At Accord Super Speciality Hospital, the Department of Obstetrics and Gynaecology, preconception counselling is done to ensure that the woman is healthy enough for pregnancy. Our experts' team has a common goal of providing the best possible care before pregnancy to every woman by optimizing their health and knowledge beforehand.

Antenatal Care (ANC)

Prenatal care is the checkups and different tests conducted during the nine months of pregnancy. The routine lab tests differ from trimester to trimester and also include the fetal assessment.

Pregnancy is divided into three trimesters, and each trimester needs specific care. Objectives of antenatal care are:

• To promote, protect and maintain the health of the mother during pregnancy
• To detect high-risk cases at the earliest and give them special attention
• To foresee complications and to prevent them for optimization of mother and fetal health
• To remove anxiety and dread associated with delivery
• To teach the mother elements of childcare, nutrition, personal hygiene and environmental sanitation.
• To sensitize the mother's need for family planning.

Fetal Assessment

Fetal assessment is an essential aspect of pregnancy. Under it, obstetricians assess the fetus through timely ultrasounds to check the position, growth, and health of the unborn baby, diagnose any congenital disease, and predict the date of delivery.

• First trimester
• Ultrasound early pregnancy for confirmation of pregnancy, location of pregnancy, dating and viability of the fetus.
• Blood test including normal antenatal profile
• HIV screening
• HPLC (high-performance liquid chromatography)
• Rubella antibody screening
• Dual marker
• Level 1 ultrasound (Abdominal and transvaginal ultrasound)
• Chorionic villus sampling (CVS) – where indicated.
• Second trimester
• Level II Scan
• Triple marker/Quad screening
• Fetal Echocardiography
• Screening for diabetes in high-risk patients - glucose challenge test, DIPSI, OGTT
• TT
• Boostrix
• Covid vaccination (can be given in any trimester)
• Amniocentesis – where indicated
• Third trimester
• Fetal growth scan with colour Doppler if required
• Urine for albumin and sugar, culture (if required)
• HVS (High Vaginal swab culture for infections)
• CTG monitoring, if required
• Biophysical profile of fetus in cases of IUGR
• Antenatal Class – Starts from 2nd trimester onwards, it includes yoga, stretching exercises, diet consultation and a class by an Obstetrician to eliminate the myths surrounding pregnancy and to allay the fear regarding normal delivery/ LSCS

Labour and Delivery

It is the most awaited chapter of pregnancy when the baby is delivered either normally (vaginally) or by Cesarean section where a team of OBG nurses and obstetrician monitors the progress. Labour analgesia is given by an anaesthetist if required. Continuous or intermittent fetal heart rate and patterns are monitored through CTG during labour. We have a dedicated team consisting of obstetricians, paediatricians, anaesthetists and paramedical staff who work together to smoothen the labour and delivery.

Neonate Care – We have a dedicated NICU, neonatologist and paediatrician for round the clock care of the healthy as well as sick newborns.

Postpartum and Postnatal Care

The postpartum period involves the care of the mother after childbirth. After birth, the mother may experience problems, such as bleeding, weakness, unable to do activities on her own, constipation sometimes. It might also lead to postpartum blues, where the patient feels irritable and anxious for which we have a psychologist to counsel the patient. The postpartum period usually lasts for six weeks after birth.

Baby-friendly hospital

Accord super speciality hospital is a baby-friendly hospital “A Baby-friendly hospital initiative” (BFHI), created and promoted by WHO and UNICEF, has proved to be highly successful in encouraging proper infant feeding practices shortly after birth To support this initiative, the ten steps strategy was introduced which we follow here with well-trained healthcare providers including obstetricians, paediatricians, lactation experts and paramedical staff.

Postpartum contraception

Postpartum contraception plays an important role in postnatal care. It is used by every couple to prevent accidental and closely-spaced pregnancy for which we recommend the couple go for immediate contraception, as per their choice and consensus.

We use different contraceptive methods starting from the hormonal to barrier, injectable or intrauterine contraceptive devices, as per the couple’s requirement and as per their medical conditions. Permanent contraception methods like tubal ligation or Vasectomy procedures for couples are also offered, where indicated and desired.

Postpartum weight loss – FLAB-U-LESS

Shedding those extra kilos after delivery is important, but more important is to shed your weight in the right way and under the right guidance. Most women shed 3 to 5 kg after childbirth which includes the weight of the baby, placenta and amniotic fluid.

As per experts, a healthy diet combined with regular exercise is the best way to reduce weight. Your postpartum weight-loss counselling will start after 6 weeks of normal delivery and 6 to 8 months after C-section. At Accord, we offer a holistic approach to weight loss. Our customised weight loss service includes:

• Diet counselling
• Ayurvedic massage for toning and site specific weight loss
• Workout plan for safe weight loss
• Regular monitoring to ensure compliance

Creating Memories.

At Accord, we make sure that you cherish and remember this beautiful journey of parenthood forever. We are offering complimentary and paid services to make your journey to parenthoond memorable.

• The first photo shoot of baby with parents
• Pre-delivery photo shoot
• Religious rituals to be performed on the arrival of your little bundle of joy.
• Theme based room decoration
• Framed feet impression of the newborn

Conditions Treated by Accord Super Speciality Hospital’s Gynecology Department

Pubertal health problems – Menstrual problems, hormonal imbalance especially PCOS, emotional changes related to hormonal imbalance, pubertal obesity, apart from educating them about the importance of proper diet age-appropriate, the importance of physical fitness and weight management. Sometimes, contraception counselling may be required.

Premenstrual syndrome/symptoms - Premenstrual syndrome is a set of symptoms, physical and emotional, that are experienced in the time between ovulation and periods. It often includes mood swings, abdominal pain or bloating, headaches, fatigue, and soreness in the breasts. These symptoms usually subside after the periods begin. While the symptoms are easily manageable in some cases, if these start to worsen, contact your Gynaecologist immediately.

Vaginitis - Marked by inflammation in the vagina, vaginitis is a condition triggered by a disturbance in the normal balance of the vaginal bacteria, infection or alleviated oestrogen levels before puberty and post-menopause. The condition is marked by abnormal vaginal discharge, severe irritation, and pain, which aggravates during urination or intercourse.

Infections - Women can get a fungal, bacterial, viral, or protozoal infection in the vagina (vaginitis), cervix (cervicitis), and uterus with tubes (pelvic inflammatory disease). It can cause pain, itching, foul-smelling odour, and discharge. The infection can also raise complications during pregnancy and even maybe the reason for infertility.

Chronic Pelvic Pain (CPP) - CPP is the pain in the area below your belly button and up to the hip area that lasts for more than or equal to 6 months may have multiple underlying pathologies badly affecting women’s health so much so as to affect their daily lives.

Amenorrhea - Amenorrhea is a condition marked by the absence of periods. The problem may be further classified as primary amenorrhea and secondary amenorrhea. The former refers to the failure to initiate menaces by 14 years in absence of secondary sexual characteristics, and by 16 years in the presence of sexual characteristics. Secondary Amenorrhea occurs during reproductive age, it is the cessation of regular menses by 3 months or by 6 months for irregular menses.

Dysmenorrhea - Dysmenorrhea is the occurrence of pain in the lower abdomen or pelvis during menstruation. It is expected at the beginning of menstruation, and pain subsides in three days. The problem may also be associated with underlying problems like uterine fibroids, adenomyosis and endometriosis, which call for the need of proper medical evaluation.

Abnormal Uterine Bleeding (AUB) - Any deviation in normal menstrual pattern in respect of duration or interval or amount of bleeding, contact your OBGYN immediately as it may be one of the manifestations of serious underlying gynaecological diseases.

Postmenopausal bleeding and vaginal discharge - This may be an indication of underlying female genital cancers like cervical cancer, endometrial cancer etc. It should be taken care of immediately because of the aggressive nature of these lesions.

Reproductive Health Problems - Reproductive health problems is an umbrella term used for various diseases and ailments that interfere with your ability to conceive. Here are some of the common reproductive health problems that we deal with

• Polycystic Ovary Syndrome (PCOS)
• Fibroids
• Endometriosis
• Ovarian Cysts
• Adenomyosis
• Uterine Polyps
• Sexually Transmitted Infections (STI)
• Ectopic pregnancy/H. Mole

Infertility/Subfertility - Infertility refers to the inability to conceive within a year of unprotected intercourse. The condition can be a result of many different factors and can affect both, the female, as well as the male partner. While the problem can be treated in some of the cases, in others there might be a need for assisted reproduction. Treatment depends upon multiple factors, including age, health, medical condition, personal preferences, and is different for men and women. At Accord Superspeciality Hospital, we have a dedicated Infertility Unit, where we give patient hearing to all your problems. We ensure full privacy in all our counselling sessions, The services we offer here range from simple modalities like ovulation induction and IUI to advanced procedures like IVF and IUI.

The Department of Assisted Reproductive Techniques comprises fully trained doctors /embryologists / IUI nurses and counsellors. It is a one-stop centre for all fertility solutions. Various services that we offer include

• HSG
• D2/D3 USG TVS
• Hormone profile
• Follicular monitoring
• Semen analysis
• Ovulation induction
• IUI

We also specialize in advanced procedures like

• TESA/PESA
• IUI
• ICSI

Gynaecological cancers - Gynecological cancer is an umbrella term for various malignancies that are specifically found in women. These include:

• Cervical cancer
• Ovarian cancer
• Uterine cancer
• Vaginal cancer
• Vulvar cancer
• Fallopian tube cancer

Our experts offer state of the art modalities for cancer screening, diagnosis, assessment, treatment and management.

Accord Super Speciality Hospital’s Gynecological Procedures

Cervical Biopsy

This test is performed to check for precancerous conditions or cervical cancer in the cervix area of females. The procedure involves removing tissue from the cervix to test for cancer or abnormal condition. The biopsy can be done using punch biopsy, cone biopsy, and endocervical curettage (ECC). Endocervical curettage (ECC) is done to detect any pathology in endo cervix. A cervical biopsy is performed when abnormalities are found during visual examination of cervix.

Colposcopy

It is a procedure to prevent cervical cancer by diagnosing precancerous lesions. It is usually recommended if Pap smear is abnormal. A colposcope is used to obtain a magnified view of the cervix, vagina, and vulva to identify and distinguish between normal and abnormal tissue growth and to take a guided biopsy from the affected area to confirm the diagnosis by histopathology.

Loop Electrical Excision Procedure (LEEP)

LEEP is a cost-effective, safe, and fast procedure to remove abnormal tissues detected in the cervix through colposcopy. Although LEEP has a high success rate, complications such as infection and haemorrhage can arise.

Dilation and Curettage

Dilation and curettage or D&C is a surgical procedure in which the cervix is dilated and with the help of curette, the uterine line or endometrium is removed to check for abnormal tissues. The test is performed to diagnose and treat abnormal bleeding, determine the cause of excessive uterine bleeding, detect cancer, and check for reasons for infertility/rule out genital tuberculosis

Endometrial Biopsy

It is a diagnostic modality that helps to detect traces of malignancy, as well as infections like genital tuberculosis.

Gynecological surgeries

Abdominal hysterectomy

Abdominal hysterectomy is a surgical modality that involves the partial or total removal of the uterus. The procedure is performed by making a small incision on the patient’s lower abdomen. In the case of partial hysterectomy, only the uterus is removed, leaving the cervix completely intact, whereas, in the case of total hysterectomy, the cervix is removed along with the uterus.

Myomectomy

Myomectomy is a surgical intervention that aims at removing uterine fibroids, also known as leiomyomas. The procedure is also known as fibroidectomy. Unlike hysterectomy, the procedure keeps your uterus preserved.

Ovarian cystectomy

Ovarian cystectomy is a laparoscopic intervention that involves the extraction of ovarian cysts, with the aim of relieving symptoms and preserving your chances at motherhood.

Ruptured Ectopic pregnancy

Ecotopic pregnancy is a serious condition marked by the implantation of the fertilized egg outside the uterus. In nearly 90 per cent of the cases, the embryo gets implanted in the fallopian tube. The egg can rupture, causing the tube to burst, which in turn leads to serious internal bleeding.

For malignancies

A malignancy is a cancerous growth that can develop in any part of the body. Gynaecological malignancies specifically refer to cancerous tumours that originate in the organs of the female reproductive tract. These include uterine cancer, cervical cancer, ovarian cancer, vulvar cancer, vaginal cancer and gestational trophoblastic tumour.

Suction and Evacuation or Suction Aspiration or Vacuum Aspiration

The suction and Evacuation procedure is performed as an induced abortion procedure that is performed after miscarriage or medical termination of pregnancy In this process, the cervix is dilated and vacuum suction is performed to remove tissues from the uterine cavity. After a miscarriage, it helps in the proper removal and cleaning of the uterus. At Accord Super Speciality Hospital highly trained doctors perform these suction and evacuation procedures blindly, or under USG guidance if required.

MTP – Medical (up to 9 weeks) & Surgical (up to 24 weeks)

As per guidelines of PNDT and MTP rules for MTP or induced abortion is performed in certain cases if there is a failure of contraception, there is a possible health risk to the physical or mental condition of the mother, potential risk of the health of the growing fetus, and in the case when female get pregnant as a result of sexual assault. In India, MTP can be performed under certain circumstances until 24 weeks of pregnancy. It can be done by medical method and surgical method. By the medical method, it can be managed by medicines only and can be provided up to 9 weeks of pregnancy under the strict vigilance of the OBGYN team.

The surgical method of MTP can be given up to 24 weeks. Up to 12 weeks, it can be managed by 1 OBGYN expert and for 13 to 24 weeks MTP needs opinion and management by two OBGYN experts as per rule for the indications specified as above. It is done by suction evacuation method and to make the procedure smooth and safe, to keep uterus safe completely for further normal pregnancy, we do prior medication to dilate the cervix and then introduce the instrument to remove POCS completely under antibiotic cover and USG guidance.

Vaginal surgeries

At Accord Super Speciality Hospital experienced doctors and staff, state-of-the-art infrastructure, and well-equipped laboratory services that help cater to all needs of patients and provide them with a safe and effective comprehensive solution for all their medical needs. We specialize in surgical interventions for vaginal conditions like

• Vaginal hysterectomy for utero vaginal prolapse
• Vaginal cysts
• Anterior Colporrhaphy
• Posterior colpoperineorrhaphy
• Vaginal tightening
• Hymenectomy – in cases of imperforate hymen

Gynae endoscopy / minimally invasive surgery

Gynaecological endoscopy has many applications in modern gynaecology. What started as a humble diagnostic tool has now spread its horizon to unko surgeries and for entities like MRKH (Mayer-Rokitansky-Küster-Hauser) syndrome.

It is a surgical discipline that uses optical instruments, specially designed to help diagnose and cure the pathology insane setting. It is being increasingly favoured over abdominal approach because of its well recognized advantages like

• Minimal trauma
• Superb visualization
• Lower incidence of complication
• Reduction of adhesions
• Minimal blood loss
• Short hospital stays
• Rapid recovery
• Aesthetically pleasing results with less scarring

At Accord Super Speciality Hospital we offer two types of endoscopic surgery. These are

Laparoscopy

The technique involves the use of a laparoscopy, which is a long flexible tube, with a light source and camera on one of its ends. This is introduced inside the patient’s body via a keyhole incision. Laparoscopy allows the doctors to examine the reproductive organs like the uterus, fallopian tubes and ovaries, as well as helps to carry out surgical interventions.

At Accord, we specialize in both, basic and advanced laparoscopic procedures like

• Total laparoscopic hysterectomy
• LAVH
• Fertility enhancing surgery
• Tubal reconstruction surgery

We offer laparoscopy for the following:

• Diagnosis, assessment and treatment of endometriosis
• Treatment of ectopic pregnancy
• Removal of scar tissues, ovarian cysts and fibroids
• Sterilization, or closing of fallopian tubes
• Diagnosis, staging and definitive/debulking surgery of malignancy

Hysteroscopy

Hysteroscopy is a diagnostic and treatment modality that allows to assess the uterine cavity without any incision or cut present in the abdominal cavity, without any incision or cut. The technique involves the use of a hysteroscope, which is introduced inside the body via the vagina. The procedure is usually recommended to women experiencing abnormal vaginal bleeding and infertility for proper evaluation and assessment.

Hysteroscopic surgeries /operative hysteroscopy for

• Uterine polyp, fibroids, adhesions
• Septum incision & metroplasty
• Hysteroscopy for Asherman's syndrome (AS)
• Endometrial ablation for abnormal, heavy or lengthy menstrual flow.

Advanced procedures

• Hysteroscopy - Diagnosis
• Hysteroscopic – Polypectomy
• Hysteroscopic Myomectomy
• Hysteroscopic Septum

Fertility enhancing surgeries

Fertility enhancing surgeries are surgeries that helps to enhance or restore fertility in women in sub fertility. It includes surgery for tubes, uterine surgeries for fibroids, pelvic surgeries for endometriosis etc.

This involves various procedures that help to diagnose and treat the various causes of infertility, thereby helping patients start the journey towards parenthood. The procedures are either performed with the help of laparoscopy and hysteroscopy. Some procedures offered by our experts include

USG – Role of USG in sub fertility has led to this new concept of sonography done by infertility specialist so as to comprehend the information to reach a diagnosis and plan further treatment the procedure offered by our expert includes.

Baseline USG TVS – it is done on day 2/day3 menses as the proverb lies in proximity to the pelvic organs like uterus, ovaries and tubes. They can be accessed in a better and more accurate manner.

Folliculometry/ ovulation study – serial USG done to access the ovulatory function

Salinesono salpino graphy (SSG) – to detect intra cavity lesions like polyp, submucous fibroid, so that definitive/corrective surgery can be planned.

Doppler study to access sub endometrial blood flow

3D/4D scans to detect mullerian duct anomalies and for fibroid mapping

Ultrasonography is a diagnostic modality that helps to generate images of the reproductive organs to assess their normal functioning. It can help to detect problems related to the ovaries, endometrial lining and uterus.

TVS - Transvaginal ultrasound helps to assess the reproductive organs. It can help to detect fibroids, polyps and uterine irregularities

Follicular monitoring - It involves a series of ultrasounds that help to monitor ovarian follicles and egg mutation. It also helps to track the ovulation pathway. The procedure is also recommended for women who are taking fertility medicines.

Fibroid mapping - Fibroid mapping is done for Müllerian duct anomalies. These are congenital anomalies caused by the abnormal development of the Mullerian Ducts.