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Doctor In The House:Obstetrics And Gynecology - Health (207) - Nairaland

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Ultrasound Machine Training On Obstetrics Pregnancy & Pelvic Scan in 2016 / Questions And Answers In Obstetrics, Gynaecology And Reproductive Health Issues / Re: Doctor In The House:obstetrics And Gynecology (2) (3) (4)

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Re: Doctor In The House:Obstetrics And Gynecology by matrix199(m): 4:54am On Jan 23, 2016
Babyrex:
Hi doctor,
I am 25, my period has stopped since July 2015. Took hormonal test and all was normal except progesterone which was 0.2
Placed on primolut-N, noticed that my period comes after using the drug, but doesn't show up the following month. It has happened twice already.
I am a single lady and need your help. Tnx

You're having low progesterone secretion. Your ovary is not secreting the hormone as usual. Did you ever take emergency contraceptive pills in the past?
Re: Doctor In The House:Obstetrics And Gynecology by Rukkington(f): 9:48am On Jan 23, 2016
matrix199:

If the pelvic scan reveals a POD is free(no fluid observed), it means no PID thus, no "prognosed" tubal blockage.
Well, apart from the HSG, no other less scarier diagnostic procedure. But then, if you don't have PID or salpingitis or endometriosis, you have nothing to worry about tubal blockage.

Thanks a bunch Doc.... Now am happy der is nothing wrong with me..... Lemme jez hope in God for a successful pregnancy.
Re: Doctor In The House:Obstetrics And Gynecology by Babyrex(f): 2:07pm On Jan 23, 2016
matrix199:


You're having low progesterone secretion. Your ovary is not secreting the hormone as usual. Did you ever take emergency contraceptive pills in the past?
Yes, once. I used postinor and I saw bleeding about 2days after. My period has stopped since then
Re: Doctor In The House:Obstetrics And Gynecology by omicron(m): 9:00am On Jan 26, 2016
Babyrex:
Hi doctor,
I am 25, my period has stopped since July 2015. Took hormonal test and all was normal except progesterone which was 0.2
Placed on primolut-N, noticed that my period comes after using the drug, but doesn't show up the following month. It has happened twice already.
I am a single lady and need your help. Tnx
Hi,

If you bleed following Primolut-N treatment, but do not bleed after treatment, it means that you are low on the hormone progesterone. This in turn means that you are not ovulating, as progesterone is mostly produced following ovulation.

So, the first stage is to diagnose the cause of your lack of ovulation. The commonest cause of lack of ovulation is PCOS, but there are other less common causes such as high prolactin.

Since you are apparently not ttc, and if it turns out to be PCOS, you may require extended treatment with a combined oral contraceptive, as this has been shown to help in PCOS as well as in absence of ovulation for which no cause is known.

However, you should not take any hormonal treatment, including oral contraceptives, until you have seen your doctor, and until you have been properly diagnosed.

All the best.

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Re: Doctor In The House:Obstetrics And Gynecology by Orente21(f): 9:37am On Jan 26, 2016
Pls help me,i beded cd 8,10,12, had high temperature in d mornin on cd 14, bed again cd 15,17,19. I had serious cramps and breast sore cd 24,25. I thot it was implantn.bt sadly Got my af on cd 28. What could b wrong wit me. B4 i get,i visitd hospital last month,was nt check bt placed on antibiotic,and told to start clomid nxt cycle. Bt i blv i ovulate bt implantatn didnt occur. Sorry 4d long story.
Re: Doctor In The House:Obstetrics And Gynecology by Nobody: 10:00am On Jan 26, 2016
Hi Doc, pls what do u advise for a woman who is 31weeks pregnant, scan shows fetal weight of 1.9kg, diagnosed with gestational diabetes(controlling with 6unit insulin twice daily 70\30) fasting for past 3weeks has been 75 to 95(75 been the lowest, and the highest been 95). Can she go ahead with. Normal delivery, her doc intends to remove her cerlage @37weeks. Her after meal 1hr has been between 100 and 140, occasionally 150(very rare). Does GDM stop vaginal delivery.
Re: Doctor In The House:Obstetrics And Gynecology by omicron(m): 1:35pm On Jan 26, 2016
Orente21:
Pls help me,i beded cd 8,10,12, had high temperature in d mornin on cd 14, bed again cd 15,17,19. I had serious cramps and breast sore cd 24,25. I thot it was implantn.bt sadly Got my af on cd 28. What could b wrong wit me. B4 i get,i visitd hospital last month,was nt check bt placed on antibiotic,and told to start clomid nxt cycle. Bt i blv i ovulate bt implantatn didnt occur. Sorry 4d long story.
Hi,

There is not enough from your history to suggest that something is wrong with you. Perhaps, you are overly anxious.

The symptoms you felt are unspecific, meaning that they do not specifically indicate a condition or problem. Generally, they could be seen in normal cycles during the second half of the cycle (ovulation - mesnses), or they could be part of the Premesntrual Syndrome (PMS) or pregnancy (which you have ruled out), while some could be a side effect of clomid.

Your days of bedding were in order (though you missed day 13), but even in perfect circumstances, coituss on the ovulation day does not guarantee conception for reasons not known.

Do not become too anxious, continue your clomid (as prescribed by your doctor) and keep trying. It will yet work.

All the best
Re: Doctor In The House:Obstetrics And Gynecology by omicron(m): 1:43pm On Jan 26, 2016
ilesanmioo:
Hi Doc, pls what do u advise for a woman who is 31weeks pregnant, scan shows fetal weight of 1.9kg, diagnosed with gestational diabetes(controlling with 6unit insulin twice daily 70\30) fasting for past 3weeks has been 75 to 95(75 been the lowest, and the highest been 95). Can she go ahead with. Normal delivery, her doc intends to remove her cerlage @37weeks. Her after meal 1hr has been between 100 and 140, occasionally 150(very rare). Does GDM stop vaginal delivery.
Hi,

No, GDM does not stop vaginal delivery. Unless there are other indications for CS, a woman will GDM will be allowed vaginal birth. In labour, the only difference is that your blood sugar will be monitored and insulin drip or injections given as required. And the baby would be monitored very carefully from the time of birth for signs of distress or low blood sugar.

Your blood sugar control has been very good.

Normally, women with GDM are induced at 38wks but since you are carrying a cerclage, 37wks is ok.

All the best

1 Like

Re: Doctor In The House:Obstetrics And Gynecology by Orente21(f): 1:50pm On Jan 26, 2016
omicron:
Hi,

There is not enough from your history to suggest that something is wrong with you. Perhaps, you are overly anxious.

The symptoms you felt are unspecific, meaning that they do not specifically indicate a condition or problem. Generally, they could be seen in normal cycles during the second half of the cycle (ovulation - mesnses), or they could be part of the Premesntrual Syndrome (PMS) or pregnancy (which you have ruled out), while some could be a side effect of clomid.

Your days of bedding were in order (though you missed day 13), but even in perfect circumstances, coituss on the ovulation day does not guarantee conception for reasons not known.

Do not become too anxious, continue your clomid (as prescribed by your doctor) and keep trying. It will yet work.

All the best
tanx doc. Its just dt i had cramp,swollen and sore breast,lost of appetite,and high temparature. So i thot dey were implantatn signs after ovulation.I felt i dnt ovulate regularly,bt wen i visitd d doc,he said,my cycle is stil normal range. So i wonder y am nt pregnant yet.bin tryin 4 few months nw. Al d same,tanx doc.
Re: Doctor In The House:Obstetrics And Gynecology by Nobody: 2:02pm On Jan 26, 2016
omicron:
Hi,

No, GDM does not stop vaginal delivery. Unless there are other indications for CS, a woman will GDM will be allowed vaginal birth. In labour, the only difference is that your blood sugar will be monitored and insulin drip or injections given as required. And the baby would be monitored very carefully from the time of birth for signs of distress or low blood sugar.

Your blood sugar control has been very good.

Normally, women with GDM are induced at 38wks but since you are carrying a cerclage, 37wks is ok.

All the best
Thanks God Bless you. Sorry you didn't comment on the size of the foetus, is that a normal range or bigger. Thanks God bless you real good doc
Re: Doctor In The House:Obstetrics And Gynecology by omicron(m): 2:20pm On Jan 26, 2016
ilesanmioo:
Thanks God Bless you. Sorry you didn't comment on the size of the foetus, is that a normal range or bigger. Thanks God bless you real good doc
You are welcome

The weight is slightly bigger than expected, but it is not enough to worry about as the measurement was subjective, and the final weight of the baby is what is important.

Keep the blood sugar within limits and the baby might not be too big to cause a problem.

All the best
Re: Doctor In The House:Obstetrics And Gynecology by Nobody: 2:38pm On Jan 26, 2016
omicron:
You are welcome

The weight is slightly bigger than expected, but it is not enough to worry about as the measurement was subjective, and the final weight of the baby is what is important.

Keep the blood sugar within limits and the baby might not be too big to cause a problem.

All the best
Thanks
Re: Doctor In The House:Obstetrics And Gynecology by omicron(m): 2:56pm On Jan 26, 2016
Orente21:
tanx doc. Its just dt i had cramp,swollen and sore breast,lost of appetite,and high temparature. So i thot dey were implantatn signs after ovulation.I felt i dnt ovulate regularly,bt wen i visitd d doc,he said,my cycle is stil normal range. So i wonder y am nt pregnant yet.bin tryin 4 few months nw. Al d same,tanx doc.
Ok

Don't worry then. If you try a few more months without success, then you may start investigations starting with semen analysis.

But for now, just be normal and you will take in.

1 Like

Re: Doctor In The House:Obstetrics And Gynecology by Orente21(f): 6:31pm On Jan 26, 2016
omicron:
Ok

Don't worry then. If you try a few morr months without success, then you may start investigations starting with semen analysis.

But for now, just be normal and you will take in.
tanx so much doctor.
Re: Doctor In The House:Obstetrics And Gynecology by Babyrex(f): 9:41pm On Jan 26, 2016
omicron:
Hi,

If you bleed following Primolut-N treatment, but do not bleed after treatment, it means that you are low on the hormone progesterone. This in turn means that you are not ovulating, as progesterone is mostly produced following ovulation.

So, the first stage is to diagnose the cause of your lack of ovulation. The commonest cause of lack of ovulation is PCOS, but there are other less common causes such as high prolactin.

Since you are apparently not ttc, and if it turns out to be PCOS, you may require extended treatment with a combined oral contraceptive, as this has been shown to help in PCOS as well as in absence of ovulation for which no cause is known.

However, you should not take any hormonal treatment, including oral contraceptives, until you have seen your doctor, and until you have been properly diagnosed.

All the best.
Thanks
Re: Doctor In The House:Obstetrics And Gynecology by Debbie2872: 9:13pm On Jan 27, 2016
Dear Doctor,

I carried out the HSG test but later results confirmed that but tubes are blocked.
So what are the possible alternatives for unblocking.

Thanks,
Re: Doctor In The House:Obstetrics And Gynecology by bamiyo05: 1:03pm On Jan 28, 2016
Hello Doctor, when can I go for hormonal test? and again can a raptured appendix block the fallopian tube?
Re: Doctor In The House:Obstetrics And Gynecology by omicron(m): 6:56pm On Jan 28, 2016
Debbie2872:
Dear Doctor,

I carried out the HSG test but later results confirmed that but tubes are blocked.
So what are the possible alternatives for unblocking.

Thanks,
Hi,

Blocked tubes can be treated by tuboplasty- a surgery to repair the tubes- while hydrointubation, an unfavoured procedure whereby solutions are used to flush open the tubes, might help in partial blockade. The success rates of these procedures are unfortunately not good.

Most gynaecologies will advise IVF as soon as tubal blockade is comfirmed.

Let a gynae review your HSG and advise you individually.

All the best
Re: Doctor In The House:Obstetrics And Gynecology by omicron(m): 7:02pm On Jan 28, 2016
bamiyo05:
Hello Doctor, when can I go for hormonal test? and again can a raptured appendix block the fallopian tube?
Hi,

Hormone profile is done between CD 3-5, except progesterone which is done on day 21 (in a woman with a 28-day regular cycle).

Yes, ruptured appendix can cause tubal blockade, after it has caused peritonitis - an inflammation of the thin membrane covering the internal abdominal organs.

All the best

1 Like

Re: Doctor In The House:Obstetrics And Gynecology by Chili89: 8:36pm On Jan 28, 2016
Hello doc, I went for a scan todays which is suppose to be 8weeks but scan says I'm 9weeks. My LPM was 4th of dec. Though there's a heart beat but I'm super worried. Is everythn ok?
Re: Doctor In The House:Obstetrics And Gynecology by omicron(m): 10:20am On Jan 29, 2016
Chili89:
Hello doc, I went for a scan todays which is suppose to be 8weeks but scan says I'm 9weeks. My LPM was 4th of dec. Though there's a heart beat but I'm super worried. Is everythn ok?
Hi,

If it is just the difference in the gestational age then no need to worry. You may repeat the scan at 20weeks to check for any foetal anomaly. This should be routine, and does not suggest that there is something wrong with your baby

You have nothing to worry about

All the best.
Re: Doctor In The House:Obstetrics And Gynecology by Kudibaby(f): 7:35am On Jan 30, 2016
hello dr,my period ranges from 25-28 days.my last period this month came on day 30,though when it came,it was painless but it lasted 7 days,on day 8 when we bd,i saw blood and this lasted 4 a day, this has never happend b4,am so confusd cos i am ttc,though i ws diagnosd of fibriod and ovarian cyst could they b d cos.ps my flow used to b very heavy on day 1 nd 2 dark blood with cloth and in d 3rd nd 4th day it ll dark spot nd by d 5th it will b brownish,bt this time it came with plenty ewcm and d blood is red without cloth.my question is
1-what could cos d delay
2-why did d flow lasted 4 8 days
3-is d fibriod nd cyst d reason my flow used to be dark with clot.thanks may God bless u.
Re: Doctor In The House:Obstetrics And Gynecology by sleekybaby29: 8:49am On Jan 30, 2016
Good day Doc. Pls does egovin Boost sperm? A friend told me to buy for my hubby. We have been TTC for a year plus now. I really don't kw wat to do.
Re: Doctor In The House:Obstetrics And Gynecology by folash: 8:06pm On Feb 01, 2016
Hi doc Omicron and Matrix199 can u pls help interpret this result.
The uterus is bulky (AP diameter 5. 46cm), empty and anterverted with regular outline and seen returning homogeneous echopattern.
The endometrial plate is seen and intact.
There are two ovoid shaped hypoechoic intramural solid masses with smaller seedlings measuring 2.89cm × 2. 12cm and 2.03cm × 1. 36cm seen in the fundus and posterior uterine segment respectively indicative of uterine leiomyomas.
The right ovary is remarkably larger than the left normal sized ovary and both are seen with peripherally arranged rudimentary follicles arranged in a "string of pearls" pattern indicative of polycystic ovaries.
right ovary: 4. 50cm × 3. 31cm × 2. 41cm; volume=18. 74cm
left ovary : 3. 43cm × 3. 57cm × 2. 71cm; volume= 10. 02cm
There is no significant fluid collection seen in the pouch of douglas
Re: Doctor In The House:Obstetrics And Gynecology by omicron(m): 9:23pm On Feb 01, 2016
folash:
Hi doc Omicron and Matrix199 can u pls help interpret this result.
The uterus is bulky (AP diameter 5. 46cm), empty and anterverted with regular outline and seen returning homogeneous echopattern.
The endometrial plate is seen and intact.
There are two ovoid shaped hypoechoic intramural solid masses with smaller seedlings measuring 2.89cm × 2. 12cm and 2.03cm × 1. 36cm seen in the fundus and posterior uterine segment respectively indicative of uterine leiomyomas.
The right ovary is remarkably larger than the left normal sized ovary and both are seen with peripherally arranged rudimentary follicles arranged in a "string of pearls" pattern indicative of polycystic ovaries.
right ovary: 4. 50cm × 3. 31cm × 2. 41cm; volume=18. 74cm
left ovary : 3. 43cm × 3. 57cm × 2. 71cm; volume= 10. 02cm
There is no significant fluid collection seen in the pouch of douglas
Ok.

The uterus has small fibroids within its muscle layer. This should however not cause problems (except maybe pains during pregnancy) as they are small and within the muscle, rather than in the cavity.

The right ovary showed features of Polycystic ovaries, a condition whereby small small egg follicles fill the ovaries without any of them maturing, hence no ovulation.

If you have other features such as appearance of masculine hairs (beards, chest hair, upper thighs, etc), deepening of voice, scanty menses or irregular menses, along with the polycystic ovaries, they point towards Polycystic Ovarian syndrome (PCOS)


In summary, the scan showed small insignificant fibroids, and features suggestive of PCOS.

All the best
Re: Doctor In The House:Obstetrics And Gynecology by firstlady4(f): 9:28pm On Feb 01, 2016
firstlady4:
Hi Dr, could not upload test results.

HOMONAL PROFILE

LH 14.27 U/L
FSH 3.61 U/L
PROLATIN 24.30 NG/ML/(5-25)
PROGESTERONE 0.289 NG/ML
OESTRADIOL (E3) 145.9 PG/ML

ENDOCRINE THYROID

TS4 3.01 ( 0.27-4.2)
T3 2.62 (1.3 -3.10)
T4 109.3 (6.0 -181.0)

FEMALE REFERENCE RANGE

Follicle ph/Ovulatry ph/Luteal P/ Post Menopause
fsh(u/l) 3-20 9-26 1.0-12 18-153

lh (u/l) 2-15 22-105 0.6-19 16-64

pro(ng/nl)<1-5 - 3-20 0-15

E3 (ng/ml) 50-145 1/2-443 50-241 <59

DID THE HOMONAL PROFILE 2DAYS BEFORE EGG WHITE DISCHARGE.


PELVIC SCAN

" Uterus is non-gravid, anteverted and significantly bulky in size with non-uniform myometrial echo pattern. It measures 41.2mm in AP Diametre. With a defined cystic masses with internal echoes measuring 30mm x 34mm was noted at the right ovary.
left adnexen is free
mild fluid collection noted in the pouch of douglas.

Vagina culture result

Wet Preparation

Pus cell - 0 - 2/hpf
Epithetial cell - many / hpf
Bacterial cells - +
yeast cells - +

Culture: No significant bacterial growth after 48hrs of incubation at 38c.

THE PELVIC SCAN AND CULTURE WAS DONE FOUR DAYS AFTER MY PERIOD.


Please sir am seriously worried. Would be happy if you can help me evaluate the above results. God bless you.

Please Dr. Omicron, help me out I asked this question two weeks ago no reply.
Re: Doctor In The House:Obstetrics And Gynecology by omicron(m): 9:56pm On Feb 01, 2016
firstlady4:


Please Dr. Omicron, help me out I asked this question two weeks ago no reply.
Hi,

I cannot interpret the hormone profile now as I don't comprehend the reference ranges given. I will check the corrrect ranges later tomorrow or so, and get back to it.

The culture is insignificant. No signs of infection.

The scan showed a right ovarian cyst. Normally, this should not cause any alarm unless it fails, or has failed, to disappear after about 3 months.

There is also a non-uniform myometrial echo pattern. This is not enough to make any diagnosis, but it is not the normal pattern. It could be a misjudgement from the sonographer, perhaps blood vessels within the womb. It can also suggest adenomyosis, a condition whereby the the cells from the lining of the womb, grow within its muscle layer causing infertility, painful and heavy menses. It is better to redo the scan, by a more experienced or qualified personel.

All the best
Re: Doctor In The House:Obstetrics And Gynecology by folash: 10:37pm On Feb 01, 2016
omicron:
Ok.

The uterus has small fibroids within its muscle layer. This should however not cause problems (except maybe pains during pregnancy) as they are small and within the muscle, rather than in the cavity.

The right ovary showed features of Polycystic ovaries, a condition whereby small small egg follicles fill the ovaries without any of them maturing, hence no ovulation.

If you have other features such as appearance of masculine hairs (beards, chest hair, upper thighs, etc), deepening of voice, scanty menses or irregular menses, along with the polycystic ovaries, they point towards Polycystic Ovarian syndrome (PCOS)


In summary, the scan showed small insignificant fibroids, and features suggestive of PCOS.

All the best
Thanks doc. Pls does it mean that every other thing is fine according to the scan except the polycystic condition. I have none of the named masculine features, and i have a regular monthly period, ranging between 32-35 days.
Re: Doctor In The House:Obstetrics And Gynecology by Saao(m): 10:51pm On Feb 01, 2016
Hi Doc,
Please I need ur advice. My wife is 6 months plus pregnant, our first baby. She so much like hollandia yuoghout and she uses it to take her drugs, can it affect the child anyway? Again I really want her to give birth naturally, that is her wish as well. What precautionary must we take to achieve the above? Thanks alot

1 Like

Re: Doctor In The House:Obstetrics And Gynecology by firstlady4(f): 1:05am On Feb 02, 2016
omicron:
Hi,

I cannot interpret the hormone profile now as I don't comprehend the reference ranges given. I will check the corrrect ranges later tomorrow or so, and get back to it.

The culture is insignificant. No signs of infection.

The scan showed a right ovarian cyst. Normally, this should not cause any alarm unless it fails, or has failed, to disappear after about 3 months.

There is also a non-uniform myometrial echo pattern. This is not enough to make any diagnosis, but it is not the normal pattern. It could be a misjudgement from the sonographer, perhaps blood vessels within the womb. It can also suggest adenomyosis, a condition whereby the the cells from the lining of the womb, grow within its muscle layer causing infertility, painful and heavy menses. It is better to redo the scan, by a more experienced or qualified personel.

All the best

Thank you for the swift response. I have being feeling strange pains on my right pelvic which comes 7-8days after my periods for over a year now. some times, the pain extend to my leg and arms but only last for two days every month.

My period, irregular which most times can be 32, 35 and 40days counting from the last flow to the next. But I do see egg white discharge every 2weeks after my period monthly.

I have attached a scanned copy of the homonal profile result.

Re: Doctor In The House:Obstetrics And Gynecology by Nobody: 7:16am On Feb 02, 2016
Hi doc pls I need to confirm sumtin for a female friend of mine, she v bin aving yeast infection for like 3years nw but it not going,coz she gave used different antibiotics some one told her 2 use flaggy for 10days that it will go pls how effective is flaggy on such infectn? Thanks
Re: Doctor In The House:Obstetrics And Gynecology by oomiyale(f): 9:30am On Feb 02, 2016
Hi doc,

Pls I av been ttc since my last ectopic preganacy last year April.nd I'm not getting pregnancy thought I only tried for 2 month nd got pregnant with d first ectopic. My doc as me to hsg to know d condition of my tubes. Plz is that neccesary. And my period r irregular Tnx

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