Pregnancy Care for patients with Kidney Disease

Pregnancy results in important alterations in acid-base, electrolyte, and renal function due to pregnancy-associated physiologic changes in renal and systemic hemodynamics that occur.

Understanding these changes is essential when evaluating kidney disease pregnancy . Disorders that cause acute kidney or renal failure in early or late pregnancy generally fall into very different categories, and it must also be remembered that pregnancies in women with underlying chronic kidney disease and dialysis who require dialysis during pregnancy, or who have previously undergone renal transplantation pose unique sets of issues. Understanding the physiologic changes and disorders that occur in women with renal disease in pregnancy forms the basis of appropriate management of these unusual disorders.

Chronic kidney disease (CKD) carries significant risks to the mother and fetus in pregnancy. 

 

During a normal pregnancy the renal function undergoes physiological and anatomic changes.

Physiological changes:
The renal plasma flow rate escalates 50-70% during pregnancy (heavy load for kidneys), this change may be more visible during the first 2 trimester. This results in an increased glomerular filtration rate (GFR), that is, 150% of normal. This will be reducing the levels of both blood urea nitrogen (BUN) and creatinine. These changes may lead to renal disease during pregnancy.

Anatomic changes:
During the conception period the female body will show some anatomic changes. The size of the kidney will be increasing by about 1-1.5 cm. A dilatation of the uterus and pelvis occurs and is presumed to be secondary to the smooth muscle–relaxing effect of progesterone. This dilatation is often more pronounced on the right side secondary to dextrorotation of the uterus and dilatation of the right ovarian venous plexus, which in turn can lead to urinary stasis and, as discussed later, an increased risk of developing urinary tract infections (UTIs).

Srishti Assisted Fertility and Advanced Laparoscopy (SAFAL), an exclusive clinic for reproductive medicine center situated at the core of Puducherry, is here to assist you with best Pregnancy Care for patients with Kidney Disease.

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Pregnancy Care for Diabetes Patients India

Diabetes is a disease in which your insulin level in the blood is high. Insulin is a hormone which helps the body use glucose or sugar from the blood for energy.

Gestational diabetes is diabetes that happens for the first time when a woman is pregnant. Diabetes during pregnancy goes away when you have your baby, but it does increase your risk for having diabetes later.
If you already have diabetes before you get pregnant, you need to monitor and control your blood sugar levels.
Either type of diabetes during pregnancy raises the risk of problems for the baby and the mother. To help reduce these risks, you should follow your meal plan, exercise, test your blood sugar and take your medicine.
 The following are the symptoms of the Gestational Diabetics:
- Sugar in urine (revealed in a test done in your doctor's office)
- Frequent infections of bladder, vagina and skin
- Frequent urination
- Unusual thirst
- Nausea
- Fatigue
- Burred vision
At Srishti fertility centre, Puducherry provides best health care for diabetics is carried out with an affordable and fair price.
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Hysteroscopic Septal Resection for Successful Pregnancy

A patient who is unable to carry a pregnancy to term or women infertility is sometimes found, on hysterosalpingogram, to have a septate form of double uterus. In such cases,hysteroscopic resection of septum often corrects the problem and results in a successful pregnancy.

                           

Physiologic Changes:

    A septate uterus is thought to cause fetal wastage because it cannot provide sufficient endometrium, which, in turn, provides nourishment for the developing placenta. When the septum has been removed, adequate endometrium returns, and nourishment becomes available.

    Before the introduction of the hysteroscopic operative instruments, this operation required a laparotomy as well as a hysterotomy with resection of the septum.The introduction of operative hysteroscopic instruments offers a new form of treatment that avoids a laparotomy, resulting in a shorter hospitalization and faster recovery.

    Srishti, Assisted Fertility & Advanced Laparoscopy Center (SAFAL), the reproductive medicine center, first one of this kind in the union territory of Puducherry, enables you with full package on Hysteroscopic Septal Resection.

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Hysteroscopy-Infertility Diagnosis India

Hysteroscopy is a female infertility testing where the doctor look at the lining of the uterus with the use of a medical instrument called a hysteroscope.This test is mainly done for women infertility.

The hysteroscope has a light and camera hooked to it so your doctor can see the lining (endometrium) on a video screen.The camera transmits a signal to a receiver so the doctor can see the inside of the uterus on a video screen.

The tip of the hysteroscope is put into your vagina and gently moved through the cervix into the uterus.

It is best to have a hysteroscopy done when you are not having your menstrual period. If there is a chance that you could become pregnant, the hysteroscopy should be done before you are ovulating so your doctor is sure you are not pregnant.

It also may be done to see if a problem in your uterus is preventing you from becoming pregnant (infertility). A hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps.

Your doctor may take a small sample of tissue (biopsy). The sample is looked at under a microscope for problems. Another surgery, called a laparoscopy, may also be done at the same time as a hysteroscopy if infertility is a problem.

Why it is done?

The hysteroscopy procedure may be done to discover the cause of abnormal bleeding after menopause.

It is also used to determine if there is a problem with the uterus such as:

• See whether a problem in the shape or size of the uterus or if scar tissue in the uterus is the cause of infertility.
• Look at the uterine openings to the fallopian tubes. If the tubes are blocked, your doctor may be able to open the tubes with special tools passed through the hysteroscope.
• Find the possible cause of repeated miscarriages. Other tests may also be done.
• Find and reposition a misplaced intrauterine device (IUD).
• Find and remove small fibroids or polyps
• Check for endometrial cancer.

Hysteroscopy test can be best done at Srishti fertility center, Puducherry.

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Fertility Enhancing Surgical Procedures

Though technology is far behind god’s creation but it could make slight change to the existing norms. With the advancement in technology, the medical field has also imbibed a lot.

Many conditions can contribute to infertility problems, including fibroids, endometriosis, pelvic adhesions (scar tissue in the pelvis) and uterine anomalies such as a uterine septum and adhesions (scar tissue inside the uterus)

The following surgical procedures can be performed to treat conditions that lead to infertility:

Hysteroscopic Treatment Options

Some of the hysteroscopic procedures, such as

- removal of scar tissue from the inside of the uterus or removal of a uterine septum, can be performed in the office.

- others are performed in the operating room with anesthesia.
Laparoscopic Treatment Options
Many procedures that were traditionally only done through large open incisions can now be done laparoscopically.

Laparoscopy is a process to study the organs of the abdominal and pelvic cavities and heal conditions using minimally invasive surgery. One of the greatest advantages of this typical treatment is that through laparoscopy, treatment procedure can avoid major surgery.

Fertility Enhancing Surgical Procedures (FESP) at Srishti Assisted Fertility &Advanced Laparoscopy Center (SAFAL), Puducherry, offers a variety of treatment method under the supervision of dexterous doctors. Dr. Dash and his team here is to help you with various treatment that will result on better satisfaction of the patients.

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Frozen Embryo Transfer,Assisted Reproductive Treatment

Frozen embryo transfer (FET) also known as Frozen Embryo Replacement (FER), consists of the thawing of embryos which were frozen during previous IVF or related treatment, and the replacing of them in the uterine cavity at the appropriate time of the menstrual cycle.
In simple, Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy.

It is common during IVF/ICSI embryo transfer treatment for more embryos to be produced than are required at the time. Good quality embryos remaining after the initial embryo transfer can be successfully frozen and stored at extremely low temperature,which ensures that they do not deteriorate over the number of years they are stored.

This stored embryos are then embryo replacement, which allows a couple to have up to three or four cycles from the same egg collection.

Embryo Transfer Procedure

Like the other conventional treatments like IVF or ICSI, Frozen Embryo replacement cycle does not require the ovaries to be stimulated. Instead Oestrogen is administered, normally in tablet or patch form. This enables the uterine lining to develop for the embryo’s to be replaced.In a Frozen Embryo Transfer Cycle, the woman takes medications to prepare her womb to receive these embryos.

The advantage of frozen embryo implantation treatment is that there is no need to use hormone injections to stimulate the ovaries.

An ultrasound scan is performed to assess the lining of the uterus to determine whether it is ready to receive the embryo. Once the lining is ready, embryos are thawed and transferred.

Dr. Soumyaroop Dash of Srishti fertility center, Puducherry,India is a leading infertility specialist who helps the couples to have a child with frozen embryo transfer procedure.

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Human Artificial Insemination-A Solution To Infertility

The goal of fertility treatment is to maximize the opportunity for a live birth of a healthy singleton child, born at full-term. Artificial Insemination is a procedure used to treat infertility.Artificial Insemination in India provides a risk free pregnancy with advanced medical care. Artificial insemination or Intrauterine Insemination (IUI) can help women who are facing problems for pregnancy due to complications caused by their male partners.It's a popular infertility treatment for men who have a very low sperm counts.

Infertility Treatments:

Artificial insemination is a fertilization procedure in which sperm is artificially placed into a woman’s overy,the process of ovarian stimulation.

During the artificial insemination process,the woman’s menstrual cycle is closely monitored using ovarian kits, ultrasounds, and blood tests. This is the first step of the fertility treatment. The length of the treatment takes less than an hour, but you may have to undergone fertility drugs for about a week before you ovulate.

With the technological advancement the IUF procedure became simpler and reliable. Here the ovaries are stimulated with FSH or HMG to produce several eggs per cycle. When the eggs reach maturity, ovulation is triggered by either an endogenous LH surge or by an injection of HCG. Approximately 36 to 42 hours later, near the time of ovulation, a prepared sperm sample is placed into the upper uterine cavity via a narrow catheter.This treatment regimen increases the chance of pregnancy.

Artificial insemination is a leading artificial reproductive technique providing amazing results to many couples who wished to become parents for a long time.As compared to other european countries,success rate of artificial insemination in India is very high and the artificial insemination costs is very low.

One of the best fertility center in India is located at the heart of Pondicherry-Srishti.A group consisting of well equipped and specialized doctors and nurses are at Srishti to rectify the problems of every patients with care and offers a more gentle and economical approach for couples struggling with infertility.

If you have any enquiries regarding this treatment,please submit the enquiry form given in the site.

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