Pregnancy Questions and Answers, Plus Gynecology FAQs

My main practice is at Divine Women's Hospital on the S.G. Highway, Gota – Jagatpur, Ahmedabad. I also see patients at Marengo CIMS Hospital in Sola, Ahmedabad. The contact page has the address, timings and a map.

Call or send a WhatsApp message to +91 90545 74829. Share the patient's name, how many weeks pregnant you are (if you are pregnant) and the day that suits you. The hospital team will reply with a confirmed time.

Bring all your previous scan reports and blood tests, and any discharge summary from an earlier hospital stay. Also bring the names and doses of medicines you are currently on, and your antenatal card if one has been started. When the whole history is in front of me, the plan we make at that visit is a sounder one.

Yes. Divine Women's Hospital keeps its obstetric and labour services running round the clock, every day of the week. For an emergency there is no need to book: phone the hospital and come straight in.

Yes. Send your reports on WhatsApp in advance so they can be looked at before you come. The team can then plan your visit and give you a suitable time.

I consult in Gujarati, Hindi and English, so please use whichever you are most comfortable with.

No. Disclosing the sex of the baby is prohibited under the PCPNDT Act, and it is not revealed at any scan.

Please call the hospital with your insurance company's name and policy details before admission. The team will confirm whether a cashless claim is possible or whether you will need to claim reimbursement afterwards.

No. A high-risk label does not decide the mode of birth on its own, and many women with a high-risk pregnancy have a normal vaginal delivery. I base the choice on your condition, your baby's growth and how labour progresses, and we talk it through well before your due date.

That depends on your condition. Early in pregnancy it is often about once every four weeks. In the third trimester it may become weekly or even twice a week. I give you a written plan so you know the schedule in advance.

Some medicines can be continued as they are, some need a change of dose and a few need to be switched to an alternative suited to pregnancy. Please do not stop any medicine on your own. Bring all your prescriptions to the first visit so I can go through each one.

Often, yes. Planning a vaginal birth is reasonable if the twin nearest the cervix lies head-down and the pregnancy has otherwise been uncomplicated. The labour team stays ready to assist with delivering the second twin.

No. Carrying two babies calls for extra protein, calcium, folic acid and iron compared with carrying one, yet the calorie need does not double. At your early visits I hand you a diet plan written for twins.

Yes. Some of the tests are done in both partners, and chromosomal testing of both of you is advised when there is a reason for it.

For most couples there is no medical need to wait longer than one normal menstrual cycle. I do suggest completing the key tests, and starting any treatment they point to, before you conceive again.

Aim for 6 to 8 weeks of pregnancy. Women who already live with a medical illness, or who faced a problem in a past pregnancy, should come as soon as the pregnancy test turns positive.

For most women, yes. The epidural is given by an anaesthetist once labour is established, and its possible risks are explained to you beforehand.

It may be an option for a woman carrying one healthy baby that lies head-down at term, whose labour moves along normally. Whether it still suits you is reassessed once you come in with labour pains.

For home monitoring, I usually suggest a fasting value below 95 mg/dL. After a meal, aim for below 140 mg/dL at one hour and below 120 mg/dL at two hours. The cut-offs used to diagnose gestational diabetes depend on the test. On the DIPSI test, for example, it is 140 mg/dL at two hours.

Poorly controlled sugar can make the baby grow large, make the birth harder, and leave the newborn with low sugar or breathing difficulty. When levels are kept in range and growth is followed on scans, most of these babies are born healthy.

Yes. Insulin has a long record of use in pregnancy and does not cross the placenta in meaningful amounts. Needing insulin does not mean your diet has failed.

Yes, in moderate portions. Whole fruits such as apple, guava, pear and orange are the better choices; keep mango, chikoo and grapes to small portions.

In most women it settles within a few days of the birth. I still ask for a glucose test between 6 and 12 weeks after delivery, followed by a yearly sugar test from then on.

Not necessarily. A caesarean is considered mainly when the baby is estimated to be very large or there is another obstetric reason.

A reading below 140/90 mmHg is generally acceptable, and healthy pregnant women often run at around 110–120/70–80. If one reading is high, repeat it after resting; readings that stay at 140/90 or above need a medical review.

Often it causes no symptoms at all, which is why regular BP checks matter. Warning signs include a headache that does not go away, blurred vision or flashing lights, and pain under the ribs on the right side. Vomiting, and puffiness of the face, hands or feet that appears suddenly, are warning signs too.

Low-dose aspirin improves blood flow to the placenta. Started before 16 weeks in women at higher risk, it reduces the chance of early pre-eclampsia. Please take it only on medical advice.

The usual choices, labetalol, nifedipine and methyldopa, have a long history of use in pregnant women and are considered safe. High BP that is left untreated poses the greater risk to both of you.

Often, yes, with induction of labour aiming for a vaginal birth. A caesarean is needed when the disease is severe and delivery is urgent, or for other obstetric reasons.

The overall chance of it recurring is roughly 1 in 6, and higher if it was early or severe the first time. Next time, I start aspirin early and set up a monitoring plan from the first trimester.

Yes. In most women it moves away from the cervix by the third trimester. I repeat the scan at around 32 weeks before making any decision about delivery.

When the placenta is still over the cervix in late pregnancy, the baby has to be born by caesarean. A vaginal birth is often considered if the last scan places the placental edge more than 20 mm away from the cervix.

Not routinely, because strict bed rest raises the risk of blood clots. Avoid heavy work and intercourse, and come in promptly if you bleed. Some women are admitted for observation.

Placenta accreta means the placenta has grown into the uterine wall, so it may fail to come away after the birth and heavy bleeding can follow. It is serious, and outcomes are much better when it is recognised beforehand and the delivery is planned.

Often, removing the uterus at the time of the caesarean is the approach with the least risk in the accreta spectrum. Conservative options exist for selected cases, and I discuss them with you before delivery.

In the second trimester, if there has been no bleeding, desk work and short local trips are usually fine. In the third trimester, avoid long journeys and remote places, and do not travel alone.

Yes. Most women with obstetric APLA take home a live baby when aspirin and heparin are combined with careful monitoring. Close follow-up still continues for the whole pregnancy.

Low molecular weight heparin stays on your side of the placenta, so it is considered safe for the baby. Small bruises at the injection sites are common and do no harm.

Usually as soon as the pregnancy is confirmed, but the exact timing is set in your individual plan.

The risk of a flare is lower if your lupus has been inactive for six months before you conceive and you continue hydroxychloroquine.

Yes. Heparin, warfarin (after delivery) and hydroxychloroquine are all compatible with breastfeeding; other lupus medicines are reviewed one by one.

Usually yes, with careful timing. Preventive-dose heparin is stopped about 12 hours before the epidural, and a treatment dose about 24 hours before.

Roughly: 20 weeks - about 300 g; 28 weeks - 1 kg; 32 weeks - 1.8 kg; 36 weeks - 2.6 kg; 39–40 weeks - around 3 kg. Where your baby sits on the centile chart, and how that changes over time, matters more than any one figure.

A balanced diet with enough protein, and treatment of anaemia, do support growth. But when the placenta is the cause, extra food alone will not reverse it. Stopping tobacco in any form does make a real difference.

No. Plenty of babies measuring under the 10th centile are small by nature and perfectly healthy. Steady growth on serial scans with a normal Doppler is reassuring.

When the placenta was the likely cause, I begin low-dose aspirin before 16 weeks next time. Giving up tobacco and getting APLA or high BP under treatment help as well.

There is no fixed number to count. From about 24 weeks, get to know your baby's usual pattern. If the movements slow down or change, contact the hospital the same day.

Not always. Many small babies born at term stay with their mother. NICU care is needed mainly for babies born early or with significant growth restriction.

On a transvaginal scan between 16 and 24 weeks, anything over 25 mm is generally normal; typical readings are 30–40 mm. We call it a short cervix when it measures 25 mm or under before 24 weeks.

You receive spinal anaesthesia while the stitch goes in. For a day or two after, light cramping and a little spotting are common. Taking it out at 36–37 weeks usually needs no anaesthetic; it feels much like an internal check-up.

No. Strict bed rest is not advised. Do not lift heavy weights, and hold off on intercourse if I ask you to.

In women with a short cervix, vaginal progesterone taken every night reduces the chance of preterm birth. In other situations it is prescribed only for specific reasons.

Yes. Most women go into labour on their own after the stitch is removed at 36–37 weeks, and many have a vaginal birth.

For many women, yes. After one lower-segment caesarean and with an uncomplicated pregnancy, a planned VBAC is a reasonable choice. In general, around 60–80% of women who plan one achieve a vaginal birth.

An interval of at least 18 months is generally preferred, because a shorter gap raises the risk of the scar giving way (rupture).

Stay active, and keep your weight gain and blood sugar in check. Attend antenatal classes, and wait for labour to begin naturally where that is appropriate. Come to hospital once labour is established.

Yes. An epidural is compatible with VBAC and is given once labour is established.

It is possible, but induction raises the risk of scar rupture, particularly with prostaglandins. A balloon catheter or breaking the waters are alternatives we can discuss.

I advise a repeat caesarean after a classical incision, a previous uterine rupture, placenta praevia or certain other complications. Choosing a planned caesarean after counselling is also a valid decision.

The chance of chromosomal conditions, diabetes, high blood pressure and placental problems is somewhat higher, so I offer extra screening. Most women over 35 have healthy pregnancies and babies.

Most IVF babies are healthy. There is a small increase in some risks, partly linked to the reasons for infertility rather than to IVF itself.

Your age by itself does not call for an invasive test. Combining the NT scan with blood screening, adding NIPT if you wish, gives a risk figure specific to you. CVS or amniocentesis is offered when that figure is raised, or if you would rather have a definite answer.

No. IVF by itself is not a reason for a caesarean. The mode of birth is decided the same way as in any other pregnancy.

Usually at around 10 to 12 weeks, as agreed with your fertility specialist.

It is possible to conceive naturally after 40, although fertility declines and miscarriage becomes more likely as age advances. Past 35, I suggest a fertility review once six months of trying have not led to a pregnancy.

During the first trimester, a TSH of roughly 2.5–4.0 mIU/L or less is generally acceptable. The exact limit is set by your lab's reference range, and I read it alongside free T4 and thyroid antibodies. For women already on thyroxine, I target the lower end.

Overt hypothyroidism left untreated is associated with miscarriage, early birth and an effect on how the baby's brain develops. Once treated and held within range, the risks come down to about the same level as for women without a thyroid problem.

11 g/dL or more is normal. 10–10.9 g/dL is mild anaemia, 7–9.9 g/dL is moderate and below 7 g/dL is severe.

Modern IV iron preparations are considered safe in the second and third trimesters and raise haemoglobin faster than tablets. They are given in hospital with monitoring.

Iron commonly causes constipation, nausea and darker stools. It often helps to take the tablet with a light snack, drink more water and eat more fibre. You can also change to another preparation. If you still cannot tolerate tablets, IV iron is an option.

No. Take thyroxine first thing in the morning on an empty stomach, and keep at least four hours between it and any iron or calcium tablet.

Diagnostic ultrasound is considered safe when it is done for a medical reason, by trained operators, using the lowest exposure needed.

Sometimes a moderately full bladder gives a clearer picture in early pregnancy; after the first trimester it is usually not needed. The team will tell you when you book.

No scan can detect every condition. The anomaly scan detects most major structural problems, but some conditions cannot be seen on ultrasound at all.

Most women feel brief pressure or a cramp. The procedure takes a few minutes, and after a short rest you can usually go home the same day.

When an experienced operator performs it, the additional risk is well under 1 in 100. I discuss your individual risk with you before the procedure.

For a day or two, keep away from heavy lifting and strenuous work. Tell us at once about fluid leaking, bleeding, fever or strong cramping.

Most babies measure under 3 mm. A value of 3.5 mm or more is above the 99th centile. I always interpret the NT together with your age and the blood test.

Between 11 weeks and 13 weeks 6 days; around 12–13 weeks is often the most convenient time.

No. It estimates the chance of Down syndrome; a definite answer needs a diagnostic test such as CVS or amniocentesis.

A moderately full bladder helps; it does not need to be very full.

No. NIPT does not check the baby's anatomy, heart or placenta, or assess the risk of pre-eclampsia; the NT scan does.

Usually 20 to 30 minutes. If the baby is lying awkwardly, you may be asked to walk around and come back for a second look.

Level I is a basic look: heartbeat, size, the baby's position, the placenta and the fluid. Level II goes further, checking the baby's structure systematically, organ by organ, and I recommend it in every pregnancy at 18–22 weeks.

Between 18 and 22 weeks. Around 19–20 weeks often works well, because the images are clear and there is still time for any follow-up tests.

Yes. TIFFA stands for targeted imaging for fetal anomalies, which is the detailed mid-pregnancy anomaly scan.

Not reliably. The NT scan, combined screening or NIPT are better suited to chromosomal conditions.

The anomaly scan is mainly a 2D examination. 3D is added only to answer specific questions, for example about the face, spine or limbs.

Bring your earlier scans, NT and blood screening results and current prescriptions. A full bladder is usually not needed.

Usually between 18 and 24 weeks. In a high-risk pregnancy, an early heart scan is possible from about 13–16 weeks.

It is a dedicated and longer examination of the baby's heart, with more views and Doppler to study blood flow and rhythm.

Larger septal defects such as VSD and AVSD are usually visible. Very small holes may be missed, and an ASD (a hole between the upper chambers) cannot be judged before birth.

No. It is an ultrasound scan through the abdomen, the same technology as your other pregnancy scans, with no radiation and no needle.

Most irregular heartbeats are harmless extra beats. The scan identifies the rhythm, and babies who need treatment are managed together with paediatric cardiology.

Blood flows forward throughout the baby's heartbeat, and the resistance (PI) falls as pregnancy advances. I compare it with charts for your week of pregnancy. Raised resistance, or flow that stops or reverses, means closer monitoring is needed.

Usually within about 10–15% of the actual birth weight. The trend over several scans tells me more than any one estimate.

Your dates may be slightly off, your baby may simply be constitutionally small, or the placenta may not be supplying enough. The Doppler helps tell these apart.

Generally not more often than every two weeks, because growth needs time to show. Doppler checks may be done several times a week when the placenta is under strain.

A balanced diet helps, but extra food does not usually correct growth restriction caused by the placenta. Stopping smoking, controlling BP and sugar, and attending your scans make more difference.

Contact the hospital the same day, especially in the third trimester. Do not wait for your next scheduled scan.

In published studies, NIPT detects about 99 in every 100 pregnancies with Down syndrome, with a false-positive rate of about one in a thousand. It is a screening test, so a higher-chance result is confirmed with CVS or amniocentesis.

From 10 weeks of pregnancy. It is often combined with the 11–14 week NT scan.

For the common trisomies, NIPT picks up more affected pregnancies and gives fewer false-positive results than the double marker. The combined test, on the other hand, comes with the NT scan and pre-eclampsia screening. We choose together during counselling.

Yes, although its accuracy has some limits in twins, and it is less reliable after a vanishing twin.

The lab was unable to report a reliable result, most often because the sample held too little placental DNA. It happens more with higher body weight or when the test is done very early. You can then give a fresh sample or choose another screening test.

No. Under the PCPNDT Act, the sex of the baby is neither tested nor reported.

It means giving blood to the unborn baby while it is still in the womb. Under ultrasound guidance, a fine needle is passed into the umbilical cord or a vein in the baby's liver. Its purpose is to correct anaemia in the baby.

For anaemia caused by parvovirus, often one or two. For anaemia caused by Rh antibodies, transfusions are usually repeated about every 2–3 weeks until delivery.

This Doppler measures the speed of blood in one of the arteries of the baby's brain. Because blood moves faster when the baby is anaemic, it lets us time a transfusion without any needle.

It is an established treatment, and for a baby with severe anaemia the benefits clearly outweigh the risks. There is a small risk of complications, including pregnancy loss, which I explain in detail beforehand.

Your baby may need phototherapy and sometimes a top-up transfusion after birth. The neonatal team plans for this before delivery.

It usually affects later pregnancies. Anti-D injections given during and after pregnancy greatly reduce the chance of antibodies forming.

Most patients can. Very large fibroids, extensive previous surgery or certain medical conditions may make open surgery the better choice, so I assess each patient individually. I do not perform open surgery; if it is the better option for you, I refer you to a surgeon who does.

A myomectomy keeps the uterus, and many women conceive afterwards. Depending on how deep the fibroid was, I may advise a waiting period before trying and a planned caesarean for the birth.

PCOS is a long-term condition. Its symptoms, such as irregular periods, weight gain, acne and difficulty conceiving, respond well to lifestyle changes and targeted treatment.

Every three years from the age of 25, or every five years with HPV co-testing from the age of 30. I may advise a different interval for you.

There is no one-time cure, but the symptoms can be controlled. Many women get regular cycles once their weight and insulin resistance improve.

In everyday use in India they are the same condition. Medical guidelines use the term PCOS.

Yes. Most women with PCOS conceive, either naturally or with help to ovulate. Options include letrozole tablets with scan monitoring, injections, laparoscopic ovarian drilling or IVF, and improving weight and sugar control helps.

No. The pill is one option and can be stopped. Alternatives include lifestyle change and progesterone tablets to bring on a period.

Weight loss does not change the underlying tendency. But in overweight women, losing 5–10% of body weight often restores ovulation. It also improves the skin and lowers the risk of diabetes.

If very infrequent periods go untreated for years, the lining of the womb can develop abnormal changes. A regular bleed protects the lining, and bleeding between periods should always be checked.

Often, yes. A fibroid that causes no trouble can just be watched on scans, while heavy periods can be controlled with tablets or a hormonal IUD. An operation comes into the discussion when symptoms continue, fertility is affected, or a fibroid is large and enlarging.

Fibroids are benign. A leiomyosarcoma arising from a fibroid is extremely rare; rapid growth after menopause or unusual features on a scan are investigated.

There is no single size cut-off. I decide on the basis of your symptoms, where the fibroid sits and your plans for pregnancy.

A myomectomy does not stop new fibroids from forming. A hysterectomy is the one operation that removes that possibility entirely.

Yes, they usually shrink and the symptoms ease, so if you are close to menopause, waiting may be an option.

Discharge is usually after 1–2 days. Most women are back at a desk job in around two weeks and fully active by 4–6 weeks.

Functional cysts often resolve within one to three cycles, and I repeat the scan after 6–12 weeks to confirm. Dermoids, endometriomas and cystadenomas do not go away by themselves.

Simple cysts under 5 cm in women before menopause usually need no treatment. Removal is considered for cysts larger than about 7 cm, or for those that persist, grow, have complex features or cause pain.

Most functional cysts do not. Endometriomas are linked with endometriosis and fertility problems, and when surgery is needed I try to keep the healthy part of the ovary intact.

In torsion the ovary twists around the vessels that supply it. The pain comes on suddenly and severely on one side, frequently with nausea and vomiting, and emergency keyhole surgery is needed.

No medicine dissolves an existing cyst. The pill can prevent new functional cysts from forming, but established dermoids or cystadenomas need surgery.

You can usually go home within a day and return to desk work in 1–2 weeks. Avoid heavy lifting for about four weeks.

The hospital stay is usually 1–2 days, and I encourage walking from the first day. Light housework is fine after the first week, desk work after 2–3 weeks, and full recovery takes around six weeks.

Not if your ovaries are kept; they continue to produce hormones. If both ovaries are removed before menopause, menopause begins immediately, and we discuss HRT.

When a patient is suitable, the keyhole route generally brings less pain, fewer days in hospital and a quicker recovery. Open surgery may be favoured for a very large uterus or after extensive earlier operations. Open surgery is not something I perform, so in that case I arrange a referral.

The operation itself does not cause weight gain. Being less active during recovery can, so getting back to regular walking helps.

Yes. Intercourse can resume once the vaginal vault has healed, usually after about six weeks, and many women find it improves.

Usually not, if the cervix was removed for a benign reason and your earlier screening was normal. Otherwise, screening continues.

A diagnostic hysteroscopy can cause period-like cramps for a few minutes; pain relief and local anaesthetic are available. An operative hysteroscopy is done under anaesthesia.

You usually go home the same day and are back to normal activity in 1–2 days. Spotting for a few days is common; avoid intercourse, tampons and swimming until the bleeding stops, which is about a week.

It can, when it corrects a problem inside the uterus such as a septum, polyp, adhesions or a submucosal fibroid. This may improve implantation and lower the risk of miscarriage. Routine hysteroscopy when the scan is normal has not been shown to improve IVF outcomes.

Hysteroscopy views the inside of the uterus, entering through the cervix without any cut. Laparoscopy views the pelvic organs from outside them, through small cuts in the abdomen.

After a diagnostic procedure or polyp removal, from the next cycle. After division of a septum or treatment of adhesions, usually after 1–2 cycles, sometimes once a check of the cavity has been done.

Not always. Short diagnostic procedures are often done without it; operative procedures are usually done under a short general or spinal anaesthetic.

On average in the late 40s, typically between 45 and 50. Anywhere between 45 and 55 is considered normal; menopause before 40 is premature and should be evaluated.

If you are healthy and begin HRT before 60, or within 10 years of menopause, the benefits generally outweigh the risks for most women. It is not suitable for everyone, for example after breast cancer or with certain clotting disorders, so I assess each woman individually.

Hot flushes last about seven years on average. Vaginal symptoms respond well to local treatment.

Over the age of 45, usually not: your symptoms and the pattern of your periods are enough to make the diagnosis. An FSH test earns its place mainly below 45, or when the picture is not clear.

Yes. Keep using contraception for two years after your final period if you are below 50, and for one year if you are over 50.

Cool clothing, regular exercise, weight loss and avoiding your triggers all help. Prescription non-hormonal medicines and cognitive behavioural therapy (CBT) are further options.

Start it three months before trying if you can, and no later than one month before. Carry on until 12 weeks of pregnancy. Most women take 400 micrograms daily, while some need 5 mg.

Blood group, haemoglobin, thalassaemia screening, thyroid, blood sugar, rubella immunity, hepatitis B, HIV and syphilis, plus a Pap smear if one is due.

Avoid pregnancy for one month after the MMR vaccine.

Often, yes. He should be tested if you are a thalassaemia carrier, and a semen analysis is advised if you have not conceived within the expected time. Smoking, alcohol and some medicines can affect sperm.

About eight in ten couples conceive within a year of regular unprotected intercourse. Under 35, I suggest an evaluation after one year of trying, and at 35 or older after six months. If your periods are irregular, come sooner at any age.

Some medicines are fine to continue and some need changes. Do not stop anything on your own; we review them all at the pre-conception visit.

No. Fertility returns after removal, often in the very next cycle.

It cannot travel to the heart or the stomach. Rarely, in about one in a thousand insertions, it passes through the wall of the uterus, usually at the time of insertion, and is then removed laparoscopically.

You may feel cramps for a few minutes. Taking a pain-relief tablet beforehand helps.

It is very unlikely, under 1 in 100 users in a year. When a pregnancy does occur with it in place, it is more likely to be ectopic, so see your doctor without delay.

Both are effective. A Copper-T contains no hormones but may make periods heavier; a hormonal IUD usually makes periods lighter and also treats heavy bleeding. The choice depends on your health and preference.

The Cu-T 380A lasts 10 years and the Cu 375 lasts 5 years. You can have either taken out whenever you wish, and a new one can go in during the same visit.