ECTOPIC PREGNANCY

An ectopic pregnancy typically occurs in one of the fallopian tubes. This type of ectopic pregnancy is known as a tubal pregnancy. In some cases, however, an ectopic pregnancy occurs in the abdominal cavity, ovary or cervix.
Abdominal or pelvic pain and light vaginal bleeding are often the first warning signs of an ectopic pregnancy.
The risk of having an ectopic pregnancy increase, if you have a history of ectopic pregnancy, or infection of fallopian tubes in the past.

Ruptured Ectopic pregnancy is an emergency situation, and may lead to excessive bleeding and shock.
Early diagnosis is important; Ultrasonography is the test of choice. 

EXCESSIVE MENSTRUAL BLEEDING / MENORRHAGIA

Menorrhagia is defined as menstruation at regular cycle intervals but with excessive flow and duration. Clinically, menorrhagia is defined as total blood loss exceeding 80 mL per cycle or menses lasting longer than 7 days.

Young patients, from menarche to the late-teen years, most commonly have anovulatory bleeding due to the immaturity of their hypothalamic-pituitary axis.

Women aged 25-50 years may have organic or structural abnormalities. Uterine Fibroids or polyps are frequent  findings.

Postmenopausal women with any uterine bleeding should receive an immediate workup for endometrial cancer.

Pregnancy should  be excluded before further testing or medications are advised.
Other differential diagnoses must be kept in mind while assessing a patient with menorrhagia.

Investigations : Pelvic ultrasound is the best noninvasive imaging study to assess uterine shape, size, and contour; endometrial thickness; and adnexal areas.

Successful treatment of chronic menorrhagia is highly dependent on a thorough understanding of the exact etiology. Treatment must be individualized based on the cause of bleeding.

For any queries, pl contact Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669

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