PAP Smear : What you MUST know to prevent Cervical Cancer

 
 
Cancer of the cervix  is the  most common genital cancer among women worldwide. The best way to detect cervical cancer is by having regular Pap smears.  A Pap smear is a microscopic examination of cells taken from the uterine cervix.
 
A Pap smear can detect certain viral infections such as human papillomavirus (HPV), that is known to cause cervical cancer.

Risks factors for cancer of the cervix include  the following:

• Multiple sexual partners (or sexual partners who have had multiple partners)
• Starting sexual intercourse at an early age
• Weakened immune system
• Previous cancer of the lower genital tract

Cervical cancer screening by PAP smear is now recommended every 3 years starting at age 21. Screening may be carried out every 5 years for women over age 30 if a Pap smear and HPV test are performed.

Women over age 65 or older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having Pap tests.

A negative or normal test finding means that the cervix looks healthy. All the cells are of a healthy size and shape.
A positive or abnormal test finding means that there is something unusual  in the sample. The test found cells of a different size and shape.

An abnormal Pap smear result does not always indicate cancer. Cells sometimes appear abnormal but are not cancerous. The woman will have to return to the doctor for follow-up care.

• An infection of the cervix may cause an abnormal test result. A yeast, trichomonas, chlamydial, or gonorrheal infection can cause the cervical cells to appear inflamed. If the Pap smear result is positive because of an infection, the underlying cause should be treated. The test should then be repeated in 2-3 months, because cancer of the cervix can be hidden by an infection. After the infection is treated, the Pap smear result usually returns to normal.

          A check-up with a doctor is necessary.
A vaccine is now available to prevent HPV infection,

For any further queries, pl contact your gynecologist

AIR TRAVEL DURING PREGNANCY

Dr Deepika Tiwari, Gynecologist, Gurgaon www.gurgaongynae.inhttp://www.drdeepikatiwari.blogspot.com/http://www.gurgaongynecologist.webs.com/

Pregnant women & those contemplating pregnancy need special consideration because of specific nature of the potential health hazards of long distance flights.These include exposure to cosmic radiation, reduced arterial oxygen pressure, immobilization & unforseen medical & obstetrical emergencies encountered during flight.

More radiation shielding is provided by atmospheric air at lower altitudes.The dose received from cosmic radiation is usually lower during short haul flight since long haul flight are usually flown at higher altitudes.

The changes in heart rate & BP which are associated with decreased partial oxygen pressure may affect women with compromised pregnancies.

Increased risk of venous thrombosis may occur due to prolonged immobilization from cramped seats, which is called Economy class syndrome.

ADVICE

1.  Pregnant women  should use their seat belts continuously while seated.

2. Long distance flights are not recommended for women upto  36 wks gestation with singleton pregnancy & 32 wks with multiple pregnancies.

3. Travellers should be updated on routine immunizations including TT,Diptheria, Influenza, & other immunization  based on  geographic  risk

4. Travel is not  recommended at any time during pregnancy for women who have medical /obstetrical prblems that could result in emergencies

NOTE : Always consult your gynaecologist, whenever you are planning for air travel.

Smoking in Pregnancy

Dr Deepika Tiwari, Gynecologist, Gurgaon 
www.gurgaongynae.in
http://www.drdeepikatiwari.blogspot.com/
http://www.deepikatiwari.com/


If you smoke and you are pregnant, or planning to become pregnant, you are strongly advised to stop smoking.
Smoking when you are pregnant increases the risk of: miscarriage; slowing the growth of the baby leading to a low birthweight; premature labour leading to the baby being premature (prem); stillbirth.
Even after the birth, children of smoking parents have an increased risk of developing chest infections, asthma, glue ear, and sudden infant death syndrome (cot death).

You and your baby will get most benefit, and the risks will be most reduced, if you stop before you become pregnant. Planning to become pregnant is a good incentive to stop smoking for many women, and is often a good time to persuade partners to give up too.

Painful Periods in Women

Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669
www.gurgaongynae.in
http://www.drdeepikatiwari.blogspot.com/
http://www.gurgaongynecologist.webs.com/



Painful periods are common in teenagers and young adults.
Primary dysmenorrhoea is the most common type of painful periods. This is where there is no underlying problem of the womb (uterus) or pelvis. It often occurs in teenagers and women in their 20s.
Secondary dysmenorrhoea is pain caused by a problem of the womb or pelvis. This is less common, and is more likely to occur in women in their 30s and 40s.

The main symptom is crampy pain in your lower abdomen.

• May spread to your lower back, or to the top of your legs.
• Usually starts as the bleeding starts, but it may start up to a day before.
• Usually lasts 12-24 hours, but lasts 2-3 days in some cases.
• Can vary with each period. Some periods are worse than others.
• Tends to become less severe as you get older, or after having a baby.

The following may indicate secondary dysmenorrhoea:

• If you have a change in your usual pattern of pain. For example, if your periods become more painful than they used to be, or the pain lasts longer than it used to. In some women with secondary dysmenorrhoea the pain starts several days before the period begins, and lasts all the way through the period
• Other symptoms may include.
• Irregular periods.
• Bleeding between periods.
• Pains between periods.
• The bleeding becomes heavier than previously.
• Vaginal discharge.
• Pain during sex.

It is important to differentiate between the primary and secondary dysmenorrhoea; the treatment depends on the underlying cause. Supportive care and Anti-Inflammatory medication help control the severeity of symptoms.

Breast Feeding of Newborn

 Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669
www.gurgaongynae.in
http://www.drdeepikatiwari.blogspot.com/
http://www.deepikatiwari.com/

 

Breast milk is the best nutrition for babies. The World Health Organization recommends that babies are fed only breast milk for their first six months, and that breast-feeding then be continued as part of a mixed diet until the age of two years. A vitamin D supplement is recommended for all breast-feeding women and for breast-fed babies.
On average, breast-fed babies have fewer infections in their early life. The main reason for this is that antibodies are passed in the breast milk from mother to baby. Antibodies are proteins that help to fight infection. Breast-fed babies have less diarrhoea and vomiting, and fewer chest and ear infections, compared with babies who are not breast-fed. Breast-feeding enhances the bonding process between baby and mother.
There is now good evidence from research studies that, on average, the following health problems in later life are less common in those who had been breast-fed compared with those who had not: obesity and overweight; high blood pressure; high cholesterol level; eczema; type 2 diabetes; leukaemia; asthma. ref

It is recommended to start breast feeding as soon as practical after the baby birth. Colostrum is an important source of antibodies for the newborn. Some women have difficulty in initiating breast feeding. Such issues can be easily treated with supportive care , and some counselling by the gynecologist.

Hypothyroidism in Pregnancy

Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669
www.gurgaongynae.in
http://www.drdeepikatiwari.blogspot.com/
http://www.gurgaongynecologist.webs.com/
Hypothyroidism affects 1% of pregnant patients. Defining symptoms of hypothyroidism include;

cold intolerance,

slow heart rate(Bradycardia) ,

delayed relaxation of tendon reflexes,
excessive menses (in non pregnant ) 

The most common cause of hypothyroidism is autoimmune.

Hypothyroidism is diagnosed with reduced free T4 concentration with increased TSH levels.

Most serious consequence of hypothyroidism in pregnancy is Myxedema Coma which is a medical emergency. Neuropsychiatric development is delayed in offsprings born to hypothyroid mothers . However correction of maternal hypothyroidism in first 12 wks of pregnancy might improve outcome.

Cretinism (deaf mutism, spastic motor disorders & hypothyroidism ) is distinct & severe form of brain damage caused by severe maternal iodine deficiency .

Patients with hypothyroidism should be counselled to delay pregnancy until maintenance level of T4 is achieved.

Hypothyroid in pregnancy requires treatment with thyroxine with thyroid function tests repeated every 3 months ( however they should be repeated every 4-6 wks if dosage changes are to be made).

Pregnancy with Diabetes

It is estimated that 3- 5 % of pregnancies are complicated by Diabetes mellitus.With increasing prevalence of Diabetes in young women, it is important to understand  the common symptoms that a pregnant lady may suffer, to diagnose it early.

Some important features to be understood…

*Gestational Diabetes refers to the condition where in high blood glucose levels are monitored for the first time during pregnancy.

*Diabetes diagnosed before pregnancy may be insulin dependent (IDDM), or non- insulin dependent (NIDDM).

* During pregnancy, there is a physiological increase in insulin resistance, to satisfy the nutritional demands of foetus.

* High levels of maternal blood glucose levels, may lead to high levels of glucose in foetal blood.

* Patients who are already diagnosed with Diabetes, before getting pregnant, may develop high blood pressure during pregnancy, and increased susceptibility to infection; may increase the likelihood of caesarean section; large baby size (Macrosomia); shoulder dystocia etc.

*Increased risk of congenital abnormalities in the foetus, miscarriage, still birth, premature delivery.

Intensive control  of glucose levels around the time of conception, can reduce the incidence of congenital abnormalities. In non diabetic subjects fasting glucose should be 70mg/dl- 126mg/dl .Diabetic subjects tend to have higher post prandial  & sustained minor elevations of glucose,

WHEN TO CONSULT A DOCTOR

A higher fasting, postprandial sugar levels

An abnormal glucose challenge test

An abnormal Glycosylated Hemoglobin

Repeated infections especially urinary infections

Polyhydraminos (increased liquor )

H/o previous stillbirths, large babies, premature delivery, traumatic delivery

For any queries, pl consult your doctor

Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669
www.gurgaongynae.in
http://www.drdeepikatiwari.blogspot.com/
http://www.gurgaongynecologist.webs.com/