Gynaecological check-ups, treatments and minimally invasive procedures ensure your health and comfort during puberty, pregnancy and Menopause

You may not be pregnant yet, but the best way to care for your future pregnancy is to get a thorough pre-conception check-up. A careful evaluation will make it easier to address potential risks before embarking on the pregnancy journey. Dr Krick will help optimize your health.

Your first pregnancy appointment focuses on you to ensure the best pregnancy outcome possible. A detailed history into your health and previous pregnancies, as well as thorough physical examination, help Dr Krick determine any risk factors which need to be addressed. During your ultrasound examination you get your first glimpse of your precious baby (or two). Dr Krick will also be able to give you an estimated due date.

Throughout the pregnancy journey, Dr Krick strives to create a relationship of understanding and trust with her patients. Antenatal assessments are aimed at optimising your health to provide the ideal environment for development and growth of your baby as well as creating a positive experience for you by providing support and guidance throughout your pregnancy. Dr Daniela provides you with individualised care aimed at minimizing common bothersome pregnancy symptoms. She will also screen you for any possible pregnancy complications and ensures good growth and well-being of your unborn baby.

Dr Krick has extensive training and experience in supporting pregnancies complicated by multiple gestation (twins/triplets), diabetes, hypertension, pre-eclampsia, preterm labour, placental problems and more. With a network of other experts (feto-maternal specialists, physicians and other experts) she can co-ordinate specialised care should this be needed. In addition CBMH is renowned for its state-of-the-art neonatal unit.

Throughout your pregnancy Dr Krick will perform scans to check on baby’s growth, position and placental function. 3D scans may provide you with some amazing images to add to your baby’s first photo album. Dr Krick refers moms to fetal assessment specialists for specialised scans:

• Nuchal Translucency (for Down’s Syndrome/ trisomies)
• Fetal Anomaly Scan (for intensive anatomical assessment)

Should further testing be desired or required NIPT testing, amniocentesis or chorionic villus sampling can be done.

Because each mother and baby are unique, no delivery is the same. Giving birth leaves you with an experience to remember for the rest of our life, therefore it is important to ensure you are comfortable and confident in your choices regarding labour and delivery. With Dr Krick’s support and guidance, you will be able to choose the delivery plan that best suits your pregnancy. She is pro natural birth and strives to honour your birth preferences, but always makes your and baby’s safety the priority. Under the right circumstances VBACs, after one previous Caesarean Section, are welcomed.

Because each mother and baby are unique, no delivery is the same. Giving birth leaves you with an experience to remember for the rest of our life, therefore it is important to ensure you are comfortable and confident in your choices regarding labour and delivery. With Dr Krick’s support and guidance, you will be able to choose the delivery plan that best suits your pregnancy. She is pro natural birth and strives to honour your birth preferences, but always makes your and baby’s safety the priority. Under the right circumstances VBACs, after one previous Caesarean Section, are welcomed.

In order to start a young woman’s relationship with gynaecological services in a positive way, Dr Krick creates a comfortable, non-judgemental and safe space. She has a particular gift in connecting with people of all ages. No question should feel awkward and no issue is off limits. The goal is to empower young women by educating them about the female anatomy and physiology as they transition to womanhood. Dr Krick’s relaxed nature also makes it easy for young women to talk about safe sex and the best contraceptive choices available.

There is a multitude of choices available when it comes to contraception. Dr Krick will help you choose the one which is safest for you and suit your lifestyle best, be it pills, patches, rings, implants or intrauterine devices. The Implanon®, Mirena®, Kyleena®, Copper-T, Copper Pearls® (IUB) can all be inserted as a quick in-room procedure. Sedation services are also available by a registered sedationist if required.

Menopause and peri-menopause is a natural stage of life and may not require any specific medical treatment. However, a variety of frustrating symptoms may negatively affect a woman’s physical, sexual and emotional well-being. These include hot flushes, mood and sleep disturbances, vaginal dryness and painful intercourse, bladder leakages and frequent infections. A thorough check-up including cervical cancer screen, mammogram and bone density screen (when appropriate) are essential to optimise the mature woman’s health and minimise any risk factors. There are many options available to alleviate symptoms and restore your quality of life ranging from lifestyle modifications, hormone therapy, bioidenticals to complimentary medicines and even laser treatment. Let Dr Krick help you choose the best option for you.

Pain free Pap smears are part of routine gynaecological examinations. The sample is sent to the laboratory for testing. Results take approximately 3-5 days and may be reported as normal or abnormal. Keep in mind that not all abnormal results mean cancer. Depending on the results, routine follow-up screening, repeat testing in 6-12 months or a colposcopy may be advised. For information on colposcopy please see our procedures section.

Most women get through their monthly periods with few or no concerns. Their periods come like clockwork, starting and stopping at nearly the same time every month, causing little more than a minor inconvenience. However, some women experience a host of physical and /or emotional symptoms just before and during menstruation. From heavy bleeding and missed periods to unmanageable mood swings, these symptoms may disrupt a woman’s life in major ways. Most menstrual cycle problems have straightforward explanations. A range of treatment options exist to relieve symptoms and Dr Krick is ready to offer you the best solution to your problem. Should you experience bleeding after menopause it is important to make an appointment to see a gynaecologist.

Uterine fibroids (also known as myomas or leiomyoma) are non-cancerous growths that can be found in the muscle layer of the uterus of 20 to 40 % of women. Fibroids are mostly not noticed, but may lead to a number of symptoms, including:

• Menstrual symptoms: heavy, prolonged and/or painful periods.
• Pressure symptoms: abdominal discomfort and bloating, urinary frequency or retention, constipation, backache, painful sexual intercourse.
• Fertility and pregnancy problems.

Most fibroids can be left alone but depending on the size, number and location of the fibroids, and the severity of your symptoms, various treatment options exist. Not all fibroids require surgery as symptoms can be controlled with medication. Many women with fibroids are advised to have a hysterectomy, but several uterus preserving treatments which shrink or remove the fibroids are also available. These include uterine fibroid embolization or various surgical options. Dr Krick will help you choose the option best suited to your individual needs.

Endometriosis

Endometriosis is a condition where tissue, similar to the tissue that normally grows inside the uterus (endometrium), also grows outside of the uterus. Some women with endometriosis have few or no symptoms while others have severe pain symptoms: period pain, chronic pelvic pain, painful intercourse and/or pain when passing stool or urine. Endometriosis may also cause abnormal bleeding and fertility problems. There is no cure for endometriosis, but there are several treatment options ranging from medication to surgery. The best treatment depends on your individual situation and takes into account your symptoms, age and desire to have children.

Chronic Pelvic Pain

Chronic Pelvic Pain is long-standing (more than 6 months) pain in and around the pelvic area. The condition is frustrating and can lead to serious anxiety as well as sexual dysfunction. Dr Krick will carefully assess you to find the cause and implement the most effective treatment that can significantly improve your quality of life.

Most fibroids can be left alone but depending on the size, number and location of the fibroids, and the severity of your symptoms, various treatment options exist. Not all fibroids require surgery as symptoms can be controlled with medication. Many women with fibroids are advised to have a hysterectomy, but several uterus preserving treatments which shrink or remove the fibroids are also available. These include uterine fibroid embolization or various surgical options. Dr Krick will help you choose the option best suited to your individual needs.

Ovarian Cysts are fluid-filled sacs in the ovary. There are many different kinds of ovarian cysts. The diagnosis of an ovarian cyst is made when performing a pelvic ultrasound. Most cysts rarely cause symptoms and resolve on their own without treatment. However, if an ovarian cyst grows larger and causes symptoms such as pain, bloating and pressure, surgical removal may be advised. Although ovarian cancer is rare, ovarian cysts which look suspicious on ultrasound or occur after the menopause always require further investigation and removal.

PCOS is a condition that can cause irregular periods, skin complaints and/or excess face or body hair growth because of hormonal imbalances. It occurs in approximately 10% of women. Regular monthly ovulation is not occurring and women with this condition, if wanting to conceive, may need fertility assistance. Although PCOS is not completely reversible, there are a number of treatments that can reduce or minimise bothersome symptoms. Women with PCOS benefit from Dr Krick’s holistic approach to empower them through education, and improving self-image and confidence. In addition, Dr Krick will take steps to decrease their risk of long-term complications such as diabetes, obstructive sleep apnoea and endometrial cancer. Most women with PCOS are able to lead a normal life without significant complications.

Common infections often present as itching, burning, discomfort, excessive discharge or a bad odour. No need to be embarrassed! Many of these infections are not sexually transmitted and most importantly, are easily treated. Some STIs (sexually transmitted infections) cause symptoms, others do not. It is important to screen for and treat STIs to protect your long-term health and your partner. Dr Krick provides a relaxed, non-judgemental environment to discuss any concerns you may have.

Bladder infections are common in women. When home remedies and over-the-counter medications don’t alleviate the symptoms, an antibiotic may be required. Women with persistent or recurrent symptoms need to be examined and investigated to exclude any underlying reasons for the problem and to provide long-term relief. Incontinence or leakage is more common than many realise! Don’t let it impact on your quality of life. Several treatment options are available depending on the woman’s individual symptoms.

Pelvic organ prolapse occurs when the muscles, ligaments and supporting tissue that hold these organs (bladder, uterus and intestine) in their correct positions become weakened. Women might feel “a ball” or fullness in the vagina, back ache, painful intercourse, problems passing urine or stool. Dr Krick will be able to advise you on the various non-surgical and surgical treatment options available to relieve your symptoms.

For couples trying to conceive the wait can be very frustrating and disheartening. A woman’s chance of conceiving naturally declines with increasing age. If you have not conceived after a year of trying (or within 6 months if you are over 35 years old) it is advisable to see a gynaecologist for assistance. Dr Krick can assist with fertility evaluation (assessment of ovulation, health of the female reproductive organs and semen analysis interpretation). She can offer basic fertility assistance (conceptual education, ovulation induction and cycle monitoring) and can refer to highly experienced fertility specialists for assisted reproductive techniques should this be required.

A miscarriage is a heart-breaking experience for any woman or couple. Miscarriages are more common than most realize but that does not make dealing with the loss any easier. Recurrent miscarriages (2 or more consecutive miscarriages) raise the question of an underlying cause. Unfortunately, in most cases no cause can be found but in about 25% of couples some kind of abnormality can be detected and treated to positively affect the chances of a good outcome of a future pregnancy. Dr Krick will take a careful history, do a thorough physical examination and recommend a number of tests to try and find an underlying cause which may be treated so you may enjoy a healthy, successful pregnancy in the future.

Dr Krick understands that sometimes a pregnancy is not planned and may negatively affect a woman’s well-being. She believes in patient choice and autonomy and will help with a request for a first trimester termination. Patients beyond the 12th week of pregnancy can be referred for assistance.

If the result of your Pap smear is abnormal, depending on the abnormality, Dr Krick will advise you to have a colposcopy. A colposcopy is an exam that’s performed in the examination room in much the same way as a Pap smear, but with a special magnifying device called a colposcope. This enables the doctor to get a clearer view the cervix and surrounding. The colposcope is placed at the vaginal opening (outside the vagina) and a bright light is shone into the vagina and onto the cervix. Dr Krick looks through the magnifying lens to examine and evaluate the cervix for any abnormal areas. A solution may be applied to the cervix and walls of the vaginal canal to help highlight abnormal cells, making them easier to see.

If an abnormal area is identified, a small sample or biopsy of tissue may be taken for further evaluation. Colposcopy typically takes less than 15 minutes to perform, and women can resume their normal routines immediately afterward. There may be some mild cramping or light spotting if a biopsy is taken, but these will resolve soon afterward.

A hysteroscopy is a procedure used to examine the inside of the uterus using a thin telescope with a video camera and light, called a hysteroscope. It is performed to diagnose and treat a variety of problems: abnormal bleeding, identifying growths in the womb and removing them, finding the reason for recurrent miscarriages and diagnosing cancer. The procedure is done under anesthesia and is therefore painless, although you may experience some cramps and spotting afterwards. No cutting is involved!

Endometrial ablation can be performed in conjunction with hysteroscopy. It is a procedure to cauterize the innermost lining of the uterus in order to treat heavy menstrual bleeding. There is a chance that the lining grows again and if heavy bleeding recurs, ablation may need to be repeated. If you are still considering future pregnancies endometrial ablation is not an option.

Laparoscopy is also known as minimally invasive or “key hole” surgery. This procedure has been used for more than three decades and utilises a laparoscope to look into the patient's pelvis and abdomen. A gynaecologic laparoscopy can be used both for diagnosing as well as treating the following conditions: endometriosis, uterine fibroids, ovarian cysts, ectopic pregnancy, pelvic adhesions or abscesses, infertility, reproductive cancers.

Hysterectomies and treatment for prolapse can also be performed via this minimally invasive technique. The benefit of laparoscopy is that owing to the tiny incisions made compared to open abdominal surgery there is much less pain, less blood loss, less scarring and patients can return to full functioning much sooner than after conventional surgery. Dr Krick has obtained advanced certification by the European Academy of Gynaecologic Surgery and is actively involved in training and examining young doctors wishing to gain this valuable qualification.

When laparoscopy is not a suitable option you are in excellent hands with Dr Krick, both for open abdominal as well as vaginal surgery. Dr Krick won the departmental prize for surgical skills while still in training at UCT. Dr Krick is experienced in performing uterine surgery (hysterectomies, myomectomies), ovarian surgery (cystectomies, oophorectomies), prolapse surgery and vagino-, labio- and hymenoplasty (vaginal rejuvenation).