources.

A Quick Guide on Telemedicine and Digital Health in Gynecology

A Quick Guide on Telemedicine and Digital Health in Gynecology

Telemedicine and digital health have transformed the landscape of healthcare, and gynecology is no exception. With the rapid advancements in technology and increased internet connectivity, accessing quality healthcare has become more convenient and accessible. Telemedicine offers a range of benefits, such as remote consultations, real-time monitoring, and access to specialist care, empowering women to take charge of their reproductive health. Even it makes it easier to consult the Best Gynecologist in Greater Kailash. Let us have a detailed look at it.

Convenience and Accessibility

One of the most significant advantages of telemedicine in gynecology is the convenience it offers. Women no longer need to travel long distances or wait for extended periods to see the best gynecologist in Greater Kailash. Through telemedicine platforms, patients can schedule virtual appointments at their preferred time and interact with healthcare professionals from the comfort of their homes. This accessibility is especially crucial for women in rural or remote areas who may have limited access to specialized gynecological care.

Enhanced Monitoring and Early Detection

Digital health technologies have revolutionized patient monitoring, particularly in high-risk pregnancies and gynecological conditions. In such situations, quick access to the best abortion clinic could be there and one can take appointments right from home. Wearable devices, such as smartwatches and health trackers, can collect real-time data on vital signs, fetal movements, and other important health parameters. This data is transmitted to healthcare providers, enabling them to monitor patients more closely and identify potential complications or issues at an early stage.

Privacy and Confidentiality

Women often seek gynecological care for sensitive issues, such as reproductive health, family planning, and sexually transmitted infections. Telemedicine platforms prioritize patient privacy and confidentiality, allowing women to discuss their concerns openly with healthcare professionals without fear of judgment or stigma. Patients can have secure virtual consultations that comply with strict privacy regulations, ensuring that their personal information remains protected.

Reduced Wait Times and Increased Efficiency

In traditional healthcare settings, long wait times are common due to the volume of patients and limited appointment availability. Telemedicine significantly reduces these waiting periods, allowing the best gynecologists in Greater Kailash to serve more patients efficiently. By streamlining administrative tasks and using telemedicine for non-urgent consultations, healthcare providers can focus on patients with more critical needs, thereby enhancing overall healthcare efficiency.

Continuity of Care

Telemedicine facilitates continuity of care for gynecological patients. Women with chronic conditions, such as polycystic ovary syndrome or endometriosis, can maintain regular follow-up appointments through virtual visits. Additionally, post-operative care and counseling can be conducted remotely, ensuring that patients receive ongoing support throughout their treatment journey.

Health Education and Awareness

Digital health platforms provide an excellent opportunity for health education and awareness campaigns in gynecology. Through webinars, online seminars, and informative resources, women can access valuable information about reproductive health, menstrual hygiene, contraception options, and pregnancy care. Empowering women with knowledge can lead to better health outcomes and informed decision-making.

Important Points You Should Know About Post-Abortion Care

Post-abortion care (PAC) is a critical aspect of comprehensive reproductive healthcare that focuses on providing support and physical and emotional well-being to individuals after they have undergone an abortion. Regardless of the circumstances surrounding the decision, compassionate and comprehensive post-abortion care is essential in ensuring the overall health and well-being of those who have chosen to terminate a pregnancy.

Here, we will see some key points about post-abortion care. However, if you are planning an abortion due to any reason, it is always a good idea to find the best abortion clinic in Delhi

Physical Recovery and Healthcare

Following an abortion, individuals require proper medical attention and care to ensure their physical well-being. Post-abortion care includes monitoring for potential complications, providing pain management, and offering any necessary follow-up services.

Depending on the type of abortion procedure performed, healthcare professionals may provide guidance on post-procedural care, including instructions on pain management, hygiene, and when to resume regular activities. It is crucial for healthcare providers to create a safe and non-judgmental environment, where individuals feel comfortable discussing any concerns or questions they may have.

Emotional Support and Counseling

The emotional well-being of individuals after an abortion is equally important as their physical recovery. Many individuals may experience a range of emotions, including relief, sadness, guilt, or a sense of loss. Post-abortion care involves offering emotional support and counseling services to address these feelings and provide a safe space for individuals to express and process their emotions.

Compassionate counseling can help individuals navigate the complex emotional landscape, reduce feelings of isolation or stigma, and promote healing and self-care.

Contraceptive Education and Family Planning

Post-abortion care also plays a vital role in ensuring access to contraceptive education and family planning services. Individuals who have had an abortion need guidance on contraceptive methods to prevent unintended pregnancies in the future.

Healthcare providers can offer information on various contraceptive options, their effectiveness, and help individuals choose a method that aligns with their preferences and lifestyle. By providing comprehensive family planning support, post-abortion care contributes to empowering individuals in making informed decisions about their reproductive health and preventing future unplanned pregnancies.

Addressing Stigma and Promoting a Supportive Environment

The stigma surrounding abortion can have a profound impact on individuals’ experiences and their ability to seek post-abortion care. It is crucial for society, healthcare providers, and communities to foster a non-judgmental and supportive environment for those who have had an abortion.

This includes challenging stigmatizing attitudes, providing accurate information about abortion, and promoting empathy and understanding. By creating a supportive atmosphere, we can ensure that individuals feel comfortable accessing the care and support they need, facilitating their healing process and overall well-being.

Dr. Ruchi Tandon, the best gynecologist in Greater Kailash can help you with safe abortion and post-abortion care.

A Quick Guide to In-Vitro Fertilization

A Quick Guide to In-Vitro Fertilization

Infertility can be a heartbreaking journey for couples longing to have a child. However, thanks to medical advancements, In Vitro Fertilization (IVF) has emerged as a beacon of hope, offering a ray of light to those struggling with conception.

IVF has revolutionized the field of reproductive medicine, allowing couples to achieve their dream of parenthood. If you want to know about the procedure in detail, an infertility specialist in Greater Kailash can help. In this blog, we will have a quick look at IVF to get you acquainted with the procedure better.


Understanding IVF

In Vitro Fertilization is a complex assisted reproductive technology that involves combining an egg and sperm outside the body in a laboratory setting. During IVF, the doctor gives certain fertility medicines to the patient. These medicines stimulate ovaries to produce mature eggs which are later retrieved surgically for in-vitro fertilization.

Meanwhile, sperm from the male partner or a donor is collected and prepared for fertilization. In the laboratory, eggs and sperm are combined, and fertilization takes place. The resulting embryos are closely monitored, and one or more are transferred into the woman’s uterus, with any remaining embryos frozen for future use.


Success Rates and Advancements

Over the years, IVF success rates have improved significantly due to advancements in laboratory techniques, better embryo selection methods, and the use of preimplantation genetic testing. Factors such as the woman’s age, the quality of eggs and sperm, and the expertise of the fertility clinic can influence success rates. Today, IVF offers hope to couples facing various fertility challenges, including issues such as tubal factor infertility, male factor infertility, advanced maternal age, endometriosis, and unexplained infertility.

Moreover, innovative techniques like intracytoplasmic sperm injection (ICSI) and blastocyst culture have further enhanced the chances of success in specific cases.


Emotional Aspects and Support

Couples often experience a rollercoaster of emotions, ranging from hope and excitement to disappointment and anxiety. It is essential to acknowledge and address these emotional aspects. Many fertility clinics offer counseling services to provide emotional support, helping couples navigate the emotional ups and downs.

Additionally, connecting with support groups and seeking guidance from infertility communities can offer invaluable comfort, understanding, and advice. IVF is not just a physical process; it’s an emotional and psychological journey that demands compassion, patience, and a strong support system.


Ethical Considerations and Future Possibilities

As IVF continues to transform the lives of countless couples, ethical considerations arise concerning the creation and disposition of embryos, the use of donor gametes, and the potential for genetic manipulation. Society is continually grappling with these complex questions, striving to strike a balance between scientific progress and ethical boundaries.

Furthermore, ongoing research and innovation offer promising possibilities for the future, such as improved embryo selection techniques, advancements in cryopreservation, and advancements in fertility preservation for individuals facing medical treatments that may affect their fertility.

Consult Dr. Ruchi Tandon, the best gynecologist in Greater Kailash for any fertility concerns.

Spine Health and Pregnancy – What You Should Know About?

Pregnancy is one of the best phases in a woman’s life. And why not? It is the time when life is giving birth to another life. However, the fact can also be not denied that this phase is not easy for women as they go through a lot of emotional and physical changes. To avoid any severe complications and manage such changes, it is important to stay in touch with the Best Gynecologist in Greater Kailash.

Well, one of the noticeable facts during pregnancy is the changing spine health, and this is what we will be discussing in the post.

How Pregnancy Affects Spine Health?

If we talk about lower back pain during pregnancy, then it often occurs because of the change in the posture of women. Added weight because of the growth and development of the fetus is the reason.

Now, the fetus’s growth also contributes to postural changes in women. Studies have found that the curvature of the lumbar spine increases to around 2.7° during the third trimester of pregnancy when compared to the curvature in non-pregnant women. This is because of the forward-pushing weight of the fetus. However, lower back pain in the first and second trimesters may not be because of these changes. The pain often becomes intense during the later stages of pregnancy and the growing fetus is the cause of the same.

How to Maintain Spine Health During Pregnancy?

Over 50% of women complain of lower back pain during pregnancy and we can say it is a sign of a developing baby. Well, as the fetus grows, your back has to take all the pain. However, there are certain tips that can help you with the pain and maintain spine health during pregnancy:

Regular Exercise

Exercising is the best form of defense against back pain, and during pregnancy, it becomes a must. So, safe exercises must be routinely performed to get long-term relief from backache and maintain optimum spine health. If you are confused about which exercises you should perform, consult a specialist.

Heat and Cold Therapy

The application of heat or cold packs may also help with temporary back pain relief. This must be done for up to 20 minutes several times a day. Here, it is advised not to apply heat to the abdomen during pregnancy.

Improve Posture

Another way of maintaining spine health is to improve posture while sitting, standing, or sleeping. Leaning towards the back is likely during pregnancy, however, expert advice may help you cope with the changing posture. The use of a support belt may be of good help in such a situation.

Dr. Ruchi Tandon is a renowned pregnancy doctor in Delhi and she also provides the best fibroids treatment in Greater Kailash.

Common Orthopedic Problems in Pregnancy

Common Orthopedic Problems in Pregnancy

A woman experiences a lot of physical and emotional changes during pregnancy. To cope with them, it is important to consult the Best Gynecologist in Greater Kailash.

If we talk about physical changes in women during pregnancy, then orthopedic problems are common, and this is what we will be discussing here in the post.

Orthopedic Issues During Pregnancy

Lower Back Pain

Back pain is among the commonest orthopedic issues that a pregnant woman experiences. This is often because of the extra body weight. As a result of the growth and development of the fetus, the expecting mother gains weight. This puts pressure on the back muscles. Sometimes, the pain is severe. In such situations, having a strong back is important. So, maintain a strong back by doing exercises under the guidance of a skilled and experienced physiotherapist.

Osteitis Pubis

Another orthopedic condition that women may experience during pregnancy is osteitis pubis. It is an inflammatory condition that affects pubis symphysis. Bones at the front of the pelvis are called the pubic symphysis. Inflammation at this junction occurs because of the added weight and the position of the developing fetus. Pain associated with the condition can improve with the application of ice and heat and non-steroidal anti-inflammatory drugs (NSAIDs).

Heel Pain

Added body weight during pregnancy also causes heel pain. However, heel pain may occur because of plantar fasciitis. This is a condition characterized by the inflammation of a thick band of tissue present at the bottom of the foot. This band is called the plantar fascia and it connects the heel bone to the toes. Stabbing pain is what one experiences because of the condition which occurs during pregnancy. It is intense in the morning and the latter stages of pregnancy.

The application of ice and the use of shoe inserts may help improve the condition. In severe cases, the healthcare service provider may give cortisone shots.

Transient Osteoporosis of the Hip

This often occurs during late-term pregnancy. Transient hip osteoporosis is characterized by temporary bone loss around the hip joint. This makes the hip joint weak. The reason for the same is unknown but hormonal changes are believed to cause the same. Besides this, weight-bearing stress also contributes to the condition.

Knee Pain

Knee pain is very common in pregnancy and the reason for the same is simple i.e., added weight of carrying the baby. This is why rest is advised during pregnancy as it helps cope with knee pain by relieving pressure. This is especially true in the later stages of pregnancy as the fetus grows heavy.

To manage these conditions timely and ensure a healthy & happy pregnancy, consult an experienced doctor. Dr. Ruchi Tandon is an experienced gynecologist in South Delhi and also provides the best fibroids treatment in Greater Kailash.

Cervical infection in women


Cervicitis is an inflammation of the cervix (the end of the uterus). Cervicitis often does not cause symptoms, but if they do happen, they may include abnormal vaginal discharge, painful intercourse, or vulvar or vaginal irritation. Antibiotics successfully treat cervicitis in most cases. For other cases, laser therapy or surgery may be required.

What is cervicitis?

Cervicitis is an inflammation of the cervix (the end of the uterus). This inflammation may be acute or chronic in nature. Cervicitis might not have symptoms, or a woman with cervicitis may have abnormal vaginal discharge.

Who gets cervicitis?

Cervicitis is very common. It has been projected that more than half of all adult women will have cervicitis at some point. Women who engage in high-risk sexual behaviors and have multiple partners are at a higher risk for cervicitis. Women who have had sexually transmitted diseases, or who have partners who have had sexually transmitted diseases, are also at a higher risk for cervicitis. Sexual practices are far from the only cause of the condition, however.

What are the causes of cervicitis?

There are many causes of cervicitis. Acute cervicitis is usually caused by an infection. Chronic cervicitis is more likely from a noninfectious cause.
Infections can result from the introduction of staphylococcus or streptococcus bacteria into the uterus. The sexually transmitted diseases chlamydia and gonorrhea are also significant causes of cervicitis. It has been estimated as much as 40 percent of cases of cervicitis are related to chlamydia. Herpes simplex virus, trichomonas and mycoplasma genitalium are also sometimes a cause.

Noninfectious causes of cervicitis include exposure to chemicals or

mechanical irritation. These include:

• Chemical irritation from spermicides or douches or the latex used in condoms
• Reaction to diaphragms, cervical caps, tampons or pessaries inserted
• Radiation therapy or systemic inflammatory diseases

What are the symptoms of cervicitis?

Symptoms of cervicitis can include:

• Abnormal vaginal discharge that may be yellow, white, or gray and have an unpleasant odor. This may persist for a long period of time.
• Sexual intercourse may become painful.
• Vulvar or vaginal irritation.

Cervicitis often does not have any symptoms, however. This is one reason why women should have regular gynecological appointments. It is especially important to seek an exam if you notice any of the above symptoms and/or have had chlamydia or another sexually transmitted disease in the past.

How is cervicitis diagnosed?

If you have any of the above symptoms, or if you have engaged in high-risk sexual practices, you should see your Gynecologist for a full pelvic exam. At this exam, your Gynecologist may perform tests including a Pap smear. In this test, a swab is used to collect cells from the cervix and uterus to look for abnormalities.

Your Gynecologist will also take a sample of any vaginal discharge to test for bacteria, such as bacterial vaginosis under a microscope. Tests for the sexually transmitted diseases gonorrhea and chlamydia will also be done.

Your Gynecologist also perform a full manual pelvic exam, looking for:

• Any redness on the cervix
• Discharge
• Blood on the vagina or cervix
• Inflammation of the vaginal walls
You will lay down on an examination table with your feet in stirrups for these tests.

How is cervicitis treated?

If your Gynecologist determines that you have cervicitis, you will usually be prescribed an antibiotic to treat any bacterial infections that may be causing the condition. Women under age 25 or who engage in high-risk behaviors may be treated with antibiotics even if bacteria are not detected in the diagnosis. Some bacteria can be hard to detect but may still be present. You should abstain from intercourse until treatment is done.

Antibiotics successfully treat cervicitis in most cases. If cervicitis is not successfully treated by antibiotics, laser therapy or surgery may be required. Your Gynecologist can best determine the treatment for your cervicitis based on your age, habits, diagnostic tests, and the length of the condition.

Dr. Ruchi Tandon is a reputed Gynecologist practicing in leading hospitals in South Delhi namely Max and Apollo hospitals with over 14 years of experience in handling all kinds of Gynecological conditions including cervical and vaginal infections .

Can Pelvic or uterine adhesions cause infertility?

Pelvic adhesions, sometimes referred to as “scar tissue”, are a common cause of both infertility and pelvic pain.

Pelvic adhesions can occur as a result of a variety of different conditions including endometriosis, pelvic infection, and previous abdominal or pelvic surgery. It is well known that pelvic adhesions develop over 90% of the time following major abdominal surgery. The most common types of surgery that predispose to the development of pelvic adhesions include the removal of uterine fibroids (myomectomy), treatment of endometriosis, removal of ovarian cysts, and the repair of obstructed fallopian tubes.

Many complications can occur as a result of pelvic adhesions. For example, it is thought that adhesions may be a significant factor in as much as 40% of cases of infertility. They are also thought to be responsible for up to 50% of cases of chronic pelvic pain. In addition, adhesions are typically responsible for 50-75% of cases of bowel obstruction. Although more recent data are lacking, the treatment of pelvic adhesions accounted for 3% of all surgical procedures performed in the United States in 1998, as well as 1% of all hospital admissions and 2% of all patients admitted for surgeries around that time.

How do pelvic adhesions occur?

Adhesions typically develop in response to injury, as part of the normal healing process. Immediately following injury, cells that cause healing (inflammatory cells) migrate to the site of the injury. Within seven days following injury, the scaffold for healing or adhesion formation has already developed. As a result, it appears that no new adhesions form more than seven days after an injury. Rather, the character of the adhesion changes, progressing from thin, filmy adhesions to more dense, vascular adhesions. The earlier in this process that adhesions can be removed, the less likely it is that they will recur and cause long-term problems.

Adhesion formation that occurs following surgery can be of two types; de novo adhesion formation or adhesion reformation. De novo adhesion formation means the formation of adhesions at a site that did not have any adhesions affecting it prior to surgery. This would include the formation of adhesions around the uterus following the removal of a fibroid tumor or the formation of adhesions around an ovary following removal of an ovarian cyst.

Adhesion reformation refers to the recurrence of adhesions following a procedure designed to remove pre-existing pelvic adhesions. This difference is important, as the techniques described below may be very effective at preventing de novo adhesion formation, while they appear to be somewhat less effective at preventing adhesion reformation

What types of surgeries can increase my risk of adhesions?

In most cases of adhesions, they form in the majority of women after gynaecologic pelvic surgery. Studies have shown that adhesions formed in 55-100% of patients who had reproductive pelvic surgery, whether open or laparoscopic.

For example:

• myomectomy (surgery to remove fibroids)
• tubal surgery (to remove an ectopic pregnancy)
• surgery on the ovary (to remove cysts)
• surgery for endometriosis
Even surgery to remove adhesions can lead to new adhesions. It can be a vicious cycle.
• Laparoscopic surgery (surgery done through several small incisions using a camera) has been known to cause less adhesion formation than laparotomy (surgery through one larger incision without use of a camera).
• Microsurgery (surgery using a microscope or magnifying glass, and special surgical technique) leads to less tissue damage and has a lower incidence of adhesion development than the traditional approach.
• Diagnostic procedures, which only involve a visual inspection of the organ(s), such as a diagnostic hysteroscopy or diagnostic laparoscopy, rarely lead to adhesions.

How can I reduce my risk of adhesions?

It starts with talking to your doctor and explaining your concerns about adhesions. There are techniques which can be used at the time of surgery to reduce the risk of developing adhesions. In addition to using microsurgery or laparoscopic techniques, prevention of infection is essential.

During surgery, various products are used to inhibit adhesion formation, known as adhesion barriers. These include gauze-like materials placed over the tissue which dissolve to become a gelatinous layer to reduce the incidence of post-operative adhesions. This material is eventually absorbed by the body.

Dr. Ruchi Tandon is a reputed Gynecologist practicing in leading hospitals in South Delhi namely Max and Apollo hospitals with over 14 years of experience in handling all kinds of Gynecological conditions including infertility and high risk Pregnancies.