Incarcerated Uterus
Uterine incarceration is an obstetrical complication whereby a growing retroverted uterus becomes wedged into the pelvis after the first trimester of pregnancy.[1]
Causes
A number of situations may interfere with the natural process that would antevert a retroverted uterus during pregnancy. Such situations include pelvic adhesions, endometriosis, uterine malformations, leiomyomata, and pelvic tumors.[2]
Development
When the uterus is tilted backwards, it is considered to be retroverted; this situation is common and regarded a normal variation. It has been estimated that about 15% of pregnancies begin in a retroverted uterus.[3] Normally, during the first trimester, the growing uterus changes spontaneously to an anteverted position, thus allowing expansion of the enlarging uterus into the abdomen. The cervix is then inferior to the body of the uterus. Thus, the presence of an early pregnancy in a retroverted uterus is not considered a problem.[1]
On rare occasions the uterus fails to become anteverted, and the pregnancy continues to expand the retroverted uterus within the confines of the pelvis. By about 14 weeks the size of the uterus fills out most of the pelvis, pushing up the cervix. At this point the uterus may get trapped below the sacral promontory and symphysis. With further growth the pregnant woman may experience lower abdominal and pelvic pain, back pain, and difficulty, even inability to void, as the bladder is pushed upward and its outflow becomes obstructed. Constipation may be encountered. The frequency of this complication has been estimated to be about 1 in 3,000 pregnancies.[2]
Diagnosis
The cervix lies posteriorly to the urinary bladder, and the uterus normally extends superiorly from it, but the direction of the body of the fetus reveals that the uterus extends backwards.
In a pregnant woman who is entering her second trimester, the combination of urinary difficulties and pelvic pain may alert the physician to consider uterine incarceration as a possibility. On physical examination, the cervix is pushed up and anterior, and the pelvis entirely filled by the soft mass of the body of the pregnant uterus. Sonography may indicate the retroverted position of the uterus, check on the viability of the fetus, and demonstrate the location of the bladder being pushed cranially and unable to be emptied.[4] Also magnetic resonance imaging has been found to be helpful in the diagnosis of the condition.[4][5]
Sequelae
Spontaneous resolution of the condition can occur during the second trimester.[6] An unresolved incarcerated uterus can lead to further pain, vaginal bleeding, loss of pregnancy or premature delivery. Also, the uterus may develop a uterine sacculation, that is a part of its back wall softens like an aneurysm and allows expansion of the fetus into the abdomen with a risk of uterine rupture.[3] Further, urinary complications may develop such as cystitis, and bladder distention could eventually lead to rupture of the bladder.[7]
Management
A pregnant woman with an incarcerated uterus may present in the emergency room because of pain, bleeding, inability to void and constipation. Upon diagnosis steps can be taken to manually position the uterus into an anteverted position. The bladder is decompressed by a Foley catheter and the obstetrician may attempt to manipulate the uterus if necessary using general or spinal anesthesia.[3] Rarely will a woman with an incarcerated uterus reach term; if so, a cesarean delivery is called for.[8]
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Uterine Bleeding Specialist in Alexandria VA
Unusual uterine bleeding can cause concern, particularly when you don’t know the cause. Seeking care quickly is crucial when this occurs outside of your regular menstrual cycle. Here’s how you can find the top uterine bleeding specialist in Alexandria, and what you can expect for diagnosis and treatment.
Abnormal Uterine Bleeding: An Overview
The definition of this condition is bleeding that is unpredictable in amount, timing, and duration. It generally happens outside of your regular menstrual cycle, but it can include bleeding during your cycle that is abnormal.
The causes include:
Hormonal imbalances that typically involve excessive estrogen or insufficient progesterone
Irregular ovulation
Polycystic ovary syndrome (PCOS)
Polyps
Uterine fibroids
Cancer
Risk factors such as age and obesity can increase the likelihood of developing abnormal uterine bleeding.
What Exactly Does a “Regular” Menstrual Cycle Mean?
A typical menstrual cycle is an important aspect of your reproductive health, yet it can manifest differently in individuals. It usually spans from 21 to 35 days, though some women may experience variations outside this range. The menstrual cycle comprises four phases: menstruation, the follicular phase, ovulation, and the luteal phase.
Menstruation, which marks the beginning of the cycle, entails the shedding of the uterine lining. This bleeding usually lasts for two to seven days, with an average blood loss of approximately 30 to 40 milliliters (mL).
The flow’s intensity may vary. It may start lightly, gradually increase, and then diminish. A normal menstrual cycle is characterized by regularity, predictable patterns, minimal discomfort, and consistent flow, all of which typically do not signal abnormal bleeding.
How Is Uterine Bleeding Diagnosed?
An exam by an experienced specialist, a gynecologist, is necessary to determine what’s going on. It’s necessary to rule out serious causes and to plan a course of treatment.
Your visit will begin with a discussion about your symptoms. You’ll be asked questions about your medical background, health conditions, and current medications. Be sure to have that information handy.
If you can fill out patient forms ahead of time, do so. It’s easier to do at home than in a waiting room.
You can expect a pelvic exam and a PAP smear. If needed, your specialist may also recommend any of the following:
Pregnancy test: To rule out pregnancy-related causes or miscarriage
Blood tests: To assess blood clotting and get a complete blood count
Thyroid test: To evaluate thyroid function, which can impact ovary function and bleeding patterns
Hormone levels test: To identify hormone imbalances contributing to abnormal bleeding
Hysteroscopic exam: Examining of the uterine lining for fibroids, polyps, or signs of cancer
Pelvic ultrasound: Visualizing reproductive organs for growths like fibroids or polyps
Sonohysterogram, or saline-infusion sonography: A sensitive imaging technique for identifying abnormal uterine structures
Endometrial biopsy: Collection of tissue samples from the uterine lining to detect cancer or precancerous cells.
How Is Uterine Bleeding Treated?
Fortunately, you have options when it comes to treatment. After a comprehensive exam, you can count on the best uterine bleeding specialist in Alexandria to recommend whatever treatment is suitable for your needs.
Depending on your diagnosis, medications may be recommended. These can include but aren’t limited to birth control, hormone therapy, and nonsteroidal anti-inflammatory drugs. In some cases, surgical intervention may be necessary.
You Can Find an Experience Uterine Bleeding Specialist By Following Simple Steps
Finding the right specialist may take time, but careful consideration is well worth the effort.
It’s a good idea to begin by seeking recommendations from your primary care provider. Friends and family may also provide referrals.
If you have insurance, check with your carrier to see which medical professionals are covered under your plan.
Look for specialists in your area using reputable online sources, such as health directories or medical organization websites. Many hospitals and clinics have directories of their medical staff on their websites.
Online patient reviews and testimonials can also offer insights into the experiences of other patients with specific specialists.
Ensure the specialist is board-certified in gynecology or a related field. You can typically verify their credentials through state medical boards or professional organizations.
What To Expect During Your Consultation With A Uterine Bleeding Specialist
Once you have a short list of potential specialists, schedule consultations with them. This will allow you to meet in person, discuss your concerns, and assess your communication style and expertise. Their approach should align with yours.
During the consultation, ask questions about their experience in treating abnormal uterine bleeding, their approach to diagnosis and treatment, and what treatment options they offer.
Remember, specialists with more experience treating uterine bleeding have encountered a wider range of cases and can offer a broader perspective on treatment options.
Choose a doctor with whom you feel comfortable and trust. Effective communication and a good doctor-patient relationship are essential.
Consider where the specialist practices. Hospitals and medical centers vary in terms of resources and services. If they perform surgical procedures outside of the hospital, vet the facility they use.
Ensure that the specialist accepts your health insurance and that you understand the billing process.
If You’re Searching for the Top Uterine Bleeding Specialist in Alexandria Call Women’s Health Care Specialists Now!
Our skilled providers practice a holistic approach and offer personalized healthcare.
We integrate cutting-edge medical advancements with state-of-the-art technology to provide exceptional care. We believe in building lasting patient relationships, emphasizing education and women’s healthcare research.
Dr. Navita Modi and the team enthusiastically welcome new patients to our practice. If you’re encountering any form of abnormal bleeding, please do not delay treatment. Call 301-812-3400 to book your appointment today.
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Uterine Artery Embolization in Borivali: A Leap Towards Non-Surgical Treatment of Fibroids
In the heart of Borivali, a suburban area in Mumbai, an advanced medical procedure known as Uterine Artery Embolization (UAE) is gaining prominence as a highly effective, non-surgical treatment option for women suffering from uterine fibroids. This minimally invasive technique has become a beacon of hope for many, offering a less painful and quicker recovery alternative compared to traditional surgical methods.
Uterine fibroids, non-cancerous growths in the uterus, affect a significant number of women during their reproductive years, leading to symptoms like heavy menstrual bleeding, pelvic pain, and in some cases, infertility. While surgery was once considered the standard treatment, the advent of UAE in Borivali's medical landscape has revolutionized patient care.
The procedure involves the insertion of a catheter through the femoral artery in the groin, which is then guided to the uterine arteries supplying blood to the fibroids. Tiny particles are released to block these arteries, causing the fibroids to shrink and symptoms to alleviate over time. The precision of this technique ensures minimal impact on surrounding tissues, highlighting its safety and efficiency.
Borivali's healthcare facilities, equipped with state-of-the-art technology and staffed by skilled interventional radiologists, have made this advanced treatment accessible to a wider audience. The patient-centric approach adopted by these medical centers emphasizes personalized care, ensuring that each woman receives a treatment plan tailored to her specific needs and condition.
The benefits of UAE extend beyond its medical efficacy. The procedure's minimally invasive nature means shorter hospital stays and rapid return to daily activities, making it an attractive option for busy professionals and homemakers alike. Moreover, preserving the uterus opens the door to future pregnancies, a significant consideration for women of childbearing age.
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