• Can a woman have a baby in late forties without a problem?

Having a baby in late forties is definitely a concern. There are some risk factors that need to be addressed and counselled if a woman intend on becoming pregnant in her late forties.

The main problem of postponed desire of a child is decreased fertility. The longer you wait, the difficult it gets to become pregnant due to reduction of the ovum (eggs) both in quantity and quality. There are increased chances of these ovums and sperms of an older man manifesting chromosomal defects, thus increasing the chance or miscarriages or having babies with genetic defects like downs syndrome, turners syndrome etc.

Complications during pregnancy is another problem which occur more frequently when you get pregnant at a later age. During the pregnancy, the risk of high blood pressure and diabetes is rather very high. Complications with the delivery and placental problems arise frequently too leading to babies with low birth weight and prematurity.

• How early and how often does one need to do an ultrasound?

Ultrasound is done thrice in an uncomplicated pregnancy- one in each trimester( three months). The first trimester ultrasound is usually done to know the presence of a pregnancy, number of pregnancies and confirm fetal cardiac activity. If someone has irregular menses, this helps in confirming the dates, and to assign the expected date of delivery. If a woman has vaginal bleeding it becomes mandatory to do an ultrasound to rule out ectopic pregnancy, or a miscarriage.

The second trimester ultrasound otherwise known as the targeted ultrasound is done to rule out any gross congenital anomalies, to note the location of the placenta and confirm the number of fetuses.

The third trimester ultrasound is done to know the growth of the fetus and the weight, amount of amniotic fluid present, location of the placenta, presentation of the fetus.

The frequency of the ultrasound scanning increases if a woman has any high risk factors like a predisposition to genetic deformity, or any medical illness like diabetes, high blood pressure, kidney diseases etc.

• What causes decreased libido in women after pregnancy?

Hormonal changes during pregnancy, just after having a baby and during breast feeding can decrease libido. Hormones are not the only factor which damper libido. Fatigue, changes in body image and the pressures of pregnancy and decrease in sleep while caring for the new baby all contribute to decrease in libido post pregnancy.

• How can lumps in breasts be cured?

Lump in the breast need to be investigated first to know whether it is cancerous or non-cancerous. Once a woman is diagnosed with a lump in the breast, a mammogram is taken and if found suspicious Fine needle aspiration cytology or lump excision biopsy is done. If found non-cancerous, a simple excision will suffice. But if found malignant, the modality of treatment ( may it be surgery, chemotherapy or radiotherapy or a combination of these) depends on the type and stage of the cancer, extent of its spread.

• What are the symptoms of pelvic organ prolapse?

The main symptom of pelvic organ prolapse is mass descending per vaginum. There are other accompanying symptoms like voiding dysfunction including urinary incontinence, urinary urgency, and at the extreme is urinary retention, anuria, and resultant pain. Other symptoms associated with pelvic organ prolapse include pelvic pain, defecatory problems (eg., constipation, diarrhea, fecal incontinence, tenesmus), back pain, flank pain, overall pelvic discomfort and dyspareunia.