by Dr Neelima Mantri | Jul 25, 2023 | Blog, Uterine Fibroids
Submucosal fibroids are the type of uterine fibroids that can potentially cause prolonged and heavy menstrual bleeding, pelvic pain and pressure, and urinary and bowel problems like constipation and bowel obstruction.
“But the most surprising complication of these fibroids is that they cause infertility problems and even decrease the success rate of fertility treatments like IVF. They have a higher potential to cause problems than another type of uterine fibroids”, says a gynaecologist specialist in Mumbai, Dr. Neelima Mantri.
What are submucosal fibroids, what causes them, and how are they treated to prevent possible complications? With inputs from a female gynaecologist in Mumbai, Dr. Neelima Mantri, we answer all your questions today.
What are Submucosal Fibroids?
Submucosal fibroids are a subset of the broader category of uterine fibroids, which are non-cancerous growth that develops in the muscular walls of the uterus. They vary in location, size, and number and are usually classified based on their site.
Submucosal fibroids are the type of fibroids that grow beneath the uterus lining, which, when they grow, protrude into the uterine cavity, thus directly affecting menstrual bleeding and pregnancy outcomes.
Are Submucosal Fibroids a More Dangerous Type of Uterine Fibroids?
As said, submucosal fibroids have more potential to cause problems due to their location beneath the uterine cavity. When these fibroids grow, they may put pressure on the uterine cavity, cause prolonged bleeding and cause fertility problems, negatively impacting pregnancy outcomes, according to the gynaecologist in Mumbai, Dr. Neelima Mantri.
What Causes Submucosal Fibroids?
Hormonal imbalance, disruption in uterine tissue, and genetic predisposition are the common causes of uterine fibroids, which also apply to submucosal fibroids. It is always a combination of all the above factors, along with environment and lifestyle choices, that are believed to increase the risk of submucosal fibroids.
Younger women with a family history and obesity are more prone to fibroids. Vitamin D deficiency, a diet rich in red meat and lower in dairy, fruits, and vegetables, also is believed to be a risk factor for submucosal fibroids.
Diagnosis and Treatment for Submucosal Fibroids:
Submucosal fibroids are usually discovered during routine pelvic exams and are confirmed with blood tests, imaging studies, and hysteroscopy. There are several approaches to managing and treating submucosal fibroids:
- Watchful waiting: This approach is taken when the fibroids are small, asymptomatic, and not causing significant issues. Regular monitoring is done to assess their growth and impact.
- Medications: Medications that reduce pain and symptoms and hormone agonists that temporarily shrink the fibroids are used to manage submucosal fibroids. Painkillers, oral contraceptives, vitamins, and iron supplements may also address specific symptoms and improve overall reproductive health.
- Non-invasive procedures: MRI-guided ultrasound surgery is a surgical procedure that can be used to destroy fibroids. Uterine artery embolization, which involves blocking the blood supply to the fibroids, is another option to shrink the fibroids.
- Radiofrequency ablation: This procedure uses heat to destroy the fibroids and relieve symptoms.
- Myomectomy: Both laparoscopic myomectomy and abdominal myomectomy are surgical procedures that remove the fibroids, offering permanent relief.
The choice of treatment is recommended by the gynaecologist based on the specific condition of the patient, the severity of the fibroids, and their impact on reproductive health. For more information on submucosal fibroid treatment in Mumbai, you can contact Dr. Neelima Mantri.
by Dr Neelima Mantri | Jun 23, 2023 | Blog, Obstetrician
Cephalopelvic disproportion (CPD) refers to a situation where a mother’s pelvic structure is mismatched with the dimensions and form of her baby’s head, rendering natural delivery difficult or impossible. Cephalopelvic disproportion can result from diverse causes, such as the infant being comparatively larger, fetal positioning abnormalities, unconventional pelvic structures, or maternal conditions that entail possessing a narrow pelvis.
To ensure a safe and successful delivery, healthcare professionals need to understand the underlying reasons behind CPD and be able to identify potential risks while devising appropriate management strategies.
Cephalopelvic disproportion, a condition where the fetal head is too large for the birth canal, often stems from fetal macrosomia – an anomaly where the baby has an excessively large body size. The outcome could be linked to maternal elements, including gestational diabetes or increased weight during pregnancy. Fetal macrosomia increases the chances of cephalopelvic disproportion (CPD) due to the possibility of the infant’s head being too large to pass through the mother’s pelvis.
Certain fetal positions, like breech or transverse, may cause a size difference between the baby’s head and the mother’s pelvis. Sometimes, when the infant’s head and the mother’s pelvic region do not align correctly, it can make giving birth naturally difficult or even impossible.
Anomalies in the mother’s pelvic framework may also lead to cephalopelvic disproportion. Certain factors,such as genetic traits or prior injuries, can result in an unusual pelvic structure, including a compressed or distorted pelvis, exemplified by a narrow opening or a pelvis with an irregular shape. Pelvic anomalies can impede the infant’s passage during childbirth, leading to cephalopelvic disproportion. Consultation from the best obstetrician in Mumbai can help to resolve this issue.
Certain maternal factors can increase the chances of developing cephalopelvic disproportion. Some factors contributingto the problem include being short in height, having a narrow birth canal, or experiencing cephalopelvic disproportion at an earlier stage. Maternal factors impact the size and shape of the birth canal, which in turn can affect the likelihood of CPD.
The possibility of cephalopelvic disproportion can also be affected by genetic variables. Sometimes, the genetic makeup can result in a larger-than-usual head size of the unborn baby or a comparatively small pelvis of the mother. The probability of CPD can increase when there are genetic factors affecting the growth and formation of the skeletal structure.
The likelihood of experiencing cephalopelvic disproportion increases in multiple pregnancies, for instance, twins or triplets. Having multiple fetuses can worsen the problem by adding more pressure on the mother’s pelvic area, obstructing the baby’s head from passing through.
Sometimes, labourcan be impacted by shortcomings or tardiness, resulting in a cephalopelvic disproportion problem. Several issues, including inadequate uterine contractions, prolonged labour, or failure to descend, may cause a dissimilarity in the size of the baby’s head and the mother’s pelvis, leading to complications during natural childbirth.
To obtain a clear understanding of the abnormalities, it is essential to seek guidance from the best gynecologist in Mumbai. Effective management practices for managing cephalopelvic disproportion typically involve careful monitoring, efficient pain management, and quick action in scenarios where proceeding with a vaginal delivery becomes impractical or risky. One way to ensure safe delivery of the baby might be to opt for a cesarean section.
In conclusion, comprehending the causes of cephalopelvic disproportion is crucial for guaranteeing effective management during childbirth. Consulting an experienced gynecologist in Mumbai or other reputable hospitals can provide insightful advice and suggestions to identify potential risks, monitor the progress of labour, and make informed decisions regarding the delivery method to achieve the best possible outcome for both the mother and baby.
Dr. Neelima Mantri, a renowned gynecologist in Mumbai, offers expert care and guidance for addressing cephalopelvic disproportion. She provides personalised strategies to ensure safe and successful childbirth using her expertise and abilities.
by Dr Neelima Mantri | Jun 22, 2023 | Blog, Laparoscopic Surgery
A tubo ovarian abscess is a condition characterised by a serious inflammation of the fallopian tubes and ovaries, which can result in pain and discomfort. It is essential to have profound knowledge and awareness about symptoms, causes, and available courses of treatment to act promptly. This article examines the essential elements of tubo-ovarian abscess, elucidating this ailment and its treatment.
The Primary Symptoms:
One must consult with gynecologists in Mumbai or another tier 1 city having the best medical facilities which can identify the disease through proper symptoms. Some of the common symptoms are:
Chronic and intense pelvic discomfort represents the primary indication of TOA. The discomfort can be confined to a specific pelvis areaand may intensify during physical activity or sexual intercourse.
Systemic symptoms such as fever and chills are frequently caused by infections. These signs could suggest the existence of a tubo-ovarian abscess.
Abnormal vaginal discharge can be experienced by certain women, the odourof which is unpleasant and the colour
Suffering from TOA may result in unpleasant sensations or discomfort during sexual intercourse due toswelling and infection in the reproductive organs.
Certain women may undergo urinary symptoms, including recurrent urination or discomfort during urination.
The Fundamental Causes:
Usually triggered by sexually transmitted infections like gonorrhoea or chlamydia, pelvic inflammatory disease (PID) frequently leads to the development of tubo ovarian abscess as a complication. If the infection is not taken care of, it can advance and result in the development of a pus-filled pocket.
Some other factors that can increase the likelihood of developing a tubo ovarian abscess are a record of pelvic infections, engaging in sexual activities with multiple partners, relying on intrauterine devices, and having experienced TOA or PID before. Consult female gynecologists in Mumbai or other cities to ensure the exact reason behind the cause of the abnormality.
Treatment:
Consulting the best gynecologist in Mumbai or other well-reputed hospitals to ensure the best treatment is a must and to be followed by all. Some of the basic treatments are:
- In the case of an infection, it is common to prescribe broad-spectrum antibiotics to target the bacteria responsible specifically. In severe circumstances, intravenous administration of antibiotics may be provided, and a particular period of oral antibiotics may follow.
- Sophisticated abscesses of significant size may necessitate drainage to remove the infection efficiently.
- Effectively managing pain is a crucial aspect of treating tubo ovarian abscesses. NSAIDs or other analgesics may be prescribed to relieve any discomfort.
- It is essential to have regular follow-up visits post-treatment to keep track of the development of the infection and guarantee its full recovery. Additional imaging tests may be conducted to verify that there is no reappearance of abscess.
To sum it up, timely identification and appropriate handling of tubo ovarian abscess hold great significance in achieving a positive outcome and averting potential complications. It is crucial to seek immediate medical care, receive a precise analysis, and undergo proper therapy such as antibiotic administration and drainage techniques.
It is advisable to seek advice from the best laparoscopic surgeon in Mumbai or other reputed medical facilities, as they offer expert attention and advanced surgical methods to guarantee optimal care for tubo-ovarian abscesses. Dr. Neelima Mantri, an acclaimed surgeon adept in laparoscopic procedures, has expertise in effectively addressing tubo ovarian abscesses. She combines her exceptional medical knowledge with compassionate care to provide excellent patient care.
by Dr Neelima Mantri | Jun 22, 2023 | Blog, High Risk Pregnancy
An uncommon but possibly fatal condition that can happen during pregnancy or delivery is uterine rupture. It describes the ripping or splitting of the uterine wall, which might cause serious bleeding and put both the mother and the unborn child in jeopardy. During pregnancy, the uterus, a muscular organ, takes care of and defends the developing foetus.
The uterine wall is durable and sturdy under normal conditions. Healthcare providers and expectant moms must understand the risk factors, symptoms, and proper management of uterine rupture to provide prompt and efficient care during childbirth.
Causes
- Previous uterine surgery: Compared to women with an intact uterus, women withprevious uterine operations, such as caesarean sections (C-sections) or myomectomy (removal of fibroids), are at a greater risk of uterine rupture.
- Uterine overdistention: The risk of rupture rises when the uterus is overextended or overly strained. Multiple pregnancies, polyhydramnios (high amniotic fluid), and macrosomia (a huge fetus) are situations where this might happen.
- Augmentation of labour: Utilising some drugs, like oxytocin, to hasten or intensify labour contractions might raise the risk of uterine rupture, particularly if contractions are too frequent, strong, or protracted.
- Uterine anomalies: The uterus’ structural abnormalities, such as a uterine septum or a bicornuate uterus (a uterus with a heart-like shape), might put a woman at risk for uterine rupture.
Symptoms
- Sudden, strong abdominal pain: As per top gynecologists in Mumbai, women occasionally feel sharp, sudden stomach pain that may be localised or generalised. Sharp, stabbing or ripping pain can be either persistent or sporadic.
- Foetal heart rate changes: The foetal heart rate may vary if the rupture damages the placenta or impairs the blood supply to the foetus. The infant’s heart rate can changeor exhibit indications of distress, such as pauses or bradycardia (slow heart rate).
- Vaginal bleeding: Uterine rupture can cause vaginal bleeding, ranging in intensity from little spotting to substantial bleeding. In addition to bleeding, tissue or clots may travel through the wound.
Treatment
- Emergency caesarean delivery: To deliver the baby as soon as practicable after a uterine rupture, an emergency cesarean section is frequently done. This is done to protect the unborn child and minimise any damage to the uterus. The mother’s and baby’s health will play a role when cesarean delivery is performed.
- Repair of the uterine rupture: The uterine rupture is surgically fixed after the baby is delivered. The size and location of the rupture will determine how much mending is necessary.
- Blood transfusion: Cesarean blood transfusions may be performed to compensatefor lost blood and maintain the mother’s hemodynamic state after a uterine rupture, which can cause severe bleeding. To maintain blood pressure to prevent shock, intravenous fluids and medications may also be given.
In Mumbai, India, there is a renowned gynecologist named Dr. Neelima Mantri. She has made a name for herself as an established member of the community of lady gynecologists in Mumbai with extensive knowledge of gynecology. Do consider consulting her for your gynecology concerns.
by Dr Neelima Mantri | May 17, 2023 | Blog, Female Gynaecologist
An inflammation, thinning, and dryness of the vaginal walls is known as atrophic vaginitis. After menopause, it typically occurs as a result of declining estrogen levels. As ovaries generate fewer hormones during menopause, the body begins to go through multiple changes.
The hormone estrogen levels tend to decrease by about 85% in vaginal atrophy cases. The urethra, the pelvic floor muscles, the vaginal lining, as well as the vulval skin are all thin when estrogen levels are low. Reduced blood flow in the pelvis and discomfort in these regions are also possible effects of this.
Lately, the term genitourinary syndrome of menopause (GSM), which is more recent, has taken the place of vaginal atrophy. This new phrase assists in describing the urinary as well as vaginal signs and symptoms that may develop from low estrogen. Although atrophic vaginitis is a typical menopausal symptom, not much is known about the ailment, therefore few people look for atrophic vaginitis treatment.
The Causes
Estrogen is required for the vagina (as well as other tissues in the pelvis) to remain functional. The elasticity and fullness of vaginal tissues decline as estrogen levels drop. They instead become drier, thinner, and more sensitive. As a consequence, there is a higher chance of irritation or abrasions, which can lead to urinary tract infections.
Estrogen levels begin to fluctuate irregularly throughout perimenopause (the years before menopause), and they continue to decline following menopause. Estrogen levels can be lower due to:
- Surgical menopause
- Chemotherapy
- Breastfeeding
- Oral contraceptives
- Pelvic radiation treatment for the cancer
The Symptoms
When you have vaginal atrophy, the tissue that borders the vaginal wall becomes thin, dry, and inflammatory. The first symptom is frequently a loss of lubrication (dryness). Female gynecologists in Mumbai say the following are other signs of genitourinary syndrome of menopause:
- Frequent or urgent bathroom visits
- Recurrent urinary tract infections
- Burning sensation when urinating
- Narrowing and tightness of the vaginal canal
- Bleeding after sex
- Itchy vulva
- Blood in urine
- Vaginal dryness
- Thin, yellow discharge
The Treatment
Typically, vaginal lubricants and estrogen vaginal preparations are used as the first line of treatment for vaginal atrophy. Non-estrogen topical hormonal therapies, however, may be recommended for people who are unable to utilize estrogen. If none of these therapies work, a CO2 laser procedure may be suggested. This procedure can regenerate vaginal tissue, boost collagen synthesis, and restore the vagina to normal functionality.
HRT, also known as systemic estrogen treatment, is another option for treating it. It is taking medication to replenish the hormones lost during menopause. Gynecologists in Mumbai can prescribe HRT, which comes in a variety of forms such as tablets, gels, and implants. The body receives estrogen from this kind of estrogen therapy.
HRT is advised if you have other menopause-related symptoms because it will have a more significant impact on the body than vaginal estrogen. It’s crucial to remember that HRT has several risks and side effects, such as vaginal or urinary issues, which may discourage many women from pursuing this course of treatment for their vaginal atrophy.
Dr. Neelima Mantri is one of the best gynecologists in Mumbai, known for successfully managing High-Risk Obstetrics and handling numerous complex obstetric cases. If you are looking for effective treatment for Vaginal Atrophy issues, you may consult Dr. Neelima Mantri.
