Adiva Services, IVF & Reproductive Medicine, Endoscopy, Birthing, Neonatal Care, Aesthetic Surgery

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Services

1) IVF & Reproductive Medicine

Adiva is godsend for couples who crave to become parents. When nature lets you down, we step in to resume the process and bring you the gift of motherhood every woman dreams of. Adiva offers a comprehensive array of services for infertility treatment and women care. We provide a homely environment with the highest degree of personal attention.

Adiva Superspecialty IVF Centre

Adiva's In-Vitro Fertilization Program: The term 'in-vitro fertilization' or 'test-tube baby' is the procedure to fertilize eggs with sperm outside the human body. Thousands of babies have been conceived through IVF, and it continues to offer hope to infertile couples the world over.

Here's a brief description of Adiva's IVF program, step by step. Before we begin the treatment, we have detailed counselling sessions. The entire process is explained to you and your husband in detail, so that both of you are mentally and physically prepared for the experience.

You take fertility drugs to help you produce a number of eggs.
Once the eggs are mature, they are retrieved from your body.
The eggs are fertilized with your husband's semen, outside the womb, in a laboratory. The fertilized eggs become embryos within a few days.
The embryos are then placed in your uterus in the hope that one or more will implant and become a successful pregnancy.

Needless to say, throughout the process our trained staff will address your every concern, be by your side, and lend you emotional support. In fact, you will find the whole experience quite simple and effortless.

Specialised Services Related to IVF

Counselling
Investigation of Infertile Couple
Intra Uterine Insemination (IUI)
Ovum Pickup, Insemination
Embryo Transfer
Laser Hatching
ICSI (Intra Cytoplasmic Sperm Injection)
TESA, PESA for Male Factor
Blastocyst Culture
Cryopreservation Freezing of Embryos, Semen, (Slow Freezing and Vitrification)
Foetal Reduction
Donor Services: Surrogacy, Donor Egg, Donor Sperm, Donor Embryo

The centre has facilities for treating difficult cases, repeated IVF failures and sexual dysfunctions.

2) Endoscopy

a. Laparoscopic Surgeries

Adiva women care is a centre for advanced gynaecological laparoscopic surgery performed by experienced laparoscopic surgeons. Our laparoscopic operation theatre is designed by MGI and is provided with laminar flow and hepafilter. State of art laparoscopic instruments by karl Storz, Germany are installed in the OT with three chip high definition camera.

Laparoscopic techniques allow surgery to be performed with less pain to patients, and minimal damage to body tissues. This often means fewer days in the hospital and much less pain during recovery. In many cases, patients go home on the same day or the next morning.

The cosmetic advantage of laparoscopic surgery is that the bad mutilating scar of traditional open surgery is avoided. Almost all gynaecological surgeries are done by laparoscopy in our hospital starting from infertility to cancer surgeries.

(i) Diagnostic and Operative Laparoscopy for Infertility

Laparoscopic surgeries for infertility both primary and secondary are performed in our centre by expert infertility specialists. The status of the fallopian tubes, ovaries and the other abdominal organs can be seen at the time of surgery. We correct the abnormalities at the same time. Blocked tubes can be opened by laparoscopic surgery.

(ii) Laparoscopic Surgery for Ovarian Cysts & Tumours

Ovarian cysts are common problems in reproductive age group. We remove simple and non-cancerous ovarian tumours by laparoscopic surgery when indicated without opening the abdomen. We always try to preserve the normal ovarian tissues for reproductive and endocrinological functions.

(iii) Laparoscopic Hysterectomy (Removal of Uterus)

Laparoscopic route is the preferred route of hysterectomy to avoid bad abdominal scars. Our centre provides removal of uterus completely through laparoscopic route by experienced and highly skilled laparoscopic surgeons. The patients are usually admitted on the day of surgery and discharged on the next day.

(iv) Laparoscopic Surgery for Gynaecologic Cancers

The recent advance in the field of gynaecologic oncology is minimally invasive surgery. Our centre provides laparoscopic surgery for patients with cervical and uterine cancers. The patient morbidity and operative complications are comparatively less than traditional open surgery. The duration of hospitalization is also significantly less than open surgeries.

(v) Laparoscopic Myomectomy (Removal of Uterine Fibroid)

Uterine fibroid is the most common tumour of female pelvis. They are usually asymptomatic but may present with abnormal uterine bleeding, pain in abdomen or infertility. In indicated cases we remove the fibroids by laparoscopic route. The fibroid is removed from the abdominal cavity in small chips using electric morcillator.

b. Hysteroscopic Surgeries

(i) Diagnostic Hysteroscopy

Diagnostic hysteroscopy is a minor surgical procedure in which the inside of the uterine cavity is seen by a telescope. It is done in cases with abnormal uterine bleeding and in cases with infertility. The procedure is done under both sedation and general anaesthesia. The internal openings of the tubes and the endometrial linings are seen in a magnified field. This is done as a day care surgery and the patients are discharged on the same day. Diagnostic hysteroscope consists of 30^o telescope with inner and outer sheath with integrated fibreoptic light transmission.

(ii) Operative Hysteroscopy

The uterine pathology is treated in the same sitting by operative hysteroscopy. For operative hysteroscopy general anaesthesia is administered. The following hysteroscopic surgeries are done in our centre.

Hysteroscopic Septal Resection
Hysteroscopic Myomectomy
Hysteroscopic Adhesiolysis
Hysterosopic Polypectomy
Endometrial Ablation

At Adiva we have following karl storz equipments for hysteroscopy.

Bettochi hysteroscope with grasping forceps to remove polyps after resection.
Scissors for dissecting septum, adhesion or the base of polyps.
Biopsy forceps for optically controlled biopsy collection.
Resectoscope with working elements, roller ball, resection loop 90^o and dissection needle
Endomat is used for distention of uterine cavity for the panoramic view

3) Birthing

Adiva makes giving birth the most memorable and cherished memory of your life. It provides you with every possible comfort of a home. Not just that we make you feel special right from the day you conceive your little one till the moment you hold him in your arms.

Adiva’s Birthing Centre offers professional counselling and care throughout pregnancy, childbirth and early parenthood. We provide you with continuing support and information on all pregnancy issues and questions, parenting, a large variety of choices for a natural birth including water birth, advice about breastfeeding, the care of new-borns and family planning. Adiva has something for the fathers as well. We offer ideas about how they can support and protect their wives and babies throughout this special time through childbirth classes and the exchange with other like-minded parents.

We offer a safe and comfortable alternative to the traditional hospital birthing environment. The Birth Centre enables you to have a natural birth experience with minimal medical intervention within a hospital setting. Here, we provide the personal experience desired by many women, with care provided by highly specialized faculty.

You'll have a variety of choices to help you give birth with little or no pain medication, with techniques including birthing balls and stools, massage, walking, breathing and more. If necessary, the option of anaesthesia, epidural or more intensive medical care is also available. You can also bring your favourite music to be played while you are in your delivery room so that you can relax and enjoy the most memorable part of your life. Most importantly, unlike home you are just minutes away from the latest technology and state-of-the-art obstetrical/neonatal units, should they be needed. With the Birth Centre located within our hospital, patients have true peace of mind, knowing that advanced medical care is available immediately for mother and the baby.

You will have a private labour room for giving birth where you can make yourself comfortable, take a bath, wear your own clothes and have food when you feel hungry. Every birth is different, our aim is to strive together for a physical, emotional and spiritual intactness and entity. We will be at your side throughout labour and childbirth. We will observe the progress of birth and the wellbeing of mother and child. The foetal heartbeat is monitored by recent techniques.

After the birth you will have time for yourself to peacefully greet and welcome your child and establish the first precious bonding. We then measure, weigh and bathe the child together and do a medical examination in your presence. This will be followed with a celebration in which you, your family and the entire staff will rejoice the coming of your precious little one.

a. Epidural Anaesthesia

Epidural is a kind of anaesthetic (medication to block pain). It is commonly used during labour and delivery because it numbs your lower body while allowing you to remain awake. While giving epidural, anaesthesia is injected into the area around your lower spine outside the spinal fluid. Within minutes, your body becomes partly numb from about the waist down. You may lose muscle control in your legs, but you can usually still push during contractions. An epidural is usually not started until you're in active labour. You'll be asked to sit on the edge of the bed or lie on your side. First a small area around your lower spine is numbed with a local anesthetic. The anaesthesiologist then inserts a needle into the epidural space. A tiny plastic tube (catheter) is threaded through the needle. The needle is removed, and the anaesthetic is delivered through the catheter. Sometimes a pump is attached to the catheter. The pump gives you a constant level of anaesthetic throughout labour and delivery. During this time, your blood pressure and heart rate and your baby's heart rate are also closely watched.

b. Caesarean Suites

For Caesarean births, you will also find a family-centered approach. Your obstetrical nurse will remain with you during the preparation, birth and recovery after your delivery. Your spouse or support person is encouraged to attend this joyous event. After your baby is born, a specialized team of physicians, nurses and respiratory therapists will perform your baby's first health exam in the delivery room with you. We make every effort to have healthy moms and babies recover together.

4) Neonatal Care

With improved technological and medical expertise, NICU unit of Adiva is established as one of the best, not only in Delhi but also in India. Strength of the unit comes from the state of the art obstetrical and perinatal services rendered in the hospital, which attracts large number of high-risk deliveries. We have one of the best equipped nursery with 5 beds and 40-50 admissions per annum.

Services Provided

Care of Preterm and very Low Birth Weight Babies:
The preterm babies have many problems including respiratory difficulty, feeding intolerance, infection and increased chances of bleeding. The unit has 2 Warmer with in-built temperature control and oxygen delivery system. The survivals are improving over months.
Mechanical Ventilation:
The unit has mechanical ventilator (C-PAP ventilators) to support babies with breathing difficulty. This is a gentler, and better mode of ventilation in specific conditions. The NICU takes pride in declaring that it was the upcoming unit in private setup to start ventilation. The survival of babies on mechanical ventilation has improved remarkably now.
Parental nutrition:
Because of poor swallowing capability and immature gastrointestinal functions, the small preterm and sick babies are not able to tolerate oral feeds well and require intravenous nutrition in form of fats and proteins. We have been using intravenous nutrition in our unit which is well supported by pioneer work in Parental Nutrition initiated in the department. We encourage breast feeds at the earliest and mothers express their milk in the nursery and very premature babies are started on expressed breast milk. Mothers are also involved in the care of the baby, they are encouraged to hold the baby next to their skin ( Kangaroo Mother Care) which helps in establishing lactation and also improves the bonding with the baby.
Surfactant Delivery:
Premature lungs are deficient in surfactant chemical which results in breathing difficulty and they may require ventilatory support. Giving surfactant to such babies improves their lung function, helps them come out of ventilator faster and ultimately helps in improving survival and reduces hospital stay. We have been using surfactant in such babies with good results.
Neurosonography:
Premature babies are prone to have intraventricular hemorrhage (brain hemorrhage) especially in first week of life. Sick ventilated babies also have a higher chance of having such problem. Bed side ultrasound is very important in picking up these hemorrhages for diagnostic value, to decide treatment modalites and to prognosticate. We have the facility of portable USG round the clock done by very senior consultants in the field.

Ultrasound is also used to diagnose many malformations related to other organ systems.
Bed side Xray Facility:
Xray machine is stationed in the nursery to get the Xrays of the babies without any untoward delay.
Developmental Support Team:
A team comprising of a Developmental Pediatrician visits the nursery regularly and remains involved in the developmental support of the sick preterm babies. We try to give physical, visual and auditory stimuli once sick babies are stable for their faster recovery and rehabilitation.
Staff Nurses:
We have trained neonatal staff nurses to take care of the neonates. We have a nurse: baby ratio of 1:2 for intensive care area and 1:3 nurse: baby ratio for babies not requiring intensive care.
Routine Hearing Screening:
All babies in nursery are subjected to OAE (otoacoustic emission test) done to pick up babies with hearing loss. It is a simple test done in nursery itself and has been a great help in picking up babies with hearing loss.
There is a neonatal consultant available round the clock in the NICU along with the resident staff.
Procedures:
All procedures related to the neonate like exchange transfusion (both central and peripheral), peritoneal dialysis, surfactant delivery, central line insertion, arterial line insertion and intercostal tube drainage are carried out with precision.

Common Neonatal Problems and Solutions

Premature Babies: Babies born before 37 weeks of gestation are premature and especially those born before 34 weeks are more prone to have problems. These babies may need to be in the nursery for a period of 1-8 weeks depending on the level of prematurity. These babies require special care in NICU including temperature control, respiratory support, and nutritional support.

Respiratory Distress: It means difficulty in breathing in newborn, which may manifest as fast or laboured breathing. It may be because of prematurity per se due to immaturity of lungs, congenital or aspiration pneumonia or rarely structural congenital malformations of the lungs. Baby may need oxygen therapy with hood or may need to be supported with a ventilator (artificial life support system). Such babies need closed monitoring for first 5-7 days and are also given intravenous fluids, antibiotics and other supportive medications. Preterm babies may require a medicine called "Surfactant", which is instilled in their lungs for better lung maturity.

Thermoregulation: All newborns have a higher chance of having low temperature called hypothermia. They are properly covered with clothes specially covering the head, hands and feet. They are placed in incubators or radiant heat warmers specially designed to take care of their temperature and humidity needs . Those babies whose hands and feet are cold, but rest of body is warm are in cold stress which may be a sign of sickness and it also results in poor weight gain.

Kangaroo Mother Care (KMC): It is a technique where the mother keeps the baby close to her with skin to skin contact within her clothing. This helps the baby to maintain temperature and also helps to establish bonding between mother and baby and breast-feeding.

Nutritional Support: Though breast feeding is the best feed for all sick and premature babies alike, many of these babies are not in a condition to accept direct breast feeds. They are given intravenous nutrition initially and then expressed breast milk through orogastric tube, which goes from mouth to stomach. Later breast feeds are supplemented to fulfill the increased protein and calorie requirements of sick and preterm babies.

Retinopathy of Prematurity: It is a disease almost exclusively limited to premature babies and is an important cause of blindness in these babies. It is due to developmental immaturity of the newborn eyes and is usually seen in babies &less; 1500 gms of birth weight. A small percentage of babies (6-10%) with ROP may require laser surgery. Frequent eye check ups are required from 4 weeks of age after birth to monitor the growth of retina to be continued till 42 weeks of gestation.

Do's and Don'ts of Newborn Care

Baby should be given only breast milk for first six months of birth.
Exclusive breast feeding means nothing except breast-feeds not even water, ghuttis, gripe water, tonics or any form of milk.
Babies need proper clothes, which cover them properly especially head, hands and feet. They should not be over clothed as well.
Babies pass watery stools after first 3-4 days of life especially after feeding which is normal for them.
A baby, who is feeding well, will be passing urine at least 8-10 times a day.
Babies don't need any Kajal, Surma, Talcum powder or daily bath. Bathing should be postponed for first few days after birth. A good rule to follow is delay bath till umbilical cord falls.

Vaccination is the most cost-effective way of health for children.

5) Aesthetic Surgery

To look and feel good is a celebration of womanhood. As a woman, you are beautiful inside. At Adiva, we can help you project your beauty and become more attractive. Come, empower yourself with beauty. Let your face glow and your skin be radiant. With the help of lasers, Botox and tissue fillers, we can make your skin unblemished and your face perfect. Eliminate unsightly bulges, firm sagging skin and shape your figure. Our experts will contour and sculpt your body the way you want it, bringing back your youthful looks.

When you look good, you feel good too. Bring out the beauty in you, and live the life you have always wanted to. To lift your spirits, all you need is to look at the mirror.

To make you lovelier, we have brought together the world's most advanced treatments in aesthetic surgery. Our team of experts will examine you, and guide you to the one that suits you best. Have a look at the various services available for you at Adiva: