Rama Kirshna Health Care

Prenatal period
Prenatal defines the period occurring "around the time of birth", specifically from 22 completed weeks (154 days) of gestation (the time when birth weight is normally 500 g) to 7 completed days after birth.

Legal regulations in different countries include gestation age beginning from 16 to 22 weeks (5 months) before birth.
Postnatal period
The postnatal period begins immediately after the birth of a child and then extends for about six weeks. During this period, the mother's body returns to prepregnancy conditions as far as uterus size and hormone levels are concerned.

Duration
The expected date of delivery (EDD) is 40 weeks counting from the first day of the last menstrual period (LMP), and birth usually occurs between 37 and 42 weeks.[12] Though pregnancy begins at implantation, it is more convenient to date from the first day of a woman's last menstrual period, or from the date of conception if known. Starting from one of these dates, the expected date of delivery can be calculated using the Naegele's rule for estimating date of delivery. A more sophisticated algorithm takes into account other variables, such as whether this is the first or subsequent child (i.e., pregnant woman is a primip or a multip, respectively), ethnicity, parental age, length of menstrual cycle, and menstrual regularity.

There is a standard deviation of 8-9 days surrounding due dates calculated with even the most accurate methods. This means that fewer than 5% of births occur at exactly 40 weeks; 50% of births are within a week of this duration, and about 80% are within 2 weeks. It is much more useful and accurate, therefore, to consider a range of due dates, rather than one specific day, with some online due date calculators providing this information.

Pregnancy is considered "at term" when gestation attains 37 complete weeks but is less than 42 (between 259 and 294 days since LMP). Events before completion of 37 weeks (259 days) are considered preterm; from week 42 (294 days) events are considered postterm.[14] When a pregnancy exceeds 42 weeks (294 days), the risk of complications for both the woman and the fetus increases significantly. Therefore, in an otherwise uncomplicated pregnancy, obstetricians usually prefer to induce labour at some stage between 41 and 42 weeks.

Laparoscopy is direct visualization of the peritoneal cavity, ovaries, outside of the tubes and uterus by using a laparoscopy. The laparoscopy is an instrument somewhat like a miniature telescope with a fiber optic system which brings light into the abdomen. It is about as big around as a fountain pen and twice as long.

An instrument to move the uterus during surgery will be placed in the vagina. Carbon dioxide (CO2) is put into the abdomen through a special needle that is inserted just below the navel. This gas helps to separate the organs inside the abdominal cavity, making it easier for the physician to see the reproductive organs during laparoscopy. The gas is removed at the end of the procedure.

Microlaparoscopy a new minimally invasive diagnostic surgical procedure uses telescopes and instruments that are much smaller than normal. If this procedure is appropriate for your condition, smaller incisions will be made and postoperative abdominal tenderness may be reduced.

Colposcopy is an examination of the cervix by the microscope. It is a simple procedure which involves inserting a speculum for an internal examination. A diluted solution of 5% acetic acid is applied and the cervix is examined for white areas. It is usually associated with the discomfort encountered during a smear test and takes only 5 minutes to complete. A biopsy may be taken from these areas (slightly more painful) and sent for further testing in the Laboratory. Although the consultant will be able to give you some idea, however the final outcome can only be obtained after the biopsy result

Hysteroscopy is a procedure that allows a gynecologist to look inside your uterus. The hysteroscope is a long tube, about the size of a straw, which has a built-in viewing device. It is inserted through the and cervix into the cavity of the uterus (endometrial cavity). The uterine cavity is then distended with fluid and visualized.

Hysteroscopy is useful for diagnosing and treating some problems that cause infertility, miscarriages, and abnormal menstrual bleeding. Sometimes other procedures, such as laparoscopy, are done at the same time as hysteroscopy.

Urogynaecology is dedicated to the treatment of women with pelvic floor dysfunction such as urinary orfecal incontinence and prolapse (bulging or falling) of the vagina, bladder and/or the uterus. Pelvic organ prolapse simply means displacement from the normal position. On average, 11% of women will undergo surgery for this condition. Pelvic organ prolapse quantification system (POP-Q) is an objective, site-specific system for describing the anatomic position that can be used to determine the stage of the prolapse. Urinary incontinence (leakage of urine) is a very common condition affecting at least 10-20% of women under age 65 and up to 56% of women over the age of 65. The most common subtypes of urinary incontinence are (1) stress urinary incontinence (SUI) ; (2) urge urinary incontinence (UUI) ; and (3) mixed urinary incontinence (MUI). Patients presenting with symptoms of pelvic organ prolapse or incontinence should undergo a thorough medical evaluation consisting of a targeted history (include bladder diary or voiding diary), physical examination, urinalysis and urine culture, and postvoid residual volume (PVRV) by pelvic ultrasound. Treatment options for patients with pelvic organ prolapse and urinary incontinence are nonsurgical (lifestyle interventions, pelvic floor muscle rehabilitation, and pessary placement) and surgical management.

Signs and symptoms
The symptoms of ovarian cancer may be vague and not specific, and can therefore be trivialised. The commonest symptoms resemble bowel problems such as IBS (Irritable Bowel Syndrome) or indigestion, abdominal swelling or a change in bladder symptoms. More obvious gynaecological symptoms such as bleeding or pain on intercourse may sometimes occur. These symptoms are common to many other conditions but the development of new abdominal symptoms in a middle-aged lady is always a concern.

Endometrial cancer (cancer of the lining of the womb)
This cancer is most common among post-menopausal women although 20% of cases present in women of childbearing age. Endometrial cancer typically presents with abnormal bleeding and is more common among women taking HRT, and those with maturity-onset diabetes. It may be associated with polycystic ovaries in young women. Hysterectomy is the mainstay of treatment, but minimal access techniques are increasingly being used to reduce the morbidity of this.

Cervical cancer
This cancer is particularly common in young women but fortunately it is being detected earlier thanks to the success of the UK screening programme. New minimal access surgical techniques for early stage cancer reduce scarring and side-effects and may, in certain circumstances, preserve a woman’s fertility.

Vulval cancer
These cancers usually present with an itchy or painful skin lesion, wart-like growth or ulcer on the genital skin. They may cause bleeding or a blood-stained discharge and pain in the area of the vulva. Current treatment involves surgical removal of lymph nodes in the groin to ensure the malignancy has not spread. This causes significant morbidity as up to 50% of wounds may break down and delay healing. New equipment will minimise the risk of these complications.

cancer
Cancer of the is rare with fewer than 300 women diagnosed with it each year in the UK. The most common symptoms of this cancer are a blood-stained discharge, bleeding after  intercourse and pain. Problems with passing urine, such as blood in the urine, the need to pass urine frequently and the need to pass urine at night, can also occur. Pain in the back passage (rectum) may occur.

Causes of infertility include a wide range of both physical and emotional factors. A couple's infertility may be due to female factors,

FEMALE INFERTILITY :

Female infertility may be due to :

 Problems with a fertilized egg or embryo being able to survive once it is attached to the lining of the uterus
 Problems with the fertilized egg being able to attach to the lining of the uterus
 Problems with the eggs being able to move from the ovary to the uterus
 Problems with the ovaries producing eggs

Female infertility may be caused by:

Autoimmune disorders, such as antiphospholipid syndrome (APS)
 Clotting disorders
 Defects of the uterus and cervix (myomas or fibroids, polyps, birth defects)
 Excessive exercising, eating disorders, or poor nutrition
 Exposure to certain medications or toxins
 Heavy use of alcohol
 Hormone imbalance or deficiencies
 Long-term (chronic) disease, such as diabetes
 Obesity
 Ovarian cysts and polycystic ovary syndrome (PCOS)
 Pelvic infection or pelvic inflammatory disease (PID)
 Scarring from transmitted infection or endometriosis
 Tumor