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Antenatal: Regular check-up could save your life, your baby

By Vision Reporter

Added 7th September 2012 11:15 AM

For various reasons, many women won’t hear a thing about going for antenatal check-up yet this kind of procedure could help you detect some complications, save your life and that of your baby

Antenatal: Regular check-up could save your life, your baby

For various reasons, many women won’t hear a thing about going for antenatal check-up yet this kind of procedure could help you detect some complications, save your life and that of your baby

For various reasons, many women won’t hear a thing about going for antenatal check-up yet this kind of procedure could help you detect some complications, save your life and that of your baby, writes Martin Kanyegirire 

Eunice Nakamate, 32, avoided antenatal care while she was pregnant. Just three months down the road, she got a miscarriage. The doctor told her a cyst could have been the cause of the miscarriage.  

Brenda Mbabazi, a mother of one, went for antenatal care. She went through several prenatal and diagnostic checks. Having discovered that she had an ovarian cyst, Mbabazi knew it would be hard for her to conceive. But she was hopeful owing to the doctor’s affirmation that he would keep the cyst in check until she gave birth.

Nine months later, she successfully gave birth.  
“However, in some communities, some people still think that an ultra sound scan has negative impacts on people’s lives,” said John Luwakanya, the Mpigi district chairman. 

He was speaking at an event held to pass 22 midwives from Mpigi. They had completed a one-year course in ultra sound scanning at Ernest Cook Ultra Sound Research and Education Institute in Mengo. The function was also held in celebration of the donation of 14 ultrasound scan machines to Mpigi Health Centre II, Buwama. The solar-powered scanning equipment was donated by Management Sciences for Health, a non-profit health organisation that focuses on giving quality health care to all people. 

Luwakanya appealed to health workers to counsel women and their husbands before initiating a scan on a pregnant woman.

According to Dr. Edith Namulima, a public health consultant with the Midwives Antenatal Ultra Sound project in Mpigi district, more women are attending scanning sessions as part of antenatal care. She, however, noted that the numbers are not high enough to achieve the acceptable maternal mortality rate by 2015.

“Routine prenatal care has played a part in reducing maternal death rates and miscarriages, as well as birth defects and low birth weight,” Namulima noted.

Men and antenatal care
At the same event, Dr. Ruth Nassanga, the district health officer for Mpigi district, advocated male involvement in reproductive health decisions and practises. 

“Studies have shown that educating men about the importance of healthcare for the family increases the promotion of health-seeking behaviour such as antenatal care and immunisation of children,” Nassanga said.


Ovarian cysts need not bring you tears 

By Vision Reporter

Pregnancy is a joyous time, but can be worrying with the discovery of ovarian cysts. In most cases, ovarian cysts are discovered at the time of routine prenatal ultrasound screening, according to Dr. Josephat K. Byamugisha, the head of the obstetrics and gynaecology department, Mulago Hospital. 

Medical experts say most ovarian cysts found during pregnancy are benign tumours that do not require surgical intervention. However, surgery may be indicated if there is an acute complication such as rupture or torsion, disrupting the blood supply or if the size of the cyst is likely to present problems with the pregnancy.

What are ovarian cysts?
They are small fluid-filled sacs that develop in a woman’s ovaries. An ovarian cyst can be as small as a pea or as big as an orange.

Experts say the ovaries are two small, bean-shaped organs that are part of the female reproductive system. “Every woman has a pair of ovaries that sit on either side of the womb,” Byamugisha says.

Signs and symptoms 
Doctors believe that in many cases where ovarian cysts are small and benign or harmless, there are usually no signs or symptoms. 

“Even if there are symptoms, they alone cannot determine whether a patient has an ovarian cyst. There are several other conditions with similar signs and symptoms of ovarian cysts like ectopic pregnancy or ovarian cancer,” says Dr. Twaha Mutyaba, a gynaecologist at Mulago Hospital.

However, he notes that signs and symptoms of an ovarian cyst may include painful, heavier irregular menstruation periods and persistent or intermittent pain in the pelvis that could spread to the lower back and thighs.

Other symptoms are pelvic pain shortly before menstruation begins, pelvic pain just before menstruation ends, pelvic pain during sexual intercourse, pain and discomfort in the abdomen after intercourse, pressure on the bowels, breast tenderness and nausea during pregnancy and hormonal abnormalities.

Dr. Innocent Mugume, a research specialist with Kabwohe Clinical Research Centre, says for complicated cysts, the stem of an ovary can become twisted if the cyst is growing on the stem, blocking the blood supply to the cyst and causing severe pain in the lower abdomen. 

“In rarer cases, an ovarian cyst may be an early form of ovarian cancer,” Mugume says

What are the causes of ovarian cysts?
Mugume says during ovulation, a cyst-like structure called a follicle is formed inside the ovary. The mature follicle ruptures when an egg is released during ovulation. The mature and ovulated eggs form from an empty follicle and if pregnancy does not occur, the mature, ovulated egg dissolves. 

“Sometimes, however, this process does not conclude correctly, causing a common type of ovarian cyst; functional ovarian cysts. Abnormal ovarian cysts, such as polycystic ovarian disease, may occur as the result of an imbalance of the female hormones; oestrogen and progesterone,” Mugume explains.

Treatment options 
According to experts, the patient’s age, whether the cyst is postmenopausal or appears during pregnancy, the appearance of the cyst and its size are factors put into consideration when deciding on the type of treatment.

“Observation is recommended, especially if the woman is pregnant and she has a small functional cyst,” Mugume says.
He explains that if a woman has small cysts in just one ovary, her risk of developing cancer is very small. He also notes that in most cases, such cysts go away within a few months. 

“If there are symptoms,” Mugume explains, “the cyst is large, does not look like a functional cyst, is growing, or persists through two or three menstrual cycles or grows till the second trimester of pregnancy; the patient might need surgical measures to get rid of it.” 

Removing it addresses the risk of the cyst eventually becoming cancerous.

Cost of treatment
Mugume says it depends on the type of treatment. “If a doctor recommends a surgical procedure, then it is more expensive than if the pregnant mother’s cyst is benign to be monitored by a doctor until she gives birth. 
“Lest, ovarian cysts are not treated by chemotherapy,” Mugume says.

The cost of treatment also varies with the hospital one receives the treatment. “In Mulago, treatment is free,” Byamugisha notes.

Who is prone?
According to medical researchers, there is no clear cause of ovarian cysts, making it hard to point out the categories of women prone.

“However,” Mugume says, “women who have been over exposed to x-ray radiations and certain medications are likely to have ovarian cysts.”

Ovarian cysts are very common. Mugume estimates that virtually all women who still have a menstruation period and about one in five women who have been through menopause, will have one or more ovarian cysts. He notes that serious cases of ovarian cysts are much less common, affecting about three in every 25 women.

There is no definite way of preventing ovarian cyst growth. However, regular pelvic examinations, which allow for early treatment, usually protect the woman from complications, according to Mutyaba. 


Antenatal: Regular check-up could save your life, your baby

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