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Preconceptional Counselling & PCOS (Polycystic Ovarian Syndrome)
What is preconceptional counseling?
As soon as you start thinking about having a baby, visiting your doctor at least 3 to 6 months before you start pregnancy is called preconception counseling.
When a couple visits for preconception counseling a detailed history and examination is done. The aim is to identify factors that have a negative impact on you or your baby during pregnancy. A treatment plan can then be worked out.
The only major obstacle is that most pregnancies are unplanned and most women take it for granted. Therefore, ideally it should be offered to all women of childbearing age, regardless of their intention to become pregnant.
It is a good opportunity to ask your doctor all the questions you have about pregnancy. All doubts regarding any pregnancy accident in the family should be considered. You should also discuss causes/complications related to premature birth, repeated pregnancy loss, intrauterine death and ectopic pregnancy as many of these are preventable. Many unfortunate events can be prevented by treating them before they start. If the mother is over 35 years old, there is a risk of Down’s syndrome in the baby which can be confirmed with some advanced tests. Also ultrasounds history of birth defects, mental retardation, blood clotting disorders, congenital blindness in the family and consanguineous marriages warrant genetic counseling.
Some important things you can do for prenatal health are:
Take 400 to 800 micrograms of folic acid daily. It reduces your risk of birth defects in the brain and spine.
Stop smoking and drinking alcohol. Avoid contact with toxic substances. Stay away from cat or rodent droppings.
If you have a medical condition, such as anemia, asthma, diabetes, oral health, obesity, epilepsy, thyroid disease, hypertension, epilepsy, tuberculosis or kidney disease, make sure it is under control.
PCOS (Polycystic Ovarian Syndrome) and you
A typical case scenario seen in our clinic is a young obese girl with intractable acne, irregular cycles, and increased facial hair. On ultrasound, polycystic ovaries can be seen, creating a lot of anxiety in the mind. But it is the most common endocrine disorder that affects 25 to 30% of young women. About 75% of anovulatory women have polycystic ovaries.
About the disease
PCOS, known as Stein-Leventhal syndrome, is a syndrome of ovarian dysfunction with characteristics of male hormone increase and ovaries showing a polycystic morphology without another explanatory endocrinopathy.
The etiology is complex with recent studies suggesting the role of insulin resistance. Abortion worsens the signs and symptoms of PCOS by triggering symptoms of insulin resistance. The symptoms can be as varied as irregular or missed periods, excessive hair growth on the face, around the nipples, and / or around the lower abdomen, obesity, thinning of the hair on the head, acne do -accessible, infertility, miscarriage, and type 2 diabetes or pre-diabetes.
A good history, clinical examination, and pelvic ultrasound are followed, and a hormonal profile completes the diagnosis of PCOS. Ultrasound shows enlarged ovaries, with several small cysts usually oriented on the periphery, like “String of pearls”. A hormonal profile shows high levels of DHEA, LH, AMH, and a normal level of FSH. High LH Levels with a normal FSH level are similar to PCOD
Goal of Treatment
Weight loss through diet and exercise is the most effective treatment. It reduces insulin resistance which restores regular cycles and ovulation. Anti-diabetic drugs like metformin, glitazone, newer drugs like D-chiro-inositol, Myo-inositol, Vitamin D3, and acupressure are other complementary treatments.
Fertility reform – Not every woman has a problem to feel. For those who do, ovulation is induced with drugs such as clomiphene or HMG/FSH injections. Some may require laparoscopic ovarian drilling (a laser or a cautery is used to drill 4-10 multiple holes through the thickened ovarian capsule). Those who do not respond to these and diet and lifestyle changes, IVF (in-vitro fertilization) is the option. The results of treatment with PCOS are good
Treatment of hirsutism or acne
Restoration of regular menstruation, to prevent endometrial hyperplasia and endometrial cancer by using progesterone or a combined contraceptive pill. If periods occur at least every three months there is no need for treatment.
Early diagnosis and treatment can reduce the risk of type 2 diabetes and heart disease.
Is there a cure?
There is no direct cure. Medical treatments reduce the symptoms and consequences of PCOS. Most women respond excellently to lifestyle changes alone
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#Preconceptional #Counselling #amp #PCOS #Polycystic #Ovarian #Syndrome