CHRONIC PELVIC PAIN

Chronic pelvic pain is defined as pain the abdomen / pelvis below the level of the belly button (umbilicus) that has been present for 6 months or more.It may or may not be associated with menses or periods. It is not a disease but a symptom that can be caused several different conditions.

CAUSES OF PELVIC PAIN
Some of the causes of chronic pelvic pain are

• Gynaecology
• Endometriosis
• Adenomyosis Adenomyosis(Endometriosis in the muscle of the womb)(scarring)
• Pelvic Infection Diverticulitis Pelvic floor pain
• Fibroids

DIAGNOSING PELVIC PAIN

• Detailed history
• Clinical examination
• Blood tests
• Urine test
• Pelvic Ultrasound
• Laparoscopy (key hole camera procedure through the belly button)
• Others: CT scan, MRI scan

MANAGING PELVIC PAIN

• Pain killer tablets (Paracetamol, Ibuprofen, etc)
• Hormonal manipulation (Endometriosis / fibroids)
• Surgical treatment of endometriosis / fibroids / adhesions or scarring
• Relaxation techniques / hypnosis
• Psychosocial support and counselling (Individual therapy / group therapy / patient support groups)

For nine months, The Nest offers you superlative care in a homely and caring environment. The TLC Privilege Package is tailored to make your long wait special. Our ante-natal program prepares you and your spouse both physically and emotionally for the birth of the baby. Our LDRP and elegant birthing suites are designed to make your stay during delivery memorable.

Women care at Fortis Hospitals ,Bannerghata Road,Bangalore launched in 2007 is a culmination of strengths has a 30,000 sq. ft. area is exclusively dedicated to Women care with consultation suites, delivery rooms, operating rooms, dedicated to obstetrics, a 12-bed neo-natal ICU & a nursery. Our Women health care programmes, besides minimal access gynecological services, also include preventive clinics (early diagnosis of breast, uterine, ovarian and cervical cancer), Infertility clinics & Menopausal clinics.

The Nest Birthing Package provides the Following

• The Nest Birthing Suit for Birthing and delivery
• LDRP birthing suites, Private deluxe, Twin-deluxe and multi-bed
• Painless deliveries
• Management of high risk pregnancies/Late pregnancies
• The Lamaze Classes
• Ante-natal classes

We emphasize on natural birthing and provide you support services like Lamaze and ante-natal classes. We give you the option of comfortable natural birthing with painless delivery techniques. The boutique-like comfort comes to you with the quality and safety standards of the Fortis Hospitals Group. The Nest is part of Fortis Hospitals Woman Care Specialty

At the core of each service at The Nest, is the safety of the mother-to-be and the child. The Nest, being a part of Fortis Hospitals, adheres to Harvard Medical International (HMI) standards in safety and quality. We offer clinical expertise that is comparable to the best in the world and cutting-edge technology in diagnostics and treatment.

Types of Rooms The Nest offers you a wide range of rooms. Besides the LDRP suites, we have Private Deluxe, Twin Deluxe and Multi-bed facilities for the new mother’s-to-be. Private Deluxe Rooms have luxurious interiors and more privacy. The walls and fine finish give it a warm feel. The rooms are spacious for the family to relax in. Twin Deluxe rooms are on sharing basis. Each room has an attached bathroom and a screen to provide families the privacy they need. Multi-bed rooms are economical options and have the provision to accommodate 3 patients. These are spacious rooms with an attached bathroom. LDRP Suites (Labor Deliver Recovery Postpartum) LDRP suites are a premium offering here. The LDRP suites are a class apart in style and functionality. These suites come with luxurious interiors and the latest equipment and techniques for delivery. More Details Lamaze Classes The Nest encourages medically approved methods, like Lamaze (breathing techniques & exercises for pregnant woman) and yoga to facilitate natural birthing (normal delivery). More Details The Nest Ante Natal Program Our ante-natal program is designed to make you feel cared for and safe. It is much beyond a regular doctor’s consultation. More Details Fetal Medicine Unit What is Fetal Medicine? Fetal medicine is a new branch of medicine that includes the assessment of fetal growth and well being, the maintenance of fetal health and the diagnosis of fetal illnesses and abnormalities. More Details Neonatal Intensive Care Unit The Nest has a 12-bed NICU and a nursery that is fully equipped to handle all types of emergencies. Experts specially trained in NICU care manage newborns. More Details High Risk Pregnancy Every pregnancy has some risks, but the presence of certain conditions increases the risks manifold. These risks could endanger the life and health of the mother or the baby. More Details Natural Birthing (Normal delivery) The Nest promotes natural birthing. We believe each woman has inherent strengths to deliver her baby naturally, unless a health condition poses risks to her and the baby. Our Woman Care professionals help you prepare for the birth from the second trimester onwards. We encourage you to learn Lamaze and yoga. The involvement of the spouse in this process is important. Pain relief during labor The Nest is one of the few advanced centers in the country to offer epidural anesthesia for painless natural delivery. We have a dedicated and experienced team of medical professionals that assesses each patient and decides the type of pain relief she requires. The pain relief program is highly individualized. Our pain relief team comprises an anesthesiologist (an expert in conducting pain less delivery) and gynecologists experienced in conducting high risk pregnancies Blood Bank The blood bank is an integral part of any hospital and extends great support and strength to surgical and trauma departments. Sometimes blood transfusion is required during delivery and having a blood bank under the same roof is a big bonus. The Fortis Hospitals blood bank operates round-the-clock and meets the high standards of screening and preservation of samples.

The Fortis Hospitals Group has an exclusive association with HMI in India.The Nest enjoys the backing of Fortis’s five core super-specialties. We give you a wide choice of eminent obstetricians and gynecologists and specialists from other disciplines.

Polycystic Ovarian Syndrome or PCOS is one of the most common female endocrine disorder manifested obesity, Hirsutism (excessive facial or body hair), Alopecia (male pattern hair loss) irregular menstruation, acne associated with enlarged ovaries, Acanthosis Nigricans (brown skin patches), high cholesterol levels, exhaustion or lack of mental alertness, decreased sex drive, excess male hormones and infertility. Other symptoms can include sleep apnea (breathing difficulties during sleeping), thyroid disorders and depression and anxiety.. This complex disorder is characterised by excessive androgen production by the ovaries which interferes with the growth of the ovarian follicles.

1.Causes of Polycystic Ovarian Syndrome The cause of PCOS is uncommon. Most researchers think that more than one factor could play a role in PCOS. Genes are thought to be one factor. Women with PCOS tend to have their mothers or sisters affected with PCOS
2. How common is the syndrome among urban women. Any statistics. Which age group is mainly affected

PCOS is commonly found amongst urban women. The incidence varies from 1 out of 10 women, more common amongst infertile women. It is prevalent in young reproductive period. PCOS are caused by imbalance in the hormones in our brain and ovaries. Many women have higher than normal levels of insulin. PCOS usually happens when a hormone called LH or levels of insulin are too high, which result in extra testosterone production by the ovary.
3. What are the early symptoms that women should watch out for PCOS
Not all women with PCOS have the same symptoms, some of the symptoms are:
• irregular menstrual period / no periods
• infertility
• Increase hair growth on the face, chest, stomach – this condition is called hirutism
• Acne, oily skin or excessive dandruff
• excessive weight gain or obesity
• male pattern baldness or thinning or patching of hair
• dark brown or black skin on the neck, arms, breasts or thighs which is called Acanthosis Nigricans

4. Are women with PCOS more prone to developing diabetes
Women with PCOS have great chances of developing type II diabetes. More than 50% of women with PCOS will have diabetes or pre-diabetes before the age of 40
5. What is the treatment procedure
There is no specific cure for PCOS. It needs to be managed to prevent the problem
Birth Control pill:
For women who does not want to get pregnant birth control pill can control menstrual cycle, it may reduce male hormone levels and help to clear acne. Only progestrogen pill or better known as mini pill, can be taken.
Metformin -a drug which is used to treat diabetes is found to help women with PCOS symptoms. Abnormal hair growth will slow down and ovulation may return after few months of use
If a woman wants to get pregnant – lack of ovulation is usually the reason for fertility problem in PCOS. Several medication that stimulate ovulation can help women PCOS to get pregnant. For most patient Clomiphene Civate is the first choice of therapy to stimulate ovulation. If this fails Metformin is taken with Clomiphene is usually tried
Gonadotropin can also be used to stimulate ovulation. These are given as injection.
For hair growth or extra male hormone – anti androgen may reduce hair growth and clear acne. Spironolactone (Aldactone) has been used to reduce the impact of male hormone
Anti androgens are often combined with oral contraceptives

Incidence of Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) accounts for 90% of women with oligomenorrhoea (infrequent periods) and 30% of women with amenorrhoea (absent of periods) and over 70% of women with anovulation.

Diagnosis of Polycystic Ovarian Syndrome

Laparoscopy

Laparoscopy allows direct inspection of the ovaries; the ovaries are enlarged and polycystic. However, polycystic ovaries may appear normal at laparoscopy.

Vaginal ultrasound scan (better than abdominal)

The vaginal ultrasound may show the typical PCOS appearance but reliability varies with expertise.

Surgical Treatment
Ovarian drilling – is a surgery that brings in ovulation. It is done when a women does not respond to fertility medicines. This is done through laparoscopy. This surgery can lower male hormone levels and in ovation. But these affects may only last for few months.
Lifestyle Modification
Keeping a healthy weight by eating healthy food and exercise is another way of helping to manage PCOS. Many women with PCOS are overweight or obese. Even a 10% loss in body weight can restore a normal period and make a women’s cycle more regular.