Dr Shazia Malik

Dr Shazia Malik
Obstetrics & gynaecology
Central London


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Dr Shazia Malik

Obstetrician - gynaecologist in
London

MRCOG MBChB (Hons)

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Dr Shazia Malik areas of expertise:

Professional statement

Dr Shazia Malik is an expert consultant obstetrician and gynaecologist in London who specialises in reproductive medicine and surgery. Dr Malik’s interests include pregnancy after IVF, early pregnancy problems, as well as PCOS, pelvic pain, menopause and menstrual dysfunction.

Dr Malik gained her medical degree with honours and a gold medal in obstetrics and gynaecology in 1991. She undertook her specialist training in Cambridge where she was also a research fellow funded by the MRC with a world-famous team, looking at abnormal vessel function in women with extremely heavy periods or endometriosis. She successfully completed her subspecialty accreditation in reproductive medicine and surgery at UCLH (London) where she remains an honorary consultant.

Dr Malik has worked as a consultant as part of the recurrent miscarriage team at St Mary’s Hospital, and as a consultant in IVF at CRGH, one of the country’s leading IVF units. She is regularly consulted by the national press and her articles appear in national publications.

 Credentials

GMC: ‍3277153

 Professional experience

• More than 25 years of experience
• Consultant Obstetrician and Gynaecologist, The Portland Hospital for Women and Children (present)
• Consultant Obstetrician and Gynaecologist, The Princess Grace Hospital (present)

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 Sub-specialties

• Reproductive medicine
• Obstetrics (general and high risk)
• Menstrual dysfunction
• Women's health check
• Pregnancy
• Miscarriage
• Heavy periods
• Pelvic pain
• Endometriosis
• Polycystic Ovarian Syndrome (PCOS)
• In vitro fertilisation (IVF)
• Caesarean section
• Pregnancy after IVF
• Ultrasound
• Subfertility
• Fibroids
• Menstrual dysfunction
• Laparoscopic surgery
• General gynaecology
• Female fertility
• Fertility medicine
• Female infertility
• Fertility advice
• Pre-pregnancy planning
• Twin pregnancy

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 Education

• Kings College Hospital, early pregnancy and gynae ultrasound (2005)
• Royal College of Obstetricians and Gynaecologists, MAS Level II Accreditation in laparoscopic and hysteroscopic surgery (2005)
• Royal College of Obstetricians and Gynaecologists, Subspecialty Accreditaion in reproductive medicine (2005)
• Royal College of Obstetricians and Gynaecologists, CCST (2005)
• Royal College of Obstetricians and Gynaecologists, MRCOG (1997)
• Liverpool University, MBChB (honours) (1991)

 ...

 Publications and conferences

• Frequently consulted by the press to write articles and make appearances for publications such as the BBC, The Telegraph, The Huffington Post and The Daily Mail.

 Professional membership

• Member of British Medical Association
• Member of Royal College of Obstetricians and Gynaecologists

Languages spoken

  • English
  • Hindi
  • Urdu

Patient reviews for Dr. Shazia Malik

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All reviews are from verified patients booked through Top Doctors.

Patient reviews

Verified Patient
07/03/2018

Would you recommend this doctor?

  • Bedside manner
  • Friendliness of the staff
  • Wait time
  • Facilities conditions

Verified Patient
18/02/2018

Would you recommend this doctor?

  • Bedside manner
  • Friendliness of the staff
  • Wait time
  • Facilities conditions

Patients comments

She's a true doctor in every sense, who can treat patients just with her smile & words beside's her expertise. she gave me what i needed most: confidence & hope

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Diseases, Medical Tests and Treatments

Caesarean

A caesarean, or C-section, is a surgical procedure performed in order to delivery a baby. This type of delivery is used when it is thought that a vagi ...

Fertility test

A fertility test is a medical protocol that aims to diagnose the causes of infertility in order to find the necessary help to get pregnant, including ...

Menopause

What is the menopause? The menopause refers to the process which naturally occurs in women as a result of ageing, meaning they no longer have p ...

Menstrual disorders

What are the different types of menstrual disorders? Disorders of cycle length: Amenorrhea (absence of menstruation) Oligomenorrhea (infreq ...

Miscarriage

Miscarriage is the loss of an embryo or foetus through natural causes, or through unintentional loss. If it happens after the 20th week of pregnancy it is called stillbirth. Miscarriage is divided into early stage (before 12 weeks) or late (between week 12 and 20). ...

Polycystic ovaries

Polycystic ovaries is a condition that occurs when there is an imbalance in the female ovaries or adrenal glands so they produce more male hormones than normal. The result is the development of cysts (tiny fluid-filled balloons) in the ovaries. Women can develop the syndrome during the teen years or reproductive age, being more common in obese women. Although sometimes there are no symptoms, some symptoms the patient may experience include irregular, infrequent or absent menstrual periods, infertility, pelvic pain, excess hair on the face, chest, abdomen and fingers, hair loss or weak hair, acne, oily skin or dandruff. Birth control pills can help regulate the period and reduce male hormone levels, so this is the treatment usually prescribed for polycystic ovaries. When the ovaries produce multiple small cysts (no more than 1 cm in diameter), it is micropolycystic ovaries syndrome, which usually has the same symptoms. Likewise, the treatment for micropolycystic ovaries may also be based on the administration of the contraceptive pill.   ...

20 week scan

What is a mid-pregnancy anomaly scan? A mid-pregnancy anomaly scan, together with the first scan or dating scan, is the most important and detailed ultrasound during a pregnancy. It is carried out between the 20th and 22nd week of the pregnancy. What does it involve? A mid-pregnancy anomaly scan is an external ultrasound (done on your tummy) very similar to a scan done during the third month of pregnancy. The scan consists in using a transducer, which has previously been covered in a gel that allows for better ultrasound waves transmission and for better image reception. The doctor is then able to show your baby’s face features and body more clearly. What is it for? A mid-pregnancy scan can be done between the 20th and 22nd week of pregnancy, in order to analyse the foetus’ anatomical (morphological) features. It is also done in order to verify whether or not there are any malformations. The scan analyses your baby’s biometrics (how much the foetus has grown), the position and structure of the placenta, how much amniotic fluid there is and the cervix’s general state of health. This systematic morphological scan looks at: The central nervous system: thalami, ventricles of the brain, fornix, the corpus callosum, brain fissures or solci which can be seen at this stage of the pregnancy, cerebellum, cisterna magna and posterior cranial fossa; The baby’s face: nose and nostrils, lips, orbits, crystalline lenses, palate; The skeletal system: spinal column state of development, long bones, hand and feet; The chest: diaphragm, lungs, heart, great vessels; The gastrointestinal tract: stomach, liver, gallbladder, intestine; Genitourinary system: kidneys, bladder, genital organs. When is the mid-pregnancy anomaly scan done? This kind of scan must be done between the 20th and 22nd week of your pregnancy for two main reasons: It is the best moment for the foetus to be analysed due to an optimal ratio between the baby’s size and the amount of amniotic fluid; Abortion or termination of pregnancy is forbidden by law after 24 weeks of pregnancy. If there is a high risk of malformation, it is necessary to carry out the scan between the 16th and 18th week (a genetic ultrasound or early mid-pregnancy anomaly scan) in order to carry out an early analysis of the baby’s growth progress. This is also helpful so that mum and dad can have a few specific genetic tests (such as foetal genome screening, array-CHG, cell-free foetal DNA test) in order to get a more accurate picture of their genetic situation. ...

Antenatal care

Management of pregnancy or prenatal care is necessary for the welfare of the mother and baby. Reviews should be monthly during the first seven months of pregnancy and more frequent as the mother approaches due date. In each appointment, routine tests are performed to check the development of the pregnancy. Some tests are conducted only in risk pregnancies. ...

Assisted conception

This treatment is undertaken when a couple is not successful in getting pregnant. It can be intrauterine insemination (IUI) or in vitro fertilisation (IVF). ...

Assisted reproduction

Assisted reproduction is a technique in which, through medical assistance, the egg is fertilized by the sperm. This technique is used when there is a medical problem that prevents the couple from getting pregnant. ...

Childbirth

Childbirth is when the baby leaves the womb at the end of the nine months of pregnancy, although it may occur prematurely. Labour starts when the mother starts feeling irregular and continuous uterine contractions, which progressively increase in frequency and intensity. Together with the contractions there are also some other physiological changes happening in the cervix, which will help the baby to be born. The pregnant woman should be taken to a hospital in order to receive all the medical care required. In some cases, she may require the help of anaesthetic drugs or oxytocin, which are used when there are complications. Ideally, during labour the baby goes through the mother’s vagina spontaneously, without complications or the need for doctors to use instruments. However, in many cases there is the need to use instruments, such as forceps, to help the baby during delivery. A lot of births are by Caesarean section, a surgical procedure in which an incision is made in the abdomen and uterus to remove the baby when a natural birth is too complicated or dangerous for the mother and child.   ...

Ectopic pregnancy

What is ectopic pregnancy? Ectopic pregnancy is a problem with the implantation of a fertilised egg cell. In a normal pregnancy, the fertilised egg attaches itself to the lining of the uterus. Ectopic pregnancy involves the fertilised egg implanting and growing outside the uterus, in places such as: the fallopian tube the ovary the cervix the abdominal cavity Just over 1% of pregnancies are ectopic. Unfortunately, the fertilised egg cannot survive in an ectopic pregnancy. Prognosis The severity of the condition depends on where the egg is growing. If the egg is growing in the fallopian tube and isn’t detected early enough it can lead to fallopian tube rupture and heavy bleeding, which can be life-threatening. Symptoms of ectopic pregnancy An ectopic pregnancy can cause: vaginal bleeding pain when going to the toilet pain on one side of your abdomen pain in your shoulder Not all people with ectopic pregnancy experience symptoms and it might only be diagnosed during a routine pregnancy scan. However, you should seek emergency help if you get a sudden intense pain in your abdomen, accompanied by dizziness or nausea, as this can be an indication of a ruptured fallopian tube. In this situation you will need emergency surgery to repair or remove the tube and control the bleeding. How is ectopic pregnancy diagnosed? After an assessment of your symptoms, the doctor will order some blood tests and a vaginal ultrasound. The blood test can help not only with diagnosis but with treatment, as you may need a blood transfusion. In some cases, a form of keyhole surgery called a laparoscopy might be recommended if it’s still difficult to make a diagnosis. If an ectopic pregnancy is found, the fertilised egg can be removed during the same procedure. What causes ectopic pregnancy? The following can increase your chances of an ectopic pregnancy: sexually transmitted infections scarring from pelvic surgery infertility treatment such as IVF pelvic inflammatory disease smoking You’re also more likely to experience an ectopic pregnancy if you are between the ages of 35 and 40. Tubal pregnancy (where the egg attaches itself to the lining of the fallopian tube) is caused by a blockage that stops the egg travelling to the uterus. This may be the result of fallopian tube surgery or damage due to inflammation. Can ectopic pregnancy be prevented? You can reduce your risk of ectopic pregnancy by stopping smoking and reducing your chances of sexually transmitted infections. How is ectopic pregnancy treated? Treatment for ectopic pregnancy depends on how early it has been detected. If the diagnosis was made early and you don’t have unstable bleeding, ectopic pregnancy can be treated with an injection of methotrexate, which should dissolve any existing cells. You’ll be monitored with follow-up blood tests and you may need to continue taking contraceptive medication for the next few months. If medication doesn’t work, or if the pregnancy is more advanced, surgery is generally recommended. A laparoscopy is performed under general anaesthetic and involves inserting small surgical tools to remove the ectopic pregnancy. If your fallopian tube is damaged and the other one is healthy, the surgeon might also remove the damaged fallopian tube. After treatment you might have a follow-up appointment with a fertility specialist to discuss your chances of getting pregnant and get advice on when to start trying again. ...

Endoscopy

What is it? Endoscopy is the use of cameras to relay images from inside the body.  The device used, known as an endoscope, is a long thin flexible tube with a camera at one end and a light source. What does it involve? Endoscopes are inserted in to the body via a natural opening such as the mouth or the anus. There are different types of endoscopy depending on the site and function of the procedure – if the bowel is to be investigated for example, it is referred to as a colonoscopy. If the airways are to be examined, the procedure is referred to as a bronchoscopy. Endoscopy can also be used for surgery, as in the case of laparoscopic surgery – in this situation the laparoscope (a specific type of endoscope) is inserted through small incisions. Once inserted, the endoscope is able to send images from the inside of the subject’s body back to a TV screen. What is it for? Endoscopy is most commonly used to investigate symptoms and help to diagnose conditions relating to the digestive system, although it can be deployed to produce images and aid with many other parts of the body, including the respiratory system, the urinary tract and the female reproductive system. An endoscope can also be used to assist with surgery. An endoscopy is commonly used to investigate symptoms such as abdominal pain, nausea and vomiting, unexplained weight loss, diarrhoea, blood in the stool or vomiting blood. How can you prepare for it? You may be required to avoid food and liquids for a period beforehand, depending on what type of endoscopy you are undergoing. In the case of a colonoscopy, you might be given laxatives to help you evacuate any stool beforehand. You may also be required to stop taking certain medication such as blood thinners to prevent excess bleeding from the procedure. What does it feel like during the procedure? The procedure usually only causes mild discomfort although a local anaesthetic is also sometimes used. It is normally performed with the patient conscious, although sedatives can be deployed to help you relax. Antibiotics are sometimes used to reduce risk of infection. What would a “bad” result mean? An endoscopy can be used to diagnose a wide range of conditions and the results are interpreted by a specialist.  Whether the results are good or bad clearly depends on what symptoms are being investigated and on which part of the body the endoscopy is being performed. ...

Family planning

What is family planning? Family planning is a wide topic that involves taking steps to control when a pregnancy occurs. It can refer to both fertility treatments for couple trying to have children and contraceptive methods to prevent pregnancy.   Why is it done? The reason depends on the type of family planning. Family planning is important to avoid unwanted pregnancy. There are different contraceptive methods available to achieve this end, and this kind of family planning is often done between the couple. However, a consultation with a doctor may be necessary to weigh up what kind of contraception is best for you. For example, some women may be unable to take contraceptive pills for medical reasons, or condoms may not be an option due to latex allergies, etc. On the other hand, if a couple is trying to conceive, they may consult a fertility specialist to find out why they are having difficulties getting pregnant or to plan how to optimise their chances of having a baby. It may be that one or both partners are infertile and may need assistance in getting pregnant.   What does it involve? Family planning to conceive a child involves consulting a doctor, usually a fertility specialist or gynaecologist, who may run tests to find out why a couple is having trouble conceiving. This could involve: Semen analysis (men) to check for low sperm count and abnormalities, such as poor movement. Blood tests can test that the correct hormones are being produced (women) Ultrasound scans and X-rays can be used to check the physical health of the reproductive organs and search for any blockages, e.g. in the fallopian tubes (women) Both sexes may be tested for STIs like chlamydia, which can affect fertility. Depending on the results of the tests, the doctor may advise different methods to maximise the chances of the couple having a baby, and will plan with the couple how they should proceed. In some cases natural family planning will be advised. This simply involves having the woman monitor the signs of fertility in her menstrual cycle to know when she is ovulating, and therefore when is the optimal time to have sex. In other cases, some sort of fertility treatment may be necessary or the couple may be advised to try options such as IVF. Conversely, family planning to avoid unwanted pregnancy largely involves contraceptive methods, such as condoms or similar barrier devices, the contraceptive pill, or, again, using the natural family planning method to determine when the woman is ovulating and avoid having sex at that time.   Benefits of family planning Family planning carries several advantages: It allows a couple to plan and have more control over when they have their children, which can be good for health, economic, or personal reasons. It gives couples the ability to control the number of children they have, and the spacing between them. It reduces the need for abortions of unwanted preganancies Some contraceptive methods used, such as condoms, also help prevent the spread of STIs. It can help couples with below-average fertility to have a baby. ...

Fertility treatments

What is fertility treatment? Fertility treatment is typically given by a fertility specialist or fertility doctor, often an obstetrician/gynaecologist specialising in the issues and treatment surrounding infertility. The sub-specialty is often referred to as 'reproductive medicine', dealing with the prevention, diagnosis and management of reproductive problems. What conditions does a fertility specialist treat? Fertility specialists consult for and are able to diagnose all manner of conditions surrounding infertility and related problems. These specialists may consult for both male and female infertility, making an initial assessment either for an individual or a couple. Fertility specialists typically use three main methods of treatment for fertility issues, being medication, surgical procedures, and assisted conception. Depending on the treatment, fertility specialists may refer to other specialists, such as surgeons or endocrinologists. Surgical procedures may be used for conditions such as endometriosis (where the womb lining grows outside the womb), fibroids, and polycystic ovary syndrome (PCOS). In men, surgery may be used to correct epididymal blockages, and retrieve sperm. Fertility medication is more commonly issued to women in order to help with ovulation issues. However, medication may be issued in some cases of male infertility or related problems. Many people visit fertility specialists for assisted conception, typically through IVF (in vitro fertilisation), IUI (intrauterine insemination), or egg/sperm donation. When should you see a fertility specialist for fertility treatment? There are many reasons to visit a fertility specialist. For women under 35, visiting a fertility specialist is recommended when pregnancy has not been achieved after one year of unprotected intercourse. Women 35 and older are recommended to visit a fertility specialist after 6 months of trying. Other reasons for visiting a fertility specialist include: irregular menstrual cycles wishing to delay conception being diagnosed with cancer during fertile years and wishing to conserve eggs In those with a thyroid condition, or who are overweight, or have a known reproductive issue such as PCOS, visiting a fertility specialist is advised before trying to get pregnant. In addition, some may wish to visit a fertility specialist and consult for the following reasons: Pelvic inflammatory disease Having had an STI Multiple miscarriages or a history of miscarriage Having had abdominal or pelvic surgery Absence of periods Painful periods Issues with erectile dysfunction Problems ejaculating Sustaining an injury to the genitals or groin A lump or swelling in the testicles (varicocele) ...

Fetal medicine

What is foetal (fetal) medicine? Foetal/fetal medicine, or maternal-fetal medicine (MFM) focuses on managing health concerns which a mother and foetus may experience before, during, and immediately after pregnancy. Fetal medicine is also referred to as perinatology. Fetal medicine specialists are obstetricians/gynaecologists who later train in how to assess and manage high-risk pregnancies. These specialists have an advanced knowledge of complications in pregnancy, be they medical, surgical, or genetic. Which conditions are treated through fetal medicine specialists? Fetal medicine specialists are specialised in high-risk pregnancy, which means any condition or any situation which threatens the health or life of the mother or the foetus can be treated by a fetal medicine specialist. Some of the following conditions will be monitored and treated by a fetal medicine specialist: Existing conditions such as HIV, high blood pressure, obesity, and diabetes Complications from previous pregnancies, e.g pre-eclampsia, pre-term births Problems with the foetus e.g birth defects Multiple gestation – twins, triplets, or other multiples When should you see a fetal medicine specialist? If you are aware that you have an existing condition while either trying to conceive, or once pregnant, you should discuss this with your doctor who will refer you on to the correct specialist. Your doctor will also refer you on to a fetal medicine specialist if they deem it necessary during pregnancy. ...

Foetal surgery

Fetal surgery is the procedure performed while the fetus is in the womb of the mother. It is rare, only 1 in 1,000 pregnancies requires this type of operation. The fetal surgery can save the life of a baby who has a malformation or disease ...

Gynaecological examination

What is a gynaecological examination? A gynaecological examination is done to assess the overall health of the female reproductive system. During the exam, the gynaecologist will look at the external and internal reproductive organs, as well as at the breasts, to determine whether there are any problems or conditions present. What does a gynaecological examination involve? During a gynaecological examination, you will be lying down with your knees up and spread wide apart. The gynaecologist will inspect your vulva and vagina. With both a physical examination and a transvaginal ultrasound, the doctor will also check your uterus and ovaries. It is very common to also do a smear test during the examination, to determine whether there are precancerous cells in your cervix. The sample taken is sent for examination in a laboratory with results shared, usually in a couple of weeks after the appointment. The last part of the examination consists of a breast exam, where the gynaecologist checks for lumps or abnormalities. You will also be taught how to do a breast self-exam, so that you can do them at home periodically. The whole examination does not last more than 20-30 minutes. What is a gynaecological examination for? A gynaecological examination is helpful to assess the general state of health of the female reproductive system, as well as to identify potential infections or problems. The very first examination should be done after the first menstrual cycle or after you become sexually active, even if there are no obvious problems or red flags. Should you have any itching, a burning sensation, abnormal vaginal discharge, as well as irregular menstrual periods or abnormalities or lumps on your breasts, you should go for a gynaecological examination as soon as possible. Even if you do not have any issues, you should go for a check-up at least once every three years (or more often if you have a family history of uterus or breast cancer). How can I prepare for a gynaecological examination? You do not need to do anything before a gynaecological examination. However, you should schedule your examination away from your menstruations and remember to empty your bladder before the visit to avoid any potential discomfort. What does it feel like during the examination? A gynaecological examination is not painful at all. The feeling you will have during the internal examination is like that of using a tampon. What would a “bad” result mean? There are many potential anomalies that could be found during an examination. By going for your check-up, the gynaecologist can identify potential tumours, conditions, infections or even small irritations and determine the best treatment for you. ...

Heavy periods

Heavy periods, known in medical terms as ‘menorrhagia’ can be experienced along with other symptoms such as period pain. On average women lose around 30-40ml of blood during their period. The amount varies from woman to woman, but generally amounts lost above 60ml are considered to be heavy menstrual bleeding. Heavy periods are not always an indication that something is wrong, but they can be uncomfortable and disruptive in everyday life. Some conditions which can cause heavy periods include fibroids, PCOS (polycystic ovary syndrome), endometriosis, hyperthyroidism, and pelvic inflammatory disease. ...

High blood pressure pregnancy

What is it? If your blood pressure has constantly been going up since the end of the second trimester of pregnancy, you may have gestational hypertension. It is essential that you monitor your blood pressure and the baby’s as well, as this condition may lead to some complications. What are the symptoms? The main symptoms of gestational hypertension are: a sudden decrease in your urine flow abdominal pain swollen ankles and face headache vomiting general fatigue in some cases, pre-eclampsia. How is it diagnosed? To diagnose gestational hypertension, your doctor will monitor your blood pressure reading: your systolic pressure should never be higher than the 140/90 to 149/99mmHg range. What causes it? It is not clear yet what causes this condition. However, it has been demonstrated that women 35 or older who have been pregnant before, as well as those who have a family history of gestational hypertension, have a higher risk of developing it. A combination of factors, such as a weakened immune system, placental abnormalities and a diet low in calcium, zinc and proteins can also lead to developing gestational hypertension. How can it be prevented? You should make sure to maintain a healthy weight before the pregnancy. Being obese or overweight is a risk factor, as during the nine months of pregnancy your weight will inevitably increase. That will lead to a higher risk of developing high blood pressure. A healthy weight also depends on eating a healthy diet, avoiding eating too much, making sure you get all the nutrients you need and staying hydrated by drinking two litres of water per day. You must absolutely avoid smoking and drinking alcohol, as those will increase your risk of getting gestational hypertension as much as ten times. Finally, in case your clinical situation is not clear, you should monitor your blood pressure monthly, increasing the frequency of the readings during the last trimester of pregnancy. How is it treated? Hypertension isn’t usually a major problem during pregnancy. The doctor will only induce labour at the 40th week in the most critical cases. Treatment consists in taking some medications; however, you should carefully assess any potential side effects on the baby (neonatal mortality and postnatal developmental toxicity). Another common treatment is bed rest, to avoid increasing your blood pressure, especially in the placenta and uterine area. ...

High-risk pregnancy

Risk pregnancy is a type of pregnancy in which there are many chances that the mother or the child develop problems during the pregnancy. Rest and medical supervision are required and, in some cases it is necessary to take medication or additional food supplements. To be considered a medium, high or very high risk pregnancy, the mother or the foetus would have an illness or be under circumstances that could endanger both. Medium risk: Pregnancies under the age of 17 and over 38, obese women with abnormalities in the pelvis, blood group Rh negative, those who smoke. High-risk: Mother with severe anaemia, pregnancy with twins, women who have had cervical surgery or who have a critical obstetrical history, infections, gestational diabetes, suspected foetal malformation, morbidly obese. Very high risk: Multiple gestations, uterine malformations, heart disease, diabetes, cervical incontinence, restricted foetal growth, foetal malformation confirmed, placenta praevia, severe pre-eclampsia, preterm labour, ruptured membrane. ...

Hormone replacement therapy (HRT)

During the menopause, women's hormone levels fluctuate. This can cause a range of unwanted symptoms like hot flushes. HRT aims to replace the lost hormones with medication, and restore balance to the body. ...

In vitro fertilisation (IVF)

In vitro fertilisation (IVF) is used when a couple are having difficulty getting pregnant via natural methods. A woman’s own (or a donor’s) egg is artificially inseminated by her partner’s (or donor’s) sperm, to obtain one or more embryo. The embryos can then be transferred to the woman’s uterus to develop as a normal pregnancy, or frozen for use at later time. ...

Infertility

What is infertility? Infertility is the inability of a couple to become pregnant through natural means. Infertility affects the couple, both the man and the woman, who cannot have a child naturally. There are two types of infertility: primary infertility, affecting couples who have not become pregnant after at least one year of unprotected sexual intercourse, and secondary infertility, affecting couples who were able to become pregnant in the past but are now unable to. Symptoms of infertility: There are various symptoms of infertility in men and women. In women, symptoms may be related to the menstrual cycle and ovulation: abnormal menstruation, with more or less bleeding than usual; irregular menstruation, when the number of days between each menstruation is different each month; amenorrhoea, i.e., no menstruation; or dysmenorrhea, very painful menstruation. There may also be symptoms unrelated to menstruation, such as pain during sexual intercourse. In men, the symptoms of sperm-related infertility include small amounts of ejaculate. There are also symptoms unrelated to semen, such as changes in hair growth, changes in sexual desire and erection problems. Men may also have a low sperm-count, making the chance of conceiving naturally more difficult. What causes infertility? Common causes of infertility among men and women are: Birth defects of the reproductive system Cancer, tumours, chemotherapy drugs, radiation therapy Excessive alcohol consumption Hormonal imbalances Obesity Scarring from sexually transmitted infections, abdominal surgery, or endometriosis Smoking Older age Pelvic infection In women, infertility may be caused by: Autoimmune treatments Clotting disorders Diabetes Excessive exercise Eating disorders Neoplastic lesions of the cervix and/or uterus, ovarian cysts, polycystic ovary syndrome Tubal ligation Thyroid problems In men, the causes of infertility may include: Impotence Infection Use of certain medications such as cimetidine, spironolactone, and nitrofurantoin Retrograde ejaculation Scarring from sexually transmitted diseases, injury, or surgery Environmental toxins Vasectomy or vasovasostomy failure Can infertility be prevented? Generally, if the origin of the infertility is genetic or caused by disease, then nothing can be done. However, you can avoid certain factors that may cause infertility: Take preventive measures against sexually transmitted infections (STIs) Do not use drugs Do not drink alcohol frequently or excessively Maintain good personal hygiene For women, have a gynaecological check-up once a year once you are sexually active For men, wear loose underwear and avoid hot baths, saunas and exposure to sources of radiation What is infertility treatment? Methods to treat infertility in men and women include taking hormones to resolve the hormonal imbalance, supplements to improve fertility, and antibiotics in the case of infection. For women, having minor surgery to remove blockages or scar tissue from the fallopian tubes, uterus, or pelvic area is another option. If these methods are unsuccessful, assisted reproduction techniques can be tried. ...

Laparoscopy

Laparoscopy is a surgical technique used to inspect the abdominal cavity, allowing the surgeon not to make large incisions. During the procedure, a laparoscope,  which is a tube containing an optical system coupled with a light source, is inserted into the abdomen. The camera allows the doctor to inspect the pelvic organs from a monitor and, if necessary, to introduce other instruments through the same laparoscope to correct a problem. The advantages of laparoscopy are many, such as the patient requiring shorter hospitalisation and recovery time, fewer chances of infectious complications, less postoperative pain and no visible scars. Laparoscopy is used primarily in processes such as prostate cancer or some kidney diseases. ...

Multiple pregnancy

Multiple pregnancy means that a woman has more than one baby in her uterus when pregnant. This can happen because of the fertilization of two or more eggs. Children from multiple pregnancies are twins....

Polyps

Polyps are abnormal tissue growths. They can form in different parts of the body: Colon polyps Uterine polyps Nasal polyps, etc. Polyps are a common problem and most of them are benign, although some types have been linked to cancer.  ...

Preeclampsia

Preeclampsia is a condition that can occur in women during their 20th week of gestation. During this stage, the pregnant may experience high blood pressure, protein in the urine and a series of symptoms that disappear within 6 weeks after giving birth. ...

Pregnancy

What is it? Pregnancy is the physiological condition of a woman, starting from the moment of conception of the foetus and goes on with the baby’s growth, until birth. Pregnancy is usually categorised by weeks (for a total of 40) and lasts around 280 days. Under particular circumstances, the baby can be born before (premature birth) or after the estimated due date. Conception Conception is the result of the semen entering the woman’s reproductive system. The spermatozoa in the semen then travel through the cervix to the Fallopian tubes. The ovum or egg, which can be found in the Fallopian tubes, is then fertilised by a sperm and undergoes a series of cellular divisions while it travels to the uterus. Once it has reached the uterine cavity, the fertilised egg adheres to and penetrates into the uterine lining (the endometrium). From that moment on, the foetus starts developing. Women’s fertility reaches its peak during ovulation, when the egg moves towards the Fallopian tubes. This time frame can last up to six days and it is known as ‘fertile window’. 40 weeks of gestation Gestation usually lasts 40 weeks, which is the time it takes for the baby to develop. The first eight weeks are really important because at that time the baby is developing the organs he or she needs to survive. The mother will have symptoms such as nausea, irritability, fatigue and enlarged breasts. Between weeks eight to 13, the mother’s body will start changing; the baby’s genital organs will differentiate and the vocal cords will be formed. At that time, the most critical part of the pregnancy is over, leaving behind most risks of abortion or health problems for the baby. So, the second trimester of pregnancy begins. From week 13 to 17, the mother will feel less tired and the nausea will go away; the baby is now fully formed. From week 17 to 21, the mother will start feeling the first movements of the baby. Between weeks 21 to 26 the mother’s belly will become more evident and she will start feeling the first uterine contractions; at the same time, the baby’s weight will increase, the eyelids will start opening and closing and he or she will start trying to breathe. Week 26 is the beginning of the last trimester. The baby will keep on growing and between weeks 30 to 35 he or she will change position in order to get ready for birth; the mother will start suffering from intense back and abdominal pain and the uterine contractions will become more frequent. During the last month of gestation (weeks 35 to 40), the baby will be fully developed and will start turning upside down, with the head towards the pelvic cavity. Labour Labour is when the baby leaves the mother’s body. It can happen in several ways: Natural: also known as vaginal birth or spontaneous birth; Caesarean section or C-section: carried out if baby is in the breech position (feet first), if the mother has a low-lying placenta (placenta praevia), if the baby is in distress, if it’s a twin pregnancy, if the mother has had uterus surgery before or if either the mother’s or the baby’s health is in danger. A C-section can be planned, or it can be chosen as an emergency measure; Induced birth: if it is two weeks past the due date and the baby is not out yet, and either the mother’s or the baby’s health is in danger, delivery can be induced manually or by administering oxytocin and giving an epidural to the mother. Which doctor should I talk to? Pregnancy is a very delicate period both for the future mother and for the baby: that is why they both need to be assisted throughout this whole journey. It is important to see a specialised obstetrician/gynaecologist, who will be able to give you more information about pregnancy, what are the related risks and symptoms and what to do so that both you and your baby will be perfectly healthy. ...

Premature birth

What is it? Any labour and birth that occurs before the 40th week of pregnancy is considered to be premature or preterm. Usually a pregnancy lasts around 40 weeks. If labour and delivery happen between the 20th and 37th week of gestation, it is considered premature. There are several kinds of premature birth: Moderate to late premature birth: between the 34th and the 37th week of pregnancy; Very premature birth: between the 25th and the 33rd week of pregnancy; Extremely premature birth: before the 25th week of pregnancy. What are the symptoms of a premature birth? Babies born before full term tend to have a low birth rate and other symtoms depending on how early they are born. It is important that the foetus stays in the uterus as long as possible, so that the organs will develop correctly (especially the lungs, brain and heart). The earlier the baby is born, the more severe the consequences will be. The baby, once born, may have respiratory problems, heart conditions, neurological conditions, gastrointestinal tract conditions, metabolic or immune system disorders. From the 37th week on, the baby has everything he or she needs to be considered a fully developed foetus. However, this doesn't exclude the possibility of complications. What causes premature birth? The possibility of premature birth is linked to some elements in your pregnancy and medical history: having had a previous premature birth being pregnant with twins an interval of less than six months between pregnancies conceiving through in vitro fertilisation any problems or conditions in your uterus, placenta or cervix; smoking, alcohol or drugs consumption during the pregnancy malnutrition amniotic fluid infections hypertension and diabetes being underweight before getting pregnant previous history of miscarriage physical injury or trauma uterine anomalies How can it be prevented? It is important to go to all your scans and checks during the pregnancy - especially those during the 31st and 32nd week, such as the transvaginal ultrasound, which can detect whether you have cervical insufficiency (your cervix is smaller than 2.5 or 2 centimetres). Cervical insufficiency is one of the main causes for spontaneous premature birth. ...

Premenstrual syndrome

Premenstrual syndrome is characterised by a set of symptoms that affect the body and the mood of women. They usually start one to two weeks before menstruation and disappear when it starts. The vast majority of women experience at least one of these symptoms: joint pain, tender and swollen breasts, migraine, acne, fatigue, constipation, irritability, hot flushes, depression, changes in mood, low sex drive, etc. Sometimes they are severe enough to interfere with their normal life. There is no definitive treatment for premenstrual syndrome, but general recommendations include to exercise regularly, take pain killers or evening primrose and follow a healthy diet (avoiding sugars, replacing processed food with whole food, reducing fat). ...

Prenatal diagnosis

Prenatal diagnosis is the set of tests that examine the proper formation and development of a foetus. There are different techniques, both invasive and non-invasive. ...

Preparation for childbirth

What is childbirth preparation? The term “childbirth preparation” encompasses a range of tools that help parents-to-be prepare for the birth of their child from the start of pregnancy. They usually take the form of talks providing information about foetal development and medical check-ups; psychological aspects of pregnancy, birth and the postpartum period; what happens during childbirth; breastfeeding etc. In practical sessions, a specialised instructor shows pregnant women postures and exercises that will help make muscle structures more elastic in order to facilitate childbirth, as well as breathing and relaxation techniques to provide them with better self-control during labour contractions. Why is it done? Pregnancy is a period of major adaptation for future parents, who should be aware that they are nurturing a new life and that they are responsible for their future child’s health and wellbeing, and they should be informed about the changes that the mother will experience and that pregnancy is ultimately an enriching experience. It also helps future mothers be better prepared during delivery, by working on elasticity, better postures for childbirth and control of contractions. What does preparation for childbirth involve? Childbirth preparation sessions are imparted by a specialist in obstetrics and gynaecology at hospitals, social and educational facilities or health centres. The pregnant woman can attend by herself or with their partner or companion. Sessions are usually between 1 and 2 hours. They are held over a period of 5 to 8 weeks, usually from the first trimester. There are theoretical and practical sessions: Theoretical sessions : the pregnant women receive information about the changes they will undergo during pregnancy, types of childbirth, and in general what they will experience in each of the phases of childbirth. Practical sessions : postural exercises, breathing and relaxation techniques for childbirth. What you need to know before childbirth preparation Pregnant women should obtain information about the various childbirth preparation courses available to them, as well as the techniques to be done in them. Childbirth preparation courses are based on several techniques, of which the most commonly used are: The Bradley method: places emphasis on avoiding as much as possible the administration of medications, taking care of one’s diet, physical activity and relaxation, and also involving the partner in the process. The Lamaze method : places emphasis on supporting the pregnant woman with words of encouragement, massages, tactile and visual stimulation, that help her feel confident about the pregnancy and delivery. The partner plays a fundamental role in supporting the woman. Alternatives to childbirth preparation Childbirth preparation is not compulsory. It is undertaken by future parents who want to be better informed and prepared for pregnancy and delivery. Alongside the childbirth preparation course, the pregnant woman must also be under the care of a specialist in obstetrics and gynaecology who will monitor her pregnancy and provide individualised care. ...

Recurrent miscarriage

Repeated miscarriages are the loss of three or more consecutive pregnancies before the 20th week of gestation. Each case should be individualized, with the age of the woman, the circumstances surrounding the losses or the anxiety of the couple all being aspects to be taken into account. ...

Second medical opinion

What is a second medical opinion? A second medical opinion is when you consult with a doctor that is not your regular doctor about a potential diagnosis and/or treatment plan. There is no legal right to a second opinion, however, it is rare for a doctor to refuse. Why would you get a second medical opinion? Patients may consider a second medical opinion if they are facing a new diagnosis or recommended treatment because sometimes this can feel confusing and a second opinion can put their mind at ease. In addition, there are certain situations where a second medical opinion is sought after: Potential treatment is risky and could be life-changing or the diagnosis is possibly life-threatening The diagnosis is not clear-cut If you are considering a new treatment approach that is experimental The aims of obtaining a second medical opinion are: To confirm whether a diagnosis is correct and/or appropriate. To confirm whether a suggested treatment is correct and/or appropriate. To compare information received from each doctor so that you can make an informed decision – sometimes a second medical opinion can rule out the need for a potentially unnecessary invasive procedure. Possible disadvantages of seeking a second medical opinion include: The process can delay the start of treatment. Logistically, seeing another specialist might be difficult and possibly time-consuming. It might be stressful to hear the same diagnosis again. How would you seek a second medical opinion? You can request a second medical opinion from your GP or consultant, but before doing so it is recommended that you ask for as much clarification and explanation about the initial diagnosis and treatment, before seeking a second opinion. Obtaining a second medical opinion does not mean that the second doctor will then take over – if that is what the patient decides, then this needs to be agreed formally between doctors and hospitals.  ...

Ultrasound

What is ultrasound? Ultrasound is a diagnostic imaging procedure that allows you to see organs and soft structures inside the body. At present, they can be 2D, 3D or four-dimensional images. Ultrasound is a non-invasive technique, in which radiation is not used and thanks to this, it is used to visualise developing foetuses. What does an ultrasound scan consist of? It is carried out using high frequency sound waves emitted through a transducer that captures the echo of different amplitudes which occurs when they ‘bounce’ off the organs. These signals, once processed by a computer, give a series of images. Why are ultrasounds carried out? With this procedure you can clearly differentiate the shape and size of each structure inside the body. In medicine it is used to see the heart, kidneys, liver and blood vessels, among other organs. In addition, ultrasounds are also carried out on patients who are pregnant. Another function is the study of different tissues of the body such as the blood flow of arteries and veins to detect arteriosclerosis and blood clots. Ultrasounds also allow the analysis of the thyroid gland and other soft structures of the neck as well as tendons, ligaments, muscles and joint structures, and mammary glands. Preparation for Ultrasound Usually, you do not need any type of preparation for having an ultrasound. In cases where the area to be examined is the abdomen, the specialist may tell you to drink three glasses of water approximately one hour before the test. How does it feel during the ultrasound? During the ultrasound, the patient will lie on a table or stretcher with the area to be analysed exposed. The specialist will apply a transparent gel that will allow the movement of the roller built into the transducer. During the scan the expert will interpret the images and determine which shots are correct according to each case. The only slight discomfort that can be felt is the gentle pressure that the specialist applies when passing the transducer over the body area. The gel applied can also feel quite cold when applied. Meaning of abnormal results The types of images that are considered abnormal are: Congenital anomalies An alteration to tissue due to trauma or injury Cysts ...

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