🩺 Gestational Hypertension: More Than “Just High Blood Pressure”

High blood pressure during pregnancy is often minimized  especially when it does not meet the criteria for preeclampsia.

However, gestational hypertension is a distinct clinical entity that deserves careful attention, structured follow-up, and informed decision-making.

👏Gestational hypertension is diagnosed when: 

• Blood pressure is ≥ 140/90 mmHg

• Develops after 20 weeks of gestation

• Occurs without proteinuria

• And without signs or symptoms of preeclampsia.

Because it lacks dramatic features, it is often labeled as “mild” or “not concerning.”

This assumption can be misleading.

🎯Gestational hypertension is not a benign diagnosis.

🔹 It may progress to preeclampsia at any point

🔹 It can impair placental function and uteroplacental perfusion

🔹 It is associated with fetal growth restriction and preterm birth

🔹 It requires active surveillance, not passive reassurance

Blood pressure in pregnancy is not just a number.

It reflects the dynamic interaction between maternal vascular health and placental adaptation.

✌A diagnosis of gestational hypertension should trigger: 

✔️ Accurate and repeated BP measurements

✔️ Regular urine screening

✔️ Maternal symptom assessment

✔️ Fetal growth and wellbeing surveillance

✔️ Individualized clinical decisions  not a one-size-fits-all approach.

Pregnancy does not tolerate “wait and see” medicine.

👁In this series, we will explore gestational hypertension in depth: 

• How it differs from preeclampsia

• Why “mild” does not mean “safe”

• How to monitor it properly

• When and how to intervene

• And what it means for long-term maternal health.

Because awareness, timing, and follow-up are what truly protect both mother and baby.

#DrRababCares 

#GestationalHypertension

#HypertensionInPregnancy

#MaternalHealth

#AntenatalCare

#HighRiskPregnancy

#BeyondPreeclampsia

 🧨🧨🧨Emergency Ovarian Cyst: When Sudden Lower Abdominal Pain Should Not Be Ignored

Many women are living their normal lives with a known ovarian cyst, often told it is “benign” or under observation.

🤔But sometimes, things change suddenly.

If a woman with a known ovarian cyst develops acute lower abdominal pain, this should always raise concern for a possible ovarian emergency.

⚠️ What could be happening?

Sudden pain may indicate:

-Ovarian torsion (twisting of the ovary)

-Cyst rupture

-Bleeding into the cyst

-Rapid cyst expansion

These conditions can occur even in cysts previously considered benign.

🚨 Red flags that need urgent attention:

• Sudden, severe lower abdominal or pelvic pain
• Pain associated with nausea or vomiting
• Pain not relieved by rest or simple analgesics
• Abdominal tenderness or guarding
• Dizziness, fainting, or signs of internal bleeding.
• Pain occurring during activity, exercise, or intercourse

🏥 What should be done?

• Do not ignore the pain or wait it out at home
• Seek urgent medical assessment
• Clinical examination + urgent pelvic ultrasound
• Blood tests if bleeding or infection is suspected

⏱ Why timing matters

In conditions like ovarian torsion, delayed diagnosis can lead to:

Loss of ovarian function

Ovarian necrosis

Avoidable surgery

Early intervention may allow ovarian preservation, especially in young women.

💡 What women should remember

A “known cyst” does not mean a harmless situation forever

Sudden pain is not normal, even with a benign diagnosis

Emergency symptoms deserve emergency evaluation

⛈Key Message

Most ovarian cysts are not dangerous 

but acute pain is never something to ignore.

Listening to your body and acting early can make a critical difference.

#DrRababCares

#OvarianCysts

#EmergencyGynecology

#AcutePelvicPain

#OvarianTorsion

#RupturedOvarianCyst

 🧨Functional vs Pathological Ovarian Cysts:

• Functional vs Pathological Ovarian Cysts
• Not all ovarian cysts are the same.
• Ovarian cysts are often grouped under one label, but clinically they behave very differently.

🎯Understanding the difference betwee

 functional and pathological cysts is essential for safe decision-making.

🤔Functional ovarian cysts

These are related to the normal ovarian cycle and are usually physiological:

-Follicular cysts

-Corpus luteum cysts

They often resolve spontaneously over time and may only require observation and follow-up imaging, especially in asymptomatic women.

🤔Pathological ovarian cysts

These arise from abnormal tissue and are not part of the normal cycle:

-Endometriomas

-Dermoid cysts

-Benign or malignant ovarian tumors

They are more likely to persist, cause symptoms, or grow, and often require closer monitoring or surgical evaluation.

Why the distinction matters

Management is not based on the word “cyst” alone.

Age, symptoms, persistence, growth pattern, and imaging features all matter.

Treating all cysts the same can lead to over-treatment in some cases — and delayed diagnosis in others.

⛈Key messag

Not every ovarian cyst needs surgery.

Not every cyst can be ignored.

Good care starts with correct classification, followed by individualized management and appropriate follow-up.

#DrRababCares

#OvarianCysts

#FunctionalCysts

#PathologicalCysts

 🎯Ovarian Cysts: When “Benign” Is Not Reassuring Enough.

Ovarian cysts are commonly labeled as “benign” based on initial imaging findings.

While many ovarian cysts are indeed harmless and self-limiting, the term benign can sometimes create a false sense of reassurance for both patients and clinicians.

A benign appearance on ultrasound does not always predict a benign course.

🧨Why “benign” can be misleading

Ultrasound describes morphology, not behavior.

A simple-looking cyst today may change, persist, grow, or become symptomatic over time. 

Labeling a cyst as benign should never be the end of clinical thinking it should be the beginning of appropriate follow-up.

🤔Size is not everything

Cyst size alone does not determine risk.

Small cysts can cause significant symptoms, while larger cysts may remain asymptomatic.

 Growth pattern, persistence, symptom correlation, and patient factors are often more clinically relevant than size alone.

🧨🧨Red flags that deserve attention:

+Certain features should prompt closer

 evaluation rather than reassurance:

Persistent or worsening pelvic pain

Symptoms that do not correlate with imaging findings

Increase in cyst size over time

New onset symptoms in peri- or postmenopausal women

Associated gastrointestinal or urinary complaints

Acute pain suggesting torsion or rupture

👍Reassurance without context can delay diagnosis and management.

✌Follow-up is part of the diagnosis:

The natural history of an ovarian cyst matters.

Follow-up imaging and clinical reassessment are essential components of safe.

 management. A “benign” label without a follow-up plan is incomplete care.

👏Reassurance vs responsibility

Reassurance is appropriate when supported by clinical reasoning, not when used to close a case prematurely.

Responsible reassurance includes explanation, monitoring, and a clear plan — not dismissal of symptoms.

🤗Key Message

Not every ovarian cyst is dangerous, but not every “benign” cyst is harmless.

Sound clinical judgment lies in knowing when reassurance is safe and when vigilance is necessary.

#DrRababCares 

#OvarianCysts

#BenignIsNotAlwaysHarmless

#Gynecology

#OBGYN

#WomenHealth

 🎗️ Cervical Cancer Awareness – January

Cervical cancer remains one of the most preventable and treatable cancers in women, yet it continues to claim the lives of thousands every year  largely due to late diagnosis and lack of awareness.

This type of cancer develops slowly over several years, starting with precancerous changes in the cells of the cervix.

 In most cases, it is linked to a persistent infection with Human Papillomavirus (HPV) — a very common virus that many women carry at some point in their lives without knowing.

The most dangerous aspect of cervical cancer is that early stages are usually silent.

Many women feel completely well until the disease becomes advanced, which is why screening is not optional  it is lifesaving.

🔍 Common warning signs (usually late):

+Abnormal vaginal bleeding

(after sexual intercourse, between periods, or after menopause).

+Persistent or unusual vaginal discharge.

+Pelvic pain or pain during intercourse.

⚠️ These symptoms should never be ignored and always require medical evaluation.

🛡️ Prevention and early detection:

The good news is that cervical cancer is largely preventable through:

 ✔️ Regular Pap smear and HPV screening

✔️ HPV vaccination, especially before the onset of sexual activity.

✔️ Early identification and treatment of precancerous lesions.

✔️ Awareness, education, and timely access to healthcare

When detected early, cervical cancer has a very high cure rate.

🌍 Why awareness is critical:

In many low- and middle-income countries, cervical cancer is still one of the leading causes of cancer-related deaths among women.

Limited access to screening and delayed presentation remain major challenges.

Raising awareness, encouraging routine

 screening, and breaking the fear and stigma around gynecological exams can save countless lives.

💬 Final message:

Cervical cancer is not a death sentence.

It is a disease we can prevent, detect early, and successfully treat —

with the right knowledge, proactive screening, and compassionate care.

💗 Taking care of your health is not a luxury.

Screening is an act of self-respect and empowerment.

#DrRababCares 

#CervicalCancerAwareness

#HPVAwareness

#HPV

#EarlyDetectionSavesLives

#CancerPrevention

#GynecologicOncology

🔹 What are polyps?

Polyps are small, benign (non-cancerous) growths that develop from the inner lining of the uterus (endometrium) or the cervix. 

They are usually soft, reddish, and attached to the lining by a thin stalk or a broad base.  

🔹 Types:

- Endometrial polyps: arise from the uterine cavity.  

- Cervical polyps:arise from the cervical canal.  

🔹 Symptoms:

- Irregular or heavy menstrual bleeding.  

- Spotting between periods.  

- Postcoital bleeding (after intercourse).  

- Infertility or difficulty conceiving in some cases.  

- Sometimes asymptomatic and found incidentally during routine exams.  

🔹 Causes & Risk Factors:

- Hormonal imbalance (excess estrogen stimulation).  

- Chronic inflammation or infection.  

- Associated with obesity, hypertension, or tamoxifen use.  

- More common in women aged 40–50.  

🔹 Diagnosis:

- Ultrasound (TVS/sonohysterography). 

- Hysteroscopy: both diagnostic and therapeutic.  

- Pap smear and biopsy if needed to exclude malignancy.  

🔹 Management:

- Small, asymptomatic polyps: may just be observed.  

- Symptomatic or large polyps: removal via polypectomy (usually hysteroscopic).  

- Histopathological examination is essential to rule out premalignant or malignant changes.  

🔹 Prevention & Follow-up:

- Regular gynecological check-ups.  

- Timely management of abnormal bleeding.  

- Hysteroscopic evaluation in recurrent cases.  

✅ Key Message:

Most endometrial and cervical polyps are benign and treatable. However, because they can sometimes cause symptoms like abnormal bleeding or infertility, it is important for women to seek medical advice early for proper diagnosis and management.  

#DrRababCares 

#WomenHealthMatters 

 #EndometrialPolyp

 #CervicalPolyp

 Why Pelvic Organ Prolapse Surgery Sometimes Fails  and How Failure Can Be Prevented

When pelvic organ prolapse recurs after surgery, it is often labeled as a surgical failure.

In reality, recurrence is rarely caused by the procedure alone. It usually reflects a combination of anatomical, functional, and patient-related factors.

Why does prolapse surgery fail?

1. Oversimplified diagnosis

Pelvic organ prolapse is not a single condition.

Cystocele, rectocele, and uterine prolapse differ in anatomy and biomechanics.

Even within the same compartment, prolapse may result from tissue distension or true displacement. Treating all cases with the same surgical approach increases the risk of recurrence.

2. Ignoring pelvic floor dysfunction

Surgery restores anatomy, but it does not automatically restore function.

If pelvic floor weakness and poor muscle coordination persist, repaired tissues remain exposed to the same forces that caused the prolapse initially.

3. Unaddressed contributing factors

Chronic constipation, chronic cough, obesity, repeated straining, and poor tissue quality can all compromise surgical outcomes if left unmanaged.

4. Unrealistic expectations and limited counseling

When surgery is presented as a definitive solution without addressing lifestyle modification and rehabilitation, long-term success becomes less likely.

5. Measuring success by anatomy alone

Absence of a bulge does not always equal success. Persistent symptoms and functional limitations matter just as much.

How can failure be prevented?

Prevention starts before the operation and continues after it.

- Accurate, mechanism-based diagnosis

- Individualized surgical planning

- Integration of pelvic floor rehabilitation

- Optimization of bowel habits and lifestyle factors

- Realistic preoperative counseling

- Structured postoperative follow-up and physiotherapy

The most durable results are achieved when surgery and rehabilitation work together, not when either is used in isolation.

Key Message

Pelvic organ prolapse surgery does not fail because surgery is weak.

It fails when a complex condition is reduced to a single repair — and succeeds when anatomy, function, and patient factors are addressed together.

#DrRababCares 

#PelvicOrganProlapse

#PelvicFloorHealth

#ProlapseSurgery

#PelvicRehabilitation

#Cystocele

#Rectocele

#WomenHealth

#QualityOfLife