Polycystic Ovarian Syndrome (PCOS) is a very common syndrome among many young girls and women. Problems like irregular periods, weight gain, acne, hair loss and other hormonal imbalances are the common symptoms. It is a common cause of infertility and pregnancy problems. If left untreated it may lead to diabetes, heart disease and even cancer.

Here are the most natural ways to handle PCOS problem-

1) Mind your Diet: Easiest way is to work on your diet. Avoid junk food. Eat more of fruits, vegetables and whole grains.
2) Physical Exercise Works: Exercise is a must. It will help you manage body weight and can also help in conceiving. Exercise also balances testosterone and insulin levels.
3) Vitamin Supplements: Add more Vitamins A, E and C and Minerals like Zinc and calcium to your diet, in consultation with your doctor.
4) Drugs depending on menstrual problems or infertility. But main treatment is always weight control .

Cases of multicystic ovaries with primary hypothyroidism
have been reported in girls as a cause of pseudoprecocious
puberty,[1,2] and in adult females with abdominal pain.[3] The
ovarian cysts are thought to be due to increased ovarian
sensitivity to gonadotropins[4] or more likely an action
of increased circulatory levels of thyroid stimulating
hormone (TSH) (secondary to chronic untreated primary
hypothyroidism) on follicle stimulating hormone (FSH)
receptor (FSHR) causing gonadal stimulation.[5,6] Here
we report a case of juvenile primary hypothyroidism
presenting in adulthood as abdominal mass due to huge
bilateral ovarian cysts.

All mothers who are on the verge of motherhood have one common fear. The fear is of acute labor pain during the time of childbirth. The quantum of pain varies from one mother to another mother. Some has very less labor pain and the pregnancy is easy and many have long delayed labor pain.

Labor pain is severe for most women who do not receive pain relief. With advent of modern medicine and availability of techniques with skilled practitioners, it is now possible to relieve the pain of labor. Management of pain is the most crucial thing in the delivery of baby and painless delivery techniques are providing respite from excessive pain, be it in normal deliveries or caesarean (that need operations). The technique of painless delivery called as Epidural Analgesia or Epidural Anesthesia is a popular technique used by women, if advised by the doctor, during labor. The technique is not only cost-effective, but also gives relief from unbearable labor pain during deliveries. Such deliveries have registered 6-7% rise in the past two-three years.

It is estimated that out of every 25 deliveries, there are around 8-10 painless deliveries. In fact most of those going for it are educated and come from well-off families. As threshold to bear labor pain among women has reduced, they prefer to go for epidural anesthesia. Most of patients come to us after knowing about it from friends and relatives. With women postponing motherhood till late thirties and conditions like obesity and hypertension, chances for normal delivery become less. As one grows old, threshold to bear pain also reduces but epidural anesthesia increases chances of having normal deliveries, doctors say. With women postponing motherhood till late thirties, with conditions like obesity, diabetics and hypertension becoming common, chances for normal delivery were becoming less.

In an Epidural procedure a small injection is placed in your lower back, through which a fine tube (epidural catheter), the size of a thread, is passed into your back. Drugs can be injected through this tube to relieve the pain of labor. These drugs are local anesthetics which cause numbing of the nerves and pain sensation without affecting the ability to move. These drugs are also very safe for the baby. With an epidural in place, you may feel the contractions, but they will not be painful. It provides respite to expectant mother from unbearable pain during delivery. The anesthesiologist and your nurse will check that the epidural is working well.

Pain is the reason to have epidural and whenever your pain is significant you can request for an epidural. All women in labor who need pain relief can have an epidural, except those on blood thinning drugs or abnormal blood tests. Epidural is not necessary for you to have delivery, but it can be beneficial in reducing the pain of labor. You only need to be in established labor, but there is no need to wait for a particular dilatation of the cervix. Also in those very anxious or keen to have an epidural, it can be placed at a convenient time before the labor pain is too bad, so that your cooperation is better.

Advantages: There are quite a few advantages of administering Epidural Analgesia. A few are listed below:

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Disadvantages: Disadvantages of epidural anesthesia include its potential for contributing to uncommon minor complications such as persistent positional headache afterwards, shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating. Epidural makes pushing more difficult and additional medications or interventions may be needed such as forceps or cesarean.

Who should have an epidural?

WHO should not have an epidural?

Can an Epidural Fail?

Get all the details and read more ...........

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Your obstetrician and anesthetist will discuss these with you.

Occasionally, epidural may not work as well as we would like it to. If this happens, the anesthesiologist will help by giving extra doses or changing your position or the catheter position. If it still does not work, the procedure has to be repeated (by placing the epidural catheter again).

Do epidurals increase the chance of a cesarean section?

A large amount of research has been done on this topic and it is clear that epidural per se does not influence the rate of cesarean section. A proportion of women planning normal delivery will end up having a cesarean section. This proportion remains the same with or without an epidural.

Seeking pain relief methods for child birth is mother’s choice. This is discussed beforehand only with the doctor in charge of delivery at the clinic. Moreover, a well informed patient is usually more cooperative and adaptive during labor and delivery. Hence, prenatal pain-relief education should work and mutually benefit parties, the patients as well as the care providers. Not every woman needs an epidural and not every woman wants an epidural. But women who are interested shouldn't wait. Rupal Hospital for Women in Surat is a one stop place for all Gynaec and Obstetrics problems and our expertise lies in providing affordable Laparoscopic surgeries and difficult cases of infertility. Rupal hospital is renowned for its comprehensive services under one roof for all your Obstetric need like Painless Normal Deliveries and Caesarean Deliveries and Post natal care and advice. We have one of the best facilities of painless delivery using epidural analgesia in Surat. For the backup, we have the most sophisticated sonography machines at our disposal.

You can contact the team of our doctors at http://www.rupalhospital.com/obstetrics_maternity.html or at http://www.rupalhospital.com

Breastfeeding Guidelines:
No one has ever studied breastfeeding thoroughly in a society. Even normal feeding requires a technique that has to be learned, especially with the first baby. If a women has a problem with breastfeeding, as commonly happens, she has no inborn knowledge of what to do? She must be taught what to do if her baby refuses to suck, if her nipple hurts, or if her milk supply seems to be diminishing.
In a traditional society, older woman give younger ones confidence by helping them through their earlier experience.
• The mother should offer the baby her whole breast, not just the nipple.
• The baby should take the whole nipple and much of the areola into his mouth. (the dark area encircling the nipple)
• How much milk a breast produces depends on how much the baby sucks.


Tips for nursing mother.

 The infant should be allowed to suck the breast within an hour of a delivery.
 Frequent sucking is necessary to establish lactation.
 For first few days after delivery, the breast secrets colostrums (Yellow fluid).
It contains antibodies, growth factors and has laxative effect.
 Breast milk is clean and free of bacteria.
 It contains all nutrients that baby needs for first 4 to 6months.
 Baby does not need extra water.
 The mother should hold the baby close to her body. If baby is not close enough, it may have to suck too hard on nipple and can damage the nipple skin.
 Sucking makes mother’s uterus to contract and it helps to stop uterine bleeding.
 Do not wash nipple with soap, it can damage the skin.
 Let the baby suck until it releases the breast spontaneously.
 If the breast are full (engorged), express the excess milk.
 Mother should feed infant regularly from both the breast.
 Cancer of the breast and ovary is less likely in women who breastfeed compared to those who do not.
 The common problems that new mother may have are:
o Sore nipple.
o Engorged breast.
o Not enough milk.
o Too much milk.
o Leaking breast.
o Flat nipple.
o Inverted nipple.
 If the nipple looks red and sore, she should consult doctor immediately.


Tips for working mother

If you are planning to return to work, you can still nurse your baby either by expressing breast milk or by supplementing with complementary feed.
 If you prefer that your baby be totally breastfed,
o You can express your milk by hand or hand pump. You have to express several times a day to keep up the supply of stored milk ,stimulate milk production and to avoid engorgement.
o Covered, sterile expressed milk can be stored in refrigerator for 1 -2 days.
 If you decide to supplement with infant formula,
o Consult your doctor.
o Do not give whole cow’s milk.
o Follow manufacturer’s instruction properly for preparing formula feed (Not to over dilute or under dilute).

By
Dr. Manoj D. Chohan.
Obstetrician & Gynaecologist.
Gokul Maternity & Surgical Nursing Home.
D 3/2, Vijay Nagar.
Marol Maroshi Road, Andheri (East).
Mumbai 400059.

Even healthy people can get sick because of hot weather. However, the pregnant woman is at higher risk, and need to be extra careful in summer. When it’s hot and humid and you are pregnant, pregnancy can be uncomfortable. Heat and humidity, while unpleasant for most of the people, it takes a greater toll on pregnant women.

Being pregnant in the summer months poses some unique challenges for expectant mothers. Pregnancies are already uncomfortable. Add in the summer heat and they're even worse. Sweltering heat during the summer months makes moms-to-be feel like they're staggering to the finish line during the last mile of their pregnancy instead of happily anticipating a bundle of joy.

The usual pregnancy aches and pains aside, summer heat can pose some health hazards to expectant mothers who may overlook the fact that sun and heat exposure affects the body differently with a baby on the way.

Expectant mothers cannot forget that the sun and heat take a particular toll during pregnancy. A short heat hike that seems simple or even a night activity in prolonged heat can leave a mom-to-be feeling drained. It's important to listen to your body and think about the way the heat may be affecting you.

You must learn to beat the heat this summer and enjoy healthy pregnancy. The following points must be kept in mind for healthy pregnancy in this burning heat.

Dehydration: Summer heat plays an important component in dehydration, a condition which can quickly escalate into a more serious problem of heat stroke. Keep hydrated. Pregnant women are especially susceptible to dehydration. To avoid dehydration don't wait until you're thirsty to drink up, by then you're already water-depleted. Drinking eight glasses of water a day is important for several reasons. Water helps keep the body cool and energy levels high. It also can help reduce confusion due to increased contractions which creates worry and unnecessary trips to the hospital. Eat snacks that provide hydration such as melons and cucumbers. Avoid soft drinks particularly caffeinated ones as they will not quench thirst and can rob your body of needed water. Also being dehydrated can lead to urinary tract infections, a common ailment of pregnancy. Water also is an essential element to help maintain blood pressure which can increase an expectant mother’s dizziness if low. And water maintains correct physiology for a growing fetus. Always carry a water bottle while travelling.

Sunburn: If it feels like your skin is turning pink in the sun faster than it used to, it might be because it is. Pregnancy hormones cause the skin to become more sensitive, which makes some people more susceptible to quicker and more painful sunburn while pregnant. UV exposure during pregnancy can deplete the body's supply of folic acid —an important vitamin for fetal development. The best way to avoid sunburn problems while pregnant is to take the same precautions while not pregnant: Wear sunscreen, wear a hat and other protective clothing, be aware of the amount of time you spend in direct sunlight, and avoid the sun at peak hours in the day, when its rays can be the most punishing. Sunscreen can help prevent or minimize such issues, plus it's the best policy pregnant or not for safe skin.

Edema: Edema, or mild swelling, is common during pregnancy. The phenomenon can unfortunately become worse during a sizzling summer, when rising temperatures cause increased fluid retention which results in puffy feet and ankles for many pregnant women. Lying on one's left side, elevating the legs, and wearing support hose and comfortable shoes may help to relieve swelling. You should avoid prolonged sitting and standing and when sitting elevate legs if possible. While episodes of swelling may seem like the norm for many during pregnancy, it's important to notify your physician about sudden swelling, especially in the hands and face, especially if accompanied by rapid weight gain. In these cases, edema can be a sign of preeclampsia, a condition marked by high blood pressure, which can lead to seizures.

If you perspire heavily because of the heat, make sure you drink plenty of fluids. Water's good, but so are orange juice, milk, and sports drinks, which replace electrolytes that are being sweated away.

We all know pregnant women feel hotter in the summer months because they're carrying around all that extra weight, but as it turns out, their body temperatures are also slightly higher, which makes things even worse. This puts them at risk for heat exhaustion, because it takes twice the mom's energy for her body to cool off not just her, but her baby as well. And heat exhaustion, characterized by muscle cramps, excessive sweating, weakness, dizziness, and headaches, to name a few symptoms, can lead to heat stroke, which is very detrimental to the mother's health and that of her baby. It can even lead to pre-term labor or death. Hence it is utmost important to take proper precautions so that overheating does not happen during pregnancy.

Following are the tips where pregnant women can stay cool, comfortable, and safe in the summer months.

1) Drink plenty of water. It’s advised to drink water from time to time since we become pregnant. But it's even more important in warmer temperatures, when you're perspiring more and losing electrolytes. Make sure to drink water at a steady pace throughout the day, because if you are thirsty, you're already dehydrated. If your home is too hot, perhaps due to insufficient AC, then head out to the mall, a movie or even in an air conditioned car in the heat of the day. You need to keep an eye on your body temp, as too high and fetal damage can occur particularly in the early weeks.

2) Swim. Not only does swimming cool you off, it helps to take some of the weight off your sciatic nerve. Just make sure to wear extra sun block, as pregnant women are more susceptible to sunburn.

3) Wear breathable fabrics so you won't sweat; this will keep you cooler and help prevent heat rash that can develop under your breasts and abdomen, a common problem for pregnant women. Stick to cotton and skip the polyester.

4) Carry a water-filled squirt bottle so that you can mist yourself when you start to feel warm.

5) Exercise at the cooler times of day and avoid exercising to the point overheating.

6) Stay indoors. Remaining inside in the air conditioning on super-hot days is the best way to protect you and your baby. And if you must venture out of the house, try and avoid leaving the house during the hottest hours of the day.

7) Shower often. You may wind up feeling the heat even indoors, so taking multiple showers throughout the day will help keep your temperature cooler.

8) Eat smaller, lighter meals. Eating smaller, more frequent meals will keep your metabolism steady. If you gorge on larger portions, your metabolism has to work harder and generates more heat in your body which may affect you and your baby.

9) Get some rest. Sometimes there's no better way to beat the heat than taking a nap in a cool, dark room. This is one of the last times you can nap without interruptions whenever you please anyway, so you might as well go for it and stay comfortable in the process.

10) Don't over exert yourself. Sure, you want to stay in shape during your pregnancy, but working out in the middle of a heat wave isn't worth the risk. Now is the time to take it easy and not do anything that will make you sweat any more than you already are and dehydrate you.

11) Get indoors at the first sign of weakness, fatigue, dizziness, lightheadedness, or excessive thirst. Lie down and drink some cool water or electrolyte replacement liquid. If you don't feel better soon, call your doctor.

If you follow all these tips, you may very well be able to ignore the heat and get back to enjoying the excitement of awaiting the arrival of your baby. Summer can be a great time of year to get out and enjoy your pregnancy. There are many activities that can still be done during pregnancy, and with a few simple precautions, there is no reason you shouldn't enjoy summer. Remember to watch out for warning signs of dehydration, problematic swelling, or other signs that you need to call your practitioner.

Rupal Hospital for Women is a premiere leader in women's healthcare since 45 long years. The doctors at Rupal Hospital are committed to provide highest quality of healthcare to its patients in all stages of their lives from pregnancy to menopause. We are one stop place for all gynaec problems and our expertise lies in providing affordable Laparoscopic surgeries and difficult cases of infertility like IVF, ICSI, IUI, TESA/MESA, Egg, Sperm and embryo freezing, Egg /sperm/Embryo Donation, Surrogacy. We also provide to our patients information regarding pre care and post care of pregnancy related issues. Dr. Malti Shah believes that preventive interventions are equally important as curative medicine, and prevention always requires awareness and educations. She monitors the patients and gives them advise and educates them on changing seasons and its implications from time to time on their health and baby’s health.

You can contact the team of doctors in Rupal Hospital at http://www.rupalhospital.com or at http://www.rupalhospital.com/team.html