Obstetrics
In our modern era of living, some couple will be stressful during their pregnancy, worrying about the well being of their baby. The human touch from the Doctor is of most important to council the couple, we must be welling to sit down with the couple, to listen to their problem, and then make use of the modern technology to assist us to allay our patient’s anxiety.
Prenatal Diagnosis
All parents want to have a healthy baby .With proper counseling we could assist the couple to select the Prenatal test that will help them to allay the fear of having an unhealthy newborn. Prenatal Test includes the use of ultrasound, blood hormonal assay and invasive test such as Amniocentesis to achieve this aim.
Having knowing the problems, we can help parents to make decisions about the pregnancy. Certain fetal problems can be treated before the baby is born; others may need special treatment right after delivery.
Nuchal Translucency Scan- A screening test done for Down’s Syndrome from 11 to 14 weeks of pregnancy. This is a combination of Ultrasound scan and blood test to assess the risk of Down’s syndrome.
Fetal Viability Scan - Carried out between 6 to 10 weeks, the fetal viability scan is a useful test for patients who have had previous miscarriages or who are experiencing pain or bleeding. It is possible to confirm the presence and number of live fetuses using the trans-vaginal or abdominal scan
Dating Scan - This scan aims to make measurements which accurately predict the due date of the baby. This can be done from 8 to 20 weeks, but dating is more accurate when the scan is done before 14 weeks.
Fetal Anomaly Screening Scan - To examine the fetal anatomy and assess normal growth, and check the placental position and cervical status. This scan, carried out between 20 to 24 weeks, can detect up to 90% of significant abnormalities.
Growth/Fetal Well-Being Assessment Scan - This scan, which is done from 24 to 41 weeks, aims to assess the baby's growth and evaluate the placental location, amniotic fluid volume as well as fetal movement.
ANTENETAL CARE
We will spend much time during our Antenatal visit with the couple, to answer their queries, and we shall work together as a team to discuss the labour plan and to assist the patient to go through the day of Labour. Finally will render them help during their Post-natal period.
GYNAECOLOGY
FIBROID
1. Non-cancerous tumors in the muscle of the womb (uterus).
2. 25%of women of child bearing age may have fibroid.
3. Female hormone, Estrogen, stimulates growth of fibroids
Symptoms
1. Discovered during checkup with no complaint.
2. Increase in menstrual flow
3. Pressure symptoms on bladder or bowel, leading to retention of urine & painful bowel action.
4. Low backache to sharp pain
5. Infertility problem
Conservative Management
1. Observe, a big group fall into this group.
2. Symptomatic treatment
3. Hormonal therapy e.g. Progestogen, Danazol or GnRH agonist.
TYPE OF SURGERY
A)Myomectomy Removal of fibroid.
Myomectomy can be done by The Conventional Open Surgery, Laparoscope (Keyhole Surgery), or Trans-vaginal Hysteroscopy Surgery.
B)Hysterectomy
(removal of the womb)
Route - Vaginal
Abdominal
Laparoscopic (MIS) eg.LAVH
Myomectomy is the choice surgery if the patient is young, have not completed her family and the emotional aspect to retain her uterus to be youthful and sex life.
Hysterectomy is normally requested by patients who has completed her family, large & multiple fibroid or with gynecological problem (cervical dysplasia CINlll )
Ovarian Cysts
Ovarian cysts are fluid filled tumours that arise from one or both ovaries. Can be classified under four categories:
1. Functional Cyst
- Follicular cyst, Corpus luteum cyst
Normally disappear after 1-2 months, and do not require surgery
2. Endometriosis Cyst
Menstrual lining and menstrual blood embedded in the ovary and enlarges in size
"chocolate cysts"
Associated with infertility
Lower abdominal pain or painful menses
3. Benign Ovarian Cysts (non-cancerous)
serous cystadenoma
Mucinous cystadenoma
Dermoid cyst – cyst contain oil, hair, cartilage, teeth
4. Ovarian Cancer
less than 5% of all ovarian cysts
solid or semi-solid tumours
OVARIAN CYST occurs in your body silently, is good to routine gyne. Checkup:
1. No symptom especially small cyst
2. Swelling of the abdomen
3. Lower abdominal pain, when cysts rupture or twisted
4. Pressure on bladder - urinary symptoms, Pressure on rectum - urge to open bowel or constipation
OPERATION depends on: -
Severity of complaints
Size of cysts
Complexity of cysts on ultrasound study
Suspicion of cancer
Operation
1. Ovarian Cystectomy
removal of cyst and conserving the ovary for hormonal function especially for young women.
2. Oophorectomy
removal of whole ovary
3. Total Hysterectomy & Bilateral Oophorectomy
removal of both ovaries and the uterus
Mode of Operation
Laparotomy - open method
Laparoscopy or "key-hole" surgery (Minimal Invasive Surgery MIS)
Advantages of Laparoscopy (MIS)
1. Small scars - less painful, cosmestic effect.
2. Day surgery or shorter hospitalization
3. Able to eat and resume normal activities earlier
4. Return to work earlier
Urinary Incontinence
Many people especially the older lady are suffering from the leakage of urine silently; not knowing this condition can be treated & eventually cured.
We will spend time with them, to assist the patient to achieved cure.
Services available include:
1) Diagnosis and treatment of stress incontinence
2) Diagnosis and treatment of urge incontinence
3) Diagnosis and treatment of overflow incontinence
4) Diagnosis and treatment of true incontinence
5) Diagnosis and treatment of functional incontinence
Labioplasty
Labioplasty is a gynecological procedure to reshape the labia minora of women whose genitalia have become loose from childbirth and other causes.
We will spend time to listen to you so as to fully understand where your problem lies, and will recommend solutions specifically for you.
Vaginoplasty
Vaginoplasty is a gynaecological procedure to tighten the vaginal muscles and its related tissues. It may affect your and your partner sexual pleasure. We will listen to your compliant and suggest a choice surgery for you. Vaginoplasty will certainly enhance your sexual pleasure.
Hymenoplasty
Hymenoplasty is a gynaecological procedure to restore the torn Hymen.
Female Cancers
Consultation, screening & treatment services are available for:
1) Carcinoma of the vulva
2) Vulvae dystrophies
3) Valval intraepithelial neoplasia
4) Carcinoma of the cervix
5) Cervical Intraepithelial Neoplasia
6) Carcinoma of the endometrium
7) Carcinoma of the ovary
8) Cancer of ovaries
COLPOSCOPY
We will perform a Colposcopy on suspicious cervix and on abnormal Pap smear. This direct visualization of the cervix will enable us to perform a direct punch, so as to obtain a histological diagnosis. Colposcopy is safe and painless procedure. Colposcopic Leep Cone Biopsy can be performed as a day clinic surgery in our clinic.
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