Dr Madhavi Manoharan

• MBBS – Bachelor of Medicine and Bachelor of Surgery
• MD – Doctorate of Medicine
• FRCOG – Fellow of the Royal College of Obstetricians and Gynaecologists
• CCT – Certificate of Completion of Training in Obstetrics & Gynaecology
• Fetal Medicine (RCOG Special Skills Module Accreditation)
• Advanced Labour Ward Practitioner (RCOG Accreditation)
• Diploma in Obstetric Ultrasound
• Ultrasound Imaging in Managing Gynaecological Conditions (RCOG Special Skills Module Accreditation)
• DGO – Diploma in Gynaecology and Obstetrics
• Accredited by the BSCCP (The British Society for Colposcopy and Cervical Pathology)
• DFFP – Diploma of the Faculty of Family Planning

In addition to her explicit qualifications, Dr Manoharan has extensive additional training and experience in the following areas:

• Maternal medicine & high-risk obstetrics
• Fetal anomalies & growth restriction
• Advanced laparoscopic surgery
• Minimal access surgery
• Hysteroscopic surgery
• Vulval disease
• PROMPT Obstetric Emergencies Training (including as instructor)
• Trans-abdominal and trans-vaginal scans for early pregnancy problems
• Managing obstetric emergencies such as emergency caesarean sections especially with major antepartum bleedings and extreme prematurity along with severe pre-eclampsia and eclampsia Diabetes in pregnancy
• Contraception including insertion of contraceptive coils and implants
• Clinical governance and risk management

My obstetric experience spans 23 years, including more than a decade at tertiary level and 7 years as consultant at the prestigious Royal Free London NHS Foundation Trust. I have a special interest in both obstetric safety and in high-risk pregnancies, backed up by a training in maternal medicine and a specialist interest and formal accreditation in fetal medicine.

I believe in supporting women in shared decision-making about mode of delivery, including aiming for normal vaginal delivery and vaginal birth after caesarean section. I am experienced in caesarean section, instrumental vaginal delivery including ventouse and forceps. I have experience of vaginal breech deliveries and vaginal twin deliveries.

I have a special interest in diabetes in pregnancy, with extensive experience of conducting antenatal diabetic clinics, including jointly with an endocrinologist.

Pre-conception care

• Advice about pre-existing medical conditions prior to pregnancy working with specialist colleagues as necessary
• Evaluation of risk-factors for a high-risk pregnancy

Antenatal care

• Holistic management of antenatal care throughout pregnancy including screening for complications of pregnancy, monitoring fetal growth and advice about vaccinations and medication as appropriate
• Early pregnancy scanning for identification of fetal anomalies
• Management of pregnancy-related conditions and complications
• Joint decision making regarding birth plans
• Referral on to specialist services as necessary

Care in labour and delivery

• Intrapartum care including active management of labour and working with midwifery colleagues
• Normal vaginal delivery
• Instrumental delivery including Ventouse (vacuum) and forceps delivery)
• Caesarean sections both as a planned procedure and as an emergency if complications arise in labour
• Management of delivery of placenta and bleeding after delivery
• Repair of perineal tears or episiotomy

Care after birth

• Postnatal care until discharged home
• Six-week postnatal check and contraceptive advice
• Support for problems arising after delivery

I have extensive experience of managing high-risk pregnancies and for more than a decade have been actively involved in the care of high-risk pregnant women with medical complications like cardiac, haematological conditions, hyperthyroidism etc, including managing them in liaison with multidisciplinary teams.

My training and accreditation in fetal and maternal medicine has led to extensive experience in the managing women with pregnancies complicated by severe growth restriction, twin or multiple pregnancies and pregnancies with fetal anomalies. I have had training in early pregnancy scanning for identifying early pregnancy problems like miscarriage, ectopic and molar pregnancies.

I have had training in managing obstetric emergencies (including as instructor). My experience in managing obstetric emergencies extends to emergency caesarean sections especially with major antepartum bleedings and extreme prematurity along with severe pre-eclampsia and eclampsia.

I have a specialist interest, training and accreditation in fetal and maternal medicine. I have extensive experience in the managing women with pregnancies complicated by severe growth restriction, twin or multiple pregnancies and pregnancies with fetal anomalies.

Fetal Medicine sits really between obstetrics and neonatal medicine, providing care and diagnosis for your baby whilst in-utero. This is especially important in the event of complications or fetal anomalies. In this situation, I provide pregnancy care and guidance with those complications in mind, including coordinating care with my neonatal colleagues to ensure birth is carefully planned with safety in mind.

I have a long, broad-based training and experience in gynaecology services, including as a tertiary consultant in a prestigious London teaching hospital.

I am confident in both abdominal and vaginal hysterectomy, open myomectomy, vaginal repairs and hysteroscopic resection of polyps and fibroids. I am trained in advanced laparoscopic surgery, minimal access procedures, surgery for endometriosis including, excision of endometriosis, ovarian cystectomy and other operative laparoscopic procedures including adhesiolysis, salpingo-oophorectomy and ectopic pregnancy. I have carried out LAVH and laparoscopic subtotal hysterectomies and total laparoscopic hysterectomies.

I have a specific training in trans-abdominal and trans-vaginal gynaecological ultrasound scanning and can conduct this routinely in clinic for benign gynaecological conditions.

I am experienced in the management of women with prolapse, menstrual disorders, pelvic mass and fibroids.

Diagnosis and management of benign gynaecological problems:

• Menstrual disorders including bleeding after intercourse, postcoital bleeding or post-menopausal bleeding
• Pelvic pain and painful intercourse
• Urogynaecological problems including prolapse and incontinence
• Hormone problems including menopause and polycystic ovary syndrome
• Ovarian cysts and fibroids
• Vulval disorders
• Contraception
• Screening services including cervical smear tests
• Gynaecological ultrasound
• Diagnostic colposcopy (accredited)

Treatment of gynaecological problems:

• Minimal access surgery including advanced laparoscopic procedures to excise or treat endometriosis and adhesions and benign ovarian cysts
• Hysteroscopic surgery including removal and resection of polyps and fibroids and investigation of postmenopausal bleeding
• Open surgery including hysterectomy, removal of fibroids and large benign ovarian masses
• Prescribing medications as appropriate where a surgical approach isn’t required
• Treatment colposcopy in the clinic or surgical setting

I am accredited by The British Society for Colposcopy and Cervical Pathology in Colposcopy in both diagnosis and treatment of benign gynaecological conditions, including routinely performing colposcopy within the clinic environment.