Normal & High Risk Pregnancy
Obstetrical and Prenatal care - Pregnancy is an unique and a special time in the women's life, proper prenatal care is essential for a healthy development of your baby.
At Indiana Ob/Gyn we provide you with great care from very early stages of your pregnancy. You are educated in detail about prenatal care, diet , exercise and weight gain in your first prenatal visit. Dr Jain will do an ultrasound scan in the office to ensure a healthy pregnancy. On your first visit you will have labs drawn. We have in office laboratory for your convenience. In all your subsequent visits your Blood pressure and urine will be checked and you will be examined for babys growth. The staff at Indiana Ob/Gyn are friendly and experienced. They will help educating and advising you at every step of your pregnancy and postpartum.
For your pregnancy nausea and excessive vomiting, we arrange for home health nurses to come and start intravenous drip and zofran pump if necessary. We take care of diabetic mothers, both pregestational and gestational, multiple births, patients with pre existing conditions like preeclampsia and other high risk obstetrical conditions. For high risk pregnancies we provide you with up to date care liasing with St. Vincent group of Materno-Fetal doctors.
For Down Syndrome screening we provide you with latest serum screening which can also diagnose other chromosomal defects like Trisomy 18 and trisomy 13 and Turner syndrome. This test can correctly determine the gender of your baby at 9 weeks.
Breastfeeding is a physiological natural way with several advantages,. We encourage you to breast feed your baby. Our staff can help you understand the advantages of breast feeding the proper positioning and latch.
The links below will be helpful for you to learn the details of lactation help provided by the hospitals.
1. ACOG patient resource website
2. Maternity Services and classes at St. Francis Health
3. Maternity resources at Community Health
4. March of Dimes.
5. Breastfeeding resources at Le Leche Organization
Non Stress Testing
Non stress test (NST) is a common prenatal test used to check on a baby's health. During a non stress test also known as fetal herat rate monitoring, a baby's heart rate is monitored to see how it respond to baby's movements.
This test is done weekly or twice weekly starting at 26 to 28 week pregnancy in pregnancies with gestational diabetes, pregestational diabetes, preeclampsia , chronic hypertension or othe high risk conditions.
Non stress testing is a part of fetal well being testing and is combined with an ultrasound measurement of amniotic fluid measurement, called amniotic fluid index. It is also part of a fetal well being testing called Bio Physical Profile. In this test fetal breathing , fetal movements, fetal tone, and amniotic fluid index are measured along with NST. This test is done in the office with a non stress machine. If a NST is not diagnostic you will be sent to the hospital for a prolonged monitoring or additional testing.
Ultrasound is a safe non invasive procedure that uses sonic waves to create images of placenta, fetus and amniotic fluid. It has become an integral part of obstetric care for diagnosis of viability, gestational age, growth and developement of the fetus and other diagnostic and treatment modalities It is also used for Multiple pregnancy care and as a fetal well being test for high risk pregnancy and for placental localization in suspected cases of placenta previa.
In our office, we do an Ultrasound on your first obstetric visit to confirm the viability and gestational age of your baby. This can also confirm a multiple pregnancy. If any discrepency in your gestational age is found, a formal ultrasound is scheduled with our ultrasonographer.
Next ultrasound is scheduled at 19 week and is called as anatomy scan. This ultrasound studies your baby's anatomy in detail to detect any abnormality. If any abnormality is detected you may be referred for further studies to materno fetal doctors in St. Francis Hospital or St, Vincent hospital.
Further ultrasound depends on the pregnancy progress and wheather pregnancy is high risk or not.
3D/4D ultrasound can let you view your baby in a more detailed way than traditional ultrasound. It does not replace the diagnostic ultrasound to evaluate gestation age & anatomy of the fetus.
3D/4D Ultrasound provides a unique bonding experienced for the expected parents to come and enjoy the unique experience. With 3D and 4D Ultrasound scan you can see your baby much more clearly. A half hour video is prepared for you which shows your baby's profile, movements and much more.
For more information about obstetrics & Prenatal services contact our office at 3178874400 for an appointment.
An annual examination is a preventative health visit done once a year to maintain good health.
It starts in the adolescent years with the education of safe sex, contraception and sexually transmitted disease (STD) prevention.
Reproductive age group women should be emphasized to keep healthy with good diet and regular exercise. All reproductive age group women should take daily folic acid supplementation. Folic acid taken 3 monthes prior to conception and during first 12 weeks of pregnancy reduces a group of congenital abnormality in the fetus known as neural tube defects.
Regular PAP smears are done to prevent cervical cancer in women above age 21.
Family planning is discussed and guidance provided according to patients requirement and choice.
Counseling is done for smoking, alcohol and drug addiction.
In women who are desiring to start a family, preconceptional counseling is done and patients individual risk due to preexisting medical condition weight, and age are discussed. Again risks of smoking, alcohol and drugs are discussed.
In the next stage of life as women approaches forty and above, her health requirements change. She may be looking for permanent sterilization or dependable contraception.
At Indiana Ob/Gyn, we can provide you with expert care including in office. Hysteroscopic ESSURE procedure for permanent sterilization. For women over 40, changes in health are monitored with regular examination and blood tests like lipids, blood sugar & thyroid levels. Women in this age group may also start experiencing abnormally heavy periods. These may cause anemia and tiredness.
Heavy and prolonged period can be cured with a procedure called endometrial abalation , where the lining of uterus is burned up to the basal layer with some type of energy like electrosurgical, hot water or ballon filled with hot water. This procedure and can treat your symptoms with minimal discomfort and can be done in the office under local anaesthesia.
Women over the age of fifty need special health care to keep them in good health. They are in premenopause or in neoropause. Our doctor will give you advice regarding diet, exercise, supplements to keep your body healthy.
Annual breast and pelvic exam and PAP smear should be continued during this stage. Mamogram and colonoscopy are scheduled at regular interval. Menopause symptoms may be treated by hormone replacement. Specific health problem like pelvic organ prolapse, urinary incontinence, post menopaused bleeding are dealt with expertly at our office.
American college of Obsttrician and Gynecologist Patient Resources
Center for Disease Control Women's Health
Many changes in health occur as you go through adolescence, including puberty and start of menstruation. It is important to begin regular visits with a gynecologist early to make sure that you continue to stay healthy.
At Indiana Ob/Gyn, we provide comprehensive resources for young women.
Choosing a method of contraception is an important decision that can impact a woman's daily life. Your doctor can help you find a successful method of protection for you and your partner. You will be provided with information about the different types of contraceptives available and their respective advantages and disadvantages.
Birth control methods have many different variables including frequency, convenience, permanence and effectiveness. It is important to take into consideration your life, age, health and previous experience. The decision is ultimately yours, but using our knowledge and experience can help you make the right choice.
At Indiana Ob/Gyn we provide you with the right knowledge to make a good decision. If you need long term protection we can place MIRENA or PARAGUARD intrauterine device in your uterus which can work for 5 to 10 years depending on the method you choose.
You can also choose to have transdermal contraceptive device , Nexplanon placed in your arm which give you contraception for 3 years.
Infertility Testing & Treatment
One out of 6 couple will face infertility. Infertility is a couples treatment. We at Indiana Ob/Gyn provide you with the tests to determine the cause of your infertility. The work up may include Ultrasonography, blood test, semen testing of your partner, hysterosalpingogram to determine the condition of your fallopian tubes, sonohysterography to see the cavity of the uterus and laparoscopy to diagnose or treat endometriosis, pelvic cohesive disease or polycystic ovarian disease. At Indiana Ob/Gyn we also offer you ovulation induction and timed intercourse and ovulation induction and Intrauterine insemination.
Call 3178874400 for more details.
Treatment For Abnormal Menstrual Bleeding
This is a common problem affecting one in five women. The heavy bleedind may be commonly caused by hormonal disturbance, fibroid tumor or polyps in the endometrial cavity. There are several treatments available to correct heavy bleeding like birth control pills non hormonal pills that work on the clotting system. MIRENA intrauterine system and endometrical abalation. You can have endometrial abolation done as an office procedure. under local anesthesia.This procedure Lightens or stop the bleeding in 90% patients.
Call our office 317 887440 for more information.
Many women going through menopause exhibit symptoms that include irregular bleeding, hot flashes, insomnia, night sweats, fatigue, depression and more. There are several treatment options available that help relieve these symptoms, and our doctor can help you decide which option is best for you.
Prescription medication with estrogen and progesterone, known as hormone replacement therapy, is a popular treatment for women to treat symptoms of menopause and reduce the risk of osteoporosis. Patients can also seek treatment for their individual symptoms, and should be able to maintain an active and healthy life to help feel their best.
Sexually Transmitted Disease
Most sexually transmitted infections (STIs) have no symptoms, so it is hard to know if you have been infected. Periodic testing is recommended for anyone with multiple sexual partners, even if they are having protected sex using condoms. It is important to ask your partner if they have or have ever had an STI. We offer safe and confidential STI testing and treatment.
If you are diagnosed with an STI, most can be treated effectively. Many, however, cannot be cured. Antibiotics are prescribed for gonorrhea, chlamydia and syphilis and patients usually respond well. There is no cure for genital herpes, but outbreaks can be shortened with antiviral medications.
Colposcopy is done for women with abnormal PAP smear caused by Human Papilloma virus. A colposcope is a microscope that gives us a magnified view of the cervix, vulva and vagina. Colposcopy is established as a diagnostic tool for cancerous & precancerous leisions of lower genital tract.
It is safely performed in the office and is usually followed by a biopsy of the area. Once biopsy results are available , the future management of the abnormal PAP smear will be discussed with you in detal by Dr. Jain.
LEEP (Loop electrosurgical excision procedure) is a procedure done for high grade abnormality dtected by PAP smear , which is a precancerous condition of cervix.
The procedure is done in the office with local anesthesia injected on the cervix. Next the abnormal portion of the cervix is delineated by painting the cervix with Lugol's Iodine, The abnormal area is then removed with the LOOP ( instrument made of wire in the shape of a loop and mounted on a rod which is connected to electricity) which acts as a knife cutting and coagulating at the same time. The portion of the cervix removed is sent for pathology. After LEEP procedure it is recommended not to insert anything in the vagina for 6 weeks untill cervix is completely healed.
Complications of this procedure include bleeding and infection. If you have bleeding more than one pad per hour or having discharge with odor or abdominal cramping you should make an appointment to see the doctor.
You are followed up in two weeks after the procedure when the pathology result is back. At this visit the cervix is checked for any infection. The next check is at six weeks after which you can go back to your normal activities.
It is very important that you have PAP smear done every six monthes following LEEP procedure untill two successive PAP smear results are reported normal.
At Indiana OB Gyn we have a state of the art hysteroscope and a video monitor that can be used to visualize inside of the uterus directly.
This is done as a diagnostic procedure in patients with abnormal bleeding to detect fibroid, polyps. or any other intra uterine pathology. This is also done in postmnopausal women who present with bleeding to diagnose endometrial cancer.
Hystereoscopy is also done before Novasure endometrial abalation and ESSURE, or tubal ligation.
This is a unique treatment to treat heavy menstrual bleeding. Here radio frequency energy or thermal energy is used to destroy the endometrial lining. Procedure lasts for 90 seconds to 8 minutes. Procedure reduces or even eliminates menstrual bleeding and allows patients to return to work within a day.
The procedure can be done in the office under local anesthesia, or as outpatient procedure in the surgery center. First, hysteroscopy is done to visualize the uterus. Once the inside of the uterus including the ostia are visualized and your physician detrmines that the procedure can be done. A thorough currettage is done to obtain specimen of the endometrial lining , which is then sent for pathology.
The radio frquency endometrial abalation is called Novasure endometrial abalation, and the hot water ballon system is called Thermachoice. Your physician will choose the procedure according to the size and shape of the uterus.
After the procedure you usually have a vaginal discharge lasting for 4 weeks. If you feel severe cramping pain, foul odor in the vaginal discharge, moderate to heavy bleeding, you need to contact your physician immediately. Approximately 80% patient will be satisfied with this procedure.
Sonohysterography is a procedure done in office under ultrasound guidance. In this procedure a small cannula is passed in the uterus and saline is injected at the same time an ultrasound is performed with a vaginal probe. This help us visualize any fibroid , polyp or space occupying leison in the cavity of the uterus.
This procedure is done in patients with heavy menstrual bleeding or as part of infertility investigation.
ESSURE Procedure for permanent birth control
ESSURE is a non outpatient procedure to provide permanent and effective birth control. This can be done in the office.
A camera called hysteroscope is passed in the uterus from the cervix. The tubal openings are visualized and soft flexible silicon-free insert is placed in each fallopian tube under direct vision.
The risk for this procedure is minimal. Some form of contraception is continued for 3 months, after which a procedure called hysterosalpingogram is done to confirm tubal blockage.
A hysterectomy is the surgical removal of the uterus, usually performed by a gynecologist. Hysterectomy may be total (removing the whole uterus and cervix) or partial (removal of the uterine body while leaving the cervix intact; also called supra-cervical Hysterectomy). It is the most commonly performed gynecological surgical procedure.
Removal of the uterus renders the patient unable to bear children (as does the removal of ovaries and fallopian tubes) and has surgical risks as well as long-term effects, so the surgery is normally recommended when other treatment options are not available.
This surgery can be performed by abdominal or vaginal route. Some vaginal hysterectomy is also done partially with the help of a laparoscope called laparoscopic-assisted vaginal hysterectomy (LAVH).
Hysterectomy can be combined with removal of ovaries and fallopian tubes in perticular situations and called Hysterectomy with salpingo oophorectomy.
Diagnostic & Operative Laparoscopy
Diagnostic laparoscopy is a procedure that allows a health care provider to look directly at the contents of a patient's abdomen or pelvis.
The procedure is done in the hospital or outpatient surgical center under general anesthesia (while you are asleep and pain-free). A cut is made in your abdomen directly under belly button.Through this a needle is passed in the abdomen, which allows carbon dioxide gas to be passed in the abdomen ,distending the abdomen and pushing bowel so the pelvic organs can be visualized..A tiny video camera (laparoscope) is then passed in the abdomen to directly visualize your pelvis and pelvic organs ie. the uterus , ovaries and fallopian tubes..
Other small incisions are made to allow other instrumen ts to be passed in the abdomen under direct vision. Laparoscopy is done for diagnostic purposes, and for surgeries like tubal ligation, to check on the patency of fallopian tubes or for minimally invasive surgeries like hysterectomy, oophorectomy and myomectomy.After the exam, the gas, laparoscope, and instruments are removed, and the cuts are closed. You will have bandages over those areas.
Treatment Of Ovarian Mass
Indiana Ob/Gyn is well equiopped to treat ovarian masses. Ovarian masses can be both benign or malignant and are treated by either medical treatment or removal via laparoscopic or open surgery.
Tubal ligation is a permanant surgical sterilization procedure in which the fallopian tubes are tied, and cut to remove a portion of the fallopian tube, or the fallopian tubs are burned with electricity or sealed with mechanical device.
This is a permanant method of birth control and is usually done in the surgery center under general anesthesia. Procedure is done with a laparoscope , either with a single 10 mm incision under the belly button or three 5 mm incisions on the abdomen. After the surgery and a recovery period of approximately 2 hours patient is allowed to go home. Recovery from this surgery is about 7 to 10 days.
The risk of laparoscopic tubal ligations are failure of tubal ligation , risk of ectopic pregnancy, irreversibility and regret. It is therefore very important to think carefully before undergoing this surgery. Other risks are risk of bowel injury, injury to pelvic blood vessels, hemorrhage and infection. Prior to any surgery your doctor will discuss the procedure and risks with you in detail and obtain a consent from you.