Department of Obstetrics

Overview

Obstetrics is the branch of medical science that deals exclusively with pregnancy, the process of childbirth and the time period immediately after child birth (post-partum period). We at Gleneagles Global Hospital understand that these can be extremely stressful periods in women’s lives and we do our best to make them feel safe, comfortable and looked after. Our range of services cover the following:

  • Pre conception counselling and care
  • Pregnancy and delivery
  • High-risk pregnancies
  • Various infertility treatments

We have a team of expert surgeons and support staff who offer nothing but the best in services. Highly skilled, experienced and trained, they have handled both normal and high-risk surgeries with confidence. They are aided by the latest in infrastructure and equipment. Our success rate in infertility treatment is high and we believe that we can keep it that way as we are driven by the need to provide our patients with the highest quality care and comfort.

For some women, pregnancy may be a breeze while not be so for others. We understand that every woman’s need is unique and we strive to tailor our services to individual needs and expectations. We promise to do our best to make sure women have a stress-free pregnancy.

Obstetrics Treatments

Pregnancy care and Childbirth

This involves looking after the mother and the baby before, during and after delivery. The doctor will guide the mother on all the do’s and don’ts during pregnancy. In fact, the groundwork for ensuring a safe pregnancy and delivery starts three months before conception. If pregnancy is being planned, the following will help:

  • Avoiding alcohol
  • Quitting smoking
  • Taking folic acid supplements
  • Letting the doctor know about any previous/current health conditions – also any medications the patient is on should be made known.

During pregnancy, monthly check-ups to review the mother’s health and the growth of the fetus are very important. The frequency of the check-ups might increase towards the end of the pregnancy. The mother’s weight, blood pressure and other parameters will be monitored and blood tests will be prescribed. The doctor will give advice on the kind of exercises that can be carried out and will also guide the mother on the importance of nutritious food during this time. Routine scans will also be done to check on the fetus’ growth and positioning.

High risk pregnancies will need frequent monitoring and what is advisable for a regular pregnancy may not be advisable here. The doctor will guide the patient through every step of the way and easy communication between the doctor and patient is encouraged.

The 4-6 weeks that follow delivery of the baby is called the post-partum period. It is a tough time for all mothers. The body is undergoing a lot of changes and they have to deal with it while taking care of the baby. Mothers who feel overwhelmed should not hesitate to reach out for help. It might be a difficult time but it will pass. During the post-partum period, the following pointers might prove helpful:

  • Eating healthy
  • Trying to sleep whenever the baby sleeps
  • Getting extra help

We at Gleneagles Global Hospital are committed towards making every delivery as peaceful and worry-free as possible. For any questions or doubts, do not hesitate to contact us.

Family Planning procedures

There are various ways by which pregnancy can be avoided and family planning done. A detailed discussion with the doctor would be best before choosing one. Listed below are some of the options:

  • Long-Acting Reversible Contraceptives (LARCs) are an effective means of contraception. They last for a number of years depending on the type chosen and this is definitely an advantage of this kind of birth control. LARCs are intra uterine devices which can be removed when pregnancy is desired. But inserting and removing the device should be done only by doctors.
  • Birth control pills are tablets that are taken to prevent pregnancy; they contain hormones to prevent pregnancy. The duration for which the pills have to be taken depends on the particular pill and will be explained by the doctor. They are quite effective in protecting from pregnancy; if taken regularly.

The main advantage of pills is that they are an easy way of contraception while being reversible. Sometimes they might even help in regularizing periods cycle. They also prevent heavy bleeding during periods and thereby reduce the risk of anemia.

  • Barrier method or condoms while preventing pregnancy also protect from sexually transmitted infections. As the name implies, in this method, a barrier (condom) is placed between the sperm and egg to prevent pregnancy. There are male condoms, female condoms and diaphragms available.
  • Emergency contraception comes in the pill form as well as in the form of a copper intra-uterine device (IUD). The pill should be taken within three days after sex to avoid pregnancy. Weight of the person plays a role and the doctor will help determine which form of emergency contraception is best. The copper IUD should be inserted within five days after sex.
  • Permanent contraception is a permanent method of birth control – having children after undergoing this is not possible. Men can undergo vasectomy and women can undergo tubectomy to avoid any future pregnancies.

Being aware of contraception methods is the responsibility of both the man and the woman. Talking to the doctor to find out the best form of contraception is advised.

Maternal Fetal Medicine

Women who have problems during pregnancy are handled by maternal fetal medicine (MFM) specialists. These specialists have been trained in this field. The following are the typical situations during which an MFM specialist may be required:

  • When the mother suffers from conditions like hypertension, diabetes, auto immune diseases, etc.
  • When the mother has a history of miscarriages or deliveries that are pre-term.
  • The pregnancy involves twins, triplets or more.
  • When an abnormality is found in the developing fetus.

In such cases, an MFM specialist will monitor the pregnancy closely performing ultrasounds, blood tests, etc. If any problem is found with the fetus, the doctor will help manage it. He/she will also advice on future pregnancies.

Healthy Pregnancy

Eat Healthy

The nutrition requirement during pregnancy increases. It is important to make sure the mother gets enough protein, calcium and iron, taking into account the fetus within.

  • Vegetables and fruits intake is always encouraged; with this make sure to add enough dairy products like low fat milk.
  • Whole grains are also recommended.
  • Limiting sugar intake is advised.
  • Processed food is best avoided.
  • Fish is healthy and can be consumed but the fish chosen should be free from mercury. Read up on the fish you are buying to make sure it is healthy.
  • Coffee and tea – it is best to limit both.
  • Juices with a lot of sugar, bottled drinks and energy drinks are not healthy.
  • Alcohol and smoking should be stopped completely.

Avoid Caffeine

Caffeine stimulates the brain thus helping people stay alert. A lot of people begin their day with caffeinated drinks and this is fine as long as it is consumed within safe limits. However, during pregnancy, health experts recommend avoiding caffeine. Coffee, tea, energy drinks, etc. all contain caffeine. This caffeine when consumed by pregnant women can cross the placenta and enter the fetus’ bloodstream.

How can caffeine affect the developing fetus?

  • While less than 200 mg of caffeine is considered safe, more than that seems to be linked to an increase in the possibility of a miscarriage.
  • A baby with low birth weight is another potential side effect of caffeine.
  • Caffeine might also result in hypertension, anxiety, fidgety behavior, etc. for the mother.

Some herbal teas also contain ingredients that are detrimental to pregnancy. Pregnant women are advised to consult with their doctor if they are consuming herbal tea.

Take Prenatal Vitamins

Prenatal vitamins supply the additional vitamins and minerals needed for pregnancy. While eating a healthy diet will give the nutrients the body needs, it is always good to take these supplements during pregnancy just to make sure the body receives everything needed. Doctors suggest that these vitamins can be started even while trying to conceive.

Make sure a pregnant woman’s vitamins and minerals include (but are not limited to) the following:

  • Folic Acid – It helps prevent neural tube problems in the baby. Folic acid is given in the first trimester of pregnancy. Green leafy vegetables, nuts, beans, etc. are all good sources of folic acid.
  • Iron is needed to prevent anemia.
  • Calcium is needed for blood circulation, muscle movement and for maintaining hormones with proper balance. It is also needed for healthy bones and teeth. Calcium and vitamin D intake go hand in hand as vitamin D is needed for the body to absorb the calcium.
  • Zinc is responsible for good immunity, growth, healing and a host of other benefits.
  • Vitamin B12, also known as cobalamin, is good for a number of functions like RBC formation, preventing defects in fetus, reducing miscarriage risk, etc.

Exercise Regularly

If the pregnancy is normal (not a high-risk one), exercise is recommended. Before starting any form of exercise, it is best to discuss it with the doctor. Once the doctor gives the go ahead, regular exercising can begin.

Benefits of Regular Exercise

  • Prevents the onset of gestational diabetes
  • Prevents excess weight gain
  • Keeps the heart functioning well
  • Can help with back ache
  • Plays a role in preventing constipation

Regular Antenatal Check-Ups

Periodic consultations with the doctor (obstetrician) during pregnancy are called ante-natal check-ups. These check-ups will help make sure the mother and baby are both normal and pregnancy is progressing as desired. Women are advised not to skip these check-ups even if everything is proceeding normally. The body at this time will be undergoing many changes and any doubts/questions can also be cleared with the doctor. Dietary advice, how to exercise and the do’s and don’ts of pregnancy will also be discussed.

To summarize, an ante-natal check-up will involve the following:

  • Scans and blood tests
  • Evaluating any pre-existing health conditions
  • Monitoring medication taken for other health issues
  • Regular monitoring of blood pressure and weight gain
  • Clearing doubts about the changes that pregnancy brings

There will be around 8-10 ante natal visits. A high-risk pregnancy will involve more. Partners are encouraged to attend these visits and to stay involved with the pregnancy.

Pre-Conception Counselling

When couples are considering having a baby, they should go in for pre-conception counselling that will help them have a healthy and happy pregnancy period. Typically, the first session should be around 3 months ahead of when the pregnancy is planned.

Pre-conception counselling will cover the following aspects:

  • The family medical history of the parents-to-be. If there are any conditions that seem to be genetic in the family, having knowledge of it will help the doctor provide appropriate treatment. If needed, additional tests may be recommended for this purpose.
  • Medical condition of the couple themselves will be discussed. The doctor should be informed about any previous surgeries, allergies, medication being taken, etc. The doctor might suggest tests like Pap smear or blood tests.
  • The best dietary plan will be discussed. Vitamin supplements may also be prescribed.
  • The doctor will want to know the duration and regularity of the mother’s periods.
  • Information about the vaccines taken and any additional vaccines needed will be discussed.

Care for Emotional Health

Every woman handles pregnancy differently – some may sail through it while others may have a slightly more difficult time. Pregnancy is a period that brings on some never before experienced changes. The body is changing and women might experience mood swings, fatigue, increased morning sickness, etc. With all this going on, women need to focus on what brings them happiness. This is important because what affects the mother, affects the baby too. The following pointers might help with emotional well-being.

  • Indulging in art, listening to music, maybe even learning something new.
  • Bottling up feelings does not help – women are encouraged to talk with their partners, friends, etc. If needed, even professional help may be sought.
  • Exercising regularly is definitely a mood booster.
  • Eating healthy food also gives a sense of well-being.
  • Practicing meditation helps immensely.
  • Staying away from negativity can give mental peace.

Why Choose Us?

Patient Experience

We at Gleneagles Global Hospital always do our best to ensure a happy pregnancy. We believe that pregnancy is a beautiful journey and we want our expectant mothers to have nothing but the happiest of memories. A happy mother automatically translates to a happy baby and it is our goal to make every mother’s pregnancy untroubled and relaxed. Our best moments are when the mothers return to us after delivery, to thank us for ensuring the safe delivery of their bundles of joy. For us, our doctors and our entire support staff, it is indeed an honour to have been a part of your motherhood journey and we hope to be a part of many more!

Patient Experience

Latest Technologies

Gleneagles Global Hospital is committed towards providing the best quality healthcare and anyone treated by us will know that we never compromise on anything – be it our highly skilled and experienced doctors, our well-trained support staff or the best in technology and infrastructure. It is our belief that our doctors need to have access to the best technology to render the finest of care. Healthcare is a field that is constantly evolving and we make sure we stay up to date with the latest advancements made in it.

Latest Technologies

Providing Quality Care

We take pride in providing superior quality care for the mother and the baby. Our strength lies in being able to understand the unique needs of pregnant women – treatment with empathy and the patient’s best interest in mind, form the core of our approach. Our staff’s commitment to this purpose will be visible to every patient who enters our premises. We believe in communicating with our patients and encourage them to voice out their concerns and questions to us.

Providing Quality Care

Diseases and Treatments

Ectopic Pregnancies

Ectopic Pregnancies Overview

In a normal pregnancy, the fertilized egg will grow in the uterus. In an ectopic pregnancy, the egg lodges in the fallopian tube (or in places other than uterus). No pregnancy can proceed outside the uterus. Hence, they will need to be terminated. Left untreated, an ectopic pregnancy may become a condition requiring emergency treatment.

Causes and Risk Factors of Ectopic Pregnancies

  • Damaged fallopian tubes
  • Congenital defect
  • Previous abortions
  • Patient has suffered from pelvic inflammatory disease or endometriosis
  • Conception happens in spite of using birth control methods
  • Pregnancy happens by treatments/fertility medication
  • Smoking

Signs and Symptoms of Ectopic Pregnancies

  • Vomiting
  • Extreme pain on one side of the abdomen
  • Bleeding
  • Feeling of faintness
  • Breasts might hurt

Complications of Ectopic Pregnancies

  • If the tube ruptures or breaks, it needs immediate treatment as it could become fatal otherwise
  • There is a chance of more ectopic pregnancies happening
  • Might necessitate removal of fallopian tube

Diagnosis of Ectopic Pregnancies

  • A transvaginal ultrasound to check for the presence of a gestational sac. An absent sac inside uterus might mean an ectopic pregnancy.
  • Checking for hormones hCG and progesterone.

Surgery of Ectopic Pregnancies

In the initial stages (unruptured fallopian tube) the doctor will treat with methotrexate. When effective, it will terminate the pregnancy.

Sometimes surgery may be done for the removal of the pregnancy inside tube and to repair any damage done internally. If the fallopian tube is badly damaged, its removal will also be necessary.

Prevention of Ectopic Pregnancies

The following might help prevent ectopic pregnancy.-

  • Not having many sexual partners which will increase the risk of sexually transmitted diseases and PID which may result in an ectopic pregnancy.
  • Undergoing regular gynecological examination.
  • Quitting smoking.

Miscarriages

Miscarriages Overview

When a pregnancy aborts on its own before 20 weeks, it is referred to as a miscarriage. It usually happens when the fetus does not develop as it should.

Signs and Symptoms for Miscarriages

  • Lower abdominal pain
  • Vaginal bleeding
  • A fluid coming from the vagina

Causes and Risk Factors for Miscarriages

  • Chromosomal Defects – The chromosomes might be extra in some cases while it could be missing in others.
  • The mother having problems like diabetes with extremely high sugar levels, imbalance of hormones, thyroid disorder, problems with the uterus/cervix, etc.
  • Mother’s age over 35.
  • History of miscarriages.
  • Being obese or underweight.
  • Smoking, alcohol and illicit drugs can cause miscarriage.

Complications for Miscarriages

When a miscarriage happens and the tissue is not removed fully from the uterus, it could lead to a condition called septic miscarriage. Here, the remnant tissue gets infected by bacteria. The mother might experience fever, chills, pain in the lower abdomen and vaginal discharge that has a bad odor. A septic miscarriage is a serious condition that requires emergency treatment. Left untreated, it could lead to septic shock and even organ failure.

Surgery for Miscarriages

Once the miscarriage takes place, an ultrasound will be done to check if the uterus is completely clear.

Sometimes, the doctor may recommend a surgery called D&C (dilatation and curettage). It is a short procedure done when the bleeding is heavy, when there are warning signs of infection or if the mother experiences pain. During the procedure, the doctor will remove tissue remnants from the uterus.

Prevention for Miscarriages

  • Smoking, alcohol and drugs should be stopped.
  • Any health condition should be managed and kept under control.
  • It is recommended that caffeine intake be reduced.
  • Undergoing regular check-ups when pregnant.

Gestational Diabetes Mellitus

Gestational Diabetes Mellitus Overview

Diabetes refers to an increase in sugar levels. When the onset of diabetes happens during pregnancy, it is called gestational diabetes. Women diagnosed with gestational diabetes have no previous medical history of diabetes.

Signs and Symptoms for Gestational Diabetes Mellitus

There are no obvious signs for gestational diabetes. It is usually discovered during the blood tests that happen during pregnancy. However, women can watch out for the following signs:

  • An urge to urinate often
  • Excessive thirst
  • Excessive hunger

Causes and Risk Factors for Gestational Diabetes Mellitus

Normally, the pancreas produces insulin whose function is to move the glucose (sugar) from the blood into the cells. In women with gestational diabetes, the hormones produced during pregnancy increase the glucose in the blood. Usually, the pancreas will produce more insulin to counter this. But, if it does not or if the insulin does not do its function effectively, it causes an increase in sugar leading to gestational diabetes.

Risk factors include:

  • Being obese/overweight
  • Family history of diabetes
  • Hypertension, high cholesterol, pre-diabetes or PCOS
  • The mother being more than 25 years of age
  • Previous miscarriage

Complications for Gestational Diabetes Mellitus

  • Possibility of developing type 2 diabetes later
  • Baby might be still born
  • Baby might be big

Diagnosis of Gestational Diabetes Mellitus

Glucose tolerance test: During the test, the mother will have to consume a sweet drink with 50 gm of glucose in it. The sugar level will be tested in an hour. If the level is higher than normal, the doctor will provide guidance on treatment.

Treatment for Gestational Diabetes Mellitus

  • A healthy diet (low in sugar)
  • Regular exercise
  • Monitoring of blood sugar 4 times a day
  • Testing for ketones which can give an idea of whether blood sugar is under control
  • Insulin and other medication

Prevention for Gestational Diabetes Mellitus

  • Starting off pregnancy with the ideal weight
  • Following a healthy lifestyle – nutritious diet and regular exercise

Gestational Hypertension

Gestational Hypertension Overview

When women develop high blood pressure during pregnancy – more than 140/90 mm Hg – they are said to have a condition called gestational hypertension. It is usually diagnosed at around 20 weeks of pregnancy; if the mother is having twins, it can even set in earlier.

Signs and Symptoms for Gestational Hypertension

  • Increase in blood pressure
  • Headache
  • Vision is blurred or other vision changes are experienced
  • More than normal increase in weight
  • Vomiting
  • Stomach pain
  • Passing very little urine

Causes and Risk Factors for Gestational Hypertension

Although there are no known causes, the following might increase the risk of gestational hypertension:

  • Having had gestational hypertension with the previous delivery
  • Being diabetic
  • Kidney problem
  • When the mother is less than 20 years or more than 40 years
  • Having twins or more

Complications for Gestational Hypertension

  • Premature or low birth weight babies
  • Blood flow to the baby is reduced
  • Possible kidney damage
  • The mother has a possibility of becoming a hypertensive after the pregnancy
  • Possibility of preeclampsia and eclampsia

Diagnosis for Gestational Hypertension

  • Checking blood pressure
  • Urine analysis
  • Tests to check functioning of liver and kidney
  • Swollen feet

Treatment for Gestational Hypertension

Treatment depends on the symptoms. Options include:

  • Regular checking of blood pressure
  • Various scans to make sure the baby is alright
  • Sometimes, medication like corticosteroids is prescribed

Prevention for Gestational Hypertension

Preparing for the pregnancy by maintaining ideal weight will help in prevention. The mother should make sure she eats healthy food and works out actively. Not missing any appointments with the doctor will help in early detection.

Procedures

Normal Delivery

A natural way to deliver the baby, normal delivery or vaginal birth, is delivery that happens on its own without any external assistance. Normal delivery is what is preferred unless complications are expected. It can be divided into three stages:

Stage 1: This stage sets in with contractions beginning. Dilation of the cervix happens in preparation for the baby’s delivery. The duration of this stage varies form 7-13 hours depending on whether it is the mother’s first or second baby. If it is the first child, delivery will take longer.

At the commencement of this stage, contractions will be spaced apart with the cervix dilating up to 4 cm. Slowly, the contractions will increase in strength and frequency. Dilatation of the cervix increases further to 7cm. The water is expected to break at this stage and once that happens, contractions become more frequent. Full dilatation of the cervix then happens (10 cm).

Stage 2: This stage involves the birth of the baby. The mother will be encouraged to push the baby with every contraction. The mother will experience pain and fatigue. The doctor might decide to do an episiotomy, which is a cut near the vagina, to make it easier for the baby to come out. The baby coming out concludes this stage.

Stage 3: The placenta which nurtured the fetus inside the uterus is now pushed out. This might take any time between few minutes to half an hour after the baby is born.

Advantages of a Normal Delivery

  • Risk of infection is low
  • Faster recovery period
  • Normal delivery sparks milk production in the mother (lactation)
  • Baby’s immunity is increased
  • Baby has reduced risk of respiratory issues

Caesarean Delivery

Caesarean, also known as C-section, is the surgical way of delivering a baby – it is usually done when a normal delivery is not advisable due to complications. This procedure involves making incisions in the mother’s lower abdomen and uterus to deliver the baby. Caesarean is not performed before 39 weeks of pregnancy so that the baby’s development is complete. However, if there is an emergency situation, caesarean can be performed before 39 weeks.

The surgery will be performed under anesthesia and the doctor will let the patient know the anesthesia options available. Hospitalization of around 3 days will be needed and even after discharge the mother will need help till healing is complete. The doctor will give painkillers to deal with any post-operative pain.

When is a caesarean done?

  • When the baby is very big
  • When it is a breech birth – baby’s legs come out first
  • Fetal distress – fluctuations in baby’s heart rate

Recovery after a caesarean takes longer compared to a normal delivery. The following tips might help:

  • The mother needs enough rest to recover fast. Getting help from family/friends or maybe even hiring extra help are all options to be considered.
  • Strenuous activity (including lifting anything heavy) should be avoided.
  • Gentle exercise like going for a walk is advisable.
  • Good nutrition is important even after delivery and the lactating mother has to make sure she eats healthy food and consumes enough fluids.

Ventouse Delivery

This is a vaginal delivery that is assisted by a ventouse (vacuum cup). This delivery might be decided upon when one of the following conditions is true:

  • When the mother is too tired to push the baby out
  • When the baby’s heart rate is not normal in second stage of labour, with baby’s head well descended in vagina.

In such cases, a vacuum cup is fixed to the baby’s head and the baby is gently pulled out through the vagina. An episiotomy can be done to aid delivery. Sometimes, instead of a ventouse, forceps will be used to assist delivery. If the doctor feels that the ventouse delivery is not going as planned, she might opt for a caesarean.

Vaginal Birth After Caesarean – VBAC

When the first child has been delivered through a caesarean, many people are under the impression that a caesarean for the second child is the only choice. However, this is not so. A vaginal birth after having undergone a caesarean is possible. It is important to note that some factors play a role in determining whether a VBAC is possible – the uterus should be strong enough to handle a vaginal birth after a caesarean and the hospital should have experienced surgeons and the necessary infrastructure to handle it. The doctor is the best person to judge if VBAC is a viable option.

Signs that help determine whether VABC is suitable for a woman include:

  • Previous VBAC done
  • Woman is lesser than 35 years of age
  • If the previous caesarean involved a horizontal incision and not a vertical one

Some scenarios rule out the possibility of VBAC. These include:

  • A vertical incision in the previous cesarean
  • A difficult labour which does not proceed quickly
  • If the pregnancy period is more than 40 weeks
  • Baby is large
  • Multiple cesareans previously
  • Mother suffers from heart or lung conditions

VBAC has the following benefits:

  • Lowered risk of infection
  • No incisions on the abdomen
  • Quicker recovery
  • Decreased loss of blood

The risk associated with VBAC – the scar in the uterus from the previous cesarean might break open during a VBAC. This condition called a uterine rupture might necessitate an emergency cesarean. Hence VBAC can be tried only in the hospitals which have the required infrastructure to handle it.

The VBAC procedure will be the same as a normal delivery. An option of epidural for pain management is also possible. It is best to talk to the doctor and get all doubts cleared before deciding on it.

Our Doctors

Dr Padmapriya Vivek
Dr Padmapriya Vivek

MBBS, MD(OBG), Diploma in Reproductive Medicine(Germany)

Head of the Department - Obstetrics, Gynaecology & Fertility Medicine

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