Obstetrics and Gynacology

At Sudha Hospital for Women care is taken care by Dr Prasanthi M.S.(Gynec), Fellowship in reproductive medicine (CIMAR). Trained at National University of Health at Singapore in Infertility. At Sudha we had been recognized for our expertise in providing comprehensive, specialized and personalized care for Women’s health issues. Our women care facilities include fetal scan centre, Seperate rooms, ICU, Labour Room, Separate OT with the best technology to address all your health needs. We also have post delivery care for Babies as we have an in House neonatalist & Pediatrician.

At Sudha Hospital we provide the following services in Obstetric and Gynecology

Obstetric services

  • Reproductive endocrinology (hormonal defects) and infertility
  • Pain management for labour and delivery
  • Infertility services
  • Care of the pregnant woman: comprehensive pre-natal care, exclusive labour suites, 24 hr surgical capability and anesthesia support, complete maternal and fetal monitoring , immediate access to Neonatal ICU, etc.
  • High risk pregnancy including diabetes in pregnancy, pre-eclampsia and hypertensive disorder, previous or recurrent pregnancy loss, preterm labor and delivery, pregnancy with cardiac problem, any medical disorder
  • Multidisciplinary care if needed in associated cardiac, mental, renal and general medical problems.
  • Multi-disciplinary care for co management of high risk pregnancies with endocrinologist, physician, anesthetist, ultra sonologist, etc

  • Gynecological services

    Myomectomy is the surgical removal of uterine fibroids without the removal of the uterus. There are several techniques that may be used, and the choice of the technique depends on the location and size of the fibroids as well as the characteristics of the woman. It is sometimes impossible to remove all the fibroids, and new fibroids may grow after a myomectomy. Though myomectomy is the only accepted procedure for fibroids in a woman who wants to maintain fertility, a myomectomy may lead to scarring that can negatively affect future fertility. Following a myomectomy, cesarean delivery is frequently recommended to prevent the myomectomy scar from breaking open during labor. Types of myomectomies include:

  • Laparoscopic myomectomy (removal of uterine fibroids)
  • Abdominal myomectomy
  • Hysteroscopic myomectomy

  • Hysterectomy:
    Hysterectomy is a surgery to remove the uterus. It prevents future pregnancy and eliminates fibroid-related bleeding and pressure symptoms. There are two categories of hysterectomy:
  • Total hysterectomy is removal of the entire uterus, including the cervix (the lower part of the uterus)
  • Vaginal hysterectomy
  • Laparoscopic total hysterectomy (removal of uterus and cervix)
  • Abdominal hysterectomy
  • Supra-cervical hysterectomy is removal of the upper part of the uterus, but not the cervix. This type of surgery is not recommended for women with a history of an abnormal Pap smear or certain types of pelvic pain. Up to 5-10% of women may continue to have chronic cyclic bleeding after surgery, similar to a period. It was previously thought that a supra-cervical hysterectomy would preserve sexual function better than a total hysterectomy, but research does not support this theory. Benefits to supra-cervical hysterectomy include slightly faster surgery and shorter recovery time.
  • Laparoscopic supracervical hysterectomy (removal of uterus, preservation of cervix)

  • Laparoscopic surgery in endometriosis

    Our clinical experience tells us that better results are obtained when endometriosis is excised (cut out), rather than cauterized or lasered, whenever there is the slightest hint that the disease goes deeper than the most superficial layers of pelvic tissue. We have extensive experience with this technique, including in cases of very advanced (stage IV) disease.

    Laparoscopic removal of ovarian cysts

    Ovarians cysts up to 10 cm (3.5 inches) in diameter are routinely removed laparoscopically in our division. In some cases in which careful preoperative testing has shown that the risk of a cancer is very low, even much larger cysts have been removed laparoscopically. Once separated from the healthy ovary tissue, the cyst is put in a plastic bag which is removed through a small incision at the navel.

    Laparoscopic removal of adhesions (scar tissue)

    When careful evaluation has shown that adhesions may play a role in a person's abdominal or pelvic pain, we sometimes recommend laparoscopic surgery to try to reduce the amount of adhesions present. This type of procedure is most often helpful when adhesions are mild or moderate in degree.

    When adhesions are very severe, long term results are often disappointing. We do find that even if relief is incomplete or temporary, the benefits of the surgery provide an opportunity to more effectively address other parts of the pain problem such as muscle disorders, bowel function problems, deconditioning, excess weight, and depression.

    Laparoscopic removal of a tube and ovary

    When an ovary is too involved with a disease process to salvage, it is almost always possible to remove it using laparoscopic techniques. In some cases, it is necessary to divide adhesions between the bowel and the ovary in order to remove the ovary.

    Laparoscopic myomectomy (removal of uterine fibroids)

    Some fibroids can be removed laparoscopically. Laparoscopic surgical repair of incisions made in the uterus to remove the fibroids heal just as well as similar incisions performed through open laparotomy (large incision) surgery.

    Laparoscopic myomectomy is a myomectomy performed with minimally-invasive techniques, using a narrow telescope-like instrument (laparoscope) to see inside the abdomen. The abdomen is first inflated with carbon dioxide gas to create space for operating. Four or five small (1/4 - 1/2 inch) incisions are made in the navel and lower abdomen to allow insertion of both the laparoscope and long, narrow instruments through tubes called “ports”. Using the laparoscope to see, the fibroid is shelled out of the uterus, and the uterine incision is repaired. Laparoscopic myomectomy usually requires one night of hospitalization. Recovery time is approximately 2-3 weeks.

    As in any surgery, complications from myomectomy, such as bleeding, infection, or injury to nearby organs, may occur. There is a 1-8% chance of having to convert from a laparoscopic myomectomy to an abdominal myomectomy. During myomectomy, rarely (in less than 1%) an unplanned hysterectomy may be required, for instance, if the uterus bleeds excessively. Recurrent fibroids may follow up to one third of myomectomies. Pregnancy is not recommended during the first 3-6 months after surgery.

    Laparoscopic total hysterectomy (removal of uterus and cervix) / Single Incision Laparoscopic total hysterectomy

    Laparoscopic hysterectomy involves removing the entire uterus with minimally-invasive techniques, using a narrow telescope-like instrument (laparoscope) to see the inside of the abdomen. Under complete general anesthesia, the abdomen is first inflated with carbon dioxide gas to create space for operating. Four or five incisions (1/4 to ½ inch each) are made in the navel and lower abdomen to allow insertion of both the laparoscope and long, narrow instruments through tubes called “ports.” A normal sized uterus, once it is detached from its supports, can be removed through the vagina. A large uterus can be reduced to smaller pieces using a laparoscopic morcellator. With our long experience and high volume, we are comfortable removing a uterus as large as a 30 week pregnancy.

    Once the uterus is removed, the inside edges of the vagina are brought together using suture, which is readily done laparoscopically. We credit our extensive laparoscopic experience over the years for this achievement.

    Laparoscopic uterine suspension

    In about 15-20% of women, the top end of the uterus leans back toward the backbone, instead of leaning forward, toward the bladder. This is called a retroverted, or "tipped" uterus. In some women, this position of the uterus can be associated with pain, especially pain during sexual intercourse. A laparoscopic uterine suspension can fix this problem with a very high degree of success (over 90%).

    Hysteroscopic surgery (removal of polyps or fibroids from the inside of the uterus)

    When abnormalities such as polyps or small fibroids grow inside the uterus, irregular and heavy bleeding can result. In many cases, they can be removed by placing an instrument called a hysteroscope through the cervix to examine the inside of the uterus and then using various instruments to remove or vaporize the fibroid or polyp a little at a time. It takes between 30 and 90 minutes to accomplish, and usually the patient can go home the same day.

    Vaginal hysterectomy

    When the cervix and the uterus are surgically removed by operating through the vagina, this is called a vaginal hysterectomy. This procedure has been a standard in gynecology for over 50 years. In the 1970's it was commonly performed as a sterilization procedure, hence many gynecologists trained during that time gained a great deal of experience in performing the procedure. As the rate of hysterectomy has declined, and as other methods have been developed, more recently trained gynecologists have had less experience performing this procedure.

    When it is surgically possible to perform vaginal hysterectomy, then the laparoscopic approach has few advantages when the surgeon is equally skilled at both. There are some situations which increase the risk of vaginal hysterectomy, however: multiple prior Cesarean sections, other major abdominal surgery, past pelvic infections, endometriosis, obesity, small pelvic bony canal, etc. Hospital stay is usually 1 night and recovery time is approximately 2-3 weeks. In most circumstances, if a woman has not delivered a full-term baby vaginally, the hysterectomy is more easily accomplished by the laparoscopic route. There is now good evidence that less blood is lost in a laparoscopic hysterectomy than in a vaginal procedure.

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