We were married in 2002. We were really blessed in our business but we cant have children. So, we went to different places like Rangoon, Mumbai, Bangkok and Guwahati doing IVF. But all fails after 1 or 2 months. We feel really down.
Our friends told us that it is possible to have children through surrogate. So, we came to SCI International Hospital Delhi. After 16 years of marriage, we were blessed with a beautiful daughter of our own through Dr Shivani. Words cant explain the height of our happiness.
May God blessed Dr Shivani and all the staff of SCI International hospital.
Dear Dr Shivani Sachdev Gour & Dr Pooja Gupta
Words not enough to thank you for all that you did for us. You made us feel comfortable during a time that was pretty scary for us. You are a great doctor and we are so glad that you were the one to help us achieve our goal of adding to our family.
We would like to thank you from the bottom of our heart for the IVF treatment which was successful in first attempt only. We truly admire the way you handled both of us right from day one upto the day the final confirmatory test done.
This is biggest decision to us was to decide which doctor to select. We meet a couple of doctors in Delhi. But the day we meet you and the way you filled us with confidence and your diagnosis and inference, it was clear to both of us that it is you with whom we are going to move ahead and today not only we both, but whole family is very happy to hear the news that my wife is pregnant.
This is really great time for us and our family and I can say with full confidence that you are not only the best IVF doctor in India, but also best motivators, supporter with a dashing personality.
The stay is amazing. You all made us feel comfortable and important. “We will never forget what you were able to do us.”
We wish you and your entire team along with special thanks to sister for their journey and we pray that every patient gets the baby they along for.
“Thank you, Dr Shivani Sachdev Gour and Dr Pooja, for your kindness and attention throughout my wife treatment. I appreciated your gentle manner and recommendations. Your patients are lucky to have you!”
You are truly a messenger of god to people
Hi SCI team,
Hope you all had a wonderful Diwali!
We want to wish you a very happy year ahead. May this divine festival brings a lot of light, joy and cheer to your clinic for the whole new year to come. Much luck and success always.
Attached is a picture of Gabi and Leo celebrating Diwali at home.
Marina, Jesse, Gabi and Leo
Talking about the post delivery bleeding which is an important clinical situation which can have some serious consequences on the health of woman if not managed properly at the same time, Dr Shivani Sachdev Gour, Gynaecologist and IVF Expert, SCI Healthcare shares her views on how one can manage the situation. She says that its management involves an aggressive approach which includes resuscitation of the compromised mother and also to find out the cause of bleeding. This involves oxygen administration, bimanual massage of uterus, immediate intravenous fluid administration and certain injections to contract the uterus which can stop the bleeding. If the blood loss is excessive, the woman might need blood transfusion. If the bleeding persists even after massage and injections then there may be some retained placental tissue or there might be a traumatic cause for which the patient needs to be shifted to the operating room and complete exploration of the genital tract is required by an expert and experienced assistants for evidence of any injury. She lists out absence of blood transfusion facilities and ignorance of illiterate women is the factors contributing to excessive bleeding after delivery. It can cause infection, blood transfusion reactions, thrombosis and failed lactation. In order to prevent post delivery bleeding one should pay proper attention to nutrition and a balanced diet should be taken daily.
After the delivery of baby, there is bleeding from the uterine bed from where the placenta is detached. This bleeding is stopped by effective contraction of the uterus. Bleeding after delivery may continue for about a month but becomes lesser in amount and pinkish in the later days. It consists of blood and shedding of the uterine lining. Excessive post delivery bleeding is an important clinical situation which can have some serious consequences on the health of the woman if not managed properly at the right time. It can occur either after a vaginal birth or following cesarean section.
In medical terms Post delivery bleeding has been defined as excessive if the blood loss following vaginal delivery is more than 500ml or in case of C Section more than 1 Litre. But sometimes blood loss even less than this cut off may be poorly tolerated by the mother if she is anemic. It is a clinical emergency which has to be dealt with immediately in the form of fixed protocol. This is defined as PPH(Post Partum Haemorrhage) drill which has to be followed by the attending obstetrician along with the team members.
There can be different causes of excessive bleeding after delivery which can be according to the time period of presentation after delivery. Excessive bleeding within 24 hours of delivery is called primary postpartum hemorrhage or bleeding. If it occurs after 24 hrs till 6 weeks of delivery it is known as secondary hemorrhage or bleeding. Immediately after delivery of the baby, the uterus starts contracting and retracting,the placenta separates and the natural process of contracting of the uterus stops the bleeding. For the uterus to contract effectively, the placenta should be completely removed. If the uterus is contracted properly then trauma to genital organs has to be ruled out like uterus, cervix and vagina or from episiotomy. Sometimes there may be a delay in the delivery of placenta which may be more than 1hour leading to excessive bleeding. Post delivery bleeding after 24hours of delivery is usually due to infection in uterus or other parts of genital tract. It may also be due to retained bits of placenta or membranes.
There are other causes that intensify the bleeding post delivery such as presence of coagulation defects, multiple pregnancy, excessive liquor, pre existing anaemia, preence of uterine fibroids, uterine malformation or prolonged labour. Also infection due to prolonged leaking is a contributing factor.
Management of post delivery bleeding involves an aggressive approach which includes resuscitation of the compromised mother and also to find out the cause of bleeding. This involves oxygen administration, bimanual massage of uterus, immediate intravenous fluid administration and certain injections to contract the uterus which can stop the bleeding. If the blood loss is excessive, the woman might need blood transfusion. If the bleeding persists even after massage and injections then there may be some retained placental tissue or there might be a traumatic cause for which the patient needs to be shifted to the operating room and complete exploration of the genital tract is required by an expert and experienced assistants for evidence of any injury. Any laceration or tear can be repaired and one should look out for any blood collection(hematoma).
Excessive bleeding after delivery is an important cause of maternal morbidity and mortality worldwide. It is taking a high toll especially in the rural population due to lack of proper care during pregnancy and delivery. Absence of blood transfusion facilities and ignorance of illiterate women are contributing factors. Excessive bleeding may cause infection, blood transfusion reactions, thrombosis and failed lactation. Late complication may be a deficiency of hormones due to deficient blood supply to pituitary gland during shock.
PREVENTION OF POST DELIVERY BLEEDING
It is very important that one is in good health at time of delivery. Proper attention should be paid to nutrition and a balanced diet should be taken daily. Also green leafy vegetables and fruits should be included. Apart from this, one should take all the supplements prescribed to her especially iron tablets. During antenatal period one should get her hemoglobin checked frequently and any deficiency should be treated.
High risk pregnancies should be delivered at a tertiary centre. In cases of previous caesarean delivery the chances of adherent placenta increase so any USG showing the likelihood of adherent placenta must be followed by an MRI and a senior obstetrician should be involved.
Dr Shivani Sachdev Gour, Gynaecologist and IVF Expert, SCI Healthacare shares her views on how despite being sun abundant in India, Vitamin D deficiency is found in the country especially in women. She discusses the sources by which one can get Vitamin D, consequences and signs of deficiency and how one can measurement it. She further discusses the importance of Vitamin D for women. Vitamin D increases fertility, prevents breast cancer, make bones healthy and strong, prevents PCOD and support immune system. She suggests that one could obtain Vitamin D from three sources namely sun exposure, fortification of staple foods with Vitamin D and Vitamin D supplementation.
Inspite of India being a country of abandoned sunshine, it is estimated that more than 80% of healthy Indians especially women are Vitamin D deficient. Indian women both in urban and rural settings and of all socio economic strata are Vitamin D deficient and are not even aware of this deficiency and its consequences.
Vitamin D deficiency is associated with high prevalence of
Sources of Vitamin D :-
Causes of Vitamin D deficiency:-
Vitamin D helps in promoting healthy bones by promoting the absorption of calcium. Vitamin D is also important during pregnancy as it helps to build the baby’s bones and teath and a deficiency during pregnancy may cause growth retardation, skeleton deformities and low birth weight. After birth the child may develop rickets and delayed physical development. Vitamin D deficiency also affects the pregnant mother as it may lead to complications such as pre term delivery, gestational diabetes, pre eclampsia and infections.
Recommended daily intake of Vitamin D for pregnant women – 4000-6000 IU per day (as advised by Vitamin D Council).
During breast feeding also Vitamin D is important for strong and healthy bones in the baby.
Signs of Vitamin D deficiency:-
How to measure Vitamin D deficiency?
Why Vitamin D is important for women?
# increased fertility
# prevents breast cancer as Vitamin D has shown to prevent breast cancer cell growth and decrease the expression of cancer causing genes. In post menopausal women improvement in calcium and Vitamin D levels reduce the risk of all cancers.
# Strong and healthy bones
# Immune support – the killer cells of the immune system which are responsible for destroying the harmful pathogens are supported by Vitamin D.
# Prevents Polycystic Ovarian Syndrome
Recommended intake of Vitamin D in females (By Vitamin D council) – 1000 Intra Units per 25pounds of body weight
Vitamin D can be obtained from 3 sources:-
Oral: Vitamin D3, 60000 IU granules in 1gram sachets. 1 sachet can be taken at an interval of 1-4 weeks as required.
Injection: Injection Arachitol 600000 units per ml, Intra muscular, every two weeks for 2 months
Taking Vitamin D supplements can cause hypervitaminosis D, which can be dangerous.