- Dubai Health Care City, Dubai, UAE
Dr Elsa de Menezes Fernandes is a UK trained Obstetrician and Gynaecologist. She completed her basic training in Goa, India, graduating from Goa University in 1993. After Residency, she moved to the UK, where she worked as a Senior House Officer in London at the Homerton, Southend General, Royal London and St. Bartholomew’s Hospitals in Obstetrics and Gynaecology. She completed five years of Registrar and Senior Registrar training in Obstetrics and Gynaecology in London at The Whittington, University College, Hammersmith, Ealing and Lister Hospitals and Gynaecological Oncology at the Hammersmith and The Royal Marsden Hospitals.
During her post-graduate training in London she completed Membership from the Royal College of Obstetricians and Gynaecologists. In 2008 Dr Elsa moved to Dubai where she worked as a Consultant Obstetrician and Gynaecologist at Medi clinic City Hospital until establishing her own clinic in Dubai Healthcare City in March 2015. She has over 20 years specialist experience.
Dr Elsa has focused her clinical work on maternal medicine and successfully achieved the RCOG Maternal Medicine Special Skills Module. She has acquired a vast amount of experience working with high risk obstetric patients and has worked jointly with other specialists to treat patients who have complex medical problems during pregnancy.
During her training she gained experience in Gynaecological Oncology from her time working at St Bartholomew’s, Hammersmith and The Royal Marsden Hospitals in London. Dr Elsa is experienced in both open and laparoscopic surgery and has considerable clinical and operative experience in performing abdominal and vaginal hysterectomies and myomectomies. She is also proficient in the technique of hysteroscopy, both diagnostic and operative for resection of fibroids and the endometrium.
The birth of your baby, whether it is your first or a happy addition to your family, is always a very personal experience and Dr Elsa has built a reputation on providing an experience that is positive and warmly remembered. She supports women’s choices surrounding birth and defines her role in the management of labour and delivery as the clinician who endeavours to achieve safe motherhood. She is a great supporter of vaginal delivery.
Dr Elsa’s work has been published in medical journals and she is a member of the British Maternal and Fetal Medicine Society. She was awarded CCT (on the Specialist Register) in the UK. Dr Elsa strives to continue her professional development and has participated in a wide variety of courses in specialist areas, including renal diseases in pregnancy and medical complications in pregnancy.
Uterine fibroids are non-cancerous (benign) tumours, commonly seen in women of childbearing age. Fibroids are composed of muscle cells and other tissues. They develop in and around the wall of the uterus or womb. Based on their location within the uterus, uterine fibroids can be classified as:
Subserosal fibroids: Sited beneath the serosa (the membrane covering the outer surface of the uterus)
Submucosal fibroids: Sited inside the uterine cavity below the inside layer of the uterus
Intramural fibroids: Sited within the muscular wall of the uterus
Intracavitary fibroids: Sited inside the uterine cavity
Pedunculated fibroids: Develop on a stalk
The exact cause for the development of fibroids remains unknown, but some of the proposed causes include:
– Genetic abnormalities
– Alterations in expression of growth factor (protein involved in rate and extent of cell proliferation)
– Abnormalities in the vascular system
– Tissue response to injury
– Family history of fibroids
– Uterine infection
– Consumption of alcohol
– Elevated blood pressure
– Hormonal imbalance during puberty
The majority of women with uterine fibroids may be asymptomatic. However the basic symptoms associated with fibroids include:
– Heavy menstrual bleeding
– Prolonged menstrual periods
– Pelvic pressure or pain
– Frequent urination
– Backache or leg pain
– Difficulty in emptying your bladder
The diagnosis of uterine fibroids involves a pelvic examination, followed by ultrasound evaluation. Other imaging techniques such as MRI scan and CT scan may also be employed.
Different methods are being used for managing uterine fibroids. Surgery is considered the best modality of treatment. The common surgeries performed for the management of fibroids include:
– Myomectomy or selective removal of the fibroids within the uterus
– Destructive techniques that involve boring holes into the fibroids with a laser or freezing probes (cryosurgery)
– Other techniques employed are uterine artery embolisation (UAE) and uterine artery occlusion (UAO)
– Hysterectomy or removal of the uterus
– Non-surgical methods comprising of steroidal medication are also used to stabilise the oestrogen levels in the body.
Risks during pregnancy
Some studies indicate that the presence of uterine fibroids during pregnancy increases the risk of complications, such as first trimester bleeding, breech presentation, placental abruption, increased chance of caesarean section and problems during labour.