1. What is an ovarian cyst?

The ovaries are a pair of oval-shaped organs, about 3-4 centimeters in length, found on both sides of the womb. They are part of the female reproductive system, producing female hormones & eggs. A cyst is a fluidfilled space, lined by a thin wall, that can sometimes occur in the ovaries. Cysts vary in size, from tiny ones measuring a few millimeters to large growths that can be as big as a melon.

 

2. Are all cysts the same? What are the various types of ovarian cyst?

There are many different types of ovarian cyst. These include:

Functional (or physiological) cysts

These cysts form, & then shrink or disappear during various stages of the menstrual cycle. Most of them do not cause symptoms & treatment is usually not required.

Bleeding (haemorrhagic) cysts

These occur when there is bleeding into a cyst. The patient will complain of abdominal pain.

Dermoid cysts

A dermoid cyst, or teratoma, is usually benign (non-cancerous) & contains a variety of tissue, such as hair & bone.

Endometriotic cysts

Menses & some of the tissue gets implanted around the ovary. Over time, this forms a collection of blood. 
The old blood gives it a chocolate-like appearance.

Other benign cysts (e.g. cystadenoma)

Tiny cysts are found on the outer rim of the ovary – this may be associated with hormonal problems, irregular menses, fertility issues & other symptoms.

3. What are the symptoms of ovarian cysts?

Rest and Sleep

During pregnancy, the growing foetus puts new demands on your body. You may feel unusually tired during early pregnancy and as your pregnancy advances. Get at least 8 hours of sleep every night. Whenever you feel tired at work, find a quiet room, sit down, and raise your legs on a footstool or support. At home, your routine housework and family commitments will have to be adjusted. How much rest is necessary? During the day time, you should take a break and rest for at least an hour every day, or alternatively split it into two ½ hour periods. What positions should I rest in? Lie flat on the bed with a pillow under your head. Your feet may be raised higher than the head with one or more pillows. Lie on your side with a pillow under your head. The lower leg is stretched behind you; the upper leg is bent at the hip and the knee over a pillow.
There may or may not be a pillow supporting your upper arm. Sit in a leaning back position with a small cushion behind your head and in the small of your back, making sure that the whole length of your legs is supported.

Nutrition

As your foetus is growing, it is important that you have a healthy, well-balanced diet so that both you and your baby get sufficient nutrients and energy.

Exercise

Exercise is acceptable during the course of a normal pregnancy. Always consult your doctor before embarking on an exercise programme in pregnancy. If there are medical or obstetric complications in the pregnancy, exercise should be reduced or avoided.

 

What types of exercises are safe?

What types of exercise should be avoided?

Activities which require sudden and forceful contact, for example, soccer, boxing and hockey should be avoided. Exercises that require jumping and jarring motions or rapid changes in direction, for example, tennis and basketball should be avoided. Water sports like water-skiing and scuba diving are considered unsafe in pregnancy. Sports that involve continuous jumps, for example volleyball and horseback riding should be avoided. After the fourth month of pregnancy, exercises done in the supine position (lying flat on the back) for a long duration should be avoided.

What measures and precautions should I take?

Moderation is always the best policy.
Exercising three to four time a week for 20 minutes to half an hour each time is enough to maintain fitness and well-being during pregnancy.
Avoid sudden spurts of heavy exercise followed by long periods of inactivity.
Drink sufficient water (about seven to eight glasses each day) and consume enough calories to meet the needs of your pregnancy as well as your exercise programme.
Wear comfortable, well-cushioned shoes that give your body good support. Spend about 10 minutes doing low resistance exercises as part of a warm-up before each exercise.
Exercise on a safe, firm surface such as a wooden floor or tightly carpeted surface to reduce the risk of injury.
Exercise with smooth movements; avoid bouncing or jerking.
When exercising, try to time your pulse; do not allow your heart rate to go above 140 beats a minute.
If you are getting up from the floor after an exercise, do so slowly to avoid dizziness and a sudden drop in blood pressure.

What are the warning signs to stop exercising?

Posture

Correct posture and proper body mechanics are important prerequisites for a comfortable pregnancy

How should I be standing?

When standing, sway slightly forward to find a comfortable position with your body balanced over your hips and feet. Try avoid standing for long stretches of time, especially in the later stages of pregnancy.

How should I be sitting?

Sit well back on your chair with your weight taken on your buttocks and not on the end of your spine. Support your lower back with a small cushion. Move and rotate your ankle frequently during sitting to promote blood circulation in your legs.

How should I be lifting things?

Never carry anything heavier than you can manage with ease. Get close to the object you intend to carry. When reaching the object, with your feet apart, bend the knees and hips and not the waist. Always keep your back as straight as possible. Hold on to the object, keeping it close to your body. Turn by transferring your weight from one foot to the other, not by twisting your back. Stand by slowly straightening your legs.

Clothing

Clothing should be comfortable and loose. Belts or constricting garments should not be worn around the waist as this interferes with blood circulation. Maternity brassieres or brassieres of an appropriate size should be worn to give your breasts firm support and to protect the nipples. Should wear low-heeled, well-fitting shoes for comfort and support. These are less likely to cause a fall or backache.

Travel

Work

Women who have sedentary jobs may continue to work throughout the pregnancy.

Strenuous jobs that require heavy lifting, prolonged standing or walking, climbing, long hours, rotating shifts, and other efforts that require stamina and agility are not advised.

You may stop working if you have a medical condition, a multiple pregnancy, a history of premature labour, or threatened miscarriage in the current pregnancy.

Do try to take short breaks during the working hours to rest or sleep.

Towards the end of pregnancy, the increased weight and enlarged abdomen may cause you to lose balance.

Precautions have to be taken to prevent you from falling during work.

Chemicals

Certain chemicals, for example, arsenic, aluminium, alkylating agents, benzene, carbon monoxide, chlorinated hydrocarbons, and mercury compounds should be avoided as they may be harmful to the foetus. Healthcare workers should avoid substances like anaesthetic gases, ethylene oxide and formaldehyde (used for sterilising of medical equipment), and chemo-therapeutic drugs.

Ionizing Radiation

Flight attendants may run the risk of excessive exposure to radiation from the sun if their flights often bring them to very high altitudes. Healthcare workers may be exposed to X-rays used in the diagnosis and treatment of diseases.

Smoking

Smoking is harmful for you and your baby. It increases the incidence of low birth weight babies and may be associated with foetal death or damage in the uterus resulting in miscarriage or still birth.

There are also long-term effects – children of smoking mothers tend to have slower growth and development. Passive smoking is harmful too – try to avoid other people’s “second-hand smoke”.

Many harmful substances can be found in cigarette smoke: Nicotine – it travels to your foetus’ blood vessels and can cause constriction so that less oxygen reaches your foetus.

Tar Carbon monoxide – it travels to your foetus’ blood and decrease the amount of oxygen reaching the cells.

 

Alcohol

Alcohol has a deleterious effect on your foetus. Pregnant women who drink heavily have greater risk of miscarriage.

Heavy maternal alcohol consumption is also associated with the “foetal alcohol syndrome”, in which the baby may have growth retardation, characteristic facial deformities and nervous system involvement.

Caffeine

Caffeine is found in coffee, tea, cola, cocoa, certain soft drinks, and some over-the-counter drugs.

Studies have shown an increased incidence of small babies, stillbirths, premature labour and miscarriage in women who take a lot of caffeine.

Household Agents

Insecticides and herbicides some chemical insecticides have been associated with miscarriage and birth defects.

Avoid using pesticides if you are pregnant. Remember to wash your fruits and vegetables thoroughly to remove pesticides.

Cleaning products

Avoid inhaling substances that have strong odour or fumes. Always read product labels – do not use those which have warnings about toxicity. When handling household chemicals, wear rubber gloves.

These will help prevent the absorption of toxic substances through the skin.

1)First Trimester Pregnancy Scans: 0 to 12 weeks Early Pregnancy Viability or Dating Scan

An Early Pregnancy Viability Scan is helpful if you feel a bit worried or want to make sure that all is well with your baby.

It is important to have this scan if you have had vaginal bleeding or suspect an ectopic pregnancy.

When is the scan performed?

Viability scans are performed at 6 weeks – 12 weeks of pregnancy. If you have a concern about a possible ectopic pregnancy, this scan can be conducted at 5 weeks – 7 weeks.

What will I learn from the scan?

A Viability Scan is also known as a Dating Scan. It is used to determine the age of the pregnancy; and how many babies there are. It is able to confirm the presence of a heartbeat, and indicate the size of the sac or the foetus. It can also show if there is any internal bleeding which may be significant and which may need to be carefully monitored. At this stage the obstetrician or sonographer will be able to confirm that
the sac is in the uterus.

How is the scan performed and how long does it take?

If you are having a Viability Scan it can be performed trans-abdominally (through the tummy). If you are having the scan at 6-7 weeks because of a concern about a possible ectopic pregnancy, it may need to be performed trans-vaginally. In either case, the scan usually takes about 5-10 minutes.

Do I need to prepare for the scan?

It is advisable to come to the appointment with a full bladder as this will improve the visibility of the scan when performed through the tummy.

Nuchal Translucency Scan or 11 to 14 Week Scan

A Nuchal Translucency Scan confirms that there is a heartbeat, and the number of foetuses. The baby’s head, trunk, arms, legs, hands and feet can be seen and your obstetrician will also look at the placenta, amniotic fluid and umbilical cord.

When is the scan performed?

This scan is performed between 11 and nearly 14 weeks of pregnancy.

What will I learn from the scan?

A Nuchal Translucency Scan can be used as part of a screen for Down Syndrome.

How is the scan performed and how long does it take?

The Nuchal Translucency Scan is performed transabdominally (through the tummy) and usually takes 20 to 30 minutes to perform.

Do I need to prepare for the scan?

There is no special preparation needed for this scan and there is no need for a full bladder.

 

2)Second Trimester Pregnancy Scans: 13 to 28 weeks

When is the scan performed?

14 weeks – 22 weeks

What will I learn from the scan?

The baby’s head, abdomen, and leg length will be measured. The placenta can be located and the amniotic fluid and umbilical cord assessed

How is the scan performed and how long does it take?

This scan is performed through the tummy (a transabdominal scan) and usually takes 15-20 minutes.

Do I need to prepare for the scan?

You do not need to have a full bladder for this scan and no special preparation is needed.

Fetal Anomaly Scan 21 - 22 Week

Scan It is also known as a 21 Week Scan, an Anomaly Scan is a chance for your baby’s development and well-being to be assessed in greater detail.

When is the scan performed?

An Anomaly Scan can be performed from 18 weeks but some doctors advise scans between 22-24 weeks. This is because often at that time the images of the baby are clearer.

What will I learn from the scan?

With an Anomaly Scan, your baby’s anatomy is examined in detail.
Measurements will be made of the head, brain, abdomen and legs. Your baby’s heart, brain, spine, bowel and limbs are checked to detect any abnormalities.

This can never completely guarantee that the baby will be normal, but it gives very strong reassurance. The placenta, amniotic fluid and the umbilical cord are also all checked In order to examine internal organs properly, the Anomaly Scan is performed in 2D. However, this is the time when you are able to get a much clearer picture of your baby, making it an emotional and exciting scan for many parents.

How is the scan performed and how long does it take?

The Anomaly Scan is performed trans abdominally (through the tummy) and usually takes about 30 minutes. However, because there are so many parts of your baby’s anatomy to be checked, it may be necessary for you to change positions or get up and walk around a little, in order to encourage the baby to move into a more favourable position.

Do I need to prepare for the scan?

Some obstetricians will ask you to drink fluid beforehand.

3)Third Trimester Scans: 28 to 40 weeks Wellbeing Scan or Fetal Growth Scan

The purpose of this scan is to check that the baby is growing well and that the pregnancy is developing normally.
You may want to have this scan If your baby has been moving less, you have had unusual tummy pains, light bleeding you have had some kind of accident (for example on the road or in a fall).
you have had pregnancy complications or problems in a previous pregnancy.
The Scan is performed between 28 and 40 weeks of pregnancy. Some obstetrician advise that it is useful to have such a scan at about 36 weeks.

What will I learn from the scan?

In this Scan, your baby’s measurements will be taken to make sure growth is proceeding normally. The growth of the baby will be assessed by measuring the head, abdomen and femur length (thigh bone). This way your obstetrician can estimate the baby’s weight and give you an idea as to how big it will be at birth. The appearance and position of the placenta is also checked, and the amniotic fluid around the baby is measured. The flow of blood through the umbilical cord is assessed using Doppler ultrasound. Your obstetrician will look at how well the baby is moving and can tell you the sex of your baby if you wish.

How is the scan performed and how long does it take?

The Wellbeing Scan is performed trans abdominally (through the tummy). It usually takes about 30 minutes and is conducted in 2D.

Do I need to prepare for the scan?