Effect of pollution on pregnant woman and the child and what can you do to avoid complications by Dr Shivani Sachdev Gour
Conversation between Dr Shivani Sachdev Gour and ZeeBiz Anchor Anuiya Yadav
Effect of pollution on pregnant woman and the child and what can you do to avoid complications by Dr Shivani Sachdev Gour
Conversation between Dr Shivani Sachdev Gour and ZeeBiz Anchor Anuiya Yadav
Periods के दौरान इस वक्त Sanitary Pad बदलना जरूरी है . Female Specific Health Problem, JK24x7News discussed with Dr Shivani Sachdev Gour to Know about Sanitary Pad uses during periods- https://www.youtube.com/watch?v=zb-w57nfxWw&feature=youtu.be
To all the lovely staff at SCI, We will always be grateful for your compassionate care and all the help we have received from you.
Special Thanks to Shivani Mam for her professionalism & thorough knowledge which was crucial for every step of our journey.
Thank you for making our dream comes true.
A Big Thanks,
Dear Dr. Shivani Gour,
I am really happy to share with you the good news that our baby was born. He is healthy and smart.
Millions of thanks to you who made this IVF cycle a miracle for us. All other doctors in India failed to do it. I’m proud of you and thank you a lot.
I really want to say that Dr. Shivani Sachdev Gour is the only perfect Doctor in India who solved my problem and changed my life. With the help of God she solved my problem and I became pregnant and I passed a successful pregnancy period. Other Doctors in India failed to do so.
My baby boy was born in Kabul on July 12, 2018. Thank you Dr. Shivani and wish you more success in your career.
Wish you more success.
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
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.
Ms. Pooja writes her experience about her treatment at SCIIVF Hospital, the best IVF Centre Delhi.
Mrs. Pooja writes to us:
I’m Pooja from Punjab and married for 10 years. I got married at the age of 23. I’m the first daughter in my family so everyone was expecting me to tell them the ‘good news’ about my pregnancy but conceiving a baby became a nightmare for me. Our visits to doctors were never ending and I had to swallow a lot of tablets on top of it, the pressure from the family kept me worried.
My husband was very supportive and took me to almost all the fertility clinics and gynecologist around Punjab but none of it worked well for me. Some doctors were very kind and some weren’t. Several scans and numerous reports failed on us instantly. I was suffering from Tube blockage and had also gone through a surgery to remove the tube blockage. But I failed to conceive even after that and tried IUI a couple of times. When we looked back, we had already crossed 7 years of marriage and I had entered into my thirties.
I have read a lot of articles on the internet about the difficulties of conceiving after the age of 30. I was depressed, my husband was worried and we were not able to lead a normal life till we met Dr. Shivani Sachdev Gour . A close friend of mine suggested me to try the famous IVF centre Delhi and out of no hopes we took an appointment with the Dr. Shivani Sachdev Gour .
Today, I feel glad that I met my favorite doctor who helped me to become a mother. Yes, I’m the mother of the one-month-old cute little princess. We have named her Hanvi. I would like to share my experience with the doctor and how fortunate I am to have come across the most approachable, patient and friendly doctor.
I was married at the right age so I couldn’t adjust to the fact that I might be infertile. At a young age, it was too difficult for me to consider myself as infertile. First few years of marriage, we tried to have a baby but later realized that it didn’t work out and there was something genuinely wrong with us. It was already 4 years of our marriage and that is when we started searching for the right doctor to treat us.
We considered references from everyone and went through the endless number of painful tests. We also had our hopes on astrologers and believed their predictions. Followed their instructions, wore different types of strings and pendants. Upon the suggestions of the astrologer, we shifted our house and moved to a new house. And what not, I ate all sorts of powders and medicines and visited every temple.
Our life turned out to be worst and we were desperate in having a baby. I and my husband discussed only treatments and doctors and our outings were planned only to meet the doctor and for sonography scan schedules. Our days passed on by discussion only about my ‘most fertile days’. And finally, the expectations and the hype would come to an end when I got my period. Depression followed me instantly and again the month began with desperate planning with a new doctor.
Having spent almost 7 years in finding out the right doctor, we, fortunately, I heard about IVF centre in Delhi and consulted Dr. Shivani Sachdev Gour . The doctor understood the level of frustration we were going through and energized me. I was suffering from mood swings sometimes extremely high and sometimes extremely low. I was keeping myself away from the outside world and restricted from talking to anyone. The doctor helped me to come out of my difficult situation quite easily and quickly. She is more than a doctor. She understood my mental and physical state and my treatment went well.
About the Clinic:
I should definitely mention about the clinic which was calm, neat and maintained well. The staffs at the clinic were also well behaved and they carried a smile on their face all time. I did not feel like entering a strange place. The nurses, staffs and every employee there did their job perfectly well. The atmosphere at the clinic was very healthy and I no more felt like a patient!
The tests I went through before IVF:
Tests and treatments were never new to me. I had gone through several of them. However, the place where you are being tested matters a lot. To my luck, everything seemed perfect at the IVF centre in Delhi . I was hoping for miracles to happen and eventually agreed to all the basic tests before IVF.
Firstly, my age was not a big concern. Good preconception health is very important for IVF pregnancy. Conditions like diabetes, asthma, and hypertension were analyzed and thankfully I did not have any of these chronic medical conditions. Obesity can result in unsuccessful pregnancy so my ideal weight was checked and the doctor suggested me a weight management program. I was obese and it could have been because of the intake of too many tablets, powers and all. The doctor put me on a month long weight management plan that helped me get back in shape. I had to follow a strict diet and restricted myself from eating canned products, junk food, and chicken. Forgoing my favorite food to get pregnant was not a big deal for me.
My blood group was verified and several screenings were done to check if there were any conditions that could harm my pregnancy. I and the husband were tested for HIV, Syphilis, Hepatitis B, and C. Our genetic health issues were also addressed and previous illnesses like chicken pox, measles was noted.
Ovarian Reserve Testing:
This was done to check the quality of my egg. The doctor told me that due to the age of women, the ability to conceive decreases and there can be an increased case of miscarriage. This test helped to check the quality, quantity, and the potential of the egg.
The level of FSH, LH, and Estradiol: I’m familiar with these terms since I’m used to hearing this over and over again. The follicle stimulation hormone (FSH), Luteinizing (LH) and the level of estradiol are monitored on the 3rd day of the menstrual cycle. This is mainly done to find out the fertility potential.
Anti-Mullerian Hormone test (AMH): This test was done to determine the number of eggs that were remaining. This test can be done anytime during the menstrual cycle.
Uterus: This is a mandatory test before IVF. A sonosalpingography is done. The mock transfer is also done to determine the length and direction of the uterus. This test helps the doctor to analyze the condition of the uterus and improve the success rate of the IVF.
Semen Analysis: Men are lucky as they don’t have to go through physical pain. The semen of the men is analyzed and reviewed. The quality of the sperm helps in successful IVF. I got a green flag there and my husband did have healthy sperms that will result in successful pregnancy.
Every time I visited IVF Centre in Delhi , I was welcome with a warm smile and never felt lost. There have been times where I visited the clinic all alone and I never felt neglected. My silly questions were answered patiently by the receptionist and Dr. Shivani Sachdev Gour was always there to answer my smallest questions.
We are not experts:
Yes, we are not expert but we have to right to understand the procedure and process so you can ask as much as questions to your doctors. IVF centre in Delhi offers different levels of treatment and they provide different solutions to each and every patient.
Here are few questions I asked them
How did I prepare for IVF?
It took me 9 years to realize that IVF was meant for me. Husband and I discussed it with Dr. Shivani Sachdev Gour and decided that it will work for us. The doctor helped us understand the process and the procedure and my health was monitored periodically. I remember the doctor repeating her statement over and over again if the IVF is successful, you will be pregnant. This statement of hers was my energy! I was told by the doctor to maintain good health so that the success rate increases.
I was very careful and concentrated on my daily routine. I ate good food and included healthy fruits and vegetables in my diet. This helped me to maintain and support my hormones and my reproductive system. The early stage of development was very crucial and if it is not taken care the right way, it can become stressful. My husband helped me to follow my diet routines and we followed healthy practices to stay fit. I was physically and mentally prepared for the treatment.
It was tedious during those days but now I feel happy that I had gone through this procedure. Dr. Shivani Sachdev Gour monitored me closely during the entire process until my childbirth. Her care and encouraging words have helped me to conceive without any complications.
Ovulation: The doctor monitored my ovaries and the timing of the egg release. She made sure my ovaries are producing good quality of eggs and my hormone levels are maintained. I was on medication to balance my hormones.
Egg Retrieval: I experienced mild discomfort but it was completely okay. A thin needle was passed through the vaginal walls and with the use of vaginal ultrasound the fluid was removed. The egg was isolated from the follicular fluid and was transferred to the incubator.
Fertilization: The sperm sample of my husband was secured and the egg was mixed with the most active sperm and was kept in the incubator again. The doctor closely monitored the growth of the embryo (And yes, that was my little princess Hanvi).
Embryo transfer: The final step when the embryo (my little one) was transferred to my uterus and I was on rest for two days.
Dr. Shivani Sachdev Gour was gentle with me and she kept telling me that my eggs were good and the embryo is perfectly fine. She even told me to talk to the embryo. Her confidence passed on some positive energies and the result was positive this time. Had I not gone to IVF centre in Delhi , it would have been a different story. They gave us a meaning to our life and I’m holding my little one who is the gift for our love and relationship.
Apart from the treatment and the tedious wait time, couples like us need a faith and trust the doctors can pass on to us. The confidence just works on the very first meeting with them. Apart from the medical terms, the personal touch of every doctor is very important. We are at an extreme stage of our life in complete depression and the positive words from the doctor keep us energized.
What I liked about IVF centre in Delhi is the way the staffs behave. They understand the needs of every patient and are happy to help us. I was not passed on from counter to counter like a lifeless parcel. I was being guided and told the right thing to do. There was someone to guide and help us throughout the process which eased away from our pain. Their smiling faces bring a lot of happiness. I admired Dr. Shivani Sachdev Gour ’s clarity of speech and her personal care and affection.
During my childbirth:
Throughout my pregnancy, Dr. Shivani Sachdev Gour from IVF centre in Delhi was very helpful. She helped me understand the symptoms and took good care of me. Regular scans and checkups went well without any problem. I came to the clinic when I had mild pain during my 9th month and the doctor came to help me immediately. She insisted that I have a normal delivery and taught me few exercises. And yes, with her advice I was able to deliver my baby through the normal way.
The clinic is very affordable for normal people. The doctors are service minded and will not cost you a bomb. The front desk team is very friendly and you can easily book appointments as per your convenient schedule. Overall I had a great experience here.
How did I feel?
To be frank, my aim was just to get pregnant and my mind was occupied only with the thoughts of pregnancy. The physical pain during the tests and the treatment did not affect me or the husband at all; however, my emotions played a rollercoaster. The treatment is all about waiting. You have to wait for an appointment, wait for results, wait for your name to be called, wait to become pregnant, wait to become a parent and you need to just keep waiting for something good to happen. I was frustrated whenever I had to hear something negative. I was depressed when someone points their finger at me and commented: “I’m childless”.
My husband was my only strength who gave me the complete support and yes, our parents too supported us whenever we needed them. My friends who have already gone through IVF and have experienced their success and failure blessed us with their comforting words and they encouraged us throughout our treatment and the tough journey. I felt nice talking to my friends who have already gone through the same process. It made some sense to talk with someone who really did understand what I was referring to.
Husband and me: How was our relationship?
The problem of infertility cannot be managed alone! It is a problem that needs to be faced as a couple and my husband took extraordinary care of me. For the past 9 years, I had shed tears all time when he would come back home with the result of blood test and the not-so-good scan reports. He consoled me, stayed with me throughout the procedure. He was with me whenever I needed him. We discuss a lot about treatment and the procedure and he appreciates me whenever I feel low. We shared our emotions and managed it so well and it also helped us to strengthen our relationships. Our relationship got stronger as we faced the difficult times of our life together. We did not take quick decisions but discussed before deciding on anything.
Life lessons learnt
Our lives cannot be predicted and it chooses unusual ways to teach lessons. Infertility is one such kind. As a woman, I have become stronger and healthier. I am able to look after myself and concentrate on my health along with my little ones. I have been dreaming of having a baby and in my dreams, I have planned to grow them well. Now, I’m able to execute the plan. I’m able to easily deal with the arrows life throws at me. I’m able to deal with the relationships in a clever way. I have also learned that life teaches us lessons during our difficult times. This has helped me analyze my inner strengths.
If I was able to conceive at the age of 33, I’m sure you can all conceive easily. Do not worry about infertility. There are new treatment and procedures that will help you to have a baby.
I did not realize my health condition till I met Dr. Shivani Sachdev Gour . She helped me understand why I failed to conceive which was not explained to me in the past 9 years. My family is complete now. We are happy and our parents are happy.
Today, holding my little one in my arms, I would like to tell all those couples like us who are not able to conceive the normal way, not to feel bad as we are all special people. Though it is late, we must feel glad that there are opportunities that will make us “happy mothers”!Each time my little one smiles at me, I ask myself “why did I take so long to visit IVF Centre Delhi ?” If I had been to them earlier, miracles would have happened a long time back.
IVF Treatment is the highly successful procedure. For pregnancy to happen, a woman must be ovulatory with patent fallopian tubes and around the time of ovulation( midcycle) semen with good number of viable sperms must be deposited in vagina.
In Vitro Fertilization is a process where fertilization of gametes (fusion of egg and sperm )is done outside the body in laboratory under specialised lab environment .When embryos are formed after fertilization they are transferred back into uterus of the woman.
An IVF treatment cycle involves few stepwise procedures :
(1) Case selection and screening tests of the couple.
(2). Ovarian stimulation of woman to form multiple eggs in ovaries by giving hormone injections.
(3) Egg retrieval procedure.
(4) Fertilization of eggs with washed semen sample
(5) Embryos formed under lab environment are transferred back into uterus.
Internationally, the IVF success rate are around 30-40% . The factors to look out for are ; quality control of IVF centre chosen , success rate of the centre , Ivf laboratory conditions & expertise of the IVF specialist doing the procedure . Lastly, success depend very much on couple’s profile like age of wife & husband and quality of their gametes.
Usually 1-2 months are adequate to bring back hormonal profile and physical fitness to normal and IVF can be tried again.
Your chances are quite good with IVF treatment as this technique has the highest success rate (around 40%) ; although if not successful in first attempt, you can go for second or third attempt to improve the success rates further.
No, IVF treatment is not painful, egg retrieval is done under anaesthesia.
Medications used under guidance of IVF specialist are safe and has minor side effects lasting for short duration only. However in rare circumstances ovarian hyper stimulation syndrome (OHSS)can occur and has to be managed stringently.
Pregnancy test can be performed roughly after 14 days of embryo transfer.
No bed rest is recommended after embryo transfer.
You need to take all your prescribed medication on time to ensure good implantation.
There is no restrictions per se for intercourse.
Artificial insemination is a process whereby sperms are deposited directly into female reproductive tract after semen is washed and prepared in laboratory.
Assisted reproductive technology comprises of all techniques where gametes are brought outside the body and fertilisation is done in lab conditions.
Sperm motility is a parameter to assess the fertilisation potential of a sperm. To assess its ability to reach the egg and enter inside.
Why is IVF Treatment so important?
IVF offers success to all those cases of infertility where natural conception is not possible by all means and where everything fails to get a pregnancy , thereby it is becoming popular choice among infertile couples when nothing else works.
In Vitro Fertilization costs may vary depending upon various factors for example using self gametes or donor gametes from ART
banks. Also in certain cases a pre IVF laparoscopy or hysteroscopy may be needed which can change the cost of treatment. On
average, around Rs. 1 to 2 lacs is the usual expense in all. Success rate is around 40% globally.
Irregular menstrual cycles, genital Infections, and increasing age are some of the signs of infertility in woman. Tubal blockage, uterine tuberculosis, polycystic ovarian disease and poor ovarian reserve are some common causes of infertility in woman.
Yes with latest ART techniques available infertility in females can be cured.
Woman should plan timely for pregnancy. They should avoid & get treated for the genital infections . Lifestyle modifications are also needed to optimise their fertility potential.
Yes, IVF increase the chances of multiple pregnancies.
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