Donor- recipient synchronization for the success of donor egg IVF

Dr. Anita presented a paper on Donor- recipient synchronization for the success of donor egg IVF at the 2015 International congress of the “Academy of Clinical Embryology” held at Kochi. The success of donor egg program depends greatly on the synchronization of both the donor and the recipient, to get simultaneous periods and to start the luteal support on time. 

Successful Synchronization :-

• S  -  Simultaneous Periods
• U  -  Ultrasound Scan
• C  -  Coordination
• C  -  Communication
• E  -  Email Synchronisation 
• S  -  Screening donor
• S  -  Success
• F  -  Freezing semen sample
• U  - Unforeseen Risks
• L  -  Luteal support

Simultaneous periods is a must, so change the period date of the recipient by giving combined pills or progesterone, as needed.  It is better not to change the period of the donor as it may be associated with longer stimulation and higher gonadotropin consumption and lesser pregnancy rate.

Ultrasound scan is the magic tool to success. Keep checking the follicular growth and endometrial thickness. In case thickness is not sufficient you can increase the dose or consider adding Sildenafil.

Coordination between the team members team comprising   infertility specialist, IVF coordinators, international client manager and embryologist is very important and they should meet regularly  to keep update of the list of patients, donors and their timing. Train efficient staff to be the coordinators who can communicate well and arrange for the timely screening. If patients are abroad, let them collect the medicines in advance, as it may not be available in some countries.

Communication with the patient and donor before starting the ART cycle should be constant, so that the program goes well. Provide guidance for recipients in the form of leaflets  and online information, to get proper understanding about the timing and procedure.Counsellor should meet both the donor and the recipient , to make them understand the implications fully and properly.

Email Synchronisation will be helpful for the NRI patients, this will help to reduce their frequency and number of visits. The female partner can be given priming tablets to start on the second day, so that she can cut short her visit for embryo transfer. The scans can be done locally and results mailed to the doctor, so that date of luteal support can be advised.

Screen the  donor at least 1 month before, or earlier to pickup potential problems like ovarian cysts, pelvic infections and other medical problems.screening should include AFC and AMH as  needed , so that the recipient does not end up with poor responder, after all the synchronization.Deficient endometrial lining  can be avoided by screening in advance. Difficult embryo transfer is not an issue, if there is MET

Success of the treatment depends on synchronisation, health of the donor, condition of endometrium of the recepient, ART lab facilities and the expertise of the medical team.

Freezing of semen sample can be done, when the male partner visits the clinic for the first time, so that a repeat visit can be avoided, when his wife comes for the donor egg program.

Unforeseen risks like Illness of the donor or her family member, can cause chaos, so the recipient should be counseled about the possibility. Some clinics have standby donors, who are on pill. 

Luteal support should be started for the recipient either the night before egg pick up or at least on the day of retrieval , as the window of implantation is small

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.com

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Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm. Her proficiency is in genetic abnormalities and high risk pregnancies.

The benefits and medical properties of Basella Alba ( Malabar Spinach, Bengali Cheera)

Basella Alba, commonly known as Vine Spinach, Malabar Spinach, Bengali Cheera  or Ceylon spinach is a tropical creeper plant with dark green broad leaves and fleshy purple or pink stems. It tastes similar to spinach, but has many more medicinal properties. Most of the people are unaware that this plant is a treasure chest of vitamins, minerals etc. This easy to cultivate plant is commonly found in the backyards and starts giving yield in less than 40 days. It has always been popular in Asian countries like India, China and Philippines, but now the value of this plant is being recognized in European and American countries and the succulent and tender leaves and stems are  used widely in cooking.  It is easy to cultivate and a small stem cutting planted in soil will achieve rapid growth in a short span, if proper irrigation is given.

Few month back, when I planted a small stem cutting in my garden, I never imagined it will grow so fast and will become a regular part of our daily meals. I love to add few leaves in my stir fries or grind them and add to my pasta. Fresh from the garden, without any trace of pesticide, they are packed with goodness of vitamins, minerals and antioxidants. 

These heart shaped high fiber leaves  are not only easy to cook, but has very few calories with a decent protein content.  It is said to have more vitamin C than the normal spinach. It’s an excellent source of Iron, Vitamin A, Riboflavin, vitamin B6, Vitamin E, potassium, manganese, calcium, copper, Thiamin and Niacin. The mucilage and roughage aids in smooth bowel movements and prevent adsorption of cholesterol. The antioxidant vitamin C, is inevitable for the healthy body functioning  as it increase our resistance against diseases. Another important property of Basella Alba is that it gives protection against Osteoporosis, as these leaves are enriched with calcium. Appropriate levels of Folate are very essential during pregnancy, so it is highly recommended that pregnant ladies include lot of these leaves in their daily diet. Optimum level of potassium will ensure that your blood pressure and heart beat level are maintained.

Laboratory experiments proved that feeding these leaves to rats and bulls increased their testosterone  levels, so Malabar Spinach may abet to counter male infertility. 

Another striking property is that chewing these leaves are known to expel the kidney stones. Numerous studies have proved that these leaves are capable of dissolving calcium oxalate crystals ( Most commonly found type of kidney stone). One more remarkable feature of this plant is it's anti inflammatory and anti fungal properties. It will be a wise decision to include these leaves as a part of your regular diet.

" Let food be thy medicine and medicine be thy food "

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.com

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Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm. Her proficiency is in genetic abnormalities and high risk pregnancies.

Laparoscopic sterilization at minimal cost

In a mission to stop the unwanted pregnancies and abortions, we are offering to do laparoscopic sterilizations at a very reduced and nominal cost. I always had a secret guilt in some corner of my heart that, I am contributing to the population rise by offering infertility treatment, although it helps in building a lot of happy families and save many marriages in the  Indian scenario. (personally I feel that, not having a child should not affect marriages, such relations are  obviously not strong enough ! )

In the past I used to conduct laparoscopic sterilisation camps yearly. But then we expanded to Bangalore, which meant I had very little time for camps, after my weekly travelling to Bangalore.  Now that I am back in cochin and will visit Bangalore only occasionally, I can restart our good work.

On an average, a diagnostic laparoscopy will cost around 40 to 60 thousand rupees and surgical laparoscopy will cost anywhere from 50 to 90 thousand rupees or more, depending on the medical centre. We are offering laparoscopic sterilizations at a minimal charge of Rs 18,000. Medicines will cost Rs 7000, so the total cost will come to  around only Rs 25000. We will also conduct profit free camps  once in a year,  charging only Rs 7000 for the medicines.

Why should women do sterilization ?

Once family is completed and you decide that you do not want any more children, then it is better to stop pregnancy by means of a permanent method, so that there is no hassle of taking tablets daily with all its side effects. Even   Cu T has side effects  like heavy bleeding and it also increases the risk of infection.

Universally, there are plenty of unwanted pregnancies happening and many of them end up in terminations. Medical termination of pregnancy has all the risks of a surgical procedure like bleeding, infection, anesthetic risks etc. and often puts additional financial burden on families. 

It is very stressful for women, when they are  trying to avoid  pregnancy  as they are under constant fear of getting pregnant. Withdrawal methods and condoms have significant failure rates, time and again resulting in unwanted pregnancies. I regularly meet  women who tries to avoid pregnancy by keeping away from intercourse and no wonder, their husbands are unhappy and often become a public nuisance for other women. 

Compared to open minilaparotomy, laparoscopy has the advantage of being a safer procedure, with good equipments and proper view. The women need not take leave from the job or worry about other issues, as this procedure does not require hospital admission or rest and can be completed in a day.

Hippocrates quoted “Wherever the art of Medicine is loved, there is also a love of Humanity. ” I will  be also doing laparoscopies at a reduced rate for poor patients who need it for infertility evaluation. We are already doing IVF at a reduced rate for poor patients, one case every month as a part of our charity mission. Happiness doesn't result from what we get, but from what we give. The  happiness  you acquire, when you help another person cannot be measured, it  gives meaning to your life.

 Dr. Anita Mani

Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.com

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Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm. Her proficiency is in genetic abnormalities and high risk pregnancies.

PCOS Diet

 

"The human body heals itself and nutrition provide the resources to accomplish the task."

An ideal diet plan for the PCOS  not only comprises food;  the timing of meals, frequency and duration of the meals and the cooking methods are also equally important.

Ideally, within thirty minutes of waking up, we need to take some form of food to kick start our metabolism. A well-balanced breakfast is a must, skipping that would be a big NO NO. It is better to eat every 3 to 4 hours, rather than taking infrequent big meals. Sounds good doesn’t it, you need to eat more often if you want to lose weight and control your PCOS.

Eating should not be a hasty affair, take plenty of time, enjoy every bite to savor the goodness and flavor of the delicious food that nature has kindly bestowed upon us (we do not know how long we are going to get this!). To a great extent, digestion should happen in the mouth itself, so make it a point to chew the food properly. The brain takes about twenty minutes to register that stomach is full, hence if you eat quickly you are at the risk of consuming more food than is required. Chances are there that even though your stomach is full you will go on eating, so go slow.

Likewise, it is vital to understand the significance of glycemic index in controlling PCOS. Glycemic index (GI) indicates the level of sugar in blood after food intake. The rate at which blood sugar level shoots up in our body will vary depending on the type of carbohydrates that we eat. The insulin levels in the body are way too high in PCOS, which is the main reason for insulin resistance and high androgens.     (Androgens are male hormones, which are present in normal women in small quantities) PCOS women should eat low glycemic index foods to avoid sudden spurt of blood sugar level. For more info see http://bangaloreivf.blogspot.ae/2014/09/low-glycemic-food-chart-for-pcos.html

Reduce calorie intake if your weight is on the higher side, around 60 % of women with PCOS are overweight and it has been proven that in a significant number of women losing weight lead to reduction of symptoms of PCOS.

Tips

Food should be always eaten fresh – “eat like Chinese, they always take it boiling”.

1. Take natural foods, avoid processed food, limit sugar and sweet intake. (did you know that sugar undergoes lots of chemical treatment before it looks bright white?) 

2. Choose whole grains like boiled rice, whole wheat flour, millets (Ragi), oats etc.

3. Reduce salt intake, this will help reduce the risk of hypertension and other cardiovascular diseases as well.

4. Choose unsaturated fats. Boil, grill, steam, bake and avoid microwaving and frying.

5. Make sure that you are getting enough protein with every meal for controlling PCOS.

      Varieties of food 

     

     a. Green leafy vegetables are very good for you, so when you go for grocery shopping keep an eye for them

    b. Pulses are very good sources of protein and a good low-calorie alternative to the non-vegetarian food.

     c. Whole grains must occupy only a small portion in your meal plate, bulk should be vegetables, salads and pulses.

     

    d. Fish, chicken, lean meat and lean cuts of red meat can be taken in moderation, but they should not be fried in oil.

    

    

    e. Oil can be olive oil or any other plant source oil, essential fatty acids are as important to health as vitamins but should be consumed in moderation. But it should be noted that olive oil is not suited for Indian style of cooking or deep frying as the smoking point is very low, hence is best used in salads.

     Foods to avoid

Sweets and candies are neither good for you nor for the kids. Generally, people gift candies and chocolates to kids as if they are resistant to the bad effects. Please understand that they are bad for everyone, so please stop buying them for kids as well.  

Instead of ice creams, choose fruit platter when you are eating out. Skip the bakery section in supermarkets, so that you are not tempted to  buy cakes, pastries, biscuits or other sweets. Everyone knows that soft drinks and energy drinks are bad for health, but still continue drinking them. Let us save the health of the future generation, don't show your love for your children by buying them chocolates, ice creams or fast food
http://bangaloreivf.blogspot.ae/2017/08/article-on-pcos-causes-symptoms-and.html

Dr. Anita Mani

Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.com

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Dr. Anita Mani is a renowned infertility specialist in south India with 18 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore, along with her spouse  Dr. S Mani. She completed MRCOG, from Royal College of Obstetrician and Gynecologist, London, DFFP from  ART Warwick university and worked in the UK for 5 years. Dr. Anita believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre and SATYA Ayurvedic Centre, Cochin.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI, donor egg/sperm. Her proficiency is in genetic abnormalities and high-risk pregnancies.

The terrible experience of a women after surgical menopause

I could sense  my eyes welling up,  when the patient was describing the daily  miseries in her life after hysterectomy. If this was just one unusual case in my practice, I would be a happier person, but unfortunately these patients are a recurring  phenomenon, all robbed of their youth by undergoing hysterectomy at an untimely age.

I glanced into the chart and it showed that, she was just in her late thirties, but I was looking at someone who looked like the mother of a women in her thirties ! She was dressed shabbily, wearing a dull loose fitting wrinkled cotton Kurtha. Grey hair was scruffy and messy, her wrinkled face was devoid of any makeup, the black circles around her eyes clearly indicated  lack of sleep.

She described her daily life as painfully slow, worse than death. Every single joint was hurting.  If its back pain today, tomorrow is neck pain and leg pain the next day. It is as if the pain has become a constant companion and is traveling throughout the body.

On and off she suffers from hot flashes, all the body parts will burn as if on fire, after each episode she would sweat profusely, making her drench and putting her in an awkward position in front of her family and friends. 

Every day she makes plans, but she just do not have the energy to implement anything, so tasks keeps getting postponed, even the trivial ones. Just getting out of bed in the morning is a daily  struggle. She keeps forgetting things easily, sometimes even important matters. Frequent outbursts at children and her partner has made her  unpopular even in her own family.

Her skin always feels dry and the hair has lost its sheen and number. Sexual life is almost nonexistent or painful and dry. Her partner, who  is a fit 40 year old is always nagging her  and has found solace in alcohol, as it helps him sleep better. (he feels)

Her tummy has bulged and husband is happily making fun of the tyres around her body. She correctly described it, the fat cells decided to relocate, left  the breasts and the thighs and settled in the tummy.

she summed up her condition in few words which expressed her desperation   “Doctor, I  feel death is better than this”.

So why is she going thru all this trauma?
Few years back, she used to get occasional back pain, an orthopedician confirmed after check up that everything was normal. Subsequently, she consulted a gynecologist who did a  hasty hysterectomy stating uterine problems as the cause for back pain. Of course the ovaries were preserved, as she was  only 34 years old. But her ovaries stopped working within couple of months, which is the usual story after hysterectomy, leading to a premature menopause. She was later diagnosed with disc prolapse, which probably could have been the cause for the back pain.

Now she is in a state of misery, because of surgical menopause. Even though she  tried  out different types of medicines including ayurveda, she felt no relief. 

After counseling about the advantages and side effects, we have put her on HRT, and she is feeling like a human again. The symptoms completely disappear, the moment you give estrogen to these women. The millions of neurons in the brain have estrogen receptors from the time it was an early embryo, so every single function of the brain is affected due to early menopause, which in turn affects each and every bodily functions.

You  may ask, why every women who undergoes menopause does not have all these symptoms or side effects. But the case is different in  women aged 45 years or more. The hormonal changes happen gradually and  slowly over many years, around 5 to 10 years of slow change happens during natural menopause. The neurons get used to the changes slowly, and body is steadily adapting. If you put cold water in a hot vessel it cracks, but if you slowly cool the vessel, it will not  break into pieces. Similarly, it is  more easier for the body to adapt and tolerate during the natural process of menopause and there will be less side effects of menopause.

So, it is very crucial to analyse the symptoms and the disease appropriately and accurately, before a decision for hysterectomy is taken, because the side effects of hysterectomy and menopause can be devastating on many women.

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.com

    ------------------------------------------------------------------------------------------------------

Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI, donor egg / sperm. Her proficiency is in genetic abnormalities and high risk pregnancies.

Perplexing question - whether to retain or remove “FIBROIDS”

If fibroids should be surgically removed is one of the most perplexing and controversial topics in Gynaec OP. There is no straight answer to this question.The decision can be arrived upon, only after careful investigation and evaluation and the judgment will differ from patient to patient. Many people are not aware that fibroid is only a ‘BENIGN TUMOUR’ and it is not  ‘CANCER’.

I am sharing the case of one of my patient (name has been changed to protect privacy) Laila had initially come to me four years back requesting for myomectomy (surgery to remove fibroids).  She had fibroid measuring 4 cm, but I had convinced her that time that it was not necessary and she decided against the surgery. Now after four years it was found that the fibroid has grown into 7 cm size and her family panicked. She again came to me ready to undergo myomectomy. As found in some cases, she had absolutely no symptoms or discomfort due to the fibroids.

I again discussed with her all the pros and cons of surgery. The surgery is a major procedure and involves hospital admission and General Anesthesia. It may also require blood transfusion and is quite expensive. Laparotomy (open surgery) is cheaper in India compared to  laparoscopy ( keyhole surgery ), but it may involve more blood loss and requires two months rest. In rare cases, the surgeon may have to remove the whole uterus, instead of just the fibroid, if there is heavy bleeding during the procedure.

This patient was having some financial constraints and her husband was working abroad. There was no one to help her during the surgery, other than her old mother. So I advised her to analyse her decision properly and discuss with her partner and arrive at a decision. We are doing regular scans on her to make sure there is no sudden growth. One of her relatives had suggested a hysterectomy. Hysterectomy is totally out of question and will be imprudent, considering the fact that she is only 34 years old. No one should choose to voluntarily undergo menopause without a valid reason. 

Patients go thru severe symptoms after a surgical menopause and I have had some patients describing that death is better than surgical menopause. Even if ovaries are preserved during hysterectomy they tend to fail in a couple of months, so it is not an assurance that the ovaries are preserved and only the uterus is removed.  

For the time being, I have convinced her and she has decided to wait till her husband come for holidays  and we will reevaluate the situation again. Considering the fact that they are under financial stress, I feel that the hard earned money of her husband working in Gulf, should be spent on things like her kid's education and building their own house rather than on an unwanted surgery.

Some facts about  fibroids  

Generally, most of the fibroids are silent and 30 % of women have these lumps on the uterus and many of them may not be even aware of it. A general scan may pick up the diagnosis and women starts panicking and start getting stressed for no reason most of the time. Fibroids may result in heavy periods, but it is easily treatable with medications. It might also lead to discomfort and urinary symptoms if the size is very big, and may necessitate surgery if the person cannot bear the symptoms. But such difficulties are observed only in a small percentage of women.

Submucous fibroids may interfere with chances of conception and infertile patients may require hysteroscopic removal of these inner ones. The fear of cancer is the leading reason for surgery, but fibroids are not malignant or cancerous. There is a rare variety of cancer similar to fibroids called fibromyosarcoma, but it grows very fast and causes heavy bleeding. The time progression is only few days in that cancer, whereas it takes years for a fibroid to grow. 

I am actually quite happy that many of my women patients followed my advice and still have their uterus intact, keeping them young and healthy.

you can find more details in  http://bangaloreivf.blogspot.ae/2015/08/the-terrible-experience-of-women-after.html

http://bangaloreivf.blogspot.ae/2014/11/should-you-have-your-fibroids-removed.html

Dr. Anita Mani

Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.com 

+91 484 2475031,  +91 484 2475034, 

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Dr. Anita Mani is a renowned infertility specialist in south India with 18 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm. Her proficiency is in genetic abnormalities and high risk pregnancies.

Vigilance and alertness saved the epileptic mother and her unborn child !

                                       

It was a lazy Sunday morning. After sweating out in the garden, I was having a leisurely shower when I suddenly heard my staff from hospital shouting, “madam, Sandra (name changed) is having a fit”. She was totally out of breath, as she came running from the hospital which is  a stone’s throw away from my house.  It immediately struck me that my pregnant epileptic patient Sandra and her unborn baby are  both in danger.

It took me 5 seconds to quickly wear my dress ( I always keep easy to wear dresses on the top rack, which is  quickly accessible and can be slipped on briskly in case of an emergency ). It took me just 1 minute to reach the hospital and when I reached the spot, I was breathing normally and fully composed, thanks to my regular  yoga training.

On my way, I was shouting instructions to each staff  to get things ready for an emergency. By the time I reached, I  had arranged for injection ready for epilepsy, an airway ready  to keep her breathing, ambulance ready with the driver in case of emergency transfer, oxygen mask ready with the multiparameter cardiac monitor  to check her BP, pulse and oxygen saturation. All this happened within the one minute span, while  I was walking towards the patient. Meanwhile, Dr Mani and the staff had lifted the patient on to post op bed. It helps when doctors are physically fit to help in emergency and  have the willingness to do anything to save a life.

Every second was important as two lives were at stake and time was limited, few minutes delay and both the baby and  the mother  will be in danger. She was made to lie on the side and airway was secured  by keeping her mouth open      (Initially we kept a towel in her mouth, which was the first object accessible to prevent her from biting her tongue ). We managed to give her the injection to stop her fits and she was unconscious by this time. 

The staff nurse on duty was nearly out of breath from lifting the patient, she had joined only one month prior in our hospital, so getting an iv line was not easy. I calmed her down and she did it very smoothly and got an IV line at the very first attempt and we started fluids fast, so that her circulation is maintained and baby gets enough oxygen for survival.

Parameters readings were reassuring as her BP was normal. Tachycardia (an excessively rapid heartbeat) was expected, but it was not too bad. Her oxygen saturation started to come to normal, after we had given oxygen.

All these things happened in 3 minutes time and the mother was now stable. Then we checked baby’s heart and I also did a quick ultrasound scan,  it was such a relief to see that the baby was having good cardiac activity (heart beat ) and was moving its limbs. We have a portable scan machine, which weighs only 2 kg and can be taken to any spot in emergency to do scan. It was then that I realised the full benefit of the machine,  when I could see that the baby was alive and kicking and there was no internal bleeding.

She was around 36 weeks  and started having painful contractions, so we could easily deliver her as the baby was mature. She had a Caesarian and a beautiful baby girl was delivered. Past history of Caesarian was an added indication. We managed to save both the mother and baby without any complications.

Only “FAST ACTION” saved the baby and the mother.

 
Even Small details are important during emergency situations and every single human being can contribute in such scenarios. An hospital should always be prepared for  emergencies and the following actions are very  important.

 
1. Training to staff  and trial runs - all staff should be included in the training, even the  cleaners and drivers.

2. Availability of emergency medicines and equipment, which are easily accessible and in good working condition.

3. Fast reflexes of doctors and staff, who should be not only well trained but also must be physically fit and well composed to deal with emergencies. Regular fitness and yoga helped me to reach the hospital on time.

I was very happy that we could save both the mother and child and I also realised that  training in the UK had helped me so much in preparing our hospital. If I had taken longer to dress ( Indian style dressing often takes time), if I could not run, if I went breathless, if I could not lift her, if I  did not have loud commanding voice to get people  do stuff, if I did not know what emergency injection to give, if injection was not available, we could have had a disaster. Even if hospitals have all the facilities, many times there is a delay of 10 minutes  or more, which often leads to complications and fatalities. Always being prepared for an emergency will avoid such unfortunate incidents.

Media is always talking about negligence of doctors and paramedics. But do they know what medical professionals endure all the time? Do they know that we leave our children and rush to save other kids? Do they know that we never eat our meal without getting interrupted? Do they know that we get up at night constantly when there are reduced foetal movements, just to reassure the expecting mothers? Do they know that we are drenched in  blood in an effort to stop bleeding during surgeries? I never thought about the infections I will contract, when I was  covered in blood during emergencies. Can everybody put in such dedication  and sacrifice? 

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.com

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Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm. Her proficiency is in genetic abnormalities and high risk pregnancies.