In our last article for gynaecology-related conditions we looked at PCOS (to refresh your memory you can read our article here). In this article, we will be looking at Ovarian Cysts. Many people often confuse having ovarian cysts to automatically mean they have PCOS. While those with ovarian cysts can certainly have PCOS as well there is still a difference between the two. PCOS has to do with hormonal imbalance and Ovarian Cysts are usually not related to this.

We will be breaking down what ovarian cysts are and the signs and symptoms of having larger ovarian cysts or possible complications.

By the end of the article we hope you have a clearer understanding of PCOS vs Ovarian Cysts. However, if you have any questions (which is completely okay, by the way!), refer to the ‘get in touch’ section and we’d be happy to chat.

What are Ovarian Cysts?

Ovaries are small, less than 3cm in length and width. It is where the eggs are stored and then released each month. Women have two ovaries located on opposite sides of the uterus.

Ovarian cysts are pockets or sacs, located in the ovaries that contain fluid. Smaller ovarian cysts are normally resolved naturally and many woman are asymptomatic. However, some ovarian cysts can get tangled up, burst or can be bigger in size. This can result in several symptoms.

Signs and Symptoms

Mayo Clinic reports the main three symptoms to be:

• Pain in the pelvic area, mainly on one side
• Pressure or feeling weighed down around your abdomen
• Feeling bloated

If experiencing the symptoms above, book an appointment to see your physician. However, if experiencing any of the following symptoms below, please seek urgent medical attention:

• Extreme abdominal or pelvic pain, that has quickly progressed
• High temperature/fever, pain and vomiting
• Any symptoms of shock – Cold sweat, cold skin, increased breathing, feeling faint

Statistics

In terms of the frequency of women with ovarian cysts, Cleveland Clinic reports that roughly 8-18% of women (premenopausal and postmenopausal) have ovarian cysts. For women postmenopausal, it is reported that the ovarian cysts remains for several years.

Studies have also stated that in the USA, 5-10% of women required surgery for their ovarian cysts at some point. Roughly a fifth of these cysts are cancerous.

Get in touch

From the reported information above, ovarian cysts might not be the most common or serious gynaecological condition but it is evident that the risk still exists and you should remain vigilant of the symptoms. If you believe you might have complications with ovarian cysts or have any other questions about this, please get in contact at (345) 745-7450 or book an appointment here.

High-risk pregnancies: An overview

There are a small proportion of pregnancies that carry a greater risk and complications that can negatively impact the health of the mother, baby or both. These are classified as ‘high-risk pregnancies’. We use the term ‘high-risk’, because specialist care is needed during the pregnancy to ensure optimal health and safety for both the mother and baby. The majority of high-risk pregnancies and births do go without complication. However, it is important to note that this is because of the cautious approaches put in place to help ensure that any risks are addressed. It also means ensuring that you have a contingency plan put in place by specialists, which include OBGYNs but also by a qualified maternal-fetal medicine specialist where closer monitoring and management are required.

Risk-factors for a high-risk pregnancy

Some women will know from the start that they are likely to be higher risk due to the presence of certain risk factors (see below), which helps them make sensible choices about whether they might need a dedicated high-risk pregnancy service. However, for some, risk is not apparent at the start and so understanding what a high-risk pregnancy is and what to do if issues emerge is part of ensuring yours and your baby’s safety. The following list of risk factors is not designed to be fully comprehensive but certainly covers the main ones.

Existing health conditions:

• High blood pressure
• Polycystic ovary syndrome (PCOS)
• Diabetes
• Kidney disease
• Autoimmune disease
• Thyroid disease
• Obesity
• Certain infections e.g. Zika
• Women living with health problems like high blood pressure, anaemia, blood problems like thalassemia and sickle cell disease or trait, asthma epilepsy, diabetes, heart or blood disorders, obesity, autoimmune disease like lupus or rheumatoid arthritis, kidney disease, thyroid disease, or chronic infections like HIV, Hepatitis B or C are at higher risk. Some sexually transmitted infections and mental health concerns like depression can also pose a risk to pregnancy.

Life Decisions and Lifestyle:

• Age of the mother: Women who are younger than the age of 17 and older than the age of 35 are more likely to experience pregnancy complications than women between the ages of 17 and 35. Women who are over 40 years of age also have a higher risk of experiencing miscarriage and delivering a baby with genetic disorders. In Cayman, we have our fair share (or more) of pregnancies in women over 35 years of age.
• Alcohol use
• Tobacco use
• Drug use

Conditions of Pregnancy:

• Multiple gestation
• Gestational diabetes: Gestational diabetes is another complication that develops during pregnancy, usually resolving after the delivery of the baby. If you have developed Gestational diabetes, your Maternal-Fetal Medicine Specialist will follow your baby’s growth and well-being, and manage your health with nutrition counseling, glucose monitoring and, possibly, medications.
• Pre-eclampsia: Pre-eclampsia is a condition unique to pregnancy where you have high blood pressure in conjunction with protein in your urine and edema (swelling of the skin). In some women with pre-eclampsia, liver or platelet abnormalities are present. Referral to a Maternal-Fetal Medicine Specialist may be important, depending on the severity of your disease or if you are preterm. The treatment of pre-eclampsia is delivery of the baby, so this is a condition that requires very close monitoring to balance maternal complications against the risks of delivering your baby early.
• Eclampsia
• Previous preterm birth: Past preterm births may also predict future early deliveries, and so coordination with a neonatologist may be important.
• Placental complications: Placenta previa is a condition in which the placenta covers the cervix. The condition can cause bleeding, especially if a woman has contractions. If the placenta still covers the cervix close to delivery, your doctor will schedule a cesarean section to reduce bleeding risks to the mother and baby.
• Fetal problems: These can be seen on ultrasound. Approximately 2% to 3% of all babies have a minor or major structural problem in development. Sometimes there may be a family history of fetal problems, but other times these problems are completely unexpected. If you are under the care of a Maternal-Fetal Medicine Specialist, they will monitor and test for these problems and discuss them with you, advising on the implications and care options.
• Birth defects or genetic conditions: Previous issues with miscarriage and/or a complicated genetic family history are also risk factors for a high-risk pregnancy.

Role of Maternal-Fetal Medicine Specialist

As mentioned above, after the circumstances of a high-risk pregnancy are reviewed and there are risk factors or concerns, you will likely be referred to a Specialist in Maternal-Fetal Medicine. In certain cases, pregnancy women with existing health conditions or genetic risks may even be referred to Specialist in Maternal-Fetal Medicine before pregnancy. This type of doctor has received special training in how to care for women with a high-risk pregnancy. It is a higher training than normal obstetric training and carries formal accreditation in modern health systems, as well as experience of working in high-risk specialist centres.

In addition, the Maternal-Fetal Medicine Specialist has extensive training in assessment and treatment of fetal problems. In this case, the Maternal-Fetal Medicine Specialist will coordinate your care, as well as your baby’s care during pregnancy, with other doctors, nurses, and other healthcare professionals, and at delivery with the help of a Neonatal care team to ensure the best possible outcome for both you and your baby. The goal is to improve the outcome of the patient’s current pregnancy, as well as lower her risks for complications in future pregnancies. Safe care typically involves a multidisciplinary approach and seamless coordination.

Are there preventative measures?

Many recommend a preconception appointment with your health care provider or OBGYN to ensure you are as healthy as you can be before you become pregnant, even if you have no existing health conditions. OBGYNs and Maternal-Fetal Medicine Specialist may recommend the following to help reduce risk of certain conditions:

• Getting at least 400 micrograms of folic acid daily, starting before and continuing through pregnancy, occasionally you may be advised to take bigger doses like 5 mg of folic acid.
• Getting recommended immunizations
• Eating a healthy balanced diet and maintaining proper weight
• Getting regular physical activity, unless advised otherwise by your doctor
• Eating a healthy balanced diet and maintaining proper weight
• Avoiding smoking, alcohol, and drugs (except for medications approved by your doctor)
• Taking only the over the counter and prescription medicines that your doctor or midwife has OK’d for you
• Seeing your doctor regularly
• Working with them to manage problems such as diabetes, depression, high blood pressure, or infection

There is a possibility to have normal pregnancy initially and develop conditions that then classify your pregnancy as high-risk. Each antenatal visit is in effect a repeat assessment of risk factors, aiming to identifying any new risk factors that may have arisen since the last visit, coming up with an effective management plan for the condition and providing guidance on preventative measures to ensure everything runs smoothly.

Integra Healthcare’s High-Risk Pregnancy Service

The Integra Obstetric-Neonatal team collectively represents decades of consultant-level, tertiary experience in managing both high risk pregnancies and the fetal or newborn complications that can arise. It is quite simple unique on Island:

• Only combined Obstetric-Neonatal team, allowing a true, seamless, multidisciplinary approach
• Only team with both obstetric and neonatal accredited and experienced tertiary consultants
• Detailed fetal anomaly scans conducted by a highly experience sonographer and independently reported
• All key obstetric and neonatal team members live within 5 minutes of Cayman Islands Hospital in George Town
• 24/7 access to the team for concerns or urgent care issues

In the meantime, if you have would like more information or have any concerns, we’d be delighted to help:

Based on our combined experience of literally thousands of high-risk pregnancies, here and in the UK, our approach is comprehensive, designed to assess all risk factors, proactive and multidisciplinary. We’d be delighted to talk through that approach in detail, without charge, so that you can understand just why it is unique, as well as meet the team members who might be involved.

Click here for more information.

Inauguration of New Women’s Health Suite is Joined by Minister for Health & Wellness

We can’t tell you how delighted and honoured we were that the Honourable Minister for Health & Wellness found the time in her busy schedule of far more important things to come and help us with something important to us, and Women.

She was also kind enough to say some very kind things, which we are humbled by. Delighted to share all of the speeaches, including hers.

More information on: Women’s Health Suite

Dr Lisa Joels, Consultant Obstetrician & Gynaecologist: More Information

Dr Madhavi Manoharan, Consultant Obstetrician & Gynaecologist: More Information

Integra Healthcare Ltd opens dedicated Women’s Health Suite for its all-female Obstetrics & Gynaecology team

 

George Town, Cayman Islands, May 21, 2021 – Integra Healthcare Ltd announced today the opening of a new dedicated Women’s Health Suite for its rapidly growing Obstetric & Gynaecology Service, bringing purpose-designed facilities and a relaxing environment for its unique service.

Click on a pic for higher resolution images:

Dr Lisa Joels, Consultant Obstetrician & Gynaecologist at Integra commented, “Besides the state-of-the-art space and equipment, this now allows us to deliver a truly unique, combined pregnancy service that brings together tertiary obstetric care, fetal medicine and neonatal care, backed up by dedicated midwifery support during pregnancy and after delivery.”

The all-female team in the Women’s Health Suite consists of two UK-trained and qualified, tertiary hospital Obstetric & Gynaecology Consultants, a dedicated Midwife and Nurse, working seamlessly with the renowned Integra newborn paediatric consultants, to ensure a smooth pregnancy and beautiful experience, but with the back-up, teamwork and credentials necessary to deal with complications, and manage complex or high-risk pregnancies.

Commenting on the new consulting-treatment suites, Dr Madhavi Manoharan, Consultant Obstetrician & Gynaecologist, says, “Women’s health issues, especially gynaecology problems, are sensitive and require utmost privacy. It is wonderful to have spacious new suites, each with an ensuite toilet within them, allowing us to ensure dignified care in first-class facilities.”

The new suite boasts its own separate waiting room with complementary refreshments, multiple consulting room-treatment suites and dedicated nursing and midwifery rooms to allow for Integra’s enhanced pregnancy package of midwifery support, including prenatal and postnatal support well beyond what is typically available.

Allie Campbell, Integra’s midwife, explained, “I spent many years here as a doula before training and practising as a midwife in a busy London Teaching Hospital. I was aware of the lack of midwifery support in the private setting and how this affected women during their pre-natal and postnatal care. I am so excited about being able to delivery this in our new purpose-designed suite.”

Integra Healthcare Ltd is a practice devoted to Women’s, Children’s and Family Medicine, with Dermatology, and was established with the aim of raising the bar for what patients can expect from a healthcare provider. Dr Sara Watkin, Co-owner, Director and Consultant in Paediatric & Neonatal Care, explained the thinking, “From the outset, we wanted to establish fresh, purpose-designed facilities, whilst engaging clinicians from tertiary-level backgrounds, who were as committed as us to the practice of modern, evidence-based medicine. Our Women’s Health Suite represents a big investment in organising expert, multidisciplinary, team-based care, as it should be, which is why that is our motto.”

Dr Francisco Martinez, Co-owner, Director and a Family Medicine Physician, added, “GPs or primary care doctors refer women of all ages with a wide variety of gynae problems and we know they want a team they can trust with intimate and delicate issues, in a setting that is private and calming. I couldn’t be more delighted that we can now offer that, through an all-female team with facilities that enable them to deliver a truly holistic and high-quality service.”

More information about the New Women’s Health Suite at Integra Healthcare Ltd can be found at: /womens-health-suite/

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ABOUT INTEGRA HEALTHCARE LTD

Integra Healthcare Ltd is a multi-specialty clinic focused on Women’s, Children’s & Family Medicine, with Dermatology, built around the four principles of Excellence, Integrity, Commitment & Passion. With 8 doctors, backed up by a highly qualified nursing-midwifery team of 7, it places a high value on a team approach, particularly important when facing unusual or complex conditions. This approach also ensures patients always have the back-up and holiday cover that comes from a team rather than an individual doctor, whilst still having that regular relationship with a specific doctor they trust. Integra is based out of beautiful Grand Pavilion on West Bay Road, with dedicated parking and ramp access for pushchairs or the less able. It has a strong safety ethos, a commitment to painless administration and state-of-the-art electronic patient record systems allowing online booking and direct communication.