Jain Child and Maternity Hospital Pvt Ltd

Hello friends,

Main Dr Surekha Jain gynaecologist and obstetrician pichhle 40 saal se Shalimar Bagh mein practice karti hoon.

Aaj ham baat karenge ek bimari PCOD jiska aapne bohot logon se naam suna hoga, isko PCOS bhi kehte hain aur jaisa ki naam se pata chalta hai ismein bohot sari bimariyan include hoti hai ye apne aap mein sirf ek bimari nahin hai ye PCOD aurat ke jivan mein ek health ko affect karne wali bohot badi syndrome hai jismein aur jyadatar ye child-bearing age mein hota hai matlab ki 20 se 40 sal tak ki umra mein ye women ki health ko bohot tarah se effect karta hai, sabse pehla uske periods ko irregular karta hai, irregular aur flow kam karta hai, 2ndly agar patient married hai, agar female to uski fertility pe impact dalta hai, pregnant hone mein mushkil hoti hai, teesra insulin production pe affect padta hai jisse patient diabetic ho sakti hai, chautha hormonal level ka imbalance karta hai jo female hormones hoti hai estrogen, progesterone unka balance karta hai aur last mein ye patient ke blood vessels aur blood pressure pe bhi affect kar sakta hai jisse ki lambe samay me use badi-badi bimariyan ho sakti hai aur aapke appearance ko affect kar sakta hai jisse ki anchahe baal, acne ye sab aate hain.

Ab aapke paas ek sawal aata hai ki kab aapko yeh mehsoos hona chahiye ki mujhe shayad PCOD ho sakta hai aur mujhe doctor ke pass jana chahiye? to ismein se agar jo-jo baten main apko bata rahi hoon ismein se koi bhi apko lakshan lage to aap ko doctor ke pass jana chahiye.

Sabse pehla agar aapke periods abhi recently aise hone lage ki flow kam hota hai pehle saat din hota tha ab do din hi hota hai aur kam hota hai aur bich ka interval badh gaya hai, har mahine ki jagah 2 mahine, 3 mahine, 4 mahine yahan tak ki 6 mahine tak bhi period nahi aate hain to aapko sochna chahiye ki aapko kuch problem hai.

Dusra agar aapko anchahe baal dikhai dete hain jaise ki upper lip, chin aur side burns, shoulders, lower back, front of chest yahan pe aapko baal dikhai dete hain jo ki normally female ko nahin hone chahiye, suddenly aapke baal girne shuru ho jaate hain aur scalp mein jagah-jagah patches ban jaate hain jahan per ki hair nahin ho or ya aapko face par acne aate hain bohot jyada muhase aate hain jo ki period aane se pehle jyada badh jaate hain aur agar aap married hai aur aap conceive karne mein problem arahi hai aapko pregnancy nahi ho rahi hai ye sab karno se aap ko doctor ke pass jana chahiye.

Yadi aap doctor ke pass jaati hai to wo kaise approach karenge? Sabse pehle aapko ye diagnosis banane ke liye ki aap PCOD ho ya nahi, aapki history lenge, history mein wo kya-kya lenge? poochenge aapka weight gain hua Kya recently, kya aapke parivar mein aapke maa-baap kisi ko sugar hain? Kya ki bahen-maa ya koi bhi aapke blood relation ki female ko polycystic ovarian syndrome raha hai? History lene ke baad wo fir aapki jaanch karenge, aap se puchenge ki aapko kya-kya problem hai, aap jab bataoge uske baad aap ki jaanch karenge jaanch karne mein sabse pahle aapka BMI nikalenge. BMI nikaalne ka matlab hota hai weight divided by height in metre square is BMI, BMI aapko ye bataega ki aap healthy weight ho, aap overweight ho ya aap obese hoya very obese ho kyunki overweight hone ke chances PCOD main bohot jyada hote hain.

BMI nikaalne se wo aapko guide kar payenge, secondly fir wo aapka hair pattern dekhenge ki aapko kahi anchahe baal hai kya unko dekhne ke baad fir wo aapka, agar aap married hain to aapka internal checkup bhi karna chahenge ps karke dekhnge, aapki ovary size mein badi lagti hai ya aapke abdomen mein jyada fat hai aur fir insulin resistance ke sign dekhenge, insulin resistance ke sign hote hain acanthosis nigricans iska matlab hota hai ki aapka nape of neck yahan per blackish skin ho jaaye or hard thick skin ho jaaye iske alava jo pressure points hai jaise elbows hai jahan per aap pressure lagakar baithte hain wo hiisa bhi kala aur thick ho jata hai, iske alava agar aake pet per bohot jyada charbi hai to wo bhi ek sign hota hai ki aapko insulin resistance hai.

Sare examination karne ke bad fir wo aapke kuch blood test karenge, blood test aur ultrasonography karenge, blood test main aata hai ek simple aapka hemogram, blood sugar uske alawa aapka fasting insulin aur aapke FSH, LSH. Jo aapke female hormones hai serum estrogen aur FSH, LSH ke alava aapke kuch test karenge jo ye bata sakte hain kya aapke sharir mein male hormones jyada hai kya, kyunki kuch male hormones sab females mein hote hain lekin ek limit ke baad agar wo badh jaaye to wo problems khadi karte hain. last mein thyroid test aur prolactin test bhi karenge kyunki hypothyroidism aur prolactin hormone ka jyada hona bhi isi tarhan ke symptoms paida kar sakta hai, jaise ki period kam aana, weight gain hona aur ye sab signs bhi dikha sakta hai to isliye rule out karna padega iske alava kuch tumors hote hain, jaise ovary ke tumor hai, adrenal ek gland hota hai kidney ke upper uske tumors hai wo bhi is tarah ke hormones nikaalte hain Jo ye saare symptoms jo humne PCOD ke discuss kiye hai usmein bhi aa sakte hain to in sabko bhi hamen rule out karna hai.

To ham male hormones test karte hain jaise serum testosterone, DHEA-S, 17 alpha hydroxyprogesterone, SHBG etc .. last mein agar aap unmarried hai to aapka abdomen se ultrasound hoga, agar aapka married hain to transvaginal sonography is the best wo ye bataegi ki kya aapki ovary normal size se badi hai Kya? aur agar badi hai to kya unke jo ande ban rahe hain wo unki periphery pe lage hue hain sare aur nikalte nahi hai, iske alava uski jo outer layer hai wo thick hai ye sab ultrasound mein dikh jata hai aur basically polycystic ovary mein yahi problem hoti hai har mahine anda banta hai lekin shed nahi hota aur collect ho jata hai periphery pe aur ek mala si banaa leta hai isko ham pearl neck appearance bhi kehte hain jaise ki ek moti ki mala hoti hai, is tarah se ban jata hai ye saare test aap ke doctor karenge.

First ek bar humne diagnosis bana liya patient ka ki usko PCOD hai to hamare jahan mein ek sawal aur bhi hai ki uska karan kya hai? PCOD ka koi karan nahi hai abhi tak koi aisa nahi hai ki koi virus, bacteria ya koi karan hamen samajh mein aata hai sirf genetic problem samajh mein aati hai genetic matlab agar aapke parivar mein aap ki maa-bahen ya koi blood relation ko PCOD hua hai to aapko bhi jyada chances hai, iske alava kuch logon ne yeh coincidence paaya hai ki agar ladki premature hui hai ya birth weight uska bohot kam raha hai to uske chances hai ki later life mein PCOD develop karegi, humne causes jaan liye ab ham ultimately treatment per aate hain.

Treatment jab ham shuru karna chahenge most important jo hai wo hai reduction of weight and lifestyle changes. Agar aap apne existing weight ka 5 ya 10% weight bhi reduce karte hai to aapki bohot sari problem bina doctor ki bhi solve ho jayengi, aap ko doctor ke pass nahi jana padega so mind you reduction of weight is very important. Ab baki ke treatment ki baat hai ki kya aapko chahiye aur kya jaruri doctor ko lagta hai us hisab se treatment diya jayega agar aapke periods irregular hai aur koi problem nahi hai to periods regular karne ke liye oral contraceptive pills di jaati hai jo har mahine mein 21 din khani hoti hai aur 21 din ke baad period aa jata hai fir paanchve din se shuru karte hain isliye har mahine period aane lagta hai aur hamen PCOD patient mein saal mein kam se kam char bar period jarur hona chahiye nahi to patient ko uterine cancer ke chances badh jaate hain. Period regular karne ke baad, second baat aati hai agar aapko male pattern ke hair hai jyada ya aapki voice mein change hai ya baal gir rahe hain ya acne hain, in patients ko bhi ham oral contraceptive pills dete hain lekin wo dete hain jinme ek dawai aisi bhi ho jo male hormone ko kam karti hai aisi contraceptive pills bhi aati hai jin mein ye dawai hoti hai, iske alava agar bohot jyada hair hai aapko kahin baar bohot jyada hair patient ko hote hain to usmein ham alag se dawai bhi add karte hain jo male hormones ko kam karti hai. Abh agar jitni apki hair growth aa chuke hai wo nahi htaayi ja sakti sirf further growth roki ja sakti hai uske liye aap jo existing hair hai unke liye to aap vahi sab kar sakti hai jaise ki waxing karana, laser se hair remove karana, kuch creams bhi aati hai jo growth kam karti hai wo bhi doctor aapko likhkar de sakta hai. Teesra agar aapko insulin resistance aati hai to insulin sensitizers drugs di jaati hai jaise ki metformin hai, myo-inositol, D-chiro inositol hai etc. this is doctor’s will. Last mein agar aap overweight hai to aapko kis dietician ki bhi help leni pad sakti hai weight reduce karne ke liye, agar aap morbidly obese hai ya aur aisi drugs bhi khaani pad sakti hai jinse aapka kam ho jaaye weight.

Ab patient agar married hai aur wo infertile hai us patient ko in sabh ke alava hamen aisi drugs bhi deni padti hai jo har mahine unka anda bane aur gire jisse ki wo pregnant ho sake ye sab bhi doctor aapko dekh ke aapke hisab se bataenge, kahi conditions aisi hoti hai koi bhi cheez kaam nahi karti to surgical treatment bhi karna padta hai ovaries ka usse ham ovarian drilling bhi kehte hain laparoscopically ovarian drilling karke patient ko cure kar sakte hain ye short mein sara ho gaya, ab log long term precaution kya hote hain agar patient ki PCOD theek nahin karen aur wo chalta rahe to kya kya problem lambe samay mein usko ayengi to PCOD ka matlab hai ki anda girta nahi hai to progesterone jo dusri hormone anda banne ke baad nahin aati aur pehli hormone estrogen excess main ho jaati hai, excessive estrogen hi aapke period ko delay karti hain, agar lambhe samay tak estrogen Jyada rehti hai to uterus ke andar ki layer jyada badh jaati hai jisko hum hyperplasia kehte hai aur lambe samay tak agar treat nahi karen to yeh hyperplasia endometrial cancer mein badal sakta hai.

To patient Jake ultimately endometrial cancer develop kar sakti hai isliye treatment jaroori hai, dusra kyunki ismein insulin resistance hota hai to patient ko long-term mein jakar diabetes type 2 ho sakti hai aur ismein dyslipidemia hota hai heart, blood vessels aur hypertension yeh sab affected ho sakte hain aapko cardiovascular problem ho sakti hai, like stroke, thrombolysis many things, so ultimately aapko ye baat ab acche se samajh mein agai hai ki once you are aware of any symptom which is you feel ki PCOD ho sakta hai to doctor ke pass jayen, proper, diagnosis, treatment management karayen.

All said and done, last mein main aapko yahi kehna chahti hoon ki PCOD jo syndrome hai Isko aap totally cure nahi kar sakte ismein sirf jo symptoms dominating hai ya aapko life mein trouble de rahe hain unko manage kar sakte hain unko treat kar sakte hain, aap khud iske liye help kar sakti hain apna weight reduction karke, apni lifestyle badal kar ke. Doctor isko totally cure nahi kar sakta yeh specially young mothers, young ladkiyon ki mothers ko bhi samajhna hai kyunki agar ham 6 mahine tak period regular karte hain aur dawai band karte hain to fir problem ajaati hai firse wahi hone lag jata hai to ham cure nahi kar sakte that is the most important message. So friends ab mujhe umeed hai ki apko PCOD ke bare mein karan, kaise-keise usko samjh sakte hain aap, kab doctor ke pass jana hai yeh sab aapko samajh mein aaya hoga aur aap iska labh utha payenge.

Thank you very much

Hi,

I am Dr. Surekha Jain, Gynaecologist. Aaj hum baat karenge fibroid uterus ke baare mein. Ise bache dani ki rasoli bhi kehte hain. Ye fibroid us age mein hota hai jis age mein aurat garbh dharan karti hai. Ye rasoliyan mahina aane se pehle and mahina band hone ke baad kam hoti hain. Lekin agar menopausal age mein agar ye aaye toh ise gambhrta se liya jata hai. Ye problem 30-40% auraton mein paayi jaati hai. Iske hone ka karan bahut sahi se nahi malum. Ye problem unmein jyada hoti hai jinhone kabhi shaadi nahi ki and bacha paida nahi kiya. Ye kaise patient ko preshan kar sakti hai. Ye nirbhar karta hai ki rasoli kaha hai aur kini badi hai. Ye rasoli bachedani ki thickness ke bich ho sakti hai. Aur ye endometrium mein bhi ho sakti hai. Ye bachedani ke bahar bhi ho sakti hai. Aur ye aise bhi ho sakti hai ki aap ke pure peat mein ye ghume. Kabhi kabhi ye patient ke liya koi problem nahi kreate karti.

Use pata bhi nahi chalta ki use rasoli hai. Bahut sare patients mein iska koi symptom nahi hota. Lekin ye kis tarah ki problem kar sakti hai. Agar bache dani ki andruni satah par hai to patient ko baar bar aur jyada bleeding hogi. Periods ke alawa kabhi bhi bleeding ho sakti hai. Patient pregnant nahi ho payegi aur agar ho bhi jata hai toh abot ho jayega. Agar deewar mein hai toh bachedani ka size bada ho jayega. Bharipan lagega, pishab baar bar ayega, intercourse mein paon ho sakta hai, kamar mein bhi dard ho sakta hai. Agar ye rectum mein pressure daal rahi hai toh motion jaana bhi feel ho sakta hai. Agar peshab ki thali par pressure hai toh baar baar urine aata hai. Iska pata kaise chalega. Iska pata tab chalega jab aap Dr se check-up karayeinge. Correct diagnosis ka dusra tarika hai ultrasound. Agar humein detail information chahiyai toh 3D and 4D ultrasound bhi hota hai.

And MRI bhi kara sakte hain. Kabhi kabhi mariz ko 7-8 rasoliyan bhi hoti hain and patient ko pata nahi chalta, pregnancy bhi ho jaati hai. Patient ko koi problem nahi hoti. Lekin jab ye andar ki side aa jati hai toh pregnancy hone mein dikkat hoti hai aur agar ho jaati hai to patient ka abortion ho jata hai. Patient ko bar bar bleeding hoti hai. Patient ko periods bhi hote hain but kabhi bhi bleeding ho sakti hai. Kabhi kabhi treatment ki koi jarurat nahi hoti hai, patient enopause mein bhi aa jata hai aur rasoli dkhatam ho jati hai. Iske alawa medical treatment bhi hai. Medical treatment unhein diya ja sakta hai jinke bachedani nikal nahi sakte ya fir operation ke layak nahi hain. Medical treatment mein bahut sari medicines bhi hain. Kuch aisi medicines bhi hain jo sirf rasoli ko hi target karti hain. Ye medicines Dr ke supervision mein li jaati hai. Is se bleeding ka problem kam ho jata hai. Size bhi kam ho jata hai.

But jarur nahi hai ki size bilkul normal ho jaaye. Ek treatment hai uterine artery embolization. Usmein jo blood supply karne vali uterine artery hai use block kar diya jata hai. Is se fibroid ko blood supply milni band ho jaati hai. But ismein dusre rasoliyan badi ho jaati hain toh dubara procedure karna padta hai. Agla surgical procedure hai myomectomy. Vo un patients mein kiya jata hai jinhein bachon ki jarurat hai. Myomectomy durbin se bhi hoti hai aur agar problem jayada hai to peat bhi kholna padta hai. Experts aap ki sari rasoliyan nikal dete hain. Is se patient khud bhi conceive kar sakti hai ya fir IUI, IVF se bhi ho sakta hai. Agar patient ki family puri hai and bache aur nahi chaoye toh bachedani nikali bhi ja sakti hai. Ye surgery durbin se bhi ki jaati hai. Agar aap ko rasoli hai toh Dr se consult karein. Vo aap ko assurance de denge ki aap ko treatment ki jarurat hai ya nahi. Agar aap ko koi bhi symptom hain toh Dr se jaanch karayein ki aap ko rasoli hai ya koi aur karan hai.

Thank You.

Hello friends,

Main Dr. Surekha Jain hu. Aaj main aap ko batana chahti hoon AUB yani ki abnormal uterine bleeding kya hoti hai. Jaisa ki naam batata hai abnormal uterine bleeding ka matlab hai woh mahamari ya aurat ko vo bleeding jo samay par na ho aur normal flow se zada ho. Moti moti baat yahi hai ki waqt par nahi hoti, samay se irregular hoti hai aur jitna din ka flow hona chahiye usse zada hoti hai. Lekin is bleeding ko har umar mein alag alag kaaran aur alag alag tarah se treat kiya jata hai. Shuruvat hum karenge is baat se ki agar kisi ko zada ya excessive bleeding hoti hai, mahamari excessive hoti hai to usse kitni nuksan ho sakte hain. Kisi bhi umar mein zada bleeding hone se patient ko anaemia hoga khoon ki kami hogi usse usko thakan hogi, normal routine work karne mein mushkil hogi aur iss tarah se wo ek bimari ki stithi mein aa jayegi. Sabse pehle hum is baare mein baat karenge ki jo vayask avastha hoti hai jab ki ladki ko bleeding mensuration chalu hota hai ya jisko medically hum puberty kehte hain, puberty ke dauran ya puberty se ek saal, do saal ke aas paas agar hum ko abnormal uterine bleeding hoti hai to uske kaaran bilkul alag hote hain.

Uske zadatar kaaran hote hai usme sabse pehla kaaran hota hai ek saal tak ki bache ko paripakva awasthe mein nahi hota. Usme hypothalamus pituitary ovarian uterine axis jo ki puri ek axis hai jo ki patient ko bleed karati hai ya har mahine mahamari deti hai, woh paripakva vo mature nahi hoti. Immaturity ki wajah se immature signals aate hain aur har mahine anda nahi banta isliye patient ko kabhi kabhi jaldi aur kabhi kabhi late bleeding bhi hoti hai. Ek saal tak isilye pareshan hone ki zada zarurt nahi hai. Fir bhi agar ye hi awastha zada din tak rahe to hame kya karna chahiye? Sabse pehle complete haemogram patient ka pura hemoglobin dekha jaye, kitna hai kam hai zada, uska coagulation profile kya janmjaat koi coagulation ki bimari to patient ko nahi hai. Ek Von Willebrand factor bhi hota hai uski test bhi karayi jani chahiye. Thyroid ka bhi test karaya jana chahiye.

Ye common kaaran hai puberty ke around abnormal uterine bleeding ke. Uske alawa 1 ultrasound bhi zarur karana chahiye halaki ye kam bahut kam hota hai is awastha mein fir bhi kayi ovarian tumors aur abnormal development of the genital tract bhi iska kaaran ho sakta hai. Ab doosra hum aate hain vo awastha jo kareeb 25-40 saal tak ke beech mein jisko hum kehte hai childbearing age. Childbearing age mein abnormal uterine bleeding ke bohot sare causes ho sakte hain jis mein sabse pehla kaaran pregnancy se related hota hai. Pregnancy se related matlab patient pregnant hai, use pata nahi bleeding ho gayi aur usko tab pata chala vo doctor ke pass aayi jise hum threatened abortion kehte hain. Kayi bar patient pregnant hai, incomplete abortion ho gaya, patient bleed karti rahi, use maloom nahi hai, usko hum incomplete abortion kehte hain. Aur uske alawa missed abortion bhi hota hai, patient ne time pass kiya, andar hi bachcha kharab ho gaya aur thoda thoda karke bleeding hoti rahi. To pregnancy se related iske alawa ek aur stithi hoti hai jise kehte hai vesicular mole, jisme ki bachcha pura sa banta hi nahi hai aur vo khatarnak bimari hoti hai.

Isiliye doctor se jab bhi aap ko pregnancy mein bhi bleeding ho turant doctor se consult karna chahiye. Ectopic pregnancy matlab jabki pregnancy uterus mein na ho kar tubes mein hoti hai jo jaanleva bhi ho sakti hai tab bhi thodi thodi bleeding ho sakti hai. Kehne ka tatpariye ye raha ki agar aap pregnant hai, aap ko pata hai aur thodi bhi bleeding hoti hai to doctor se zarur consult karna chahiye. Iske alawa ye childbearing age mein aur bohot sari problems aisi hai jo aap ko is tarah ki bleeding de sakti hai. Jaise agar patient PCOD hai, to har mahine uska anda nahi banta aur uski growth andar jo bachchedani mein endometrium layer endometrial layer vo zada grow kar jati hai, itna grow karti hai ki vo fir hold nahi kar sakti aur fir zada bleed karti hai. To matlab kehne ka yahi hua ki aap ko jab bhi aniyamit bleeding ho ya normal se zada khoon jaye to aap ko doctor se zaroor consult karna chahiye. Childbearing age mein teesra ek kaaran jo sadharantya hota hai vo hai fibroid uterus matlab thodi thodi gathein, rasolia uterus mein ban jati hai jo is tarah ki problem de sakti hai.

Aur adenomyosis chota chota wall mein gathein banjati hai bachedani ki, vo bhi is tarah ki problem de sakti hai ya pelvic inflammation ya pelvic infection. Koi bhi infection, bohot tarah ke infections hote hain jo soojan de sakte hai pelvis mein, pelvic area mein aur bleeding zada ho sakti hai ya fir doctor dwara jaise apne koi copper-T lagvaya hai, multiload lagvaya hai ya mirana lagvaya hai vo bhi kabhi kabhi mahine ke beech mein bhi thodi thodi spotting ho sakti hai ya mahine ke time mein bohot zada bleeding ho sakti hai. Ye aur agar aap ko bachchedani ke muh pe koi jhakham hai vo bhi aap ko bleeding zada de sakta hai. Childbearing age mein hame kya kya investigation karni chahiye? Isme aur investigation ke alawa sabse important ye hai agar aap ko post-coital bleeding hai matlab aap ko husband se contact karne ke baad bleeding hoti hai to that can be woh ek nishani ho sakti hai ki aap bachchedani ke muh yani cervix ka cancer develop kar sakte hain, aisi condition main PAP smear ya HPV DNA aaj kal test hota hai jo ye doctor ko badi aasani se bohot jaldi bata deta hai ki haan aap ke saath ye problem hai aur usko badi aasani se treat kiya ja sakta hai. Iske alawa investigation mein sab aate hain hemogram, blood sugar, thyroid aur urine ka koi infection yeh saree routine test aap ko doctor se milke jarur karne chahiye. Ab aate hain hum vo awastha jo bhudapa kehlati hai ya menopause kehlati hai, pre-menopause and menopause both.

Pre-menopause mein agar aap ko irregular bleeding hoti hai to dubara se woh kaaran ho sakta hai ki aap ka physiologically anda theek se nahi ban raha kyunki ab aap ka vanning period hai dhere dhere aap ki hormones kam hoti ja rahi hai isiliye aap bleed kar rahi hai. Lekin agar aap ka menopause aa gaya hai ek saal tak aap ko koi bleeding nahi hue hai uske bad achanak koi bleeding hoti hai to vo khatre ki nishani ho sakti hai. Aise mein zarur aap ko doctor ko dikhana chahiye jo aap ke upar bohot sare test karke aap ko bata sakti hai ki koi early cancer to nahi hai. Early cancer ke liye aaj kal PAP smear aur HPV DNA jaise maine bataya vo to karte hi hai, ek aur acha test hai jo humari doorbeen hoti hai jisse hum puri bachchedani dekh sakte hai aur bata sakte hai ki andar kya kharabi hai. In sab test karane se aap khatarnak bimariyo se aasani se bach sakte hai, ultrasound, MRI ye sab hamare ko sehyog dete hai diagnosis banane mein. To mai friends aap ko yahi kehna chahti hu koi bhi abnormal uterine bleeding ko aap neglect mat kariye, usko seriously lijiye aur ek bar doctor ki raye zarur lijiye.

Dhanyavad.

I am Dr Surekha Jain, I am practicing since last 38 years in Shalimar Bagh Delhi. And I am curtsy consultant to Shalimar Bagh Fortis hospital. Today I am going to talk about a very important hormone which is known as pregnancy hormone or beta HCG. Why it is called pregnancy hormone because this hormone beta HCG is the first hormone to increase and which can diagnose pregnancy very early. Why we should diagnose pregnancy very early, now days in a era of assistant reproductive techniques like IVF, ETSY, IUI etc. We want to know whether our patient is pregnant or not very early so that we can support her and we can give her certain medications which will help her to continue her pregnancy. This is a pregnancy hormone which starts as soon as when embryo is form that is 14 to 15 days after your ovulation or egg pick up. We can detect up to 100mIU’s of Beta HCG on the 14th day after ovulation, if pregnancy is occur. So to know the welfare of the pregnancy or to know first of all whether you are pregnant or not, we do your beta HCG. Anything about 10mIU/ML is taken as positive, it is just positive but to know whether the patient is doing fine or not, we can repeat this hormone every 48 to 72 hours that is every third day and it should almost double up every third day which shows that now the pregnancy is going fine and now we are assured. And we keep on following the patient. When the beta HCG levels they reach around 1000 to 1500 International unit the gynaecologist or your doctor should be able to see by Trans vaginal sonography at least sack. If she cannot see the sack at 1000 to 1500 International unit then there must be something wrong either blighted over or anything else. Now how can you test a beta HCG there are two methods to test beta HCG one is urine and other is blood, urine beta HCG is very simple to test anybody can test it at home. You can buy a simple strip from any chemist and then you can put fresh clean urine in the small socket formed on the slide 3 drops of fresh urine and wait for about 3 to 5 minutes. What you can see on the slide is either a one single line of about red or violet colour which shows that you are not pregnant but you have done your test alright. But if you see 2 parallel lines of equal strength you are happy because indicates that you are pregnant and your pregnancy is fine. But in case you don't see any of the lines, it shows that you have not done that test correctly or you are suffering from some severe urinary tract infection or your urine is very diluted. You have taken it after lot of consumption of water or some liquids. So Urine Pregnancy Test is very easy the drawback with Urine Pregnancy Test is it just tells you that you are pregnant, it doesn't tell you what will happen or what time of the pregnancy it is. Now the second method to test beta HCG is blood, it's very important definitive and very good test to know about the conception and its progress and the time of weeks. So if you get your blood beta HCG done in your blood as I told you anything about 10mIU/ML is positive test and then you follow it every third day to find out that it becomes double or not and then when it is about 1000mIU/ML then it should be seen in the trans vaginal sonography. What is the use of this hormone, why this hormone is there it is with some purpose the purpose of this particular hormone is that when you conceive and after just fertilizations 8 to 10 days after fertilization the embryo goes and implants in the uterus and there it is formed by the plasanta, this sends a message to the ovary that corpus luteum has to keep on working because corpus luteum give the hormone progesterone which is very-very necessary for the pregnancy. Now once the corpus luteum is giving progesterone and gradually the plasanta develops. When the plasnta develops it takes so what the corpus luteum, see the nature's method tell the Corpus luteum to maintain the corpus luteum in pregnancy the beta HCG is keep on increasing till 8 to 10 weeks it is the highest it around 10 weeks its level is about 100, 1000 international unit but as soon as the plasnka takes over the work of making progesterone corpus luteum is no more required. And hence the beta HCG also keeps on reducing and it makes effective Plateau at around 20 weaks its only 20000 then it goes to Plateau and it remains at the same level till full top. Beta HCG other than telling you about the welfare of the pregnancy has certain other many important jobs to do. First of all if your beta HCG is not corresponding with the weeks of pregnancy shown in your lab report, it shows that either your pregnancy is not progressing well or you might be having ectopic pregnancy that is your pregnancy might be other than the in the uterus. It can be it outside the uterus which is very dangerous for the health of the patient. Second it shows if it is very high it shows either you are having multiple pregnancy or some pregnancy related cancers which are known as trophoblastic disease of the pregnancy. Which are also again very dangerous and followed by beta HCG test and thirdly this test is also done to know about the welfare of the foetus in the first trimester of your pregnancy that is known as double marker. So it's a very-very important hormone and is related to all the pregnancy welfares, miscarriages, blighted ovum, ectopic, twins, cancer-related pregnancy that's all, ok.

Causes, symptoms and diagnosis of Thyroid

Hello friends. I am Dr. Surekha Jain practicing as a gynecologist and obstetrician since last 40 years. I own my own hospital at Shalimar Bagh with the name of Jain Child and Maternity Hopsital Pvt. Ltd. I am also attached with the Fortis Hospital, Shalimar Bagh as a Senior Gynecologist and Obstetrician. Today, I am planning to tell you about Thyroid Diseases during Pregnancy. The reason for choosing this topic is that it is very common nowadays to find thyroid disease during pregnancy and the smallest variation in the thyroid organ can really affect your pregnancy. The thyroid disease is present in two forms: Hyperthyroidism and Hypothyroidism. Hyperthyroidism means over active thyroid and Hypothyroidism means which is under active thyroid.

Thyroid is an organ which is located in the front of your organ like a butterfly and it releases hormones which control metabolism of your body it controls even single cell of your body. Thyroid affects the whole body. During pregnancy, why we are worried about the thyroid disease that if you already know that you have hyperthyroidism or hypothyroidism at the very first consultation of your pregnancy, you should tell your obstetrician that you are either Hyperthyroid or hypothyroid and what drugs you are already taking. So that the doctor can help you adjust those medications. In case you do not know the status of your thyroid at very first visit the doctor will you investigations to be done and thyroid status is one of them.

Why is it so important to do early? Because the thyroid functions are more important in the first trimester of pregnancy to control the development of the baby. You very well know that during the very first three months of your pregnancy, the child being made, all the organs, all the systems are developed and after that the child only grows inside so the first three months are very crucial. And thyroid controls the activities in the mother and the baby. So, you should know the status of thyroid. Now, let us know what are the most important irregularities you can have in thyroid? Hyperthyroidism, even though it is rare, in early pregnancy signs and symptoms they quite mimic hyperthyroidism like excessive vomiting, nausea, irritability, giddiness and irregular heartbeat, even nervousness. So, these are very common in pregnancy as well as in hyperthyroidism.

So, if they are in a moderate amount, you can think of having these symptoms because of pregnancy. But, in case there is excessive, your doctor will definitely test you for hyperthyroid by doing certain blood tests and manage you accordingly on anti-thyroid drugs. The second most important is hypothyroidism. Hypothyroidism being more common than hyperthyroidism, therefore, it is very important to manage hypothyroidism in early pregnancy. In first, seven to nine weeks, the fetus doesn’t have any thyroid function in itself. So whatever it is getting it is from the mother. If the mother is deficient, the child will also become deficient and later on it can have multiple problems of nervous system, skeletal system, and developmental problems. Now, how do you diagnose the thyroid disease? It is very simple. Only by blood test you can diagnose thyroid. Three blood tests are there, TSH (Thyroid Stimulating Hormone), T3 and T4. These are the hormones which are released by thyroid and thyroid stimulating hormone is the controlling hormone which keeps adjusting itself according to the hormone. Only by test you can come to know whether you are youth thyroid that is normal thyroid or you are hypothyroid or hyperthyroid.

If thyroid is not controlled properly during pregnancy then there can be multiple things which can happen to the mother and the baby. Now, if it not controlled in the first trimester, then developmental problems can be there. Baby can have certain congenital birth defects but later on it can lead to prematurity, and high blood pressure. Now, how can you come to know you are suffering from symptoms only? Hyperthyroidism can lead to severe nausea, vomiting, and slight tremors in your body, trouble sleeping, weight loss, or low weight for pregnant women. How can you know about hypothyroidism? Symptoms of hypothyroidism are such as extreme tiredness, weight gain, confusion, constipation, concentration and memory problems.

So, once your doctor knows whether you are hypo or hyper, they will treat you accordingly. If you want to know more, you can contact me through Lybrate, Dr. Surekha Jain. I am a certified thyroid disease treatment giver to the patients so you can contact me by chat, telephone, by putting your questions directly to me through Lybrate. They know my telephone number, my address. You can contact me, come to me, you can chat with me and even have video chat with me. Thank you.