Many of the midwives will be transferring up to Joondalup, so we will see familiar faces up there.

We’ve delivered a few babies up there already – all went very smoothly. We’re confident that patients will be happy with the service at Joondalup.

Additionally, there is a safety advantage: with a blood bank, HDU, ICU & NICU on-site for when things get interesting. Fortunately they will be used very infrequently with our patients.

It will mean some mild logistical issues need to be solved. We’ll need to use telehealth more, and there will be some occasional cross-covering needed with the other obstetric consultants.

We’re still doing all our consulting from our Duncraig rooms – so no changes there at all.

The post Move to Joondalup Private Maternity appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

We’re still very close to Glengarry Hospital, but now we have more space, more parking & a nicer environment.

The address is:

Glengarry Cottage,
31 Arnisdale Road,
Duncraig,
WA 2063

Unfortunately we have not been able to port out out old phone & fax number from the Ramsey corporate network. Too complex according to both Telstra & Optus.

Our new details:

Phone number: (08) 6119 9160
Fax numner; (08) 6119 9161

The building is the white house on the corner opposite Glengarry Park.

The post New premises appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

Following the announcement of the projected closure of Attadale Private Hospital for obstetrics & gynaecological surgery, we can announce we’re moving our main base to Glengarry Hospital, Duncraig, Perth.

Glengarry is a friendly hospital with many similar attributes to Attadale: human scale, friendly staff, consistent familar faces, nice rooms with double beds, good food, easy free parking, easy accessibility from the freeway & coast road. The hospital is a 10 minute drive North of the city and is very accessible from all of the Western suburbs via the West Coast Highway.

Our rooms will be up & running soon, and we’re booking obstetric and gynaecology patients already. All operating will be at Glengarry in their excellent theatres.

The post New obstetrician & gynaecologist at Glengarry Hospital, Duncraig, Perth appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

Variation in IVF success

There are major differences in successful outcomes between clinics’ results per cycle of IVF. Most clinicians accept that it’s difficult to use league tables to judge IVF success rates due to differences with patients between clinics; hence, league tables aren’t published in Australia. Despite these difficulties in judging clinics, there are major differences between clinics, but it’s up to patients to work out where is best for their treatment.

In Australia, the whole country’s results on average are published here. As noted above, there are no league tables. Individual clinics can, and do, extract their own data and compare it to see their overall position. There are many tables in the linked publication, and by searching you can gain an impression of the range of clinics’ average success rates (although not the clinics’ names!)

Dr Mark Sillender

Dr Mark Sillender practices advanced fertility medicine at the PIVET medical centre in Perth. PIVET is a long-established, pioneering, respected fertility practice founded & led by Dr. John Yovich. We have a reputation for taking on the most difficult clinical cases, with poor prognosis.

Dr. Mark Sillender’s IVF success rates • 2012-13

All these results are per single blastocyst embryo transferred.

All embryos were generated by patients’ own eggs ie. none were donated eggs.

IVF success rates

35 yrs and under: 69% clinical pregnancy rate per embryo

36 – 39 yrs: 48% clinical pregnancy rate per embryo

40 years and over: 29% clinical pregnancy rate per embryo

All ages overall results: 51% clinical pregnancy rate per embryo

Patients’ own eggs. Usually only one embryo is transferred at a time.

IVF success rates – a different age breakdown

Under 38 years: 54% clinical pregnancy rate per embryo

38 years and over: 42% clinical pregnancy rate per embryo

All ages overall results: 51% clinical pregnancy rate per embryo

Patients’ own eggs. Usually only one embryo is transferred at a time.

 
Notes:

• These are Dr Sillender’s individual results. Each consultant at PIVET does the transfers on “their” allocated day. Fresh embryo transfers are transferred when they are ready, by the consultant of the day, which means you may not get Dr Sillender for a fresh embryo transfer.
• Frozen embryo transfers can be timed so that Dr Sillender can do the transfer. Timing is somewhat dependent on how the lining of the womb grows, so occasionally someone else has to do it on a different day.
• Dr Sillender’s usual day at PIVET is Thursday. He is available for consultation at the PEARL offices at Attadale hospital on other days, but his embryo transfers & consultations at PIVET in Leederville are only done on Thursdays.
• If you see Dr Sillender at Attadale, preliminary management takes place there, and then care is transferred over to PIVET for advanced management if necessary.
• These results are per embryo, with a majority being frozen. In the UK & Europe most clinics transfer 2 embryos at a time. In the USA, most clinics transfer 2-3 embryos at a time on average. There are major safety advantages to single embryo transfer, provided high pregnancy rates with single embryos are achieved.
• PIVET has a reputation for taking poor prognosis women. We do not refuse women who want to try cycles and generate their own eggs provided there is a chance, even if that chance is slim. We have several evidence-proven strategies to enhance quality of the ovarian environment.
• To discuss fertility management with Dr Sillender, please make an appointment either at PIVET or at the PEARL offices at Attadale Private Hospital. If you know you will need surgery beforehand eg. a hysteroscopy or a laparoscopy, then make the appointment at Attadale first, as this will speed things up greatly. You will need a referral from your GP with both you and your partner’s names on the letter.

Embryo transfer in IVF

Embryo transfer is a critical stage in IVF. Strangely, only 1% of IVF research addresses this most important procedure. Perhaps, because embryo transfer looks deceptively simple, it hasn’t gained the attention it deserves.

Results vary greatly. Delicacy of manipulation is crucial. Just going through the cervix with the transfer catheter leads to contractions in the uterus that prevent implantation. The more gentle this is, the fewer the contractions and the more likely the IVF will be successful. Accurate placement in the best part of the womb which has the most optimal lining is also critical. A technique that avoids touching the top of the womb boosts results; again, contractions occur if you touch the top of the womb during the embryo transfer.

PIVET’s success rates

PIVET’s overall IVF success rates. Go here

The post IVF success rates appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

Hysteroscopy

in this type of operation, a narrow telescope is passed into the womb. Problems inside the womb are therefore able to be treated without any cuts on the outside at all.

Typical operations include:

• exploratory operations
• biopsies
• removal of polyps (small growths)
• removal of small fibroids
• reshaping the interior shape of the womb; which improves fertility
• sterilisation procedures.

Recovery is very rapid, and potential complications are few. They will be discussed with you at the the time of booking during the informed consent process.

Laparoscopy

In this type of operation, a small camera is passed, usually through the tummy button. This allows us to see inside the abdomen and pelvis. This scar usually heals very well – often becoming invisible with time.

Additional small 5 mm incisions are made in the lower part of the abdomen – normally between one and three. These additional incisions allow operations to be performed using a variety of sophisticated technologies, and remove any specimens that may be needed.

Keyhole surgery is more difficult to perform than traditional open surgery but, because of the magnification, things are much clearer and the surgery is more precise. Recovery is much faster, and it’s very common for women to walk out of the hospital after a few hours after quite significant procedures, with only a week to fully recover.

Common operations performed at laparoscopy include:

• hysterectomies
• removal of ovarian cysts
• removal of the fallopian tubes
• removal of fibroids
• treatment of endometriosis
• removal of adhesions and scar tissue
• infertility surgery

Overall, 95% of Dr Sillender’s surgeries are performed using keyhole methods. There are some conditions which require traditional techniques with bikini-line or midline abdominal incisions, but the default technique is nearly always a minimal access or keyhole surgery method.

The risks of this type of keyhole surgery are important to mention. Fortunately serious complications are extremely uncommon. The most important risk is that of damage to bowel or a major blood vessel at the time the laparoscope is inserted at the start of the operation. This is said to occur in about 1:1000 cases. Other risks are infection, bruising, bleeding, and specific complications of the particular operation. For instance, removal of fibroids can lead to bleeding, scar tissue forming afterwards and slight weakening of the womb during pregnancy. Possible complications will all be discussed at the time of taking informed consent before booking the operation.

Any surgical or invasive procedure carries risks. Before proceeding, you should do your own research. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. For instance, your GP’s opinion will be very helpful.

The post The advantages of keyhole surgery appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

Sleeping is often a problem in pregnancy

Sleep is really important in pregnancy but is overlooked by just about everyone apart from the pregnant woman (and of course this obstetrician)! Pregnant women have often had poor sleep leading up to their birth for multiple reasons. Read our guide to sleep and try to optimise your rest as much as possible.

Why is my sleep poor?

You may start to sleep badly early on in your pregnancy. We don’t know why but it is relatively common.  Keeping active during the day helps.  You could do some light exercise or simply try to do some walking instead of using the car or public transport.

Right from the start, you may be peeing more than normal and you may find yourself waking frequently in the night to go to the toilet.  Reducing liquid intake after 7pm can help.

Worries about your pregnancy or the birth may be present, keeping you awake.  Money or job worries can be a problem in pregnancy.  Discuss these worries with your partner, a friend or colleague rather than bottling them up.

As your pregnancy progresses, it is quite normal to have broken sleep and some people joke this is practice for what is ahead after the birth…

In the last month of your pregnancy you are likely to have a bump making it more difficult to move around the bed in the night.  You may find that you cannot turn over without waking yourself up and using your arms.  You may have heartburn, or various aches and pains such as tingling hands or an aching pelvis, which can make getting good sleep difficult.  You may also have to wake frequently to use the toilet, as your womb and baby will be exerting more pressure on your bladder.

Sadly, there is not too much you can do about this.  Try to catch up on some sleep during the day if you can.  If your obstetrician has recommended some paracetamol for your aching pelvis or back then it may help.  Indigestion remedies before you go to bed, and even during the night can help keep heartburn away.

There are many pregnancy pillows on the market, which are designed to help you sleep more comfortably.  Some are designed to put between your legs and help you to sleep on your left, and to prop up your bump so it does not feel so heavy in bed.  Many people just use an ordinary bed pillow between their legs and one under their tummy.

Can I sleep on my tummy?

You can sleep on your front as long as it is comfortable.  For some women this may be possible for a few months until their bump gets too big to make it feasible.  If you have very sore breasts, you may not be able to sleep on your front.  It is not harmful for the baby for you to sleep on the front.  He or she cannot be squashed or damaged in anyway.

I keep waking up on my back, is this a problem?

When you sleep on your back, the vein that returns blood to your heart may become compressed by the weight of your uterus and baby.  If this is the case, your body will alert you by waking you up, and you may feel faint or nauseous.  If this happens, you will usually just naturally roll back on to your side.  Do not panic if you wake up in the night on your back.

If you cannot sleep on your side and keep waking up on your back feeling sick, then you could prop the head of the bed up  (put an object under the mattress) and this should help relieve the pressure on your veins.

Do I have to sleep on my left-hand side?

Sleeping on your left hand side is thought to be good for the baby as it helps the flow of blood to the placenta.  Later in the pregnancy, if you are suffering from varicose veins or any swelling in your feet, it can help to sleep on your left to keep the pressure off your veins and help alleviate these problems.  In your last trimester as your bump and baby become much bigger, you will find that if you lie on your back, their pressure compresses the vein that returns blood to your heart.  This may make you feel sick or faint, and for this reason you will probably not want to sleep on your back.

Sleeping positions during pregnancy have not been researched thoroughly enough for any firm conclusions to be drawn and guidelines to be set.  However, it would seem that the best current advice would be to try and sleep on your left side if possible but not to worry if you find that you roll over onto your right or back in the night.

Other tips for sleeping in pregnancy

• If you have young children, can someone else look after them if they wake during the night?
• Can someone else get them ready in the morning?
• Can you get a good afternoon nap after lunch?
• Don’t watch TV or surf the net after 8pm.
• Get the pets out the bedroom.
• If the other half snores send him to the spare room until after the birth!
• Go to bed and wake at the same time every day.
• Have a warm milky drink before bed.
• Have a tepid bath a couple of hours before bedtime.
• If hot, use air-con if you have it, fans if not.
• If you have heartburn try some antacids from the pharmacist, or even some over-the-counter Zantac – it’s safe in pregnancy.
• Try an antihistamine like Piriton at night for its drowsy effects – it’s safe in pregnancy.

Please get in touch with your local Perth obstetrician if you have any further questions.

The post Getting better sleep in pregnancy appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

1. Having a trusted obstetrician

Confidence in the care-giver, by having continuity of care and a good relationship, is very important to reduce anxiety and encourage healthy labour.

2. Training for the labour

It has been traditional for women to go to birth classes and learn breathing exercises and other techniques to prepare for labour and birth. These techniques provide some help coping with contractions but they don’t actually help with the pushing.

The second stage of labour (the pushing stage) needs 2 things from your muscles:

1) A lot of physical exertion for 30-60 minutes.
2) Relaxing your pelvic floor at the right time as the baby’s head comes down, while still pushing.

The human body performs better in any activity when the person has trained and prepared.

You can prepare your body for birth using a new trainer called the EPI-NO. This helps the pelvic floor muscles get ready for stretching during birth and also trains the pushing muscles. When a woman prepares for birth using the EPI-NO, the following benefits have been seen in several research studies.

• Significant reductions in the rate of episiotomy & the rate of tears (reduced from 50% to 10-20%).
• Reductions in urinary incontinence, prolapse, problems with sex, and faecal incontinence (due to fewer third degree tears).
• Significantly reduced chance of forceps or vacuum delivery.
• The second stage of labour is significantly reduced in length putting less strain on you and your baby.
• Fewer painkillers are needed, during and after.
• Babies have better APGAR scores after birth and are less distressed. This improves bonding, breast feeding & reduces crying.
• Anxiety is reduced.
• Confidence in birth is much increased.

There are no downsides. 98% of women using the EPI-NO would recommend it.

We strongly recommend this birth trainer, which costs $179, and is bought online or from pharmacies.

3. Perineal massage

Regular, frequent massage with olive oil reduces tears during birth by about 4% but is not as good as the EPI-NO.

4. Being well rested

This is really important but is overlooked by just about everyone! Pregnant women have often had poor sleep leading up to their birth for multiple reasons. Read our guide to sleep and try to optimise this as much as possible. If you have young children, can someone else look after them if they wake during the night? Can someone else get them ready in the morning? Can you get a good afternoon nap after lunch? Don’t watch TV or surf the net after 8pm. Get the pets out the bedroom. If the other half snores send him to the spare room until after the birth! Go to bed and wake at the same time every day. Have a warm milky drink before bed. Have a tepid bath a couple of hours before bedtime. If hot, use air-con if you have it, fans if not. If you have heartburn try some antacids from the pharmacist, or even some over-the-counter Zantac – it’s safe in pregnancy. Try an antihistamine like Piriton at night for its drowsy effects – it’s safe in pregnancy.

5. Having a birth supporter

There is evidence that having the support of an additional trusted person in labour is important in birth and reduces anxiety & the length of the labour. A mum, sister, or a good friend (as well as your partner) can be a great help – as long as they don’t get stressed by it all!

6. Inducing labour

You will hear more opinions on induction than just about anything else in childbirth! Some are opposed to induction because they think it increases the chance of problems. The opposite is actually true; this is now supported by Level 1 evidence.

It is very clear that induction reduces the chance of emergency Caesarean section, having a bad third degree tear, baby getting distressed, and stillbirth. Yes, it’s “not natural”. For the evidence, go here.

• Chance of death of the baby is reduced by 2/3
• 50% reduction in meconium (“baby poo”) aspiration into the lungs
• 11% reduction in emergency Caesarean section
• 25% reduction in very large babies

The optimum time for induction to get these benefits is between 39-40 weeks of pregnancy. If you decide to have an induction, we go slow and mimic natural labour as much as possible, and allow plenty of rest during the process.

7. Upright positions in labour

In early labour, walking around helps reduce discomfort and encourages baby’s head to move down. In active labour, upright positions encourage good labour. Even if you have an epidural, stay upright as much as possible. Upright positions during pushing can also be helpful for many women.

8. Having some nourishment in labour

It’s important to keep your energy levels up. If it’s looking like you’ll need a Caesarean we’ll ask you to be nil by mouth. But if not, it’s important to keep eating – nothing too “heavy” but have easily digestible high energy food.

9. Having a special injection to relax the cervix and shorten the labour

This single injection of hyoscine is well proven, has been used in pregnancy for decades, has no downsides, and will shorten labour by 2-3 hours without increasing contractions or pain at all. The baby is completely unaffected.

10. A word on epidurals

An epidural does increase the chance of a longer labour and assisted delivery. It does not increase the risk of a Caesarean however, despite what many people think. The techniques listed above will help, but not entirely as some babies are more likely to remain “back-to-back” with an epidural.
A new technique for reducing forceps and vacuum delivery rates is where we turn the baby from back-to-back to the correct way with a hand. This is called a manual rotation. It is performed when you reach full dilatation, and only if baby is healthy and it is safe.

The steps involved are
• “Topping up” the epidural
• Scanning to check baby’s position
• Making a judgement that a vaginal birth is realistic, even if the baby is turned
• Placing a hand on baby’s head inside the vagina and a hand on the abdomen
• Whilst you push, turning the baby by rotating the head and shoulder to an anterior position
• Monitoring the baby while this is happening.
• It takes up to 3 contractions to do this.
• You then push the baby out yourself as normal

It is quite successful a lot of the time and reduces the length of the pushing stage and the chance of forceps or vacuum.

11. If it’s your first birth and you have an epidural

An oxytocin drip started when you’re fully dilated, even if you’re already contracting, reduces the forceps or vacuum rate significantly.

The post Maximising the chances of an uncomplicated birth appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

Colposcopy is an examination of the cervix using a special microscope called a colposcope. The microscope allows the doctor to see the cervix and other areas in detail. Dr Sillender can find abnormal areas and take samples if needed.

Why do I need a colposcopy test?

You may have been referred for the test for any of the following reasons

• an abnormal Pap test result
• an abnormal area appearing on the cervix, vagina or vulva
• bleeding from the cervix

Dr Sillender will discuss with you why you are being referred.

What does having an abnormal Pap smear test result mean?

When the pathologist in the lab viewed your test on a slide he/she saw cells that looked “different” from normal cells. An abnormal test result may indicate the presence of

• HPV (Human Papillomavirus)
• low- or high-grade dysplasia(pre-cancer changes)
• bacterial infection
• pregnancy
• aging
• normal inflammation

Does this mean I have cancer of the cervix?

No. An abnormal Pap test result or referral for a colposcopy examination does not mean you have cancer.

Very few women with abnormal smear test results have cancer. A smear test helps detect abnormal cell changes before cancer develops.

How is a colposcopy done?

It is very similar to the Pap smear test. We place a speculum into the vagina to look at the cervix. A smear may be taken. A solution is applied to the cervix and vagina. You may feel a tingling sensation. Any abnormal areas turn white. Dr Sillender looks at the cervix through the colposcope – the colposcope does not enter your body. This usually takes about 10 minutes.

Tip: Empty your bladder just before the test – you’ll feel less pressure.

Will a biopsy be done?

If any abnormal areas are seen, a biopsy or small tissue sample will be taken. You may feel a pinch when the biopsy is taken or you may not feel any discomfort. Silver is applied to the biopsy site to help stop any bleeding.

What happens after a biopsy?

• You may have mild abdominal cramping
• Use ibuprofen or panadeine before your appointment to prevent this discomfort
• You may have a small amount of bleeding or dark coloured discharge. This may last a few days. The nurse will give you a sanitary pad.
• You can bathe, shower, and resume yourusual activities
• You should avoid intercourse for a few days at least

If you have any problems, call the PEARL office or ring Attadale hospital out of hours.

Will I need treatment?

You may or may not need treatment based on your colposcopy and test results. Dr Sillender will recommend the best treatment for you. Treatments are often arranged within 2-3 weeks of your visit.

Commonly used management plans include: observation with more regular PAP smears or LLETZ. Most treatments can be done awake, but general anaesthesia is available.

If you have genital warts or polyps they may be treated on this first visit.

Your colposcopy test results

Dr Sillender may discuss the colposcopy findings with you immediately after the test. In other cases a follow-up visit may be arranged to discuss your test results and possible treatment. A follow-up appointment may or may not be needed. If recommended, it is important to keep all follow-up visits.

Dr Sillender will send a letter to your GP or sexual health specialist about your findings and follow-up care. If you have any questions or concerns, please call us for more information.

Can I come for colposcopy if I am menstruating?

Yes, if your flow is not too heavy and you are comfortable coming for your test. You may wish to rebook your appointment. Please call us to rebook if needed.

Should I have a colposcopy examination if I am pregnant?

If you are pregnant, keep your appointment. Observation is usually all that is needed. Treatments are usually done 6 weeks after the birth.

Why is there a screen in your examination room?

Our colposcope is state of the art and is equipped with a video camera and TV monitor. You can see on the monitor what we are seeing through the colposcope. This may give you a better understanding of what is happening. Many of our patients choose not to watch the monitor!

Will there be more than one person in the room?

There will be a nurse in the room to assist.

The post Colposcopy with a specialist gynaecologist near Fremantle, Applecross, Attadale, Cottesloe, Mosman Park and the other Western suburbs appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

Until very recently this was the best method of non-invasive testing. 10-15% of Down’s babies are missed unfortunately with this method. Women with high-risk scores then need to undergo amniocentesis (a needle draws off some of the fluid round baby with a small risk of miscarriage) or CVS (a piece of placenta is removed – can be done earlier than amnio but higher risk of miscarriage) to make a diagnosis. The combined test is also used to indicate the possibility of rarer chromosomal problems also. Medicare rebates are available for this testing.

Blood test

This new test, which has just become available, analyses pieces of DNA from baby in the mother’s blood. It’s extremely accurate for Down’s. The chances of a baby with Down’s being missed is very small but because the test is so new, a confirmatory amniocentesis in positive for Down’s cases is still being recommended to be absolutely sure. It is unknown how accurate it is for the other rarer chromosomal abnormalities.

If you want this blood test, the cost is $1350 and it takes 2 weeks to be analysed overseas. There is no Medicare rebate. Consultation fees and rebates also apply.

Amniocentesis

Done for a variety of reasons, this simple procedure can be performed quickly without issue. The background risk of miscarriage is 1% and amniocentesis adds a little to this risk – but not as much as is generally quoted. Fluid is removed under ultrasound control from the sac away from the baby. This fluid can be analysed immediately, but definitive results take 3 weeks. We expect this procedure to be much less needed over the next few years.

CVS

Done earlier than amniocentesis, this procedure uses ultrasound to remove some placental tissue which is then analysed. Results are less reliable than amnio but are returned more quickly. The subsequent miscarriage risk is higher at about 1.5% overall. We expect this procedure to be much less needed over the next few years.

The post Screening for Down’s syndrome with PEARL obstetrics | gynaecology appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

Dr Mark Sillender is a specialist Obstetrician and Gynaecologist with a strong interest and extensive experience in the management of both uncomplicated and complicated pregnancy. We strive to offer friendly, accessible maternity care that is responsive to all your needs.

Location

We are located at Attadale Private Hospital, a friendly small hospital by the banks of the River Swan. We’re conveniently located for anywhere south of the Swan river from Fremantle to Applecross, South Perth and beyond. It’s also easy to reach us from the Western suburbs north of the river. Cottesloe, Mosman Park and Claremont are within a 15 minute drive.

The birth suites are spacious with self-contained private gardens. Rooms have easy access to adjacent parkland. Parking is free and generally easy.

Our obstetric services include – but aren’t limited to:

Preconception assessment | advice
Optimisation of medical problems and general health prior to embarking upon pregnancy. Dr Sillender has been published in academic journals on vitamin supplementation around conception.

All aspects of miscarriage care
Including the assessment and management of recurrent miscarriages. We understand the anxiety that women can have after miscarriage. We can support you and see you as often as you need. Scans can be used liberally.

General pregnancy care
We are happy to provide you with all reasonable birthing options from low-intervention birthing to Caesarean section (C-section). We are comfortable discussing all your wishes for your birth. We have our obstetrician & midwives working collaboratively – our two PEARL midwifery colleagues and the Attadale Hospital midwives help optimise your antenatal and birth experience without compromising safety. Research has shown that undergoing continuous care is the safest option for all women who are pregnant. Integrated care with both a specialist obstetrician and a midwife provides holistic care that covers all the bases.

Pregnancy care for women with medical problems
Including high blood pressure, heart problems, asthma, kidney and bladder disorders, anaemia and thalassaemia, thyroid and other endocrine problems, liver and gastrointestinal problems, inflammatory conditions such as SLE and arthritis

Pregnancy care for women with reproductive problems

• Fertility problems or those who have conceived with IVF or other reproductive technologies
• Recurrent miscarriages
• Previous cervical surgery
• Polycystic Ovarian Syndrome (PCOS)
• An increased BMI
• Previous preterm births
• Previous significant pregnancy problems eg. haemorrhage, severe pre-eclampsia, deaths
• Previous difficult or traumatic births
• Pregnancy care for women with psychological or psychiatric conditions
• Pregnancy and birth care for women with previous caesarean sections
• Pregnancy and birth care for women with multiple pregnancies. Dr Sillender has lots of experience in managing twin pregnancies – including those with monochorionic twins, and his own twin boys!
• Pregnancy and birth care for the over 40s, who often have specific relevant issues.

We believe that, even in the presence of significant complications, it is our role to make the pregnancy and birth experience as positive as possible.

The post Having a baby with a specialist obstetrician with PEARL obstetrics gynaecology at Glengarry hospital appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.