Hysterosalpingograpy (HSG Or Tube Test)

Introduction.

HSG is an X ray test which is done to see the outline of the shape of the uterus and to check if the fallopian tubes are blocked or open.

It is a minor procedure in which a special dye is injected that fills the uterus and then spills through the open fallopian tubes.

When Should this test be done

- As a part of workup for infertility.

- Usually recommended when a couple has been trying for more than a year with no success and when other basic tests have already been done.

- It is done after the periods ends but before the expected ovulation usually on cycle day 8 or 9.

Procedure

- The procedure takes around 15-20 minutes and is usually done in x ray department. 

- The woman is made to lie on a bed that is positioned so that a x ray imager is above, that can take pictures during the procedure. 

- The gynecologist will do an internal examination and then places a speculum in the vagina.

- The cervix is visualized then cleaned and then a cannula like devise is placed into the opening of the cervix.

- Then through this cannula a liquid dye that contains iodine is slowly injected to fill up the uterus.

- This dye can be seen on the Xray as a white image. 

What Abnormalities can be detected on HSG

- Abnormalities like polyps or fibroids inside the uterine cavity can be seen.

- The shape of the uterus is outlined and any abnormal shape can be detected.

- The length of the fallopian tubes and if they are open by the spill of the liquid dye confirms the patency. 

Is it Painful?

Pelvic Inflammatory Disease

 Pelvic Inflammatory disease is a condition in which there is an infection in the female reproductive organs. the include the fallopian tubes, the ovaries, uterus and the cervix. 

This is a common condition and may affect like every 5 in 100 woman, 

What actually happens is that first there is infection in the vagina which later on travels up and affects other organs. 

Clinical features

Sometimes the symptoms are very mild and the patient may not even know that they have an infection, while some may experience mild to moderate lower abdominal and pelvic area pain. Other symptoms include:

On and off Fever

Foul smelling vaginal discharge

pain during sex

pain during urination

infertility 

bleeding in between periods usually after intercourse.

tiredness and fatigue

Causes: 

Many different bacteria can cause pelvic inflammatory disease but Chlamydia and gonorrhea infections are the most common causes. 

How does the infection enter your body: 

The most common way is through sexual intercourse. Others include after a miscarriage or child birth when repeated pelvic examinations are done or when instruments are used for any diagnostic or treatment purposes. 

Risk Factors are any woman of reproductive age group who is sexually active, having multiple sexual partners, having sex without using protection (condoms), excessive use of different vaginal wash products as these may alter the normal vaginal pH causing the growth of bacteria. 

- Use of intrauterine contraceptive devise is also one risk factor. 

Treatment:

- Antibiotics are given to treat the infection. Usually a combination of 2-3 antibiotics are prescribed. - - - Pain killers and anti inflammatory medicines are given to control and manage pain. 

- It is always better to treat the partner at the same time even though males may not have any symptoms, because untreated partner usually leads to recurrence of infection and symptoms. 

Complications

- Spread to the blood can be serious and life threatening as it leads to sepsis.

- Infertility a very common complication, as long standing infections damages the pelvic organs and also leads to tube blockage.

- Ectopic pregnancy

- Chronic pelvic pain and scarring and adhesions of pelvic and abdominal organs.

Vaginal Yeast Infection

 

Yeast or Fungal infection in the vagina is a very common condition affecting almost every 3out of 5 woman, in most cases it is generally a mild infection and can be easily treated but sometimes it keeps on reoccurring. 

Presenting Features

- Itching and irritation in the vaginal and vulvar region.

-Burning and discomfort at the time of intercourse. 

- Thick, white, cottage cheese like vaginal discharge which is usually not foul smelling. 

If the infection occurs more than 4 times in a year it is considered to be a complicated case.

Why Does It Occur? 

Normally in the vagina there is normal flora (normal healthy bacteria) that help prevent many infections, sometimes due to certain conditions this normal flora is reduced and this can lead to growth of fungus. Candida albicans is the most common fungal infection affecting the vagina. The conditions commonly leading to fungal infection are.

-Pregnancy

-Any immunocompromised state like acute or chronic illness, generalized body weakness etc. 

-Use of antibiotics

-Diabetes

-Taking oral contraceptive pills or any hormonal medicines

-Use of silk panties.

- Using scented pads or tampons.

- Excessive sweating in warm conditions.

-Staying in a wet panty for a long time. 

- Stress

Yeast infection is not sexually transmitted and can even occur in unmarried girls or those who are not sexually active. 

How To Treat

Most cases are treated by using a local antifungal cream or pessary that can be used for 1 to 6 days. 

Sometimes oral antifungal treatment is also prescribed. 

Avoid taking unnecessary antibiotics like for common cold etc

Get tested for diabetes and treat and control blood sugar levels

Dietary Guidelines For Pregnant Ladies

Pregnancy is a normal physiological condition during which a baby is growing inside the mother's womb. There are different hormonal changes causing taste changes, food cravings and associated nausea, vomiting or gastrointestinal issues. During pregnancy the nutritional requirements are increased to meet the demands of the body for proper growth and development of the baby. 

Positive nutritional support during pregnancy leads to a good outcome for both mother and baby. 

Eating a balanced diet is very important and never think of starving yourself to avoid weight gain during pregnancy. 

A basic guideline is given is given below: 

- Consume a diet containing vegetables, fruits, and whole grains. 

- Take Vitamin supplements as prescribed by your doctor.

- Vitamin A containing supplement should be avoided especially during the first 3 months. 

- Drink 1-2 cups of fresh milk daily. If you like drinking flavored milk you can enjoy adding your preferred flavors.

- Avoid caffeine containing drinks. 

- Soak 7-9 almonds overnight and eat them with 3 dates in morning. 

- Take a cup of yogurt with bread or parahata (Asian bread ) 

- Eggs are safe and good source of protein. Take in any form you like boiled, omellete etc. 

- Oatmeal is healthy and helps with preventing constipation. 

- Morning sickness is common during the first 3 months, to prevent vomiting don't stay with an empty stomach, take some crackers or wheat biscuits' when you wake up in the morning. 

- Avoid taking too much liquid during mealtimes.

- Avoid foods with strong odors. 

- Drink coconut water or lemon drink whenever easily available.

- Eat proper meals containing meat, vegetables or lentils . Take small frequent meals if you face any digestive issues. 

- Totally avoid soft drinks. 

- No alcohol and No smoking. 

- Drink 8-10 glasses of water daily. 

- Avoid spicy and oily foods.

- Diet needs to be modified if you suffer from any other medical condition or gestational diabetes.

Have a safe and heathy pregnancy. 

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Postpartum Depression And How To Manage It

 

It is quiet common for the new mother to feel sad, worried, tired or fatigued. As many as 80 out of 100 mothers go through such feelings for a week or two after the birth of the baby. It is completely normal and they start to feel better and normal after a few weeks..

Postpartum depression is diagnosed when these symptoms are much severe and lasts longer. It can cause severe mood swings, and a mix of physical, emotional and behavioral changes.

The symptoms usually begins within the first few weeks after giving birth but sometimes may even begin earlier while being pregnant or later up to a year after birth. 

Suffering from postpartum depression does not mean that a mother does not love her baby or that she is a bad mother. It is just that she is suffering from a medical condition and needs counselling therapy and treatment. 

Symptoms may vary among different woman but a list of common symptoms include:

- Feeling low

-Lack of interest in daily activities

- Body aches and headache

-Lack of appetite

- Anxiety and irritability

- Not able to think or make proper decisions. 

- Feeling difficult to bond with the baby.

- No interest in friends and family,

What causes Postpartum Depression: Female body produces a lot of hormones during pregnancy but soon after delivery there is a sudden decrease of these hormones which causes changes in the chemical system of the brain leading to depression. 

How To Manage:

Depending on the severity and the type it can be treated with psychotherapy or antidepressant medications. 

It is important to seek medical help if symptoms of depression lasts longer than 2 weeks within 1 year of giving birth. 

-Get Support from friends and family. 

-Be open about your feelings and discuss it with your partner and your family. 

- Join support groups.

-Antidepressants may be prescribed to you by your doctor but they usually take 6-8 weeks to show improvement in symptoms. 

- Psychotherapy helps with more positive thinking approach.