Save uterus At Dehradoon by dr. Sharda Jain FOGSI’s Agenda of PUBLIC AWARENESS is always

1. Dr. Sharda Jain
…..Caring hearts, healing hands

2. WARM GREETINGS

3. FOGSI’s Agenda of
PUBLIC AWARENESS is always
Women health

4. WOMEN HEALTH is in women hand

5. SAVE UTERUS
FELICITATORS
• DR. SHARDA JAIN
• DR. JAIDEEP
MALHOTRA
• DR. ANJALI
• DR. PRATIMA
MITTAL,
• DR. ACHLA
• DR MEENAKSHI
AHUJA ,
• DR. NEETA

6. W.H.O..says
पहुँचाना / सोच
India is Poor but It has
• Professionals
• Technology
• Tips to improve women health &
save uterus

7. UTERINE health of
ADOLESCENT GIRLS

8. ADOLESCENT GIRLS
HB – 12 gm at
12 years
Say No
to
Cervical Cancer
Menstrual
Hygiene
DECREASE 80 – 85 % HEALTH problems of Adolescents

9. WHO
Two Vaccine are only
needed
0 & 6 if given
Between 9- 14 years

10. Every 1 in 5 Adolescent girls
have problem of Vulvo vaginitis
1 in 5

11. SELF DEFENCE

12. UTERUS REMOVAL is dismal !
When it needed -
it is needed

13. WOMEN (20 TO 40)

14. EXERCISE 60 – 70%Diet 30 – 40%
1/3 food you need /50% uncooked
WOMEN HEALTH
fundas
Anaemia

15. LIFESTYLE CHANGES have to
be done in childhood
YOGA MEDITATION PRANAYAMA
Yearly Check up & cervical cancer screening

16. Causes of women’s
DEATH in India
• CANCER CERVIX1 in 7 minutes
• PREGNANCY 1 in 8 minutes
• TB / Anemia 1 in 10 minutes ?

17. HPV
Vaccination
9 to 45 yrs
screening

18. The Uterus: An Endangered Organ

19. AMAZING FACTS ABOUT
THE WOMB !!
1. The Uterus is Super Strong..strongest muscle
in the body.
2. The Uterus is the only organ that can grow a
whole new organ within it.

20. India is home
for
unnecessary
Hysterectomy

21. USA 5.9 lac
UK 1.3 lac
Russia 3.12 lac
India 23.2 lac
CDC 2000
Numbers of
Hysterectomies Per year

22. DR DHURU SHAH
90% could be avoided
DR SHARDA JAIN
80% Could be avoided

23. 1990-2000
Life time risk
Of
Uterus Removal

24. 1:5
Women before 60 years
had Hysterectomy
U.K.

25. 1:3
Women before 60 years
had Hysterectomy
USA

26. INDIA
?

27. Average AGE of Hysterectomy in
USA
46 yrs
(40 – 50 yrs)
Uterus Removal In India
Is atleast 10 yrs. earlier

28. BIG FACT !!
Women AGE early even if ovaries
are retained
At
Hysterectomy
All Elders endorse this fact

29. Most Frequent Effects of
HYSTERECTOMY

30. Most Frequent Effects of
Hysterectomy
• An alteration in the Harmonal Environment
• Hysterectomy induces MENOPAUSE up to five
years earlier than normal,even when
OVARIES are kept.
• With Oophorectomy --woman ages even
more rapidly.
• Hysterectomy significantly increases risk of
DEPRESSION, which often emerges as much
as Two Years after Surgery .

31. Most Frequent Effects of
HYSTERECTOMY
• Hysterectomy accelerates loss of BONE & increases
the risk of OSTEOPOROSIS.
• The rate of woman,s HEART ATTACK IS 0 % during
Premenopause.
33% in women having SURGICAL MENOPAUSE
12 % for women having NATURAL MENOPAUSE.
The increase in risk for ATHEROSCLEROSIS&
CORONARY HEART DISEASE among Hysterectomised
women is THREE to SEVEN TIMES that of age
matched women who have not had the surgery .

32. EFFECTS OF HYSTERECTOMY
• Hysterectomy reduces LIBIDO ( SEX DRIVE ),
the capacity for sexual arousal ,vaginal
lubrication, & orgasmic capacity.
• Hysterectomised women frequently
experience both STRESS INCONTINENCE
(inability to hold urine when jumping
,dancing,or running ) and URGE
INCONTINENCE ( the need to urinate
frequently )

33. QUALITY OF LIFE IS
BADLY EFFECTED
• HARMONAL CHANGES
• DEPRESSION
• LOSS OF LIBIDO
HAS DEVASTATING EFFECTS

34. OVARIAN CONSERVATION V/S
Oophorectomy at Hysterectomy

35. OVARIAN CONSERVATION V/S
Oophorectomy at Hysterectomy
At
age 45 ,50, & 55 years ?
OVARIES TO BE SAVED..IF NOT
DISEASED
Prof. Pratima Mittal
Dr Meenakshi Ahuja

36. RICK REDUCING
SALPINJECTOMY
Is recommended
in cases Ovary is
being saved

37. BENEFITS OF B/L OVARY REMOVAL
• PREVENTION OG OVARIAN CANCER
• PREVENTION AGAINST BREAST CANCER
• PREVENTION OF FUTURE SURGERY FOR OVARY &
TUBES
_____________________________________
POTENCIAL RISKS
• CARDIOVASCULAR DISEASE
• OSTEOPAROSIS ,SEXUAL PROBLEMS ,UROGENITAL
ATROPHY

38. PROTECTION OF BREAST CANCER
“ B/L OVARIES REMOVAL TO BE OFFERED TO
WOMEN WITH BRCA 1 & 2 MUTATIONS
AFTER COMPLETION OF CHILD BEARING—
EARLIER THE BETTER
• ACOG PRACTICE BULLETIN JAN,2008

39. PREVENTION OF FUTURE SURGERY ON
OVARY & TUBES
• 2.7 –7.6 %
• 70 % FOR PAIN & 25 % ASYMPTOMATIC
ADENEXAL MASS
_____________________________________
WHO REQUIRE B.S.O.
• ENDOMETRIOSIS , PELVIC INFLAMMATORY
DISEASE, OVARIAN CYSTS., CHRONIC PELVIC
PAIN

40. POTENTIAL RISKS OF BSO
• CARDIOVASCULAR DISEASE—DO NOT REMOVE
UTERUS IN WOMEN LESS THAN 50 YRS
• OSTEOPOROSIS : IT IS NOT POSSIBLE TO
CONCLUDE ON OPTIMAL AGE OF BSO IN
RELATION TO HIP FRACTURES 7 OSTEOPOROSIS
• OTHER CANCERS : BSO SHOULD NOT BE
ADVISED BEFORE 45 YRS

41. PREVENTIO`N OVARIAN CANCER
• LIFETIME RISK OF OVARIAN CANCER
• 40 YRS 1 IN 2500
• 50 YRS 1 IN 1500
• 60 YRS 1 IN 600
• 70 YRS 1 IN400 (PEAK RISK )
• PLEA --NO EFFECTIVE SCREENING for O VARIAN
CANCER & DISMAL SURVIVAL RATE OF 15-25 %
• REPORT :0.7 % CHANCE OF DEATH FROM OVARIAN
CANCER AT 24 YRS F/U OF 13,305 WOMEN
• IN NURSES HEALTH STUDY obs.gynae 2009 may

42. CONCLUSION ; BEST AGE OF OVARY
REMOVAL
• NON HIGH RISK GROUP : 50 YRS IS GOOD
BALANCE…but now opinian is not to remove.
• BRICA 1 & 2 OR STRONG F/H—
OOPHERECTOMY AT COMPLETION OF CHILD
BEARING ,PREFERABLY 35..40 YRS
OVARY REMOVAL AT AGE 50 YRS WILL
REDUCE CANCER BY HALF
• CARDIAC POINT OF VIEW—NO BSO EARLIER
THAN 50 YRS

43. DUB 20%
Fibroids 30%
Endometriosis/
Adenomyosis 20%
(Pre) cancer
10%
Chronic pelvic pain 10%Prolapse 15%
Indications of Hysterectomy
In USA
1990 - 2000

44. COMMON INDICATIONS
of Uterus removal in india is
same
Dr Achla Batra
50% load of hysterectomy can be
reduced if we are obsessed to
SAVE UTERUS

45. Specific Indications for
Uterus removal
in INDIA

46. HEAVY MENTRUAL BLEEDING
50% of uterus can be saved

47. Mirena (LNG IUS)
(5 yrs)
is a
Magic Stick

48. For Treatment of DUB
Uterine Balloon Therapy
(Many Types)

49. CERVICAL LESION & UTERUS REMOVAL
Doctors said cancer cervix takes long time to develop
Treament of precancerous lesions can 100 % save the uterus

50. CERVICAL LESIONS !!
For MILD DYSPLASIA uterus is removed LEFT & RIGHT
which should not be done by public awareness
DR PRATIMA MITTAL
v/s

51. FIBROIDS
DR. ACHLA BATRA , DR. Vanita…opinioned that 1/3 rd ladies have
fibroids. If doctors councell well… again 50 % uteri can be saved if not

52. •20-40 yrs – 10 / lac
•40-50 yrs - 36 / lac
RISK OF ENDOMETRIAL CARCINOMA
In fibroids is too SMALL

53. How to save uterus at Delivery
ANTENATAL care & No
Home Delivery is the KEY

54. CANCER
Breast CANCER Cervical CANCER

55. BREAST
B/L OOPHERECTOMY
ONCE FAMILY IS
COMPLETE
BRCA 1 & 2

56. CANCER
What are the newer development of saving
uterus in Cancer Cervix in young ?

57. CANCER
What are the newer development of saving
uterus cancer cervix in young
DR. PRATIMA

58. GYNAE CANCER CURRENT BUZZ
• RADICAL TRACHELECTOMY IN MANAGEMENT OF
CANCER CERVIX IN EARLY STAGE CERVICAL
CANCER IN WOMEN WANTING TO HAVE A CHILD
• RECURRENCE RATE ,<5 %
• DEATH RATE < 3 %
• CONCLUSION : SAFE, FEASIBLE,
OUTCOME
SIMILAR TO CONVENTIONAL
RADICAL SURGERY

59. HAS NO MERCY

60. KJ Carlson, NEJM 328:856, 1993
Disadvantages
• Performed under general or regional anesthesia
• Hospitalization and recovery time
• Mortality 0.6-1/1,000
• Major complications 3%
• Morbidity 24-43%
• Psychological 25-35%
• period of convalescence—3 months
REMEMBER : Hysterectomy is
Not 100% safe

61. FOGSI & FOGSI PUBLIC AWARENESS COMMITTEE SHOWERED.*WOMEN ACHIEVER
OF THE YEAR..AWARD * AT DEHEADUN ON 27TH APRIL 2018

65. ADDRESS
11 Gagan Vihar, Near
Karkari Morh Flyover,
Delhi - 51
CONTACT US
9650588339
9599044257
011-22414049
WEBSITE :
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…..Caring hearts, healing hands
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Helpline : 9599044257
Web.www.lifecareivf.in
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Year
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