• Tubal ligation or tubectomy is a surgical procedure for sterilization in which a woman’s fallopian tubes are clamped or blocked and sealed, either of which prevents eggs from reaching the uterus for implantation. Tubal ligation is considered a permanent method of sterilization and birth control.

• Cancer screening in women includes endometrial,cervical and breast cancer. Almot all cervical cancer is caused by a virus called HPV which spreads through sexual contact. Most women’s bodies are able to fight HPV infection, but sometimes the virus leads to cancer. Women who smoke, have had many children, use birth control pills for a long time, or have HIV infection are at higher risk of cervical cancer. With regular test, screening and follow- up with the gynaecologist, it is very easy to prevent cervical cancer. Two main screening tests which can help prevent cervical cancer (a common cancer in women) or find it early are Pap test and HPV test. HPV VACCINE
  
  reduce their risk of cervical cancer by getting an HPV vaccine before becoming sexually active. There are two HPV vaccines – Cervarix and Gardasil. Vaccines are given as a series of three shots over 6 months to protect against HPV infection.
  
  Vaccines reduces a person’s risk of getting an infection thus women who get an HPV vaccine also need regular cervical cancer screening tests.

• A breast lump is a mass that develops in the breast. Breast lumps vary in size and texture and may cause pain. Some are not found until a physical or imaging exam. Most breast lumps are benign (non-cancerous).
  
  To determine whether that lump is benign, your doctor will likely order a mammogram and breast ultrasound. In addition, breast MRI, PET/CT or scintimammography may be obtained. If the lump is confirmed to be benign, no further action may be needed, but your doctor may want to monitor it to see if it changes, grows or disappears over time. If the tests are inconclusive, a biopsy using ultrasound, x-ray or magnetic resonance imaging guidance may be performed. If the lump is confirmed to be cancer, surgery is usually performed. Additional treatment may include radiation therapy, chemotherapy, or hormone therapy

• The ovaries are part of the female reproductive system. They’re located in the lower abdomen on both sides of the uterus. Women have two ovaries that produce eggs as well as the hormones estrogen and progesterone.
  Sometimes, a fluid-filled sac called a cyst will develop on one of the ovaries. Many women will develop at least one cyst during their lifetime. In most cases, cysts are painless and cause no symptoms.


• Types of ovarian cysts
  There are various types of ovarian cysts, such as dermoid cysts and endometrioma cysts. However, functional cysts are the most common type. The two types of functional cysts include follicle and corpus luteum cysts.
• Corpus luteum cysts
  During a woman’s menstrual cycle, an egg grows in a sac called a follicle. This sac is located inside the ovaries. In most cases, this follicle or sac breaks open and releases an egg. But if the follicle doesn’t break open, the fluid inside the follicle can form a cyst on the ovary.
• Corpus luteum cysts
  Follicle sacs typically dissolve after releasing an egg. But if the sac doesn’t dissolve and the opening of the follicle seals, additional fluid can develop inside the sac, and this accumulation of fluid causes a corpus luteum cyst.
• Other types of ovarian cysts include :
• Dermoid cysts :sac-like growths on the ovaries that can contain hair, fat, and other tissue
• Cystadenomas : noncancerous growths that can develop on the outer surface of the ovaries
• Endometriomas : tissues that normally grow inside the uterus can develop outside the uterus and attach to the ovaries, resulting in a cyst
  Some women develop a condition called polycystic ovary syndrome. This condition means the ovaries contain a large number of small cysts. It can cause the ovaries to enlarge. If left untreated, polycystic ovaries can cause infertility.


• Symptoms of an ovarian cyst


• Often times, ovarian cysts do not cause any symptoms. However, symptoms can appear as the cyst grows. Symptoms may include:


• - abdominal bloating or swelling
• - painful bowel movements
• - pelvic pain before or during the menstrual cycle
• - painful intercourse
• - pain in the lower back or thighs
• - breast tenderness
• - nausea and vomiting

Severe symptoms of an ovarian cyst that require immediate medical attention include :
• - severe or sharp pelvic pain
• - fever
• - faintness or dizziness
• - rapid breathing
• - These symptoms can indicate a ruptured cyst or an ovarian torsion. Both complications can have serious consequences if not treated early.

In the case of an ectopic pregnancy, the fertilized egg doesn’t attach to the uterus. Instead, it may attach to the fallopian tube, abdominal cavity, or cervix.

While a pregnancy test may reveal a woman is pregnant, a fertilized egg can’t properly grow anywhere other than the uterus.

An untreated ectopic pregnancy can be a medical emergency. Prompt treatment reduces your risk of complications from the ectopic pregnancy, increases your chances for future, healthy pregnancies, and reduces future health complications.

• Female Sterilisation


• Female sterilisation is an operation to permanently prevent pregnancy. The fallopian tubes are blocked or sealed to prevent the eggs from reaching the sperm and becoming fertilised.
• - Female sterilisation is more than 99% effective at preventing pregnancy
• - You don’t have to think about protecting yourself against pregnancy every time you have sex, so it doesn’t interrupt your sex life
• - It doesn’t affect your hormone levels and you’ll still have periods
• - You’ll need to use contraception up until you have the operation, and until your next period or for 3 months after the operation (depending on the type of sterilisation)
• - As with any surgery, there’s a small risk of complications, such as internal bleeding, infection or damage to other organs
• - There’s a small risk that the operation won’t work – blocked tubes can rejoin immediately or years later
• - If the operation fails, this may increase the risk of a fertilised egg implanting outside the womb (ectopic pregnancy)
• - Sterilisation is very difficult to reverse, so you need to be sure it’s right for you
• - Sterilisation doesn’t protect against sexually transmitted infections, so you may need to use condoms as well Female sterilisation works by preventing eggs from travelling down the fallopian tubes, which link the ovaries to the womb (uterus). This means a woman’s eggs cannot meet sperm, so fertilisation cannot happen.


• Eggs will still be released from the ovaries as normal, but they’ll be absorbed naturally into the woman’s body.


• How female sterilisation is carried out


• The surgeon will block your fallopian tubes (tubal occlusion) by either :


• - Applying clips – plastic or titanium clamps are closed over the fallopian tubes
• - Applying rings – a small loop of the fallopian tube is pulled through a silicone ring, then clamped shut
• - Tying, cutting and removing a small piece of the fallopian tube This is a fairly minor operation, and many women return home the same day.

Tubal occlusion procedure

• The surgeon accesses your fallopian tubes by making a small cut either near your belly button (laparoscopy) or just above your pubic hairline (a mini-laparotomy).
  They will then insert a long, thin instrument that has a light and camera (a laparoscope) to clearly see your fallopian tubes.
  A laparoscopy is usually used because it’s faster, but a mini-laparotomy may be recommended for women who:
• Have had recent abdominal or pelvic surgery
• Are obese
• Have a history of pelvic inflammatory disease, a bacterial infection that can affect the womb and fallopian tubes The fallopian tubes are then blocked by applying clips or rings, or by tying, cutting and removing a small piece of the tube.

Removing the tubes (salpingectomy)

• If blocking the fallopian tubes hasn’t worked, the tubes may be completely removed. This is called a salpingectomy.

Is sterilisation right for me ?

• Almost any woman can be sterilised, but it should only be considered by women who don’t want any more children or don’t want children at all.
  Once you’re sterilised it’s very difficult to reverse it, so consider all options before making your decision. Sterilisation reversal isn’t usually available on the NHS.
  You may be more likely to be accepted for the operation if you’re over 30 and have had children.

Postnatal visit to doctor is an important part of the pregnancy care. Post Natal visit to your gynaecologist is required for abdomen check-up. It is important to discuss about contraception as well, as there is a high risk of pregnancy immediately postpartum