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OBSTETRICS
&
GYNAECOLOGY
Team that Cares
Meet our team of qualified medical professionals who are adept in handling every situation with relative ease, composure and care.
Dr. (Mrs.) Kanwal Preet Gandhi
M.B.B.S. ,M.D., D.G.O.
Dr. Shabnam Khare
M.B.B.S. ,M.D.
Dr. Savana C. Rajkumari
M.B.B.S. ,M.D.
Dr. Pratibha Aggarwal
M.B.B.S., M.D.
Dr. Dolly Marya
M.B.B.S., M.D.
Dr. Sharmila Lal
M.B.B.S. , M.D.

A full-fledge women’s health care unit at Sukhmani Hospital makes our gynaecologist precisely cater to the assorted heath care of women including issues related to adolescence, reproductive years and problems of older age. We have highly sophisticated labour rooms, which are incorporated with modern amenities, monitoring systems, & equipment. The expert doctors, qualified staff & advanced facilities make us assure that every woman who visits us for her problem is in safe hands.

Note:- Please click on the bar to know mare...
Mama’s Nest

First, congrats on your mom-to-be status! As for your delivery jitters, you’re not alone. Plenty of first-time moms (and dads) get anxious about the labor-and-delivery process, especially the hospital part.es. Take a deep breath, Mama — your experience will likely be much different. Plus, at the end, you get a beautiful baby. Think about that whenever your nerves get rattled!

In the meantime, here’s a sneak preview of your journey for the next nine months.

FIRST TRIMESTER

The first trimester spans from week 1 to week 12 of your pregnancy.

On your first visit to our gynecologist after your pregnancy in confirmed, we ask you to undergo an Ultrasound (6 – 7 wks) to confirm viability & maturity and a list of essential blood tests. If all is well, we provide you the road map to a successful pregnancy; this includes a healthy diet plan; instructions of do’s and don’ts; ready list of answers to frequently asked queries to avoid problems list below….

BLEEDING- About 25% of pregnant women experience slight bleeding during their first trimester. However, if you have significant bleeding, cramping, or sharp pain in your abdomen, call your doctor.

BREAST TENDERNESS- Sore breasts are one of the earliest signs of pregnancy. Increasing a bra size and wearing a support bra can make you feel more comfortable.

CONSTIPATION- To avoid constipation increase your fiber intake and drink extra fluids. Physical activity can also help. If your constipation is really bothering you, talk to your doctor about what mild laxative or stool softeners are safe to use during pregnancy.

DISCHARGE- It's normal to see a thin, milky white discharge early in your pregnancy. If the discharge is foul-smelling, green, or yellow, or if there's a lot of clear discharge, see your doctor.

FATIGUE- Your body is working hard to support a growing fetus, which can wear you out more easily than usual. Take naps or rest when you need to throughout the day.

SECOND TRIMESTER

The Second trimester spans from week 13 to week 28 of your pregnancy.

As you enter your second trimester of pregnancy, the morning sickness and fatigue that plagued you during the last three months should be fading, leaving you feeling more energetic and like your old self again.

In your second trimester, we ask for a Level II ultrasound scan (18 – 20 weeks) to detect anomalies and two shots of Tetanus are given at the interval of one month. As you are getting ready, we provide you with the power point presentation on antenatal yoga which helps you to deliver normally.

Although you should be feeling better now, big changes are still taking place inside your body like,

BACKACHE- The extra weight you've gained in the last few months is starting to put pressure on your back, making it achy and sore. If the pain is really uncomfortable, see a doctor.

BREAST ENLARGEMENT- Much of the breast tenderness you experienced during the first trimester should be wearing off, but your breasts are still growing as they prepare to feed your baby.

THIRD TRIMESTER

The third trimester spans from week 29 to week 40 of your pregnancy. Now that you've reached the third trimester, you’ve only got a few more weeks to go, but this part of your pregnancy can be the most challenging.

Backache- The extra weight you've gained is making you feel discomfort in your pelvis and hips as your ligaments loosen to prepare for labor. To ease the pressure on your back, practice good posture.

Braxton Hicks contractions- You might start to feel mild contractions, which are warm-ups to prepare your uterus for the real labor to come. They may feel a lot like labor and can eventually progress to it. One main difference is that real contractions gradually get closer and closer together -- and more intense.

Breast enlargement- By the end of your pregnancy, your breasts will have grown. You may start to see a yellowish fluid leaking from your nipples. This substance, called colostrum, will nourish your baby in the first few days after birth.

>Discharge- You might see more vaginal discharge during the third trimester. If the flow is heavy enough to soak through your panty liners, see your doctor.

Bleeding- Spotting may sometimes be a sign of a serious problem, Call your doctor as soon as you notice any bleeding.
At the end of the third trimester an ultrasound is recommended to check the position of the baby to facilitate a normal delivery.

Preparing you for Labour

Labour moves forward in three clear stages.

  • First stage: when contractions gradually open up the neck of your uterus (cervix). It consists of early labour, active labour, and the transitional phase.
  • Second stage: when you push your baby out into the world.
  • Third stage: when you deliver the placenta.
What happens in the first stage of labour?

During pregnancy, your cervix is closed and plugged with mucus, to keep out infection. Your cervix is long and firm, giving a strong base to your uterus (womb). It's also in a position that points slightly towards your back (posterior position).

In the first stage of labour, your cervix has to move forward (anterior position), ripen and open, so your baby can be born. By the end of this stage your cervix will be fully dilated, and open to about 10cm (3.9in) in diameter.

What happens in the second stage of labour?

During the second stage of labour, you will push your baby down your vagina (the birth canal) and meet him or her for the first time.

You'll feel the pressure of your baby's head low down in your pelvis, and with each contraction, may have two or three strong urges to bear down. Listen to your body, and let it push in response to the urges. Take a few breaths between pushes.

With every bout of bearing down, your baby will move through your pelvis a little, but at the end of the contraction, he'll probably slip back a little again. Don't despair. As long as your baby keeps gradually moving down, you're doing fine.

When your baby's head is far down in your pelvis, you'll probably feel a hot, stinging sensation. This will happen as the opening of your vagina starts to stretch around your baby's head. At this time feces frequently are expelled by most of you. Now you are ready for the delivery. We get you in the lithotomy position.

Once we see your baby's head, we give an episiotomy ( incision on perineum ) so that your baby is born gently and slowly.

What happens in the third stage of labour?

The third stage of labour begins once your baby is born, and ends when you deliver the placenta and the empty bag of waters that are attached to the placenta (membranes). These come away as your uterus contracts down after the birth.

Your contractions will be noticeable but weaker when they begin again, as your uterus (womb) contracts down. The placenta gradually peels away from the wall of your uterus, and you may get the urge to push again. The placenta, with the membranes attached, will drop to the bottom of your uterus (womb), and out through your vagina.

When the third stage is complete, you can spend a little time getting to know your new baby.

Ectopic Pregnancy - Treatment

A pregnancy is ectopic when it occurs outside the womb (uterus) womb. Ectopic means 'misplaced'. An ectopic pregnancy is treated right away to avoid rupture and severe blood loss. The decision about which treatment to use depends on how early the pregnancy is detected and your overall condition. For an early ectopic pregnancy that is not causing bleeding, you may have a choice between using medicine or surgery to end the pregnancy.

Medicine

Using medication to end an ectopic pregnancy spares you from an incision/ scar and anaesthesia.

  • If your pregnancy hormone levels (human chorionic gonadotropin, or hCG) are low (less than 5,000).
  • When the embryo has no cardiac activity.
Surgery

If you have an ectopic pregnancy that is causing severe symptoms, bleeding, or high hCG levels, surgery (Laproscopic/ Laprotomy) is usually needed. This is because medicine is not likely to work and a rupture becomes more likely as time passes. Where possible, laparoscopic surgery that uses a small incision is preferred. For a ruptured ectopic pregnancy, emergency surgery is as early as possible.

Expectant management

For an early ectopic pregnancy that appears to be naturally miscarrying (aborting) on its own, you may not need treatment. Your doctor will regularly test your blood to make sure that your pregnancy hormone (hCG, or human chorionic gonadotropin) levels are dropping. This is called expectant management.

Surgery may be your only treatment option if you have internal bleeding.
Hysterectomy (All you wanted to know)

A hysterectomy is an operation to remove a woman's uterus. A woman may have a hysterectomy for different reasons, including:

  • Uterine fibroids that cause pain, bleeding, or other problems
  • Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal
  • Cancer of the uterus, cervix, or ovaries
  • Endometriosis
  • Abnormal vaginal bleeding
  • Chronic pelvic pain
  • Adenomyosis, or a thickening of the uterus

Hysterectomy for non cancerous reasons is usually considered only after all other treatment approaches have been tried without success

Types of Hysterectomy

Depending on the reason for the hysterectomy, a surgeon may choose to remove all or only part of the uterus. Patients and health care providers sometimes use these terms inexactly, so it is important to clarify if the cervix and/or ovaries are removed:

  • In a supracervcial or subtotal hysterectomy, a surgeon removes only the upper part of the uterus, keeping the cervix in place.
  • A total hysterectomy removes the whole uterus and cervix.
  • In a radical hysterectomy, a surgeon removes the whole uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina. Radical hysterectomy is generally only done when cancer is present.

The ovaries may also be removed -- a procedure called oopherectomy -- or may be left in place.

Surgical Techniques for Hysterectomy

Surgeons use different approaches for hysterectomy, depending on the surgeon’s experience, the reason for the hysterectomy, and a woman's overall health. The hysterectomy technique will partly determine healing time and the kind of scar, if any, that remains after the operation.

There are two approaches to surgery – a traditional or open surgery and surgery using a minimally invasive procedure or MIP.

Open Surgery Hysterectomy

An abdominal hysterectomy is an open surgery. This is the most common approach to hysterectomy, accounting for about 65% of all procedures.

To perform an abdominal hysterectomy, a surgeon makes a 5 to 7 inch incision, either up-and-down or side-to-side, across the belly. The surgeon then removes the uterus through this incision.

On average, a woman spends more than three days in the hospital following an abdominal hysterectomy. There is also, after healing, a visible scar at the location of the incision.

MIP Hysterectomy

There are several approaches that can be used for an MIP hysterectomy:

  • Vaginal hysterectomy: The surgeon makes a cut in the vagina and removes the uterus through this incision. The incision is closed, leaving no visible scar.
  • Laparoscopic hysterectomy (TLH): This surgery is done using a laparoscope, which is a tube with a lighted camera, and surgical tools inserted through several small cuts made in the belly or, in the case of a single site laparoscopic procedure, one small cut made in the belly button. The surgeon performs the hysterectomy from outside the body, viewing the operation on a video screen.
  • Laparoscopic-assisted vaginal hysterectomy (LAVH) : Using laparoscopic surgical tools, a surgeon removes the uterus through an incision in the vagina.
Abortion (MTP)

An abortion is when the pregnancy is ended so that it does not result in the birth of a child. Sometimes this is called 'termination of pregnancy'.

The pregnancy is removed from the womb, either by taking pills (medical abortion) which involves taking medicines to cause a miscarriage or by surgery (surgical abortion) where the pregnancy is removed from the womb. Most abortions can be done on a day care basis which means you do not need to stay at a clinic overnight.

When can an abortion be done?

It will depend on how many weeks pregnant you are. You may have a choice between a medical abortion (which means taking medicine to end the pregnancy) and a surgical abortion such as vacuum aspiration or dilation and evacuation (D&E).

After 9 weeks, surgical abortion is usually the only option. The risks from having an abortion in the second trimester are much higher than in the first trimester

Adolescent Gynecology

Many young women have special needs and concerns about changes in their bodies. We at Sukhmani, specialize in adolescent gynecology by providing the kind of one-on-one care young women want in an atmosphere that allows them to feel comfortable talking about their health.

In addition to providing initial or routine gynecologic care, we provide care for adolescents with a variety of gynecologic problems, including:

  • Menstrual irregularities
  • Heavy bleeding
  • Missed periods
  • Menstrual cramps
  • Delayed first period
  • Pelvic pain
  • Vaginal and pelvic infections
  • uneven breast growth
  • Breast lumps
  • Vaginal discharge

We offer counseling and educational materials about contraception and prevention of sexually transmitted disease.

Preconception Counseling

There are many important steps that a couple needs to take when getting ready to conceive a child. It is very important that both partners are prepared both physically and emotionally for this life-enhancing event.

The first step is to inform us that you are ready to talk about getting pregnant and you would like to schedule an appointment. At the appointment, we will probably have a routine set of questions and tests that we give to a couple preparing for pregnancy.

Here is some background information for that first visit to the Ob/Gyn

The Doctor Visit

The visit to your doctor should occur at least three months before you want to begin trying to get pregnant. This visit should include a full physical examination including a Pap smear and cervical cultures, as well as blood tests. These blood tests will test you for anemia, and your immunity to rubella and chicken pox. If you are not immune to one or both of these viral infections, you may need to be vaccinated. In this case, it is best to wait three months before trying to conceive.

Genetic disorders

You and your partner should also undergo genetic counseling and testing prior to becoming pregnant. Based on each partner's family history, targeted tests can be performed to find out whether a couple is at risk for having a child with certain diseases. Some examples include Tay Sach's disease, most commonly seen in those of Ashkenazi Jewish decent, sickle cell anemia, most common in African Americans, and cystic fibrosis, which is most common in Caucasians. If both husband and wife are carriers of a certain disease, there is a technique available to prevent passing on any disease to the child. The technique requires, however, that a couple go through in vitro fertilization, often a very expensive procedure. If you and your partner are both carriers of a genetic disease, it is best to discuss your pregnancy options with a genetic counselor

Sexually transmitted diseases

Sexually transmitted diseases (STD's) can also have an effect on a woman's fertility. We take your detailed medical history and may decide to perform cervical cultures or blood tests to prove that there are no infections that would hinder your ability to conceive. STD's, like chlamydia, gonorrhea and genital herpes, can effect your ability to conceive by causing scarring of the fallopian tubes. Recently, mycoplasma (a type of bacteria) has been identified as an agent that may be capable of preventing couples from getting pregnant. If any of the tests are positive, antibiotics can be prescribed to kill the bacteria in both partners. It is usually recommended that a couple abstain from intercourse until the infection is completely cured.

Perimenopause

Perimenopause, or menopause transition, is the stage of a woman's reproductive life that begins several years before menopause, when the ovaries gradually begin to produce less estrogen. It usually starts in a woman's 40s, but can start in a woman's 30s or even earlier.

Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last one to two years of perimenopause, this decline in estrogen accelerates. At this stage, many women experience menopausal symptoms.

How Long Does Perimenopause Last?

The average length of perimenopause is four years, but for some women this stage may last only a few months or continue for 10 years. Perimenopause ends the first year after menopause (when a woman has gone 12 months without having her period).

What Are the Signs of Perimenopause?

You may recognize perimenopause when you begin experiencing some or all of the following symptoms:

  • Hot flashes
  • Breast tenderness
  • Worsening of premenstrual syndrome
  • Decreased libido (sex drive)
  • Fatigue
  • Irregular periods
  • Vaginal dryness; discomfort during sex
  • Urine leakage when coughing or sneezing
  • Urinary urgency (a pressing need to urinate more frequently)
  • Mood swings
  • Mood swings
How Do I know If Changes in My Periods Are Normal Perimenopausal Symptoms or Something to Be Concerned About?

Irregular periods are common and normal during perimenopause. But other conditions can cause abnormalities in menstrual bleeding. If any of the following situations apply to you, see a doctor to rule out other causes:

  • Your periods are very heavy or accompanied by blood clots
  • Your periods last several days longer than usual
  • You spot between periods
  • You experience spotting after sex
  • Your periods occur closer together

Potential causes of abnormal bleeding include hormonal imbalances, birth control pills, pregnancy, fibroids, blood clotting problems or rarely cancer.

How Is Perimenopause Diagnosed?

Often we can make the diagnosis of perimenopause based on your symptoms. Blood tests to check hormone levels may also be beneficial, but they may be difficult to evaluate due to erratic fluctuations of hormones during this period. It may be more helpful to have several tests done at different times for comparison.

CONTRACEPTION
Intrauterine Contraceptive Device (IUCD)
What Is an IUCD?

An Intrauterine Contraceptive Device (IUCD) is a device which is inserted into the uterus to prevent pregnancy. There are many types of IUCDs and they come in different shapes and sizes. Commonly used types are IUCDs containing copper.

When Should The IUCD Be Fitted?

The IUCD is best inserted towards the end of menstrual flow because it is at this time that you are unlikely to be pregnant, and the neck of the womb, being softer and slightly open, makes insertion easier. An IUCD can also be inserted during the termination of pregnancy procedure.

Is The IUCD Harmful To The Body?

No. The IUCD is as safe as any other contraceptive method and it does not cause cancer.

What Are The Advantages Of The IUCD?
  • It is 98% effective in preventing pregnancy.
  • It requires only one insertion for prolonged protection
  • It can remain in the uterus for 3 - 5 years depending on its effectiveness, after which, a change of IUCD may be necessary.
  • It is readily reversible and there is no reduction in fertility after the IUCD is removed.
  • It does not interfere with sexual relations and it fact, may improve marital relations because there is no fear of an unwanted pregnancy. During sexual intercourse, you and your partner should not be able to feel either the IUCD or the fine thread that is attached to the IUCD.
What Are The Risks With IUCD?

Some women may experience abdominal cramps, slightly heavier periods and vaginal discharge after IUCD insertion. However, these symptoms usually disappear after 2 - 3 months.

Is Check-ups Necessary After the IUCD Has Been Inserted?

Yes..! It is important that you see us for regular check-ups after the IUCD has been inserted. We will advise you on the frequency.

STERILIZATION

Sterilization is a permanent form of birth control that either prevents a woman from getting pregnant or prevents a man from releasing sperm.

1. LAPAROSCOPIC TUBECTOMY (Female sterilization)

Laparoscopic tubectomy surgery is an effective, reliable and permanent method for contraception to avoid unwanted pregnancy. It is a common choice for women who have completed their family as it is simple with shorter hospital stay. We believe in performing safe and successful surgery with the help of most modern health care equipments.

2. VASECTOMY (Male sterilization)

A vasectomy is a form of contraception that involves surgically cutting or blocking the tubes that transport sperm.

TYPES OF PROCEDURE

No-scalpel vasectomy – Takes about 20 -30 minutes to perform.

Conventional vasectomy – Takes about 30 -35 minutes to perform