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18/Dec/2017

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 sucess always.

Attached is a picture of Gabi and Leo celebrating Diwali at home.

Forever thankful,
Marina, Jesse, Gabi and Leo

 

Diwali wishes from Canada


18/Dec/2017

Dear Dr. Shivani & Staff,

I just thought I need to take a moment to thank you all! Everyone of you have been so kind, friendly, helpful, professional & caring!

I am so please to have been referred to you & I am already delighted with the result.

I will certainly thankful to you

Thank you for helping us welcome our sweet baby into this world

So appreciated by :-
Pooja & Siddharth


18/Dec/2017

Dear Dr. Shivani Mam & Dr. Pooja Mam,

We both thanks to Dr. Shivani and Dr. Pooja for making our IVF Successful.

It is just because of professional knowledge and experience of Dr. Shivani and Dr. Pooja in IVF Technology. Our IVF has become successful and we both can become parents.

We both thanks to Dr. Shivani and Dr. Pooja and Sisters and entire SCI Team for their cooperation and making our IVF successful.

Thanks to Dr. Shivani & Dr. Pooja

From
Sachin & Reshu


 


18/Dec/2017

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

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).

 

CONSEQUENCES

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.


18/Dec/2017

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

  • Type2 Diabetes – Vitamin D is required to balance sugar levels in the blood by regulating the secretion of insulin. Hence, Vitamin D deficiency increases the risk of developing Type2 Diabetes later in life.
  • Tuberculosis
  • Cardiovascular diseases
  • Osteoporosis, osteopenia (thinning of bones) – as Vitamin D helps in absorption of Calcium from the food we eat in the intestine. Therefore, Vitamin D deficiency will lead to calcium deficiency as well which will lead to weak and achy bones causing osteoporosis and increased risk of fractures.
  • Cancer
  • Asthma
  • Flu – as Vitamin D plays an important role in activating the cells of the immune system which helps to fight infections. Therefore, if deficiency leads to risk of recurrent infections.
  • Anaemia
  • Infertility – a daily morning walk of 20 minutes under the sun can help in boosting the reproductive system as Vitamin D stimulates the production of female hormone progesterone.

Sources of Vitamin D :-

  • Vitamin D is photosynthesized in the skin on exposure to sunlight – UVB rays.
  • Animal food sources – fatty fish (salmon, mackerel and tuna), cod liver oil, milk, egg yolk, etc.
  • Mushrooms

Causes of Vitamin D deficiency:-

  • Staying indoors – minimal exposure to direct sunlight specially between 10.00 AM to 3.00 PM.
  • Lifestyle patterns such as clothing that limit sun exposure.
  • Strict vegan diet – most Indians are vegetarian.
  • Sun screen lotion.
  • Lactose intolerance which has a high prevalence in India.
  • Cooking practice in India – shallow and deep frying is prevalent in India during which Vitamin D is thermally degraded.
  • Inadequate fortification of dairy products with Vitamin D in India.
  • Pollution and smog in the cities can block the sun rays. Therefore, in Indian metro cities 50% females had Vitamin D deficiencies.

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:-

  • Muscle weakness – a person gets easily fatigued.
  • Depression
  • Pain sensitivity is increased
  • Stress fractures – as the bones become weak the incidences of fractures increases
  • Sleepiness specially in the day times
  • High blood pressure – as Vitamin D helps in regulating the blood pressure
  • Increased irritability – as Vitamin D affects the levels of serotonin in the brain which impacts hormones.

How to measure Vitamin D deficiency?

  • 25 – Hydroxyl Vitamin D blood test – normal range is 20 ngm/ml – 50 ngm/ml.
  • Level less than 12 ngm/ml indicates 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:-

  • Sun exposure – spending at least 15-20 min. a day in direct sunlight, 3-5 times a week without applying sun screen lotion.
  • Fortification of staple foods with Vitamin D.
  • Vitamin D supplementation – Commonly available is D3 (cholecalciferol) and 1 alpha hydroxy Vitamin D3. Multi vitamin formulations are also available which contain about 400 intra units of Vitamin D3. Supplementation can be oral or by injections. If the values are very low, injection may be the best option.

 

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.


18/Dec/2017

Dear Dr Shivani, Dr Vishal & SCI Team

Whenever we used to see such…..Thank you….cards on Walls of SCI Hospital or other IVF Clinics from where we undertook earlier IVF Cycles {and they failed EVERYTIME}, we used to wonder that when would that Day come when I would be writing my own such card…….and now when this day has come, I find myself SPEECHLESS to how to express my happiness.

Only because of YOU…..Dr Shivani, we have got success in our IVF Cycle and I tell you that for US, you are only next to God!!

What touched me most is your personalized and humane approach.

You always patiently heard our concerns & fears and gave us your honest advice…which is a rare commodity these days.

Your staff too is very gentle…an exception in this brutally commercialized world.

Best of all…was ‘follow up process’ of SCI Hospital Staff where they reminded us about Medicines, Injections, Visit to Hospital etc.

Please be this way forever…

Kalpana

&

Anand

Dr Shivani Sachdev Gour

 


SCI IVF Centre is a brand new, state-of-the-art IVF Centre located at Kailash Colony, South Delhi started in 2011. It provides comprehensive fertility services to both male and female patients as per the Government of India Guidelines and Policies. SCI IVF Centre is a unit of SCI Healthcare and is ISO 9001:2008 accredited.

SCIIVF Hospital
Address: A-1, Ground Floor, Kailash Colony
New Delhi 110048, India

Phone number : 011-41022905

Copyright 2016 SCI IVF. All rights reserved.