Woman's Clinic

Gestational Effects of Smoking with Madhav Boyapati MD

Q: If the pregnant mother smokes, does it harm the fetus?

Q: How does it harm the fetus?
When you smoke during pregnancy, your baby is exposed to dangerous chemicals like nicotine, carbon monoxide and tar. These chemicals can lessen the amount of oxygen that your baby gets. Oxygen is very important for helping your baby grow healthy. Smoking can also damage your baby’s lungs.

Women who smoke during pregnancy are more likely to have an ectopic pregnancy, vaginal bleeding, placental abruption (when the placenta peels away, partially or almost completely, from the uterine wall before delivery), placenta previa (when there is a low-lying placenta that covers part or all of the opening of the uterus), or a stillbirth.

Q: What are the consequences that a smoking pregnant mother has on the fetus?
Babies born to women who smoke during pregnancy are more likely to be born with birth defects such as cleft lip or palate, prematurely, at low birth weight, or underweight for the number of weeks of pregnancy. Babies born prematurely and at low birth weight are at risk of other serious health problems, including lifelong disabilities (such as cerebral palsy, mental retardation and learning problems), and in some cases, death.

Q: Is secondhand smoke safer for a fetus?
A: No.

Q: How is secondhand smoke dangerous for the fetus?
Secondhand smoke during pregnancy can cause a baby to be born at low birth weight. Secondhand smoke is also dangerous to young children. Babies exposed to secondhand smoke are more likely to die from SIDS (Sudden Infant Death Syndrome); are at greater risk for asthma, bronchitis, pneumonia, ear infections, and respiratory symptoms; and may experience slow lung growth.

Q: When should a pregnant woman stop smoking?
Ideally, a woman should stop smoking before she gets pregnant.

Q: If a pregnant woman stops smoking in the middle of pregnancy, will there be beneficial results?
Just days after quitting smoking during a pregnancy, the benefits will begin. For example, you and your baby’s heartbeat will return to normal, and respiratory problems will be less likely to develop in the baby. Physically, examples of the benefits when you quit smoking include never again having to go outside and look for a place to smoke and having cleaner teeth, fresher breath, fewer stain marks on your fingers, fewer skin wrinkles, a better sense of smell and taste, and more strength and ability to be more active.

Q: What are ways to help a woman quit smoking?
Write down your reasons for quitting. Look at the list when you are tempted to smoke. Choose a “quit day.” On that day, throw away all your cigarettes or cigars, lighters, and ashtrays. Drink plenty of water. Keep your hands busy using a small stress ball or doing some needlework. Keep yourself occupied, too. Try going for a walk or doing chores to keep your mind off of cravings. Snack on some raw veggies or chew some sugarless gum to ease the need to have something in your mouth. Stay away from places, activities, or people that make you feel like smoking. Ask your partner or a friend to help you quit. Call that person when you feel like smoking. Ask your health care provider about quitting aids such as patches, gum, nasal spray, and medications. Don’t start using these without your health care provider’s okay, especially if you’re pregnant. Don’t get discouraged if you don’t quit completely right away. Keep trying. If you can’t quit, cut back as much as you can. Ask your employer to see what services are offered or covered by insurance. Learn about smoking cessation programs in your community or from your employer. You can get more information from your health care provider, hospital, or health department.

Robotic Surgery with Madhav Boyapati MD

Q: What exactly is robotic surgery?
A: Robotic surgery is laparoscopy (using small incisions and then inserting the laparoscopic instruments to operate) that uses the robot or computer arm to move laparoscopic instruments rather than our hands directly.

Q: Is there a difference between robotic surgery and minimally invasive surgery?
Robotic surgery is minimally invasive surgery, like regular laparoscopy. In laparoscopic surgery, the doctor is making the movements of the laparoscopic instruments. In robotic surgery, the robot makes the movements that the doctor controls. 

Q: What sort of training, if any, is involved for robotic surgery?
It involves a special training course and preceptorship for a few cases and case reviews. Professionals in robotic surgery proctor the doctors through several cases.

Q: What are the potential patient benefits of robotic surgery in comparison to traditional surgery?
Shorter stays in hospital, less pain, and less blood loss. Some patients even go home the same day as the procedure.

Q: What are the doctorial benefits of robotic surgery?
Doctors have more precise control, more degrees of movement, and better visualization due to the 3-D camera.

Q: Does the term “robotic” entail that a surgeon is not needed to perform the surgery or operate the machinery?
No, the robot will not work without manual control by a person.

Q: Explain the process of using the robotic machinery.
You have to attach the robotic arms to the instruments (docking the robot). During the procedure, the doctor is next to the patient and is looking through a console to see inside. The doctor uses controls to move his hands so that the robotic instruments can replicate the movements of the doctor’s hands.

Q: What is the difference between a traditional hysterectomy (removal of the uterus) and a da Vinci hysterectomy?
A: Traditional open hysterectomy has two versions. One uses a large incision in the abdomen in which you go through the layers and pull out the uterus; the other goes through the vagina and pulls out the uterus from the vagina. Robotic da Vinci hysterectomy uses small incisions, instead of one large incision, and then operates with the robotic tools to remove the uterus and pull it out through the vagina.

Q: Why are you interested in robotic surgery?
Doctors can offer patients a choice that is more convenient for the patient. It is a choice that can get the patient home quicker.

Q: In conclusion, why should a patient choose robotic surgery or, more specifically, a da Vinci hysterectomy?
A: There is less pain, less hospital stay, less blood loss. All in all, it is a more convenient choice for many patients.