Meconium Aspiration Syndrome (MAS)

Meconium is the stool which baby passes inside the mother's womb.It usually happens when baby is in distress,getting reduced oxygen which leads to dilatation of anus and thus passage of stool.All cases of
Meconium don't need a caesarean section but at the same time it isn't a very easy situation for the obstetrician.As the meconium starts to thicken baby can aspirate it in the lung with problems of various severity.
Last month only I did manage to deliver two ladies with thin meconium vaginally,but yes I do get stressed while waiting.It is no win situation for the doctor.If you say it calls for caesarean patients don't like it.If you wait and baby's aspirates it(no one can predict beforehand whether baby will or won't)then it is the doctor who gets all the beating.
In last two days I came across two ladies who are second time pregnant and both had bad experiences due to MAS in 1st pregnancy.First one lost her new born child and the second one has a child with Cerebral palsy.MRI of this Child done at the time of birth is suggestive of lack of oxygen during labour.Both of them were understandably sad and blamed their Gynaecologists.While as a neutral person I couldn't find fault in management of either of the doctor.It was sheer bad luck both for the doctor and the patient.
We need to understand that doctors are no God.They can try their best but after some point there is a supreme power who decides all our fates.
And after these two incidents which I came across this week,my threshold for performing caesarean following passage of meconium would be much less.

Prevention is better...........

How many of you have been for a preventive health check up?Many of you have been and most of you have not been for one.At least till date I haven't got a preventive health check up done.Some of us think that'' I don't need it.These deadly diseases affect others not me", while others are too scared to go for it.What if there is something wrong?I belong to the second category.
But not any more.Have decided to go for a Preventive health check up soon.Even if there is a disease it can be detected early and can be fixed.
Someone close in family was detected with a breast cancer recently.Luckily for her it was still very early and hopefully she has many more years in front of her to live and enjoy life.But she is just like you and me,who enjoys life,young with young kids and no symptoms at all .About a week back she was oblivious of even her condition and celebrating life.A week later she has been operated for her cancer.It is shocking.I have been asking myself a question,if it could be her why it can't be me?Of course it can be me and you too.
Plan your Preventive health check up if it is due. And all the best .Wish you many more years of healthy and happy life.

Vaginal Delivery ,has it got anything to do with doctor's skills?

What do you think of a gynaecologist whose patients have more of vaginal delivery?That she is honest,ethical, has patience,considerate,compassionate.But has it ever crossed your mind that it needs something more than that as well.....'SKILL'.Somehow we don't associate a vaginal delivery with doctor's skills.Majority of normal deliveries are surely about being honest,ethical,having patience,considerate,compassionate but not all of them.During the course of labour there are many stages when it is very crucial how skillfully your doctor takes a decision.If baby has passed stool inside the womb,does it mean performing a caesarean section or wait for couple of hours.........it takes science,art and skill and of course experience.
When a lady is fully dilated and still not able to deliver a child and your doctor helps you out with Vacuum or forceps without causing any harm to you or the baby it needs immense amount of skill.
I have got lot many compliments for conducting vaginal deliveries but the one compliment which I still have to hear is 'Doc you are skilled'.I am awaiting to hear that.Maybe it will be you,who says so :) !! 

Role reversal

I think I can be a potential astrologer.In fact many Obstetrician have already donned that cap.
Don't get surprised..........!!I Thought not to comment anything on Poor Aishwarya Rai and her Pregnancy but the way whole media(you can still forgive them),astrologers and even well known Gynaecologists of well known Institutions have been issuing statements ,I feel deep sympathy for the Lady.Agreed she is a celebrity and open to public scrutiny but so much so that you talk about her Pregnancy and looks and bodily changes in such great detail that it is in poor taste.
As per a National daily,an astrologer has commented that she would need to drink milk in her pregnancy.Great..........I tell that to all my patients.So you see ,I have the potential to be an astrologer.Some one said she will have most likely a Cesarean.For that matter I can predict it much better,so is that astrology?
Now Obstetricians are predicting if it is an IVF pregnancy or normal conception.Someone  is predicting her trimester of pregnancy.That's is what is called role reversal..........Doctors doing predictions and astrologers giving medical advise.
Just wondering how commercial and stupid we have become.

Babymoon and maternity spa

The old adage ,patients are the best teachers  for doctors holds very true.Recently two of my patients informed me of two new concepts of modern day pregnancy and delivery.It is all about celebrating motherhood.None of them is directly related to medical aspect of Pregnancy care but I guess are surely interesting and good concept.

BABYMOON i.e, your honeymoon prior to arrival of your baby after which life would be busy for a while.Couples take time out in third trimester to be together away from the routine humdrum of life.I googled further and realised that there are various hotel groups all over the world who have 'special' babymoon packages.Maybe this could be something which can be an add on on your Pregnancy wish list.

Then came a lady who wished to know if there were any delegated maternity spa.Now again a new concept for me.And after googling and with help of another patient of mine came to know of a place marketed by Mahindra retails ( mom and me chain of stores) who have two such places in India ,one in Delhi and another in Bangalore which has hired a group of non medical professionals like a reiki expert,counsellor,massage specialist etc who conduct antenatal Lamaze classes .They have special tables where mothers can lie on their belly and get pamper.Interesting.In fact this concept has started arousing a businesswoman in me.Still an untapped area in India and we know there are many couples in India who don't mind paying a price for all the pampering they can get along with some useful information regarding pregnancy which probably increases chances of normal delivery as well.I think I can be a good brand ambassador for such a concept:)).What say friends?

Do you leak urine when you cough??

This month a lady,all of 26 yrs visited me in my OPD refd by a friend Dr Meenu Tyagi.This lady was an  lady from a family of farmers who have to work hard and lift quite heavy weights.I would appreciate that this lady told me very straight and clear that Doctor I have lost control over passage of urine and I wish you to operate on me.On examination I found that this mother of 4 had a huge cystocele and a bad incontinence of urine (GSI).It was confirmed by urodynamic study as well.
She had visited quite a few well known Gynaecologists of our town who all had diagnosed her problem but no one gave her the solution.
For a condition like GSI there is a very simple surgery called TVTO( Trans obturator tape) .It is due to lack of training gynaecologist don't offer it and at the same time patients of leakage of urine are too embarrassed to ask for help as well.This Lady had showed the courage.I performed a TVTO operation and cystocele correction on her.She after years felt good.Again a surgery with instant results !!
I would encourage if there are ladies who have lost control over urination should see a gynaecologist well trained in urogynaecology.A small visit to your doctor might improve your quality of life immensely.

Laparoscopic Sacrocolpopexy

This month has been busy and satisfying.Did some interesting surgeries .Laparoscopic Sacrocolpopexy was one of them.
A very pleasant elderly Lady,who showered me with all her blessings left me quite overwhelmed.This Lady was suffering with a big cystocele and a vault prolapse since long.Was in agony due to the cystocele and vagina getting rubbed on sitting or walking.We used a Prolene mesh to pull her vaginal vault up and fixed it to her sacrum.Cystocele (loose bladder) was repaired from below.
It is one of those surgeries which immediately gives immense relief to the patient which was so very evident in her case.It is a pity that Indian women keep on suffering in pain rather than ask for medical help.
Will post the video soon ( as soon as I get some more time).