by Dr Neelima Mantri | Dec 20, 2024 | Blog, Pregnancy Complications
Gestational Trophoblastic Disease refers to a group of rare and abnormal growths that develop during abnormal pregnancy. Though it is uncommon, understanding it is important. It is noteworthy that some GTDs are noncancerous while others are Malignant. This article discusses the types, causes, treatment, and symptoms of gestational trophoblastic disease
The Types of GTD
- Hydatidiform Mole (molar pregnancy): This is the most common form of GTD. It is usually the result of abnormal fertilization of eggs. It results in a mass of cysts. There are two types: partial mole and complete mole.
- Gestational Trophoblastic Neoplasia (GTN): This is a more serious form and can occur after a molar pregnancy. It includes several Malignant growths, such as Invasive moles (invade the uterine wall), Choriocarcinoma (spreads quickly to other parts), placental-site Trophoblastic tumor (forms at the placenta), and Epithelioid trophoblastic tumor (a rare and slow-growing tumor).
The Causes
Several factors contribute to increasing the risk of developing GTD.
- Abnormal fertilization: If an empty egg or multiple sperms fertilize the egg, it may lead to abnormal trophoblastic tissues.
- Maternal age: Women who are under age 20 or above 40 are at risk of developing GTD
- Previous Molar pregnancy: Having a history of molar pregnancy increases the risk of developing another one.
The Symptoms
The symptoms may vary and are dependent on the type and how severe. Common symptoms, however, include:
- Vaginally bleeding: Abnormal vaginal bleeding during pregnancy is one of the most common signs of GTD. It may be spotting or heavy bleeding, and the bleeding may be mistaken for a miscarriage.
- Severe Nausea and Vomiting: Most women with GTD would experience severe morning sickness. This is usually more serious than that of pregnancy nausea.
- Uterine Growth: GTD makes the uterus grow faster than expected fir the stage of pregnancy. This results from the abnormal growth of trophoblastic tissues and may be detected through a physical examination or ultrasound.
- High hCG level: Human Chorionic Gonadotropin(hCG)is a hormone produced during pregnancy. With GTD, the levels would be much higher. It can be confirmed through blood tests and is one major factor used to diagnose the condition
- Pre-eclampsia: Women with GTd may show signs of preeclampsia, like high blood pressure and protein in the urine in the first trimester.
The Treatment
Gestational Trophoblastic Disease treatment depends on the type, the stage it is at when diagnosed, and whether it is benign (not harmful) or Malignant. Treatment is to remove or destroy abnormal trophoblastic tissue, monitor for signs of recurrence, and preserve fertility whenever possible.
Specific treatment methods are:
- Suction Curettage: This is most suitable for molar pregnancy. Abnormal tissue is removed from the uterus using a gentle suction device.
- Chemotherapy: This is more suitable for invasive moles, choriocarcinoma, and other Malignant forms.
- Hysterectomy: This is the removal of the uterus. However, it is not favored by women who would still love to give birth.
- Radiation Therapy: In extremely rare cases, if it has spread to the brain or lungs, surgery isn’t possible, and radiation therapy would be suggested to help target the cancerous cells. This is, however, a thing of last resort where chemotherapy and surgery will not suffice.
Conclusion
Although rare, Gestational Trophoblastic Disease can have serious implications if not treated. However, with early detection, treatment, and follow-up, most women make a full recovery.
Knowing the symptoms and risks of GTD is crucial for ensuring that women seek timely medical attention, leading to better health outcomes and fertility prospects. To get the best female gynaecologist and laparoscopic surgeon in Mumbai, Connect with Dr Neelima Mantri.
by Dr Neelima Mantri | Nov 26, 2024 | Blog, Pregnancy Complications
Vasa Previa is a rare but serious pregnancy complication that can lead to stillbirth and is a risk to both the mother and the baby. Fortunately, babies with vasa previa have a 98.6% survival rate if they are diagnosed early and closely monitored, and a planned C-section guarantees a safe delivery.
In this blog, let’s understand vasa previa, its causes, symptoms, and treatment options. Read on.
What is Vasa Previa?
During a healthy pregnancy, the baby’s blood vessels are protected within the umbilical cord or placenta. But in vasa previa, some blood vessels pass close to the cervix, ultimately causing the delicate vessels to rupture, especially during labor.
Causes of Vasa Previa
A few common factors that increase the likelihood of vasa previa include :
- Abnormal structural development of the placenta or umbilical cord
- complications might arise with multiple (twin, triplets) Pregnancy
- Low-lying placenta position (Placenta Previa)
- Assisted reproductive techniques like IVF pregnancy.
About the Symptoms of Vasa Previa
One of the most challenging aspects of vasa previa is that it usually doesn’t show any symptoms during pregnancy which is why prenatal screenings are so important. However, if vasa previa is undetected and labor begins naturally, there can be sudden painless vaginal bleeding.
Vaginal bleeding occurs because of the vulnerable blood vessels rupturing, posing a significant risk to the baby. Swift medical attention is essential if any unexpected bleeding occurs during pregnancy, especially if it happens in the later stages.
How is Vasa Previa diagnosed?
Thankfully, modern technology offers practical ways to identify vasa previa before it becomes a threat. A routine ultrasound, typically during the second trimester, can help detect the condition. Sometimes, a color Doppler ultrasound is used to get a clearer view of the blood vessels and their positioning. Early diagnosis allows your obstetrician to plan for a safe delivery and reduces the risk of complications.
Managing and Treating Vasa Previa
Once vasa previa is diagnosed, the focus shifts to safely delivering your baby while avoiding any risks. Vasa previa treatment includes:
- Planned C-Section: Gynecologists generally recommend scheduling a cesarean section (C-section) around the 34th to 36th week of pregnancy to avoid labor and protect the blood vessels.
- Hospital Monitoring: If there’s a risk of preterm labor, you may recommend hospitalization for closer observation.
- Steroid Injections: Corticosteroids might be given around 32 weeks to help your baby’s lungs mature in case early delivery becomes necessary.
It’s important for women dealing with a complex condition like vasa previa to be aware of its risks. With today’s advances in prenatal care, it can be managed effectively to safeguard both mother and child. Early diagnosis and planned labor with the best obstetrician can make even complex pregnancies manageable.
Are you looking for the best gynecologist and obstetrician in Mumbai? Consult Dr. Neelima Mantri; with over 10 years of extensive experience in high-risk obstetrics; she specializes in treating complex pregnancy conditions like vasa previa, prioritizing the safety of mother and baby.
If you’re pregnant and have questions about vasa previa or anything else, meet Dr. Mantri here: https://www.drneelimamantri.com/contact/
by Dr Neelima Mantri | Aug 16, 2024 | Blog, Pregnancy Complications
Pregnancy is an incredible journey, full of excitement, anticipation, and sometimes a few concerns, as it involves numerous changes and potential complications.
Marginal cord insertion is a pregnancy complication where the umbilical cord attaches abnormally to the placenta. A considerably rare condition, this abnormality can affect fetal development, cause placental abruption, and even lead to preterm labor. The good news is that this condition can be effectively managed when identified early and with the right awareness beforehand, it can be prevented.
The first step to avoiding the risks is to raise awareness about possible complications and take necessary steps to mitigate them. We take that first step with this blog today.
What is Marginal Cord Insertion?
During pregnancy, the umbilical cord usually attaches to the center of the placenta, supplying the foetus with oxygen and nutrients. However, in marginal cord insertion, the cord attaches to the edge or around the placenta. This may seem minor, but it can impact the baby’s blood flow, oxygen, and nutrients.
Symptoms of Marginal Cord Insertion
Symptoms of marginal cord insertion are often asymptomatic and can go unnoticed until a routine prenatal scan. A few symptoms include:
- Slow Foetal Growth: If the baby isn’t growing as expected, it might be linked to marginal cord insertion.
- Low Amniotic Fluid: Reduced fluid around the baby can sometimes happen.
- Heart Rate Changes: You might notice variations in the baby’s heart rate due to blood vessel compression.
- Higher Risk of Complications: There could be a higher chance of preterm birth or low birth weight.
“Keep up with regular check-ups and ultrasounds. Always consult your gynaecologist for the best advice”, says gynaecologist in Mumbai Dr Neelima Mantri, when asked about the ways to identify the condition and prevent the symptoms.
Marginal Cord Insertion Causes:
So, what causes this condition? Well, researchers are still determining the exact causes of marginal cord insertion. Some studies suggest that factors such as:
- Placental development: Sometimes, the placenta doesn’t grow uniformly, leading to an off-centre cord attachment.
- Multiple pregnancies: Twins or triplets may have a higher risk due to limited space in the uterus.
- Maternal age: Women over 35 may have a slightly increased risk.
- Previous uterine surgeries: These can affect how the placenta implants.
Remember, having these risk factors doesn’t necessarily mean you’ll develop marginal cord insertion. In many cases, it occurs without even a clear cause. But how is it diagnosed and treated?
Marginal Cord Insertion Diagnosis:
Diagnosis typically happens during routine imaging studies. Here’s what you can expect:
- Second-trimester ultrasound: This is often when marginal cord insertion is first detected.
- Follow-up scans: Your doctor may recommend additional ultrasounds to monitor the condition.
- Doppler ultrasound: This specialized scan can assess blood flow in the umbilical cord.
If your doctor suggests additional scans, it’s a routine measure to ensure everything is progressing as expected.
Marginal Cord Insertion Treatment:
Many cases of marginal cord insertion don’t need particular treatment, which is encouraging. Yet, your gynaecologist will generally:
1. Monitor growth: Regular ultrasounds will track your baby’s growth and development.
- Check blood flow: Doppler scans can ensure your baby is getting adequate nutrients.
- Discuss delivery options: In most cases, vaginal delivery is still possible. However, your doctor might recommend a C-section if there are concerns about cord compression during labor.
Managing Marginal Cord Insertion:
While you can’t change the cord’s position, you can support a healthy pregnancy:
- Attend all prenatal appointments: Regular check-ups allow your doctor to monitor the situation closely.
- Follow a healthy diet: Proper nutrition supports your baby’s growth and your overall health.
- Stay hydrated: Adequate fluid intake is crucial for amniotic fluid levels.
- Avoid smoking and alcohol: These can compromise placental function.
Understanding Marginal cord insertion can bring peace of mind during your pregnancy journey. Staying informed and working closely with a gynaecologist can ensure the best possible outcomes for you and your baby.
If you have concerns about marginal placental cord insertion or any other aspect of your pregnancy. In that case, Dr. Neelima Mantri is the best gynaecologist in Mumbai and offers compassionate and expert care. As the best lady gynaecologist in Mumbai, Dr. Neelima Mantri ensures you and your baby receive the highest quality care throughout your pregnancy.
by Dr Neelima Mantri | Jul 19, 2024 | Blog, Pregnancy Complications
We all understand the crucial role of amniotic fluid, which envelops the womb to safeguard the baby. But what if the fluid levels are too high? This condition, known as Polyhydramnios, involves an excessive secretion of amniotic fluid in the uterus during pregnancy. In its mildest form, it doesn’t pose any problems or symptoms. However, severe cases may necessitate treatment.
This condition is typically identified after the middle stages of pregnancy. Severe cases can lead to preterm labor, shortness of breath, and other symptoms. Yet, with early detection and proper management, the risks can be minimized. Mild cases often resolve on their own, but severe ones require close attention. To help you understand this condition better, check out this post for more information!
An Overview of Polyhydramnios
Polyhydramnios is a medical condition found in pregnant mothers in the middle term during pregnancy. The condition arises when there is a sudden spike in the amniotic fluids around the womb in the uterus.
Ideally, the amniotic fluid plays a significant role in the development and growth of the fetus. Doctors identify this condition in the second half of the pregnancy stage. This is a rare condition that affects 1% of pregnant women. They are diagnosed using the following methods:
- Amniotic fluid volume (AFV) or Maximum vertical pocket (MPV): This measures the deepest fluid pocket of the baby inside the womb. If the value shown is more than 8 cm, it is proved that the womb has polyhydramnios.
- Amniotic fluid index (AFI):This measures the deepest fluid pocket in four areas of the womb where if the sum of the four values is over 24 cm, it is proved that the womb has polyhydramnios.
- Blood Tests: These check if some diseases and infections cause polyhydramnios.
- Amniocentesis:This procedure uses a needle to remove the amniotic fluid from the womb. Then, the fluids are checked to provide information about the baby’s health.
- Nonstress Test:The baby’s heart rate is checked through the abdomen.
- Biophysical Profile: Doctors use ultrasound to identify complications and birth defects. They also use it to monitor the baby’s movement and breathing and the volume of amniotic fluid in the womb.
Causes of Polyhydramnios
There is no exact cause diagnosed by the best gynecologist in Mumbai. However, here are a few common ones:
- Affects the baby’s central nervous system, digestive tract, genetic conditions, or specific other organs.
- Causes twin-to-twin transfusion syndrome when twins are found in the womb where one receives higher blood flow than the other.
- Causes fetal anemia due to less blood flow to the womb.
- Clashes of parent blood cell with the child’s blood cell.
- Affects the placenta through which oxygen and food are supplied to the baby.
- Heart rate problems for the baby.
- The fetus becomes infectious.
- The difference in blood types for the mother and baby.
- Create gestational diabetes and high blood glucose levels in the mother.
Symptoms of Polyhydramnios
The first notable sign of Polyhydramnios is a swollen belly that occurs after a few weeks after pregnancy. This is due to the build-up of amniotic fluids, which pressure the uterus and the surrounding organs. For mild conditions, there are low chances of seeing symptoms. On the other hand, for severe conditions, here are a few risky symptoms:
- Swollen feet and ankles
- Shortness of breath
- Contraction, cramping, and tightness (especially in the uterus muscles) in the stomach
- Heartburn
- Constipation
- Indigestion
- Uterine contractions and discomfort
- Trouble feeling that there is a baby in the womb
- Fetal malposition (the baby moves in the wrong way in the womb)
- Difficulty in finding the fetal heartbeat
- Pressures the lungs, rectum, bladders, and stomach of the mother
Conclusion
That’s all you need to know about the rare cases of Polyhydramnios. If you do not wish to be numbered with this complication, it’s best to take steps early to fight it and protect your baby. Book a consultation with Dr Neelima Mantri and start recuperating before it’s too late!
by Dr Neelima Mantri | Jun 19, 2024 | Blog, Pregnancy Complications
Intrauterine Growth Restriction (IUGR) refers to a condition in which a fetus fails to achieve its expected growth potential while in the womb. In this blog, let us shed light on the causes, symptoms, and treatment options for IUGR, a condition that requires careful monitoring and medical management.
What are the Causes of IUGR?
Several factors can contribute to Intrauterine Growth Restriction, including:
- Placental Insufficiency: Insufficient blood flow or function of the placenta, which provides nutrients and oxygen to the fetus, can hamper fetal growth.
- Maternal Health Conditions:Chronic conditions such as hypertension, diabetes, kidney disease, and autoimmune disorders can impact fetal growth.
- Infections: Certain infections during pregnancy, such as cytomegalovirus (CMV) or Zika virus, can lead to IUGR.
- Genetic Factors: Inherited genetic abnormalities or chromosomal disorders may play a role in restricted fetal growth.
- Multiple Pregnancies:In pregnancies with twins or higher-order multiples, IUGR can occur due to competition for nutrients and space within the uterus.
What are the Symptoms of IUGR?
Detecting IUGR typically involves prenatal monitoring and ultrasound evaluations. Common symptoms and indicators include:
- Small Fundal Height:The measurement of the uterus may be smaller than expected for the gestational age.
- Decreased Fetal Movements:Reduced fetal movements or activity compared to normal patterns.
- Low Birth Weight: Babies born with IUGR often have a birth weight below the 10th percentile for their gestational age.
- Decreased Amniotic Fluid: A decrease in the volume of amniotic fluid (oligohydramnios) may be observed during ultrasound examinations.
- Delayed Development:In severe cases, delayed development of organs or structures can be detected through ultrasound imaging.
What are the Treatment Options available for IUGR?
Managing IUGR requires a multidisciplinary approach involving obstetricians, perinatologists, and neonatologists. Treatment strategies may include:
- Close Monitoring:Regular prenatal visits and ultrasound assessments to track fetal growth, amniotic fluid levels, and overall well-being.
- Nutritional Support: Ensuring the mother receives adequate nutrition and hydration to support fetal growth.
- Medical Interventions: Depending on the underlying cause and severity of IUGR, medical interventions such as medication or interventions to manage maternal health conditions may be necessary.
- Fetal Surveillance:Monitoring fetal well-being through tests like Doppler ultrasound to assess blood flow in the umbilical artery and fetal heart rate monitoring.
- Timely Delivery:In cases of severe or worsening IUGR, delivery may be recommended to prevent further complications.
Conclusion
Intrauterine Growth Restriction is a complex condition that requires careful evaluation, monitoring, and management throughout pregnancy. Understanding the causes, recognizing symptoms, and seeking timely medical intervention are crucial steps in optimizing outcomes for both the mother and the baby.
For expert guidance and comprehensive care regarding Intrauterine Growth Restriction and other pregnancy-related concerns, consult with one of the best female gynecologists in Mumbai, Dr. Neelima Mantri. With her extensive experience and expertise in high-risk obstetrics, Dr. Mantri ensures personalized care and the best possible outcomes for expectant mothers and their babies.
by Dr Neelima Mantri | Apr 16, 2024 | Blog, Pregnancy Complications
When two or more fetuses are conceived, it is known as a multiple pregnancy. This condition poses special dangers and challenges for both the mother and the unborn child. Whether they are twins, triplets, or higher-order multiples, these pregnancies can result in several issues that need to be closely monitored and managed by medical specialists.
To achieve the best possible outcomes for the health of both the mother and the fetus, multiple pregnancies require specific attention and care, from gestational diabetes to premature delivery. Comprehending the possible issues linked to multiple pregnancies is essential for prompt detection, intervention, and the provision of customized medical assistance.
Maternal Health Complications
The mother’s well-being is considerably at risk due to maternal health issues that arise from multiple pregnancies. Among them are:
Increased risk of hypertension and gestational diabetes as a result of the mother’s body being under more stress.
An increased risk of preeclampsia, a potentially fatal illness marked by organ damage and elevated blood pressure.
Greater uterine enlargement and possible postpartum contraction difficulties make a woman more vulnerable to postpartum hemorrhage.
increased chance of cesarean birth, which is frequently required due to issues including placenta previa or fetal malpresentation.
Increased psychological difficulties and emotional strain brought on by the complexity of handling numerous pregnancies, including nervousness.
Delivery and Labor Considerations
Planning and handling of labor and delivery issues in multiple pregnancies must be done carefully. Among the crucial elements are:
Higher risk of preterm delivery, which calls for vigilant observation and possible measures to extend the gestational period.
Increased risk of fetal malpresentation, including transverse or breech positions, which might affect the birth method.
Possibility of difficulties that might require specialized obstetric care during labor, such as placental anomalies or cord entanglement.
A skilled medical team with experience in handling multiple pregnancies is required to guarantee safe delivery for the mother and her unborn children.
The possibility of cesarean birth owing to several reasons, such as fetal position or labor problems, necessitates cautious thought and preparation in advance.
Neonatal Care Requirements
The requirements for neonatal care are generally greater and more involved for babies delivered from multiple pregnancies than for singleton births. Numerous health issues, such as respiratory distress syndrome, low birth weight, and preterm, might affect these infants.
As a result, specialized newborn care facilities with cutting-edge equipment and qualified medical staff are crucial. When it comes to giving babies with particular requirements prompt medical treatment, breathing support, and monitoring, neonatal intensive care units (NICUs) are essential.
Close coordination between pediatricians, neonatologists, and other experts is also essential to ensuring that each infant has a thorough care plan that meets their specific medical needs and maximizes their chances of healthy development.
To protect the health and well-being of the mother and the unborn children, it is essential to comprehend the intricacies and potential issues associated with multiple pregnancies. These difficulties can be successfully overcome with the best gynecologist in Mumbai and specialized treatment and skilled management.
With her vast experience in high-risk obstetrics, Dr. Neelima Mantri is a famous gynecologist in Mumbai and she provides the knowledge and skills required to successfully manage these pregnancies and benefit both mother and child.
