Dr. Anjali Bapat Clinic

Hello friends.

I am Dr. Anjali Bapat, a gynaecologist and obstetrician. Today my topic is parenthood. In the last 30 years of my experience, I have come across many pregnant many couples having either a planned or an unplanned pregnancy. Believe me, it's the most beautiful phase of life. When you miss your period immediately consult a gynaecologist, she will advise you either to do a urine pregnancy test or a blood pregnancy test. This will tell you whether you are pregnant or not pregnant and that will be followed by a clinical examination and a sonography. The first sonography dealt the exact beginning of pregnancy and a lot of decisions will depend upon this is sonography. The first 3 months of pregnancy you have to visit your doctor every month, she will check your weight, blood pressure as well as will do an internal check-up and will advise you a folic acid tablet. In the second trimester of your pregnancy, again you have to visit your doctor once in a month, check get everything checked but along with it, it is very important to do certain blood test and sonography.

Let's talk about sonography first: at 13 weeks an NT scan has to be done which will tell you the possibility of a normal or an abnormal child and at 18 weeks an anomaly scan which tells you the structural abnormalities of the child. In the last 3 months of the pregnancy, it is important to visit your doctor and then decide the plan of the delivery. Friends, normal delivery is always better and hence choose a doctor who promises you that she will be with you during your delivery process. Choose a centre which will give all facilities to take care of a new born that means which has got a neonatal intensive care unit, anaesthetist, operation theatres and a beautiful delivery room having all the equipment.

Why is this important? This is important because when your baby is born; in case some help is required you get everything under one roof. Now once you start your labour pains, a delivery process for the first time usually is for 24 hours. During this time, you are observed by with a lot of parameters like a NST as well as a contraction test, your dilatation is examined and if you want painless labour then epidural anaesthesia is offered to you. It is always better to deliver vaginally but there are certain times where a caesarean section is must and these are supposed if you had previous caesarean section or if baby's health is not below that means a baby's buttocks are down and a head is up or baby is in a horizontal position which means the transverse lap or if you had any pregnancy complications like pregnancy-induced hypertension, diabetes, etc then, of course, you a planned caesarean section is done. Otherwise, it is always better to have a vaginal delivery with complete monitoring. During this monitoring, if a doctor finds out that the baby's head not moving adequately or if baby's foetal heartbeats that mean baby's heart beats are going up and down then definitely you need an emergency caesarean section. Friends, I have read a very beautiful quote that "a mother is born with the birth of a child", to have that beautiful experience all the best.

Thank you so much!

Yes!

Good afternoon friends. Today I am going to speak on a very important topic and that is contraception. It looks to be a very simple topic but it is so important that today's youngsters if they know about it a lot of anxiety, can be reduced. Now by word contraception, it means all the methods which are used to prevent the pregnancy. Why have I chosen this topic today? It's mainly because in my practice day by day I am seeing that many youngsters are getting confused because how to avoid pregnancy and few of them as they lack knowledge about it, they land up into an untoward, unwanted pregnancy situation. So, let's come to the point, contraceptives are divided into two types: the first one is what the males use and the second one is what the females can use. Let's talk about the ones which females can use. The contraceptive which is actually very very common and popular is the I-pill.

It is a contraceptive which many people take immediately after sex so it is also called as pill 72 which has to be taken within first 72 hours post unprotected sexual intercourse but mind you this I-pill is the is called as an emergency contraception and as you can understand by the word emergency, emergency comes just once in a while so the patients whom I have seen like they pop I-pill every month or even twice or thrice in a month often land up with some kind of hormonal disturbances. So please remember I-pill is a good contraceptive device with a good amount of success, however it cannot be taken too often. Once in a while if you take it you have to take it as soon as possible preferably within first 12 hours from the unprotected sex. The second contraceptive that is a hormonal oral contraceptive pill. Now these pills, a girl or a woman has to take regularly, mind you very regularly at bedtime one pill at bedtime and there are various kinds of hormonal contraceptives available.

Now, these brands or these contraceptives you can take it after a prescription from a gynaecologist once various conditions are ruled out. These contraceptives have to be taken irrespective whether in that particular day or that particular week whether you have intercourse or you do not have intercourse. A hormonal contraceptive that is oral contraceptive pills what it does is it prevents the ovulation from happening that means the egg is not released, as a result of that there is no question of her pregnancy. Very very unfortunately many people have a lot of serious doubts or misconceptions about this oral contraceptive pills. The first question that anytime we prescribe this contraceptive is that doctor Kuch side effect to Nahi hai na.

Well, there are a very very minimal amount of side effects and that is about to 1-2 kg weight gain but this weight gain is basically of water retention. What is the meaning of water retention? It means that once you stop using this contraceptive, your effect of the weight gain goes away. It is not the fat part of the body composition that increases. So, if a woman is on oral contraceptive pills and she watches her diet as well as does regular exercises practically there is no danger of gaining weight. Mild nausea may happen to some women but once you start taking it within the first few days it also goes away. Very important part point to remember and that is the oral contraceptive pills have a very less failure rate which means it practically fools proof. It is like using a Samsung mobile versus a Chinese mobile. You know that Chinese products there is no guarantee whereas Samsung has a good guarantee.

The same way oral contraceptive pills if taken regularly it can guarantee you that it will help you from prevention of unwanted pregnancy. Another contraceptive that is an intrauterine contraceptive device. Now this device or a copper T commonly known as is inserted inside the uterus but often it is used only after delivering a child. In a patient who has not never delivered a child, this contraceptive device is not advisable. Let's come to the male contraceptives. Often it is called as so-called protection. Now we get lots of queries about this particular method of contraception that when to apply, how to apply etc. Remember, I want to tell you one important thing any pre-ejaculatory secretions also have a potentiality of causing pregnancy, so therefore, if you are using condoms or barrier contraceptives, it has to be used every time that you have relations right from the beginning to the end of the sexual act.

The combination of various contraceptives can be done in the form of a safe period and a barrier contraceptives. Let me tell you a little bit about it. For a woman who gets periods regularly, that is once every month after 28 to 30 days, she is expected to have ovulation around 14th day of the period. So, from day 9 to day 28 to 0 is called an unsafe period. How will you calculate day 9? You have to calculate it from day one which is the beginning of the first day of the beginning of the bleeding. So accordingly, you can count it and from day 9 to day 20th is unsafe which means pregnancy can occur. Before day 9 and after day 20 is called a safe period, where there is a very very less chance of getting pregnant. So, whenever you are into that unsafe period that's the time where the couple can use barrier contraceptives or condoms and the other days there is no need of any contraceptives. This method is called as a combined method which means calendar method with a safe unsafe period with barrier method is called as a combined method of contraception. There are many other contraceptives like hormonal implants and gels and the spermicides etc, foam but tell you that these are not very often used.

The one which I would like to mention is about the injections. These injections are depo injections, hormonal injections which when given it will have an effect for about six to eight weeks, sometimes even little longer than that but it has to be repeated and mind you the major disadvantage of this particular injection is a breakthrough bleeding which means when a woman is on this particular injection as a contraceptive, she can have a bleeding a little bit of a bleeding any time during the month in the form of a spotting. However, the success rate of this particular method of contraception is really good. So friends, in a very simple way I have tried to explain to you what contraception is. The youths of today are very good with technology, about the mobiles, about the internet, computers, etc, etc.

They bother to find out how and how what is used, what is how it is to be handled, what are the details of it but unfortunately, they do not bother to get correct information about contraceptives from the expertise like gynaecologist. They rely on the various information given by their friends or on the internet or hearsay things or stories and then they get caught into various misconceptions, wrong beliefs and they land up into a very very unwanted situation of an unwanted pregnancy causing distress, anxiety, guilt and many more bad emotions. So, I will advise you that if you are going to go ahead with the sexual activities before ensure making rather ensure that you go to a proper gynaecologist, get yourself examined and take the exact guidance regarding the contraception. It will avoid a lot of unwanted movements in your life. Thank you so much.

Good afternoon everybody!

I am Dr. Anjali Bapat. I am a Gynecologist and I practice at Mahim. Now today I am going to tell you something about PCOS or Polycystic Ovarian Syndrome. Why I'm telling you this is basically because in my practice I come across many young girl from the age group of 20 to 40, who complain of an irregular period. Because of the lot of information on Google as well as in some magazines, on sites, their friends, all of them they conclude that any kind of an irregular period that they are suffering from Polycystic Ovary. Some of them even get extremely scared that ‘’Oh! Mam, I'm I suffering from Polycystic ovary so is it something very very serious’’.

Well what I would put it like this is that Polycystic ovary is over diagnosed and undertreated condition. What I mean is that after doing Sonography many of the patients it is seen that in the ovaries there are multiple cystic polystyrene cysts are present and hence they are labelled as polycystic ovary. Mind you girl that polycystic ovary is not something very difficult to treat or it is not something that is going to cause danger to your life or it is going to cause a problem in the conception once you get married or if you are married then you are thinking of a child. It's a very easily treatable condition. Let me tell you what it is, first of all, some girls have genetic predisposition towards polycystic ovary.

Which I mean is that some of their genes carry certain traits like for example diabetes, diabetes is like a genetically origin. The same way these girls have their autosomes have certain gene which makes them have a polycystic ovary. This particular genetic trait gets exaggerated or get manifested due to various lifestyle issues that this generation is facing. Which are those issues? First and foremost no exercises. We all are very busy we get exemption which means a very tiring body, tiring mind but is not an exercise. Exercise is exactly the opposite of that. There is a physical activity but it releases a lot of hormones like a endorphins, serotonin etc, which in fact releases the stress. So often I see girls who do not either have time or inclination to exercise. Second most important thing is your dietary habits. A large amount of vegetarian people consume mainly carbohydrates, so a high carbohydrate load is another causative factor which causes this kind of a manifestation of polycystic ovary.

The third most important point is the sleep, thanks to Whatsapp, thanks to Facebook and many other internet and other media. Yes, we need to be active on it but to a certain limit. Often we see that at the end of the hectic schedule when goes off to the bed we switch off the light about 12 o'clock or 12:30 and after that on an average about an hour or so we are glued to our screen. This flickering illuminated screen just before going to sleep causes hormonal imbalance. This is the most detrimental thing. The fourth most important point is stress. Stress is basically any situation which we find a bit difficult to deal with. How are we going to eliminate this stress from the surrounding? Unfortunately no. The stresses are going to be plenty what one has to learn is the response to this stress. Hence once all these four factors if you can control naturally the possibility of polycystic ovaries goes down.

As far as the treatment part is concerned, I want to tell you that there is a tried, the first it's a triangle one apex of the triangle is a polycystic ovary, second apex is obesity and the third one is insulin resistance. You understand polycystic ovary, you understand obesity that is increasing the weight. The third one Insulin resistance which is very important. What it is? Insulin resistance is the condition where the cells of our body can not adequately use the carbohydrates that are present in the body. Hence this high load of carbohydrates gets converted into what is slowly gets converted into glycogen and later on into visceral fat. So we typically a lady who is not so fat, who is not so obese, but if we do her body composition her muscle mass is very poor and percentage of a visceral fat is very high. This visceral fat is a big culprit, it causes a lot of hindrance in the metabolic processes.

Hence a control of an obesity, a control of a insulin resistance is absolutely mandatory for the control of polycystic ovary it’s a tried. One is dependent on the other what I means that obesity causes insulin resistance, insulin resistance causes PCOS and vice-versa. So it’s a by double-ended arrows for the triangle. When polycystic ovaries are also having a science of what is called as a Hyperandrogenism, that means the receptors for the androgens on the hair, facial hair, on the scalp hair or on various skin, is very sensitive to the androgens that are present in the body and this causes excessive hair growth of the body parts for the thinning of the scalp hair which is a male pattern of thinning. When such kind of such things are seen symptoms are seen at that time certainly a medication is required from the Endocrinologist out from the Gynaecology. But mine you what I see the PCOS girls that I see a large percentage is the beginners of this PCOS problem.

So with a minimal amount of a medication and most important lifestyle changes one can keep it under control but if you are having a flared up polycystic ovaries don't worry it does not usually cause a problem in the conception and if the problem occurs various assisted reproductive technologies can take care of it. So to conclude, polycystic ovary is the problem of present generation. To control it there means there are methods and you have to use it properly and scientifically. For any of your Gynaecological or Obstetric query, you can definitely contact me. Take my appointment on Lybrate.

I'll be most happy to help you Thank you so much!