This refers to a pregnancy that fails to grow, either because no embryo is formed (blighted ovum) or there is no cardiac activity (no heartbeat). Loss of a pregnancy prior to the 23rd completed week is generally considered a miscarriage. However, some guidelines use the cut-off of 20 to 22 weeks to define it.
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Combined oral contraceptives (COC) pills
The reason for practicing contraception (or birth control) is to prevent an unplanned pregnancy. Most methods of contraception enable sexually active couples to temporarily avoid pregnancy. Permanent birth control is accomplished through sterilization. There are many types of birth control methods that are currently available. There is no perfect method at the moment. Each has its own advantages and disadvantages. Be sure you know and understand the different types of birth control available to you, the risks and benefits of each, and any side effects, so that you can make an informed choice.
Cervical Intraepithelial Neoplasia (CIN)
Cervical intraepithelial neoplasia (or CIN) refers to the presence of abnormal cells seen on the cervical cytology smear. These abnormal cells are obtained from the lining of the outer cervix and can range from mild to severe changes. A diagnosis of CIN changes is not cancer. However, the severe form of dysplasia can be considered a precancerous condition and may eventually progress to cancer in several years if not treated.
The cervical cytology smear was previously referred to as Pap smear. Currently, the newer cervical cancer screening uses a liquid based cytology and the commonest one used are: Thin Prep or Sure-Path. These are better and more accurate compared to the conventional Pap smear test.
Classification of CIN
Endometriosis
Endometriosis is a condition whereby tissues from the lining (endometrium) of the uterus becomes implanted in areas outside the uterus such as the outer surface of the uterus, the fallopian tubes or the ovaries. Rarely, the endometrial tissue may spread beyond the reproductive organs and pelvic region.
In a normal menstrual cycle, the endometrial tissues respond to cyclical female hormones and becomes progressively thicker and will eventually shed each month if the woman is not pregnant. It is discharged as menstrual flow at the end of each cycle. In endometriosis, this shedding and bleeding will occur outside the uterus as well, causing significant pain. Recurrent bleeding and healing cycle will eventually cause scar tissue formation and destruction of pelvic structures. The excessive blood will accumulate over a period of time and eventually forms a cyst in the ovary (called endometriotic cyst or endometrioma). The 4 stages (classification) of endometriosis (minimal, mild, moderate or severe) are used to describe the location and the severity of the disorder.
Vaccination and Pregnancy
It is important to ensure that you are adequately protected against certain infectious diseases during your pregnancy. In the community, people are protected against infectious disease because they have had the infections before and developed immunity to it. Some are protected against chickenpox, for example, because they had it when they were kids, causing their immune systems to make antibodies to the chickenpox virus. However, over time the antibody level may decline to a very low levels and the person may lose the protection against that particular infectious agent.
Alternatively, many in the community have been vaccinated and developed antibodies to that specific infectious agent contained in the vaccine. Many countries now have an immunization schedule that tries to cover as many infectious disease as possible, hoping to reduce the disease burden to the community and the health care system.
Laparoscopy in Gynaecology
Laparoscopy is a procedure that allows visual examination and surgical treatments of the pelvic and abdominal organs pathology. The procedure is performed with a laparoscope, which is a small lighted telescope.
INDICATIONS – When is it necessary
- Evaluation and treatment of women who has difficulty in conceiving.
- Evaluation and treatment of known or suspected endometriosis.
- Pelvic infections
- Removal of diseased fallopian tubes, ovaries, cysts or uterus
- Undiagnosed pelvic pain
- Uterine fibroids
- Voluntary sterilization (tubal ligation or occlusion for permanent family planning)
- For diagnosis and treatment of a variety of other pelvic or abdominal disorders
Caesarean Section
WHAT IS IT?
Delivery of a baby through an incision in the mother’s lower abdominal and uterine walls and is performed when a vaginal delivery is not possible or is unsafe. This procedure is also called a C-section or Lower Segment Caesarean Section (LSCS).
REASONS FOR PROCEDURE
Danger to the mother or baby from one or more of many causes, including:
- Baby’s head too large to pass through the birth canal.
- Baby in the wrong orientation – head up (breech) or transverse.
- Failure of cervix to dilate (failed induction of labour).
- Abnormal placenta location obstructing the birth canal (placenta praevia).
- Failure of normal labour progress.
- Situation where urgent delivery is indicated such as fetal distress or severe illness in the mother (such as severe hypertension or sudden fits).
- Infection such as HIV or acute herpes genitalis infection in the mother.
Special situations: pregnancy resulting from assisted reproductive technology (ART), maternal request
Post-Natal Care – what to expect
Most women stay in the hospital for 24 to 48 hours after giving birth (or 3 to 4 nights after a caesarean section). This will depend on the condition of the mother and baby.
The physical changes that occur with pregnancy usually resolve by the end of 6 weeks, although some may resolve much earlier than this. It is important to know all these changes, as it will help you cope better and lessen your worries. Emotional sup¬port and much needed help from your spouse and family members is equally important to assist you in facing these changes and coping with the arrival of a new member into the family. You will also get lots of advice from friends and relatives who visit you – some may be conflicting and may be harmful. There are many ways of doing things with no particular hard and fast rules on what is best for you. It is best to avoid traditional or Chinese herbs during this period. In the end, it is all boils down to common sense and you have to decide what is best for you and your baby. Do some reading and ask your doctor or midwife about your recovery during the postnatal period