India's one of the leading Gynaecology centre
and No.1 Gynaecology centre in Tamilnadu.

CARE & CURE & CONFIDENCE

About Gynaecologist

Dr. Latha Lakshmi, Consultant OBG, working at Indira Nursing Home, completed her undergraduation, at Christian Medical College and Hospital, Vellore, following which she completed her D.G.O and MS (OG) in the same esteemed institution.

Dr. Latha , was an assistant professor at Christian Medical College and Hospital for 3 years, following which she has been a consultant at Indira Nursing Home. She is well experienced in the field of Obstetrics and Gynaecology and laparoscopic and hysteroscopic surgeries.

Indira Nursing Home is a 24 hrs hospital where there is a back up of ICU for emergency, 24 hrs pharmacy, OT , well equipped labour room with CTG machines / dopplers /transport incubators / warmers with round the clock well trained staff nurses to assist deliveries.

They tackle many high risk pregnancies with hypertension and diabetes complicating pregnancy , and those with cardiac diseases. They are equipped with anaesthetist available for 24 hrs.

About Gynaecologist

Dr. Latha, has to her credit, of conducting more than 7000 normal deliveries , more than 2000 operative vaginal deliveries and more than 3000 lower segment caesarean section.

In the field of Gynaecology Dr. Latha is an experienced surgeon who has done more than thousands of abdominal hysterectomy, hundreds of vaginal hysterectomy and laparotomy. She has also done thousands of tubectomies.

At Indira Nursing Home, they have done abdominal hysterectomy, on many high risk women with cardiac disease eg. Valvular heart disease, large septal defects, with large fibroids upto the size of 8 months gravid uterus, following prophylactic bilateral stenting.

Dr. Latha has a passion for laparoscopic surgery and has done diagnostic hysterolaparoscopy for infertility, laparoscopic ovarian cystectomy, laparoscopic excision of ectopic, laparoscopic sterilization and Laparoscopy assisted vaginal hysterectomy.

About Gynaecologist

Diagnostic and operative Hysteroscopy is part of the conservative surgery done specifically for the infertile patient.

We are specialized now in Epidural analgesia and doing painless surgery, giving good postoperative pain relief. This helps us to tackle high risk patients better as we have the facility to manage them post operatively.

We also have various insurance scheme facility in our hospital under which the gynaecology surgeries can be performed.

STATISTICS IN GYNAECOLOGY

LEUKORRHEA

LEUKORRHEA
White / yellowish discharge from the vagina.

CAUSES:
1) Infections – Candidiasis, bacterial vaginosis, trichomoniasis
2) Injuries or trauma to the vaginA
3) Poor hygienic measures
4) Irritants
5) Sexually transmitted diseases

SYMPTOMS:
1) Any discharge
2) Itching
3) Burning with urination

LEUKORRHEA

TREATMENT:
1) Hygiene
2) Antibiotics / antifungals
3) Needs PAP smear to rule out premalignant cervical condition/ cancer cervix

BARTHOLIN’S CYST
The Bartholin glands are two small organs under the skin in a woman's genital area. If a Bartholin duct gets blocked, fluid builds up in the gland and is called bartholin’s cyst

CAUSES :

1) Infection
2) Thick mucus

SYMPTOMS:

1) Painful / painless lump in the vulval area.
2) Redness /discomfort
3) Fever if infected

BARTHOLIN’S CYST

DIAGNOSIS:
Clinical diagnosis.

TREATMENT:

1) Marsupilisation
2) Antibiotics

Endometriosis

Endometriosis is a painful disorder in which tissue that normally Lines the inside of the uterus — the endometrium — grows outside your uterus.

COMMON SITES:
Ovaries
Fallopian tubes
Tissue lining your pelvis.

SYMPTOMS:
Painful periods (dysmenorrhea) – starts prior to onset of menstruation
Pain with intercourse
Pain with bowel movements or urination
Excessive bleeding
Infertility

Endometriosis

DIAGNOSIS:
a) Ultrasound/ MRI
b) Laparoscopy

TREATMENT:
i) Anti inflammatory
ii) Hormonal treatment – drugs / LNG-IUS
iii) Conservative surgery
iv) Assisted Reproductive Technology
v) Hysterectomy

Prolapse
When the uterus slips from the normal position into the vagina it is called prolapse.

SYMPTOMS:
Mass descending per vaginum
Discharge
Recurrent Urinary tract infection

RISK FACTORS:
Multiparity – normal delivery
Obesity
Chronic constipation
Chronic cough
Lifting heavy weight

Prolapse

DIAGNOSIS:
Clinical

TREATMENT:
Life style modification weight loss, avoid lifting weight
Kegel’s exercises
Pessary
Hysterectomy

Adenomyosis

Adenomyosis is a condition that involves the encroachment of the endometrial tissue that lines the uterus into the muscles of the uterus.

SYMPTOMS:
1) Dysmenorrhea
2) Heavy menstrual bleeding
3) Pain during sex
4) Tenderness in the abdominal area

DIAGNOSIS:
1) Ultrasonography
2) MRI

TREATMENT:
1) Anti inflammatory
2) Hormonal treatment
3) Hormonal intrauterine contraceptive device (LNG-IUS)

ABNORMAL UTERINE BLEEDING
AUB affects 10 – 30% of women of the reproductive age group and 50% of women in the perimenopausal age group.

FIGO CLASSIFICATION OF ABNORMAL UTERINE BLEEDING:

When is bleeding abnormal?
1) Bleeding or spotting between periods
2) Bleeding or spotting after having intercourse
3) Heavy bleeding during periods
4) Bleeding after menopause

FIBROID UTERUS:

INVESTIGATION:

1) Haemogram; thyroid profile
2) Ultrasonography
3) Pap smear & endometrial biopsy as per the cause.

treatment

Depends on the cause.

1) Treat anaemia and hypothyroidism
2) Medical management
3) Hormonal intrauterine device Eg. LNG-IUS
4) Hysterectomy if medical treatment fails.

CANCERS IN WOMEN

1) Cervical cancer
2) Endometrial cancer
3) Ovarian cancer

Carcinoma Cervix

Cancer Cervix

SYMPTOMS

1) White discharge PV
2) Bleeding after intercourse
3) Postmenopausal bleeding
4) Foul smelling discharge PV
5) Bleeding between periods

Risk Factors

a. Low SES
b. Multiple sexual partners
c. STDs – Chlamydia, Gonorrhea
d. Immunosuppression – HIV, HPV, Drugs

Cancer Cervix

DIAGNOSIS

A) PAP smear
B) Colposcopy if the pap smear is abnormal
C) HPV testing

PREVENTION

a) Vaccination – HPV vaccines

TREATMENT:

Surgery for early stages
Chemotherapy
Radiation therapy

CARCINOMA ENDOMETRIUM

a)RISK FACTORS:

a. Age > 50 yrs, postmenopausal
b. Prolonged/unopposed estrogen
c. Diabetes, hypertension, Hereditary

b) Symptoms/signs

i) Excessive bleeding in and around menopause
ii) Postmenopausal bleeding- bleeding after bleeding had stopped for 1 year duration
iii) Bleeding between periods.
iv) Abnormal vaginal discharge

c) INVESTIGATION:

i) Ultra sound Scan – to assess endometrial thickness; diagnosis of tumour and pyometra.
ii) In postmenopausal bleeding
a) endometrial biopsy (pipelle)
b) Diagnostic Hysteroscopy with biopsy

d) Treatment :

i) Surgery – removal of uterus with ovaries and lymph nodes
ii) Chemotherapy
iii) Radiation therapy

PREVENTION:

i) Prevent obesity
ii) Treat anovulatory cycles
iii) Early evaluation and treatment

Ovarian Cancer

Symptoms

a. Abdominal distension/ bloating/ mass
b. Loss of appetite and weight loss

2) Signs:

a. Ascites
b. Abdominal /Adnexal mass/ Nodules in POD

3) INVESTIGATIONS:

a) Ultrasonography
b) CT scan
c) Blood tests – tumor markers

Ovarian Cancer

4) TREATMENT:

a) Staging laparotomy
b) Chemotherapy

5) SCREENING:

a. Routine yearly pelvic examination
b. Transvaginal Ultrasound
c. Tumor markers – CA 125, CA 19-9

6) PREVENTION:

a. Oral contraceptives for 10 yrs
b. Prophylactic removal of both ovaries
c. Tubal sterilisation