Pap Smear........Must Know About!

Pap smear is a diagnostic test to detect abnormalities of the cervix which can progress to cervical cancer. With Pap smear, these abnormalities can be detected early and thus cancer cervix can be prevented.

Cancer cervix is the cancer of the mouth of the uterus . It is the most common cancer in Indian women. Unless examined by a doctor it remains undetected and patient many time remains symptom-free till cancer progresses to late stages. If not detected early cancer. The cervix has a very high mortality rate.

Yes, definitely it can be prevented. lf one does regular Pap smear check-up and routine gynecological check-up early abnormalities can then be treated and further progress to cancer is prevented.

Any female can get cancer cervix but the high-risk factors are
✔ Age of more than 35.
✔ Multiple pregnancies, early Marriages.
✔ Multiple sexual partners, Sexually Transmitted Diseases.
✔ Viral infections like HPV, HIV,HSV infections.

Yes, it is a must for all females. Even if there are no high-risk factors all sexually active females above 18 yrs. age should undergo Pap smear yearly or every 3 years as per your doctor’s advice till 65 yrs. of age In countries like US and UK pap screening is mandatory for all women and is a must for routine health check-ups.

It hardly takes 5 min. and it is just a simple speculum examination. It is not painful as well. The results are available after 5 days.

One might need to undergo Colposcopy and cervical biopsy for the definitive diagnosis, which is a daycare procedure.

Pap smear can be done at any time of the day except the days of bleeding.

Know About Caesarean Section!

Caesarean section is an operation/surgery in which the baby inside the uterus is taken out by giving a cut on the abdomen and the uterus.

It is very simple to understand! When it is unsafe for either you or your body to deliver vaginally / normally then the cesarean section is required.
Common situations where cesarean section is required,
✔ The baby’s head is relatively larger than the space available in the pelvis.
✔ The backside of baby’s head is towards the mother’s back and it doesn’t turn.
✔ The mouth of the uterus i.e. cervix fails to open up.
✔ Baby’s head remains high in the abdomen in spite of good uterine contractions and doesn’t go down. In other situations, it may not be safe to deliver the baby vaginally e.g. when a baby’s growth is less, water around the baby is less or blood supply to the baby is less or the baby has passed a motion or having decrease heart rate. In these circumstances, a baby may not tolerate the stress of delivery because with each contraction baby’s blood supply becomes less.

Some times if there is a previous cesarean section and the baby’s size is larger, the baby’s head doesn’t go down and there is no possibility of normal delivery then we need to elective do a cesarean section.

There are some stitches on the uterus and some in the abdominal wall; but outside, you will have only one single long stitch. This stitch is removed on the 12th or 1 3rd day of surgery.

Not at all. You can start sitting the same day and walking the next day of caesarean section. After that, there is no restriction as far as activity is concerned compared to normal delivery. Moving around doesn’t have any ill -effect on the stitches. Now a days we take transverse incision on the abdomen which is an-aesthetic incision and the scar is barely seen. This type of incision is less painful as well.

Caesarean section is an operation so it does have a little possibility of problems; but no. a day with the advent of new techniques and in our hospital in hands of expert surgeons and good anesthetists, the caesarean section has become much safer for both mother and the baby.

Commonly spinal anesthesia is given which makes your legs and abdomen numb and doesn’t give you any sensation of pain during the surgery. it is a very small needle prick in the back and no pain thereafter. You are awake and can see the baby. touch the baby. This is one of the safest anesthesia.

No, it is myth. It doesn’t to either of it. For further details consult your obstetrician.

Know About Down Syndrome !

✔ Maternal age> 35 years.
✔ Previous pregnancy with chromosomal or structural abnormalities.
✔ Family history of Down syndrome.
✔ Chromosomal abnormalities in either of the parents.
✔ Previous recurrent abortions.

Even in the absence of these risk factors, there is a possibility of Down syndrome. Testing only high-risk patients will detect only 25% of all babies with Down syndrome hence screening all patients antenatally is necessary.

Down syndrome can be detected in the 1st-trimester screening and Triple test. 1st-trimester USG showing thickened nuchal fold and abnormal blood tests will suggest the risk for Down syndrome. Triple test which is also a blood test done between 16-18 weeks can also suggest risk for Down syndrome. The ability of these tests to detect Down syndrome is 60-80%.

These tests suggest the probable risk but are not diagnostic. For confirmation of diagnosis, one needs to go ahead with further tests.

There is no cure for Down syndrome. So one needs to terminate the pregnancy; if Down syndrome is diagnosed.

Other genetic defects like Trisomy 13, 18, Triploidy and Turners syndrome can also be detected in 1st-trimester screening.

Female reproductive organs are situated deep down in the lower abdomen. They are uterus, fallopian tubes, ovaries, and vagina. Every month one egg is released in the middle of the cycle from one ovary. When sexual relations occur sperms get deposited in the vagina. Sperms travel up through the cervix, uterine cavity and reach fallopian tubes. The egg released also reaches a fallopian tube and unite with one of the sperms to form the embryo. This embryo then comes back to the uterine cavity and starts growing there. Any problem in this process can lead to difficulty in achieving pregnancy. In diagnostic laparo-hysteroscopy, we try to see different reasons for infertility. Uterine cavity is seen by hysteroscopy from below. This checks openings both of the tubes and the uterine cavity from inside.

Laparoscopy is an operation to look inside your abdomen. A Small cut is given at umbilicus, through which laparoscope (10 mm size telescope) is passed inside the abdomen to see the reproductive organs. We need to see the size, the shape of the uterus Abnormalities Of the tube and the ovaries also can be seen which is necessary for the transport of both sperms and ovum across. This test is done under general anesthesia. Some blood and urine tests are required before this procedure. Preoperative instructions are given at the time of appointment for the procedure, for 3 hours. patients are not given anything by mouth. Later patients are started on liquids and then solids food. if there are no problems usually patients can be discharged in the evening. Postoperative instructions are given at the time of discharge. Patients need rest for one or two days after which patients can start her daily routine. Reports of the scope are discussed with the patients and the relatives 3 days after the procedure in the OPD at the time of flow-up.