HYSTEROSCOPIC SURGERY

Office Hysteroscopy

Hysteroscopy uses a hysteroscope, which is a thin telescope that is inserted through the cervix into the uterus. Modern hysteroscopes are so thin that they can fit through the cervix with minimal or no dilation. Although hysteroscopy dates back to 1869, gynecologists were slow to adopt hysteroscopy. Because the inside of the uterus is a potential cavity, like a collapsed airdome, it is necessary to fill (distend) it with either a liquid or a gas (carbon dioxide) in order to see. Diagnostic hysteroscopy and simple operative hysteroscopy can usually be done in an office setting. More complex operative hysteroscopy procedures are done in an operating room setting.

Operative Hysteroscopy

Operative Hysteroscopy is performed under general anesthesia. This will allow the physician to both diagnose and treat most findings, which are encountered at the time of the procedure. The Operative Hysteroscope has ports, which allow the physician to insert operating tools, such as, scissors, cautery devices or a laser fiber. These may be used to resect or cauterize specific abnormalities under direct visualization. The Hysteroscope is also valuable in treating some forms of tubal occlusion. Many patients with a blockage in the fallopian tube may have an obstruction at the junction between the uterus and fallopian tube. The Hysteroscope is used to pass a small catheter through this contracted area under direct visualization. Occasionally, scar tissue can be disrupted and allow passage of sperm as the result of the procedure. A physician will be able to evaluate the cervical canal, the contour of the uterus, and the quality of the endometrial lining. The tubal ostia are the openings of the fallopian tube into the uterine cavity. They should be easily seen with the hysteroscope.

Diagnostic Laparoscopy

A diagnostic laparoscopy is a technique used by surgeons to obtain information about the inside of your abdomen without making a large incision. Through a few small incisions, the surgeon inflates the abdomen with gas (carbon dioxide) to enlarge the size of the viewing area. He or she then inserts a laparoscope or small camera which projects images of the abdomen onto a high resolution television screen. By mobilizing the camera, the surgeon can have a very thorough look through your abdomen without the pain and recovery of a larger incision. In most cases, this procedure provides the surgeon with more information about your condition than if routine tests were used.

Following surgeries can be performed by hysteroscope: Uterine septal resection

Submucous fibroid resection

Uterine Polyp removal

Uterine adhesion removal

Foreign body removal

A high-risk pregnancy might pose challenges before, during or after delivery. If you have a high-risk pregnancy, you and your baby might need special monitoring or care throughout your pregnancy. Understand what causes a high-risk pregnancy, and what you can do to take care of yourself and your baby.

What are the risk factors for a high-risk pregnancy?

Sometimes a high-risk pregnancy is the result of a medical condition present before pregnancy. In other cases, a medical condition that develops during pregnancy for either mom or baby causes a pregnancy to become high risk.

Specific factors that might contribute to a high-risk pregnancy include:

• Advanced maternal age. Pregnancy risks are higher for mothers age 35 and older.
• Lifestyle choices. Smoking cigarettes, drinking alcohol and using illegal drugs can put a pregnancy at risk.
• Medical history. A prior C-section, low birth weight baby or preterm birth — birth before 37 weeks of pregnancy — might increase the risk in subsequent pregnancies. Other risk factors include a family history of genetic conditions, a history of pregnancy loss or the death of a baby shortly after birth. Underlying conditions. Chronic conditions — such as diabetes, high blood pressure and epilepsy — increase pregnancy risks. A blood condition, such as anemia, an infection or an underlying mental health condition also can increase pregnancy risks.
• Pregnancy complications. Various complications that develop during pregnancy pose risks, such as problems with the uterus, cervix or placenta. Other concerns might include too much amniotic fluid (polyhydramnios) or low amniotic fluid (oligohydramnios), restricted fetal growth, or Rh (rhesus) sensitization — a potentially serious condition that can occur when your blood group is Rh negative and your baby's blood group is Rh positive.
• Multiple pregnancy. Pregnancy risks are higher for women carrying twins or higher order multiples

What steps can I take to promote a healthy pregnancy?

Whether you know ahead of time that you'll have a high-risk pregnancy or you simply want to do whatever you can to prevent a high-risk pregnancy, stick to the basics. For example:

• Schedule a preconception appointment. If you're thinking about becoming pregnant, consult your health care provider. He or she might counsel you to start taking a daily prenatal vitamin and reach a healthy weight before you become pregnant. If you have a medical condition, your treatment might need to be adjusted to prepare for pregnancy. Your health care provider might also discuss your risk of having a baby with a genetic condition.
• Be cautious when using assisted reproductive technology (ART). If you're planning to use ART to get pregnant, consider how many embryos will be implanted. Multiple pregnancies carry a higher risk of preterm labor.
• Seek regular prenatal care. Prenatal visits can help your health care provider monitor your health and your baby's health. Depending on the circumstances, you might be referred to a specialist in maternal-fetal medicine, genetics, pediatrics or other areas.
• Eat a healthy diet. During pregnancy, you'll need more folic acid, calcium, iron and other essential nutrients. A daily prenatal vitamin can help fill any gaps. Consult your health care provider if you have special nutrition needs due to a health condition, such as diabetes.
• Gain weight wisely. Gaining the right amount of weight can support your baby's health — and make it easier to shed the extra pounds after delivery. Work with your health care provider to determine what's right for you.
• Avoid risky substances. If you smoke, quit. Alcohol and illegal drugs are off-limits, too. Get your health care provider's OK before you start — or stop — taking any medications or supplements.