💥Endometriosis Explained – Episode 2

🤔Why does Endometriosis cause so much pain?

Many people believe that endometriosis hurts simply because tissue grows outside the uterus.

😳The truth is far more complex.

Endometriosis pain is caused by chronic inflammation, irritation of surrounding tissues, and, in many cases, direct involvement of pelvic nerves.

The endometriosis lesions release inflammatory substances that can:

• Trigger persistent inflammation.

 • Irritate pain-sensitive nerve endings.

 • Promote the growth of new nerve fibers .

• Lead to scar tissue (fibrosis) and adhesions 

• Cause pelvic organs to stick together, restricting their normal movement.

😥This is why pain may occur: 

• During menstruation

 • During sexual intercourse 

• During bowel movements 

• During urination

 • Or even throughout the entire month.

👏One important fact:

💜 The severity of pain does NOT always reflect the severity of the disease.

A woman with only a few tiny lesions may experience severe pain, while another with extensive disease may have little or no pain.

😢Pain depends more on where the lesions are located, how deeply they invade tissues, and whether nerves are involved, rather than simply the number of lesions.

Dr Rabab Cares

#DrRababCares 

#EndometriosisExplained 

#PelvicPain 

#PainfulPeriods 

#WomensHealth

🤔What Is Endometriosis, Really?

Endometriosis is a chronic, oestrogen-dependent inflammatory disease in which tissue similar but not identical to the lining of the uterus (the endometrium) grows outside the uterine cavity.

It affects approximately 1 in 10 women of reproductive age worldwide, making it one of the most common gynaecological conditions.

🧐 Despite its name, these lesions are not the same as the normal endometrium. 

They behave differently, developing their own blood supply and interacting with the immune and nervous systems, leading to persistent inflammation within the pelvis.

😳Endometriosis may appear as:

• Small superficial lesions on the pelvic lining.

• Ovarian cysts filled with altered blood, known as endometriomas ("chocolate cysts")

• Deep infiltrating lesions extending beneath the surface of pelvic tissues.

• Fibrosis and adhesions that may cause pelvic organs to stick together.

😥It is most commonly found on the:

• Ovaries

• Fallopian tubes

• Pelvic peritoneum

• Uterosacral ligaments

• Pouch of Douglas

In more advanced cases, it may also involve the bowel, bladder, ureters, diaphragm, or, rarely, distant organs.

Understanding what endometriosis really is is the first step toward earlier diagnosis and better care.

Dr Rabab Cares

#DrRababCares 

#EndometriosisExplained #EndometriosisAwareness #PelvicPain #WomensHealth #Gynaecology

 🌸 Coming Soon... Endometriosis Explained!

Period pain is often dismissed as "normal."

But what if it's not?

Millions of women live with endometriosis for years before receiving the correct diagnosis. Many are told that their pain is "just part of being a woman"when in fact, it may be a sign of a condition that deserves attention and treatment.

In this new series, we'll discuss:

✨ What endometriosis really is

✨ Why it causes pain

✨ How it affects fertility

✨ How it is diagnosed

✨ The latest treatment options

✨ Common myths and facts

✨ When surgery is needed and when it isn't

Whether you're experiencing symptoms, trying to conceive, or simply want to learn more about your health, this series is for you.

📅 Episode 1 is coming soon.

Follow along and share this series with someone who needs to hear that painful periods should never be ignored.

Dr Rabab Cares

#DrRababCares 

#EndometriosisExplained  #EndometriosisAwareness #womenshealth  #PelvicPain #PainfulPeriods #Infertility

 Episode 10: Key Takeaways

After completing this series, here are the most important facts every woman should remember:

✅ Fibroids are extremely common.

✅ Most fibroids are benign and do not turn into cancer.

✅ Not every fibroid causes symptoms.

✅ The location of a fibroid is often more important than its size.

✅ Not every fibroid affects fertility or pregnancy.

✅ Not every fibroid requires surgery.

✅ Treatment should always be individualized.

✅ Myomectomy removes the fibroids while preserving the uterus.

✅ Several effective non-surgical treatment options are available for selected women.

✅ Regular follow-up with your gynecologist is essential for appropriate management.

Final Message

Every woman is unique, and every fibroid is different.

The best treatment is the one that matches your symptoms, your fertility plans, and your personal goals not simply your ultrasound report.

Thank you for following the Fibroids Explained series.

Stay tuned for our next educational journey with Dr Rabab Cares. 

#DrRababCares 

#FibroidsExplainedByDrRabab  #Fibroids #Gynecology #EvidenceBasedMedicine #PatientEducation

 💥Episode 9: Can Fibroids Turn Into Cancer?

One of the most common fears after being diagnosed with fibroids is:

"Could this be cancer?"

The reassuring answer is:

In the vast majority of cases, NO.

🧐Fibroids are benign (non-cancerous) tumors of the uterine muscle.

They are not considered precancerous, and a typical fibroid does not turn into cancer over time.

🤔What about uterine sarcoma?

A uterine sarcoma is a rare type of cancer that develops from the muscle or connective tissue of the uterus.

It is not believed to arise from an ordinary fibroid.

Although fibroids and sarcomas may sometimes appear similar on imaging, they are considered different conditions.

🤗When should further evaluation be considered?

Your doctor may recommend additional assessment if there are concerning features such as:

🔴 Rapid growth, particularly after menopause

🔴 New symptoms after menopause

🔴 Unusual imaging findings

🔴 Persistent symptoms that cannot be explained by typical fibroids

These situations do not automatically mean cancer, but they deserve careful evaluation.

🧨Key Message

Fibroids are almost always benign.

The diagnosis of uterine sarcoma is rare, and most women with fibroids will never develop this condition.

Regular follow-up and consultation with your gynecologist are the best way to ensure appropriate care.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab 

#UterineFibroids  #Gynecology #FibroidAwareness #EvidenceBasedMedicine

 💥Episode 8: Non-Surgical Management of Fibroids

Not every fibroid needs surgery.

For many women, symptoms can be managed effectively without an operation, depending on the size of the fibroid, its location, the severity of symptoms, and future pregnancy plans.

🧠Non-surgical treatment options include:

1. Observation (Watchful Waiting)

🟢 Best for women with:

• Small fibroids
• No symptoms
• Stable fibroid size
• Regular follow-up with ultrasound may be all that is needed.

2. Medications to Control Heavy Bleeding

🩸 These do not remove fibroids, but they can help reduce menstrual blood loss and improve quality of life.

Examples include:

• Tranexamic acid
• Hormonal therapies (in selected patients).

3. Treatment of Anemia

If fibroids cause heavy bleeding, treating iron deficiency is essential.

This may include:

• Oral iron
• Intravenous iron (when indicated).

4. Hormonal Therapy

Certain hormonal medications may:

• Reduce menstrual bleeding
• Temporarily shrink fibroids
• Improve symptoms before surgery
• Their use depends on individual circumstances and fertility plans.

5. Uterine Artery Embolization (UAE)

A minimally invasive procedure that blocks the blood supply to fibroids, causing them to shrink.

It may be suitable for selected women who have completed childbearing.

🧨Key Message

Non-surgical treatment aims to control symptoms not necessarily eliminate the fibroid.

The best treatment depends on your symptoms, age, fertility goals, and the characteristics of the fibroid.

Treatment should always be individualized.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab

#FibroidsAwarness 

#NonSurgicalTreatment 

#WomensHealth 

 #Gynecology #UterineFibroids #HeavyBleeding #FibroidCare

 🤔Episode 7: Myomectomy Explained 

A myomectomy is a surgical procedure to remove fibroids while preserving the uterus.

Unlike a hysterectomy, the uterus is left intact, making myomectomy an important option for women who wish to have children in the future or prefer to keep their uterus.

🧐Who may benefit from a myomectomy?

Myomectomy may be recommended for women with:

🔴 Heavy menstrual bleeding caused by fibroids.

🔴 Fibroids affecting fertility or causing recurrent miscarriage.

🔴 Significant pelvic pain or pressure.

🔴 Large or rapidly growing fibroids causing symptoms.

🔴 Fibroids that distort the uterine cavity.

💥Types of Myomectomy

🎯Hysteroscopic Myomectomy

Performed through the cervix without abdominal incisions.

✔ Best for submucous fibroids inside the uterine cavity.

🎯Laparoscopic Myomectomy

Performed through small abdominal incisions using a camera.

✔ Suitable for selected women with a limited number and size of fibroids.

🎯Open Myomectomy (Laparotomy)

Performed through an abdominal incision.

✔ Often recommended for multiple, very large, or deeply embedded fibroids.

🧠Benefits

✅ Preserves the uterus

✅ Improves symptoms

✅ May improve fertility in appropriately selected women.

✅ Improves quality of life.

🧐Things to Remember

• Fibroids can recur after myomectomy.

• Not every fibroid requires surgery.

• The surgical approach depends on the number, size, and location of the fibroids, as well as the surgeon's expertise.

👁Key Message

Myomectomy removes the fibroids not the uterus.

The best surgical approach is individualized and should be chosen after careful evaluation and discussion with your gynecologist.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab

 #Myomectomy #Fibroids #UterineFibroids #WomensHealth #Gynecology #Fertility #PregnancyCare #MinimallyInvasiveSurgery

 🧐Episode 6: When Should Fibroids Be Removed?

One of the biggest misconceptions is that every fibroid needs surgery.

The truth is: most fibroids do not require removal unless they are causing problems.

The decision to remove a fibroid is based on symptoms, location, size, fertility plans, and its impact on quality of life not simply its presence.

💥Fibroid removal may be recommended when:

🔴 Heavy menstrual bleeding

Persistent heavy periods

Iron deficiency anemia

Bleeding that affects daily activities.

🔴 Infertility or recurrent miscarriage

Especially with submucous fibroids

Intramural fibroids that distort the uterine cavity.

🔴 Significant pelvic pain or pressure

Chronic pelvic pain

Pelvic heaviness

Pain affecting daily life.

🔴 Pressure on nearby organs

Frequent urination

Difficulty emptying the bladder

Constipation or rectal pressure.

🔴 Rapidly enlarging fibroid

Particularly when associated with symptoms

Requires careful evaluation.

🔴 Very large fibroids

Causing marked abdominal enlargement

Significant pressure symptoms

Distortion of pelvic anatomy.

🎯Surgery is NOT always necessary if:

🟢 The fibroid causes no symptoms

🟢 Fertility is not affected

🟢 Pregnancy is progressing normally

🟢 The fibroid is stable on follow-up.

🧐Key Message

The presence of a fibroid alone is not an indication for surgery.

Treatment should always be individualized, taking into account the woman's symptoms, reproductive goals, and the characteristics of the fibroid.

The goal is to treat the patient not just the ultrasound report.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab

 #UterineFibroids  #Gynecology #FibroidSurgery #Myomectomy #FertilityAwareness

 🤰Episode 5: Fibroids and Pregnancy

Many women are surprised to learn they have fibroids during pregnancy.

The good news is that most women with fibroids have successful pregnancies and healthy babies.

However, the impact of fibroids during pregnancy depends largely on their size, number, and location.

💥Submucous Fibroids

🔴 Most likely to interfere with pregnancy

These fibroids distort the uterine cavity and may be associated with: 

• Difficulty conceiving

• Increased risk of miscarriage

• Problems with implantation.

💥Intramural Fibroids

🟡 May affect pregnancy

Large intramural fibroids can sometimes be associated with: 

• Miscarriage 

• Pain due to fibroid degeneration 

• Preterm labor 

• Malpresentation of the baby 

• Increased likelihood of cesarean delivery.

💥subserosal Fibroids

🟢 Usually have the least impact on pregnancy.

Because they grow on the outer surface of the uterus, they generally do not interfere with fetal growth or implantation.

However, very large fibroids may occasionally cause discomfort or pressure symptoms.

🧠What Happens to Fibroids During Pregnancy?

Fibroids may increase in size, particularly during the first and second trimesters, due to hormonal changes.

🤰Some women may experience:

• Abdominal pain 

• Localized tenderness 

• Red degeneration of the fibroid.

Fortunately, many fibroids remain stable and cause no significant complications.

🤔Key Message

Having fibroids does not mean you cannot have a healthy pregnancy.

Most women with fibroids deliver healthy babies, but careful antenatal monitoring is important, especially when fibroids are large, multiple, or close to the uterine cavity.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab  

#Fibroids 

#Pregnancy 

#PregnancyCare 

#UterineFibroids 

#WomensHealth  #HealthyPregnancy

 Episode 4: Fibroids and Infertility

One of the most common questions women ask after being diagnosed with fibroids is:

"Can fibroids prevent me from getting pregnant?"

The answer is not always straightforward.

Many women with fibroids conceive naturally and have healthy pregnancies. 

However, the impact of fibroids on fertility depends largely on their location within the uterus.

💥Submucous Fibroids

🔴 Most likely to affect fertility

Submucous fibroids grow beneath the lining of the uterine cavity and distort its shape.

They may:

 • Interfere with embryo implantation

• Increase the risk of miscarriage

• Reduce pregnancy rates

Even relatively small submucous fibroids can have a significant effect on fertility.

💥Intramural Fibroids

🟡 May affect fertility

Intramural fibroids develop within the muscular wall of the uterus.

Small intramural fibroids usually have little or no impact on fertility.

However, larger fibroids especially those that distort the uterine cavitymay:

 • Reduce implantation rates

• Lower IVF success rates

• Increase miscarriage risk

The relationship is more complex and often depends on size and proximity to the uterine cavity.

💥Subserosal Fibroids

🟢 Least likely to affect fertility

Subserosal fibroids grow on the outer surface of the uterus.

Because they do not usually distort the uterine cavity, they generally have little or no effect on:

 • Conception

• Implantation

• Pregnancy rates

They are more likely to cause pressure symptoms than fertility problems.

🧐Key Message

When assessing fertility in a woman with fibroids, location is often more important than size.

A small submucous fibroid may have a greater impact on fertility than a much larger subserosal fibroid.

Understanding the type of fibroid helps guide both fertility counseling and treatment decisions.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab  #Fibroids #Infertility #FertilityAwareness #UterineFibroids #WomensHealth #Gynecology #IVF #PregnancyCare

 Happy Father's Day 💙

Behind every healthy pregnancy and every growing family, there is often a supportive father walking the journey alongside them.

Thank you to all fathers who provide love, encouragement, and care during pregnancy, childbirth, and beyond.

Your support matters more than you know.

#DrRababCares 

#FathersDay

 #PregnancySupport 

#FamilyCare

 🎯Episode 3: Fibroids and Heavy Bleeding

One of the most common reasons women with fibroids seek medical attention is heavy menstrual bleeding.

However, not all fibroids affect menstrual bleeding in the same way.

The impact largely depends on the location of the fibroid within the uterus.

🤔Submucous Fibroids

These fibroids develop just beneath the lining of the uterine cavity and are the type most strongly associated with heavy menstrual bleeding.

Even relatively small submucous fibroids can cause: 

• Heavy periods

• Prolonged bleeding

• Passage of blood clots

• Iron deficiency anemia.

This is because they distort the uterine cavity and increase the surface area of the endometrium.

🤔Intramural Fibroids

Intramural fibroids grow within the muscular wall of the uterus.

When they become large or extend toward the uterine cavity, they may contribute to:

 • Heavy menstrual bleeding

• Prolonged periods

• Pelvic pressure.

The effect is generally less pronounced than with submucous fibroids but can still be clinically significant.

🤔Subserosal Fibroids

Subserosal fibroids grow on the outer surface of the uterus.

These fibroids are least likely to cause heavy menstrual bleeding because they do not directly affect the uterine cavity or its lining.

Instead, they are more commonly associated with: 

• Pelvic pressure

• Abdominal fullness

• Urinary or bowel symptoms due to pressure on nearby organs.

💥Key Message

When a woman with fibroids presents with heavy menstrual bleeding, the first question is not "How big is the fibroid?" but rather "Where is the fibroid located?"

The location of a fibroid often has a greater impact on bleeding symptoms than its size alone.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab

 #Fibroids 

#HeavyMenstrualBleeding 

#UterineFibroids #Gynecology #WomensHealth #FertilityAwareness

 Fibroids Explained

Episode 2: Types of Fibroids

Not all fibroids are the same.

The symptoms, impact on fertility, and treatment options often depend on where the fibroid is located within the uterus.

There are three main types of fibroids:

1. Intramural Fibroids

These develop within the muscular wall of the uterus and are the most common type.

2. Submucous Fibroids

These grow beneath the lining of the uterine cavity and may significantly affect menstrual bleeding and fertility.

3. Subserosal Fibroids

These grow on the outer surface of the uterus and may cause pressure symptoms depending on their size.

🤔Understanding the type of fibroid is often more important than simply knowing its size.

In the next episodes, we will explore each type in detail and discuss how it may affect symptoms, fertility, and pregnancy.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab 

#Fibroids 

#UterineFibroids 

#WomensHealth 

 #FertilityAwareness

 "You have fibroids."

Few words can cause so much anxiety.

Do fibroids cause infertility? 

Will I need surgery? 

Can I still get pregnant? 

Are all fibroids dangerous?

The truth is that not all fibroids are the same, and not every fibroid requires treatment.

In this series, we will answer the most common questions about fibroids and separate facts from myths.

Welcome to Fibroids Explained.

Dr Rabab Cares 

#DrRababCares

#Fibroids

#WomensHealth

#Fertility

#Pregnancy

#HeavyPeriods

#PelvicPain

#FibroidsExplainedByDrRabab

 🔑 Key Message

Throughout this series on Müllerian

Not every suspected anomaly is a true anomaly.

An arcuate uterus,

 a septate uterus, 

a bicornuate uterus, 

a unicornuate uterus, 

and uterus didelphys 

may appear similar at first glance, yet they can have very different reproductive implications and management strategies.

This is why accurate diagnosis matters.

Careful assessment, appropriate imaging, clinical correlation, and follow-up are often just as important as the initial scan itself.

As clinicians, our responsibility is not to make the most dramatic diagnosis.

Our responsibility is to make the most accurate one.

Because the correct diagnosis guides the correct counseling, the correct management, and ultimately the best possible outcome for our patients.

Thank you for following this educational journey through Müllerian anomalies.

Dr Rabab Cares 

#DrRababCares 

#MullerianAnomalies 

#WomensHealth 

 #3DUltrasound 

#ReproductiveMedicine 

#FertilityEducation

 🩺 Uterus Didelphys

Uterus didelphys is a rare congenital Müllerian anomaly resulting from complete failure of fusion of the Müllerian ducts during fetal development.

As a result, a woman may have:

• Two separate uterine cavities

• Two cervices

• Sometimes a longitudinal vaginal septum.

Unlike a bicornuate uterus, where there is partial fusion, uterus didelphys results in two distinct uterine structures.

Can women with uterus didelphys become pregnant?

Absolutely.

Many women conceive naturally and may remain unaware of the condition until pregnancy or imaging studies reveal it.

However, uterus didelphys has been associated with an increased risk of:

• Miscarriage

• Preterm birth

• Malpresentation (especially breech presentation)

• Cesarean delivery.

One important consideration is the possible association with:

🩺 OHVIRA Syndrome (Obstructed Hemivagina and Ipsilateral Renal Anomaly)

Patients may present with:

 • Severe dysmenorrhea

• Chronic pelvic pain

• Hematocolpos

• Renal tract anomalies

Accurate diagnosis is essential.

3D ultrasound and MRI can help differentiate uterus didelphys from other Müllerian anomalies and identify associated abnormalities.

The key message:

Having two uteri does not mean a woman cannot have a successful pregnancy.

With appropriate diagnosis and obstetric care, many women achieve excellent reproductive outcomes.

Dr Rabab Cares 

#DrRababCares 

#UterusDidelphys

#MullerianAnomalies

#UterineAnomalies

#OHVIRASyndrome

#3DUltrasound

#HighRiskPregnancy

 🩺 Rudimentary Horn

A rudimentary horn is an underdeveloped uterine structure that may be present in women with a unicornuate uterus.

It can be:

 • Communicating 

• Non-communicating 

• Functional 

• Non-functional

Why is it important?

A non-communicating functional rudimentary horn may lead to:

• Severe dysmenorrhea 

• Chronic pelvic pain

 • Hematometra

 • Endometriosis

However, the most serious complication is:

⚠️ Rudimentary Horn Pregnancy

Although rare, pregnancy can occur within a rudimentary horn through transperitoneal migration of sperm or a fertilized ovum.

Because the horn is unable to expand normally, rupture may occur during the second trimester, resulting in catastrophic intra-abdominal hemorrhage.

Early diagnosis is therefore critical.

Clinical suspicion should increase when ultrasound shows: 

• A gestational sac separate from the main uterine cavity

 • An asymmetric uterine appearance 

• Difficulty identifying continuity with the cervix

3D ultrasound and MRI may help confirm the diagnosis.

Management of rudimentary horn pregnancy is surgical removal due to the high risk of rupture.

The key message:

A rudimentary horn is not simply an anatomical curiosity.

Recognizing it early can be life-saving.

Dr Rabab Cares 

#DrRababCares 

#RudimentaryHorn #RudimentaryHornPregnancy #UnicornuateUterus #MullerianAnomalies #UterineAnomalies

 🩺 Unicornuate Uterus

A unicornuate uterus is a rare congenital Müllerian anomaly that develops when only one Müllerian duct forms normally.

As a result, the uterus is smaller than usual and typically has a single functional uterine horn.

In some women, a rudimentary horn may also be present.

Why does it matter?

Although many women with a unicornuate uterus can conceive naturally, this condition is associated with increased reproductive and obstetric risks, including:

• Early pregnancy loss

• Second-trimester pregnancy loss

• Preterm birth

• Malpresentation

• Fetal growth restriction

• Increased cesarean delivery rates

One important consideration is the presence of a rudimentary horn.

A non-communicating rudimentary horn may be associated with:

• Pelvic pain

• Endometriosis

• Rare but potentially dangerous rudimentary horn pregnancy

Accurate diagnosis is essential.

3D transvaginal ultrasound and MRI can help define uterine anatomy and identify associated anomalies.

Women with a unicornuate uterus may also have associated renal tract anomalies, making further evaluation appropriate in selected cases.

With proper surveillance and individualized obstetric care, many women achieve successful pregnancies and healthy outcomes.

Dr Rabab Cares 🌷

#DrRababCares 

#UnicornuateUterus #MullerianAnomalies #UterineAnomalies  #MaternalHealth #PregnancyCare #HighRiskPregnancy #ReproductiveMedicine #FertilityEducation #3DUltrasound

 🩺 Bicornuate Uterus

A bicornuate uterus is a congenital uterine anomaly resulting from incomplete fusion of the Müllerian ducts during fetal development.

It is characterized by a deep external fundal indentation, creating the appearance of a "heart-shaped" uterus with two uterine horns.

One of the most important clinical challenges is differentiating a bicornuate uterus from a septate uterus, as management differs significantly.

Accurate diagnosis often requires:

 • 3D transvaginal ultrasound

 • MRI in selected cases.

What does it mean for fertility and pregnancy?

The good news is that most women with a bicornuate uterus can conceive naturally.

However, studies have shown an increased risk of: 

• Miscarriage 

• Preterm birth 

• Malpresentation (especially breech presentation)

 • Cervical insufficiency in selected patients 

• Increased cesarean delivery rates.

Importantly, bicornuate uterus is more strongly associated with pregnancy-related complications than with infertility itself.

Management is usually focused on: 

✔️ Accurate diagnosis

 ✔️ Individualized pregnancy surveillance 

✔️ Appropriate obstetric care

A bicornuate uterus should not automatically be viewed as a barrier to motherhood.

With proper monitoring, many women achieve successful pregnancies and healthy outcomes.

Dr Rabab Cares 

#DrRababCares 

#BicornuateUterus 

#MullerianAnomalies

 #UterineAnomalies  

 #PregnancyCare #ReproductiveMedicine #FertilityEducation #3DUltrasound #HighRiskPregnancy

 Eid Al-Adha Mubarak 🌙✨

May this blessed Eid bring peace to your hearts, comfort to your homes, and endless blessings to your families.

May Allah accept our prayers, sacrifices, and sincere intentions.

Wishing you days filled with mercy, happiness, and good health 🤍

Dr Rabab Cares

#DrRababCares

 🌍Africa is not only where I work…

it became part of who I am.

For 7 years in Zambia,

I have witnessed the strength of African women up close.

Their patience.

Their resilience.

Their love for their children despite every challenge.

As doctors, we treat patients.

But sometimes… Africa teaches us too.

It teaches humanity.

Community.

Strength during difficult days.

And how a mother can still smile while carrying so much silently.

On this Africa Day,

I celebrate the women who keep going no matter how hard life becomes.

The mothers.

The daughters.

The healthcare workers.

The women silently holding entire families together. 💚

Happy Africa Day 🌍

With love and respect to the continent that became home.

Dr Rabab Mustafa

OB/GYN | Lusaka

#DrRababCares 

#AfricaDay2026

 #AfricanWomen

 #MaternalHealth

 #Zambia

 Septate uterus is the most common

 congenital uterine anomaly and results from incomplete resorption of the Müllerian ducts during embryological development.

It is characterized by a fibrous or fibromuscular septum partially or completely dividing the endometrial cavity, while the external uterine contour usually remains normal.

Clinically, septate uterus has been associated with:

• recurrent pregnancy loss

• implantation failure

• infertility in selected cases

• preterm birth

• malpresentation

• adverse reproductive outcomes

However, reproductive prognosis varies significantly depending on:

• septum size and extent

• vascularity of the septal tissue

• associated anomalies

• and individual reproductive history

Accurate diagnosis is essential.

2D ultrasound alone may sometimes overdiagnose septate uterus, particularly in:

• early pregnancy

• arcuate uterus

• retroverted uterus

• or asymmetric cavity distortion

3D transvaginal ultrasound remains one of the most reliable noninvasive diagnostic modalities for differentiating septate uterus from other Müllerian anomalies.

Management should always be individualized.

Hysteroscopic septum resection may improve reproductive outcomes in selected patients, particularly those with recurrent pregnancy loss or adverse reproductive history.

A uterine anomaly should be evaluated carefully  not feared automatically.

Dr Rabab Cares 

#DrRababCares 

#SeptateUterus

#MullerianAnomalies

#UterineAnomalies

#ReproductiveMedicine

#InfertilityAwareness

#RecurrentMiscarriage

#3DUltrasound

#Maternalhealthcare

 “Your uterus is slightly heart-shaped.”

Many women panic when they hear this during an ultrasound.

But in many cases, the finding is simply:

🩺 An arcuate uterus.

An arcuate uterus is a mild indentation at the top of the uterine cavity.

👉 It is often considered a normal anatomical variant.

👉 Many women never know they have it.

👉 Many have completely normal fertility and healthy pregnancies.

Sometimes it is discovered during:

• fertility workup

• pregnancy scans

• miscarriage evaluation

• or even routine ultrasound

One important point:

An arcuate uterus is NOT the same as a septate uterus.

And distinguishing between them may require experienced ultrasound assessment  sometimes even 3D ultrasound.

In most cases:

🌷 No surgery is needed

🌷 No treatment is required

🌷 And reassurance is often the most important part

Because not every different uterine shape is a dangerous diagnosis.

Dr Rabab Cares

#DrRababCares 

#ArcuateUterus

#MullerianAnomalies

#UterineAnomalies

#FertilityEducation

#4DUltrasound

 “Your uterus is abnormal.”

A sentence that can immediately create fear.

But here’s something important many women don’t know:

Not every uterine anomaly is dangerous.

And not every unusual uterine shape causes infertility.

🩺 Müllerian anomalies are variations in how the uterus formed before birth.

Some are very mild and may never affect pregnancy. 

Others may require closer follow-up or treatment.

Many women only discover them during:

 • a routine ultrasound

• fertility assessment

• pregnancy scans

• or miscarriage evaluation

In this series, we’ll simplify the most common types: 

• Arcuate uterus

• Septate uterus

• Bicornuate uterus

• Unicornuate uterus

And we’ll talk about:

 ✔️ fertility

✔️ miscarriage risk

✔️ pregnancy outcomes

✔️ when treatment is needed… and when it is not.

Because understanding the diagnosis matters more than fearing the name.

Dr Rabab Cares 

#MullerianAnomalies

#UterineAnomalies

#SeptateUterus

#ArcuateUterus

#BicornuateUterus

#UnicornuateUterus

#InfertilityAwareness

#FertilityEducation

#Ultrasound

#DrRababCares

 Today, we celebrate the women who carry entire worlds quietly. 🤍

To every mother—the ones raising children, healing families, working through exhaustion, hiding pain behind a smile, and still showing up with love every single day—

Thank you.

As an obstetrician, I witness strength in many forms, but motherhood remains one of the most powerful journeys I see.

Happy Mother’s Day to every mother, every expecting mother, every woman trying, and every woman carrying love in her heart. 🌷

You are appreciated more than words can say.

Dr. Rabab Mustafa 

#DrRababCares

 Causes Of Bleeding While Using Contraceptives 

Swipe to learn common causes of bleeding while using oral contraceptive pills 👩🏻‍⚕️💊

Not every bleeding episode means something dangerous  but understanding the cause matters.

 🤔“Your Pap smear says LSIL… should you worry?”

You came for a routine check.

You felt fine.

Then the report says: LSIL.

Suddenly… anxiety starts.

Let me explain it simply 👇

LSIL (Low-grade squamous intraepithelial lesion).

means there are mild changes in the cervix,

usually caused by a very common virus called Human papillomavirus (HPV).

💡 The most important thing you need to know:

👉 This is NOT cancer.

👉 In many cases, your body clears it on its own.

👉 You don’t need panic… you need proper follow-up.

🩺 So what happens next?

Depending on your age and results:

Sometimes we just monitor and repeat the test after 1 year.

Sometimes we do a simple test called colposcopy to take a closer look.

That’s it. No rush. No fear.

⚠️ When do we take it more seriously?

If the virus persists

Or if changes progress over time.

👉 That’s why follow-up is everything

💬 A message from me as your doctor:

Don’t ignore it…

but don’t be scared of it either.

Your body is strong.

And with the right follow-up, we catch problems early  before they ever become serious.

#DrRababCares we focus on early detection, reassurance, and safe care because your peace of mind matters as much as your health.

#DrRababCares

#DrRababCares

#CervicalHealth

#PapSmear

#LSIL

#HPVAwareness

#WomensHealth

#CervicalScreening

#PreventiveCare

#EarlyDetection

#HealthcareAwareness

 Happy Labour Day.

Work means different things to different people.

For some, it’s routine.

For others, it’s responsibility that stays even on a day off.

As doctors, we learn to appreciate both

the moments we serve,

and the moments we pause.

Today is a reminder to value the work we do…

and also the rest that allows us to keep going.

To everyone working hard in their own way today and every day this day is for you.

#DrRababCares 

#LabourDay 

#DoctorLife 

#Healthcare 

#WomensHealth

 💚“I didn’t rush for a C-section.

I responded to a cord prolapse.”

One of the most dangerous obstetric emergencies can begin quietly… and within minutes, everything changes.

A patient in early labour.

Twin pregnancy.

First baby breech.

Suddenly cord prolapse.

At that moment, this is no longer about waiting.

It is no longer about “let’s observe.”

It becomes about one thing only:

Time.

Cord prolapse happens when the umbilical cord slips below the presenting part, causing compression and rapidly reducing blood flow and oxygen to the baby.

Every minute matters.

Immediate action is critical:

– Relieve cord compression

– Optimize maternal position

– Prepare for urgent delivery

– Most often, emergency Caesarean section is the safest option

Sometimes people say,

“Doctors are too quick to do C-sections.”

But obstetrics teaches us something important:

Delay can be far more dangerous than decision.

Not every emergency looks dramatic.

Some begin quietly… and demand speed, not hesitation.

Sometimes, saving a life doesn’t mean holding the scalpel.

Sometimes, it means recognizing danger early, making the right decision fast, and ensuring the patient reaches the right hands in time.

Cord prolapse doesn’t wait.

Neither should we.

Timely referral is not “just referral.”

Sometimes, it is the difference between tragedy… and two healthy babies.

Because in obstetrics,

sometimes

timing is survival.

#DrRababCares

 #Obstetrics #CordProlapse #EmergencyObstetrics #TwinPregnancy #MaternalCare #WomenHealth #CaesareanSection #HighRiskPregnancy

She’s newly married.

Recurrent urinary tract infections (UTIs) after marriage often referred to as “honeymoon cystitis” are more common than many women realize.

💥But here’s the important part:

👉 It’s not just about “infection” 

 it’s about risk factors, habits, and prevention.

Why does it happen?

- Increased frequency of intercourse → mechanical irritation of the urethra

- Short female urethra → easier bacterial ascent (especially E. coli).

- Vaginal flora changes in early sexual activity

Inadequate lubrication → microtrauma.

- Poor or incorrect hygiene practices.

🤔 Common mistakes I see in practice:

Repeated empirical antibiotics without urine culture.

Ignoring post-coital habits (like voiding).

Overuse of harsh intimate washes disrupting normal flora.

Not considering differential diagnoses (e.g. vaginitis, STIs, interstitial cystitis).

👍 What actually helps (evidence-based):

✔️ Urinate soon after intercourse

✔️ Adequate hydration

✔️ Gentle hygiene (avoid over-cleansing)

✔️ Use of lubrication when needed

✔️ Consider urine culture in recurrent cases before treatment.

✔️ In selected cases: post-coital or prophylactic antibiotics (based on guidelines)

✔️ Evaluate for underlying causes if recurrent (>2 in 6 months or >3/year).

🧐 When to look deeper?

- Persistent symptoms despite treatment.

- Atypical symptoms (no dysuria, but pelvic pain).

- Hematuria

- Suspected resistant organisms.

🤲 Because not every “UTI” is truly a UTI.

💚A gentle reminder: 

This is common, treatable, and preventable.

But it deserves proper evaluation not assumptions. 

#DrRababCares

 #WomensHealth 

#UTI

 #NewlyMarried 

#Gynecology 

#PreventiveCare

 “Your scan is normal… but your bleeding is not.”

If you’ve ever been told “everything is fine” just because your ultrasound was normal…

this is for you.

Because in gynecology, a normal scan does not always mean a normal situation.

Let’s be clear:

Ultrasound is a powerful tool 

but it mainly detects structural problems.

And many causes of abnormal bleeding are functional, hormonal, or microscopic

→ meaning they won’t show up on a scan.

So what could be happening?

Even with a completely normal ultrasound, bleeding may be due to:

• Hormonal imbalance

Irregular estrogen & progesterone → unstable endometrium → irregular or heavy bleeding

(Common in PCOS, stress, weight changes, perimenopause)

• Anovulation

No ovulation = no progesterone balance → endometrial shedding becomes unpredictable.

• Endometrial disorders

Hyperplasia, infection, or subtle pathology not always visible on imaging.

• Early pregnancy-related causes

Very early miscarriage or ectopic pregnancy before it becomes visible

• Medications

Hormonal pills, injectables, emergency contraception, anticoagulants

• Systemic conditions

Thyroid disorders, bleeding disorders, chronic illnesses

When is bleeding NOT normal?

Don’t ignore it if you notice:

• Bleeding that is heavier than usual

• Bleeding between periods

• Bleeding after intercourse

• Bleeding after menopause

• Persistent or recurrent irregular cycles

• Associated fatigue, dizziness, or anemia

So what should we do?

A normal scan is just the beginning of the evaluation not the end.

Good care includes:

• Listening carefully to the patient’s story

• Identifying patterns in the cycle

• Requesting targeted investigations (not random tests)

• Treating the cause  not just stopping the bleeding

The real message:

Symptoms should never be ignored just because imaging is normal.

Medicine is not only about what we see…

It’s also about what we understand.

#DrRababCares 

#WomensHealth 

#AbnormalBleeding 

#Gynecology 

 #PatientCare

 🤰She was not trying to be cruel

She was just… scared.

A recent case in Zambia described a woman attempting to end a late pregnancy alone, unsupported, and afraid.

The baby survived.

Against every attempt. Against every odd.

But this is not just a story about survival.

It’s a story about what happens when a woman feels she has no safe place to turn.

As an Obstetrician & Gynecologist, I want to highlight something important:

Unsafe attempts to terminate pregnancy  especially in advanced gestation are medically dangerous and unpredictable.

At this stage, the uterus is already prepared for labour.

Interventions outside a proper medical setting can lead to: 

• Severe hemorrhage

• Uterine rupture

• Sepsis and life-threatening infections

• Incomplete delivery requiring emergency surgery

• Neonates born alive but in critical condition

And most importantly…

They put the mother’s life at real risk.

But behind the medical risks, there is always a story.

Women in these situations are often facing: 

• Fear of abandonment or partner rejection

• Financial instability

• Social stigma

• Mental and emotional distress

And when there is no support system…

fear takes control.

This is why early access to care matters.

This is why safe, confidential medical counselling matters.

This is why we  as healthcare providers  must create a space where women feel safe to speak before reaching a crisis.

Because prevention is not just medical.

It is emotional, social, and human.

Sometimes…

saving a life starts by simply listening.

#DrRababCares 

#WomensHealth 

#MaternalHealth 

#ObGyn 

#Zambia

 😳Menstrual Hygiene: Pads, Tampons, or Cups?

Menstrual hygiene is not just about what you use…

it’s about how you use it.

Many women grow up without proper guidance on this topic  and end up following habits that may not be the healthiest.

Recent guidance confirms that pads, tampons, and menstrual cups are all safe  when used correctly and with proper hygiene.

🔹 Pads

• Easy, accessible, and ideal for beginners
• Should be changed every 4–6 hours
• Prolonged use → moisture + friction → irritation or infection
• Choose breathable, unscented types when possible.

🔹 Tampons

• Offer more comfort with movement and daily activity
• Change every 4–6 hours
• Do not exceed 8 hours (absolute maximum)
• Avoid overnight prolonged use
• Always use the lowest absorbency needed
• Rare but serious risk: Toxic Shock Syndrome.

🔹 Menstrual Cups

Reusable, eco-friendly, and cost-effective long term

Can be used up to 8–12 hours depending on flow

Require proper insertion technique

Must be washed with clean water and sterilized between cycles.

May need guidance at the beginning, but many women find them very comfortable over time.

🧼 Daily Hygiene Matters More Than the Product.

Wash the external area gently with water (no douching)

Avoid harsh or scented products → they disrupt normal flora.

Keep the area dry as much as possible.

Prefer cotton underwear over synthetic fabrics

Change out of wet or sweaty clothes quickly.

Always wash hands before and after changing.

⚠️ Common Mistakes to Avoid

Using one product for too long

Thinking “more cleaning = better hygiene”

Ignoring warning signs like itching, burning, unusual discharge, or strong odor

Using products that cause discomfort just because they are popular.

💡 The bottom line:

There is no “perfect” option.

The safest choice is the one that suits your body, your lifestyle… and is used correctly.

Because good hygiene is not about doing more…

it’s about doing what’s right.

#DrRababCares 

#WomensHealth 

#MenstrualHygiene 

#Gynecology

 🤔“All your tests are normal.”

But the pain is real.

Some women walk into the clinic carrying months… sometimes years… of pelvic pain,

after being told again and again: “Nothing is wrong.”

😥But something is wrong.

It might be Pelvic Congestion Syndrome (PCS) 

a condition that is often missed, simply because we are not looking for it.

🔍 What is PCS?

It’s not a mass.

Not a cyst.

Not endometriosis.

It’s a venous disorder where pelvic veins become dilated and incompetent, leading to congestion and chronic pain.

Think of it as varicose veins… but deep inside the pelvis.

⚠️ When should we suspect it?

Chronic dull pelvic pain (>6 months)

Worse after long standing

Worse before menstruation

Worse after intercourse (postcoital ache  a key clue)

Worse at the end of the day

Better when lying down

Associated symptoms may include:

Dyspareunia

Lower back heaviness

A feeling of pelvic pressure or fullness

Sometimes visible vulvar or perineal varicosities

🧠 Why it’s often missed Because:

It does not appear as a “typical gynecological lesion”

Early imaging can be misleading

It requires clinical suspicion, not just investigations

And most importantly…

👉 we are trained to look for masses, not veins.

🔎 How do we diagnose it properly?

Transvaginal Doppler ultrasound (looking specifically for dilated veins)

MRI / MR venography

Venography (gold standard — and can be therapeutic)

💊 What about medications like Venex or Vensomin? 

These are venoactive agents that may:

Improve venous tone

Reduce congestion-related discomfort

👉 They can help symptoms in mild cases

❌ But they do NOT treat the underlying venous reflux.

💉 So what actually works? 👉 Ovarian vein embolization (± internal iliac branches).

A minimally invasive procedure performed by interventional radiology,

targeting the source of venous reflux.

📊 Many patients experience significant symptom relief.

❗ Important clinical clarification Some

 patients report pain after

Current evidence shows:

It is not a proven cause of PCS

But it may unmask a pre-existing condition

💬 Why this matters Because labeling these women as:

“Normal”

“Hormonal”

Or “psychological”

…only delays the right diagnosis.

💡 Take-home message 

Not every pelvic pain is endometriosis.

Not every normal scan means nothing is wrong.

Sometimes…

the problem is not what we see.

It’s what we don’t think about.

#DrRababCares

#PelvicPain 

#WomensHealt 

#ChronicPain 

#MedicalAwareness

 💥Ectopic Pregnancy: When Medical Management Fails  What Next?

Ectopic pregnancy remains one of the most important gynecologic emergencies, where timely decision-making directly impacts both safety and future fertility.

In appropriately selected patients, Methotrexate is an effective first-line treatment.

However, close monitoring is essential.

🔹 A rising or non-declining β-hCG by Day 7 indicates treatment failure.

🔹 This should prompt a shift from medical to surgical management.

In surgical planning, several key factors must be assessed:

• Hemodynamic stability

• Location of the ectopic pregnancy

• Condition of the affected tube

• Status of the contralateral tube.

🧨In distal (fimbrial) ectopic pregnancies, conservative surgical approaches can be considered in selected cases.

🔸 Partial resection (fimbrial/segmental) may allow removal of the ectopic mass while preserving tubal structure.

🔸 This approach can help maintain future fertility potential, provided complete removal is achieved and follow-up is ensured.

🤗Postoperative care is equally critical:

• Serial β-hCG monitoring until complete resolution

• Early evaluation in future pregnancies to exclude recurrence.

🧠Clinical takeaway:

Management of ectopic pregnancy is not a single protocol 

it is a dynamic process requiring continuous reassessment and individualized decision-making.

#DrRababCares

#EctopicPregnancy

#WomensHealth

#Fertility

#ClinicalPractice

 🤐In clinic, I’ve noticed something important…

Sometimes what scares the patient is not the diagnosis itself 

but what they see.

💥Genital warts (Condylomata Acuminata)

may look alarming… especially when they grow large or multiple.

But medically, let’s be clear:

They are caused by HPV 

most commonly low-risk types 6 & 11

💡 Which means:

They are benign lesions

But they are also infectious and persistent

What many patients don’t realize is:

➡️ The virus can stay in the body even after removing the warts

➡️ Recurrence is therefore common

➡️ In some cases, lesions can grow rapidly if not treated early.

⚠️ Clinically, things change with:

Immunosuppression (HIV)

Diabetes

Delayed presentation

In these situations,

lesions tend to be larger, more resistant, and require procedural management.

🩺 Treatment is not “one approach fits all”:

Small lesions → topical therapy

Moderate lesions → cryotherapy (freezing the lesions)

Extensive lesions → cautery, excision, or laser

💥And one key message I always tell my patients:

We treat what we see…

but we also monitor what we cannot see

🛡️ Prevention is evolving

HPV vaccination is playing a major role

not only in prevention, but possibly in reducing recurrence.

🤍 Beyond all guidelines and protocols…

what matters most is early consultation, proper counseling, and removing the stigma around the condition.

Because understanding the condition

is just as important as treating it

#DrRababCares 

#HPV 

 #WomensHealth 

#PatientEducation