Department of OBS and GYNAE

INTRODUCTION

Exploring the Essential Activities in the Gynecology Department: A ComprehensiveOverview

The gynecology department serves as a pivotal realm within healthcare, focusing on thecomprehensive care of women’s reproductive health. This specialized fieldencompasses a wide array of activities, from routine examinations and screenings toadvanced surgical interventions and fertility treatments. Gynecologists are not onlytasked with diagnosing and managing conditions such as endometriosis, polycysticovary syndrome, and various cancers, but also play a crucial role in preventive carethrough education and counseling. As societal attitudes toward women’s health evolve,the gynecology department increasingly integrates multidisciplinary approaches,emphasizing holistic care that addresses both physical and emotional well-being.

Understanding the diverse activities within this department is essential for appreciatingits impact on women’s health outcomes and overall quality of life. Upon entering thegynecology department, one is enveloped in a unique atmosphere that blends clinicalprecision with a comforting warmth. The walls are painted in soft pastels, evoking asense of calm, while the gentle hum of fluorescent lights overhead creates a serenebackdrop. As patients navigate through the waiting area, they are greeted by the faintscent of antiseptic mingling with floral air fresheners, a reminder of the sterile yetnurturing environment designed to promote healing. The examination rooms, oftenadorned with motivational posters and educational materials, invite patients into aspace where their concerns can be addressed openly. Here, the cool touch of medicalinstruments contrasts sharply with the soft fabric of the examination table, which ismeticulously covered in crisp white linens. Each tool, from speculums to ultrasounddevices, gleams under the bright lights, reflecting the commitment to precision and careinherent in gynecological practice. As consultations commence, the sound of rustlingpapers and the soft murmur of voices fills the air, punctuated occasionally by thereassuring tone of the physician. This dialogue is not merely clinical; it is an intimateexchange where fears and hopes intertwine. The gynecologist listens attentively,offering insights that resonate like a soothing balm, alleviating anxieties surroundingreproductive health issues. In procedures such as Pap smears or pelvic exams, thetactile sensations become paramount. Patients may feel a momentary chill as thedoctor prepares the instruments, but this is swiftly followed by the warmth ofreassurance as the physician explains each step. The experience is akin to navigatinguncharted waters, where the skilled hands of the gynecologist serve as a steady guide,ensuring safety and comfort throughout. Ultimately, the activities within the gynecologydepartment extend beyond mere medical procedures; they encapsulate a profoundjourney of trust and empowerment. Each interaction, whether through diagnosis oreducation, fosters a deeper understanding of women’s health, transformingapprehension into knowledge and confidence. In summary, the gynecologydepartment stands as a sanctuary of care and understanding, where the complexities of

women’s health are addressed with both expertise and compassion. Each activity withinthis space—whether it be routine examinations, intricate surgeries, or educationalconsultations—serves to empower women, transforming anxiety into knowledge andfostering a sense of agency over their own bodies. The harmonious blend of clinicalprecision and emotional support creates an environment that not only prioritizesphysical well-being but also nurtures mental and emotional health. As we reflect on themyriad activities that unfold in this vital department, it becomes clear that gynecology ismore than a medical specialty; it is a commitment to enhancing the quality of life forwomen at every stage. By championing preventive care and open dialogue, thegynecology department paves the way for healthier futures, leaving an indelible mark onthe lives it touches.

Faculties: Headed by Dr. Hema J. Shobhane Obstetrics and Gynaecology department is

well supported by an array of experienced faculty members, Senior Residents andJunior Residents who are working day in and out to provide comprehensive health careservices round the clock.

Services available:

– Outpatient services

– In-patient Services

– State of Art “Smart Labor Room Services” with different labor room sections forfirst stage monitoring. The second stage labor room is divided into threesections- clean labor room, septic labor room and separate labor room for HIVand HBsAg positive patients. Special care and monitoring availableforecclampsia patients in dedicated “ecclampsia room”.

– Infusion pumps available for accurate dose delivery of life saving drugs.

– Outlet forceps delivery services available for complicated labor.

– 24 hour USG machine and CTG machine available for monitoring in labor room.

– 24 hour Emergency Patient Services

– In-house Ultrasound services

– 24 hour Operation Theatre Services for Cesarian Section, Complicated Surgerieslike ruptured ectopic, ruptured uterus, Ecclampsia

– Operation Theatre divided into three sections with one dedicated EmergencyObstetrics OT and another second Theatre dedicated to specific Laproscopy andhysterocopic procedures. The third section of OT is specifically designed formajor gynaecological and elective procedures.

– Laproscopic Surgeries for Ovarian cysts, ectopic pregnancy, DiagnosticLapsroscopy

– Diagnostic and Operative Hysteroscopy

– Fertility enhancing treatments and services like Ovulation Induction and IUI.Facilities of IVF for subfertile couples will be starting very soon.

– Comprehensive and safe abortion care

 -Family Planning Services including both temporary and Permanent methods likeFemale sterilization (both minilap and laproscopic)

– Day Care Iron Clinic

– Day Care Minor OT for simple procedures like CuT removal, hydrotubation,Endometrial and Cervical Biopsy

– Cervical Cancer Screening Via Pap Smear

– Special Clinics for Adolescent Health, Endocrinological disorders, PostMenopausal Women, Infertility, Gynae-Onclogy services and High RiskPregnancies

– Gestational Diabetes and hypertensive Screening

– Facilities for private room also available.

Research Activities and Achievements:

Apart from exhaustive patient care, there is a battery of research work going on in thedepartment.

Currently, 26 thesis work is under progress. Given below is a list of publications fron thedepartment:

– A retrospective Study of Intrauterine Foetal Demise in Bundelkhand Region- Dr.

Hema J. Shobhane, Dr. Garima Singh

-Novel technique for repairing episiotomy incisions to achieve optimal vaginal andperineal anatomy – Dr. Hema J. Shobhane, Dr. Diksha Sharma

– To study the correlation of maternal serum vitamin d levels and infant serumvitamin d levels with infant birth weight: A single center experience frombundelkhand region- Dr. Hema J. Shobhane, Dr. Srishty

– ‘Study on maternal and perinatal outcome in ecclampsia in tertiary care hospital’-International Journal of Reproduction, Contraception, Obstetrics andGynaecology Agarwal et al. Int J Reprod Contracept Obstet Gynaecol. 2023

Jul;12(7):2192-2192 www.ijrcog.org

– ‘A histopathological study of hysterectomy specimens and their clinicalcorrelation in patients at tertiary health care set up in Bundelkhand region ofUttar Pradesh- International Journal of Reproduction, Contraception, Obstetricsand Gynaecology Agarwal et al. Int J Reprod Contracept Obstet Gynaecol. 2023Aug;12(8):2412-2416 www.ijrcog.org

– Contribution in Book : A chapter on a Female Genital Tuberculosis published inMCOs in Obstetrics and Gynaecology for MD & DM Entrance Exam- Dr. SippyAgarwal

– ‘Analysis of CRP, PCT, D-Dimer in Preeclampsia Patients’ – International Journalof Science and Research (IJSR) ISSN: 2319-7064 SJIF (2022): 7.942- Dr. SippyAgarwal, Dr. Supriya, Dr. Rajni Gautam

– ‘Preterm Labor: Role of Progesterone in Pre Term Labor’ in Global Journal forResearch Analysis for 15th August 2024 issue- Dr. Preeti Kanal, Dr. Rajni Gautam

– ‘Transvaginal repair of Vesicovaginal Fistula: experience at a tertiary care centre’in International Journal of Scientific Research Volume-11 I Issue -04I April 2022IPRINT ISSN No. 2277-8179I DOI:10.36106/ijsr.- Dr. Divya Jain

– ‘Laproscopic Management of Ectopic Pregnancy’ in International Journal ofRecent Research in Life Sciences(IJRRLS) Vol 5,Issue 2,pp: (1-6), Month: April-June 2018- Dr. Divya Jain

– ‘A study to Access CAD risk in T2 DM Patients with Erectile Dysfunction: AnObservational Study’ in Journal of Cardiovascular Disease researchI ISSN:0975-3583, 0976-2833I VOL15 ISSUE6I2024I- Dr. Divya Jain

– ‘Assessing Incidence and Association of Serum Magnesium Levels, Serum UricAcid Levels and Microalbuminuria in Patients with Type 2 DM: A ObservationalStudy’ in http://jchr.org/index.php/JCHR/article/view/4970/3180 – Dr. Divya Jain

– ‘Assessment of quality of life after unilateral vaginal sacrospinous ligamentfixation (VSF)following vaginal hysterectomy for treatment of vaginal vaultprolapse’ in IJSR ( International Journal Of Scientific Research) Volume-10I Issue-06I June-2021 I PRINT ISSN No. 2277-8179I DOI: 10.36106/IJSR – Dr. Divya Jain

– Management of Symptomatic urolithiasis during pregnancy: Clinical experiencefrom a tertiary center’ in Asian Journal of Medical SciencesI Nov 2022I Vol 13IIssue 11 – Dr. Divya Jain

– ‘Interesting rare case of recurrent puerperal uterine inversion: a case report’ in

International Journal of Reproduction, Contraception, Obstetrics andGynaecology. DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20222336 – Dr.

Sushila Kharkwal, Dr. Divya Jain, Dr. Sippy Agarwal, Dr. Divya Pandey

– ‘Placenta percreta with bladder invasion-a novel approach for management: Acase report’- in Asian Journal of Medical Sciences- By Dr. Sushila Kharkwal, Dr.Divya Jain, Dr. Manish Jain, Dr. Shitangsu Kakoti, Dr. Divya Pandey

– ‘Incidence, Presentation and Management of Encephalocoele at a tertiary levelCenter’ in Global Journal for research analysis for 15th February 2024 issue. – dr.Sucheta Rajput, Dr. Dinesh Kumar Rajput, Dr. Vijendra Maurya

Government Schemes Operating in the Department:

Janani Shishu Suraksha Karyakram

A scheme by Ministry of MoHFW for pregnant women who access government healthfacilities for their delivery. to absolutely free and no expense delivery, includingcaesarean section. Essential care is provided to the mother and her neonate within 48hours. Reasons like high out of pocket expenditure ondiagnostics/investigations, blood,drugs, food and user charges institutional delivery JSSK was launched in June 2011 toeliminate out-of-pocket expenses for institutional delivery of pregnant women andtreatment of sick infants. In 2014, the programme was extended to all antenatal &postnatal complications of pregnancy and similar entitlements have been put in placefor all sick newborns and infants (up to one year of age) accessing public healthinstitutions for treatment.

Services For pregnant women-

1. Free and cashless delivery

2. Free C-Section

3. Free drugs and consumables

4. Free diagnostics

5. Free diet during stay in the health institutions

6. Free provision of blood

7. Exemption from user charges

8. Free transport from home to health institutions

9. Free transport between facilities in case of referral

10.Free drop back from Institutions to home after 48hrs stay

Services For sick newborns till 30 days after birth (now been expanded to also cover

sick infants) –

1. Free treatment

2. Free drugs and consumables

3. Free diagnostics

4. Free provision of blood

5. Exemption from user charges

6. Free Transport from Home to Health Institutions

7. Free Transport between facilities in case of referral

8. Free drop Back from Institutions to home

Janani Suraksha Yojana (JSY) : JSY is a safe motherhood intervention under the

National Health Mission. It is being implemented with the objective of reducingmaternal and neonatal mortality by promoting institutional delivery among poorpregnant women. The scheme, launched on 12 April 2005 by the Hon’ble Prime Minister,is under implementation in all states and Union Territories (UTs), with a special focus onLow Performing States (LPS).

Anaemia Mukt Bharat strategy: Anemia Mukt Bharat strategy is implemented to reduce

anaemia among six beneficiaries age group – children (6-59 months), children (5-9years), adolescents (10-19 years), pregnant and lactating women and in women ofreproductive age group (15-49 years) in life cycle approach through implementation ofsix interventions via robust institutional mechanism.

The six interventions under Anaemia Mukt Bharat strategy are as follows:

i) Prophylactic Iron Folic Acid Supplementation

ii) Periodic deworming

o MoHFW is implementing National Deworming Day (NDD) programme under whichbiannual mass deworming for children and adolescents in age group 1-19 years iscarried on designated dates – 10th February and 10thAugust every year.o Pregnant women are provided services under the strategy through antenatal carecontacts (ANC clinics/ VHND) for deworming (in the second trimester).

iii) Intensified year-round Behavior Change Communication Campaign for a0compliance to IFA and deworming; b) Appropriate Infant and Young Child Feeding (IYCF)with emphasis on adequate and age-appropriate complementary foods for children 6months and above; c) Increase intake of iron-rich, protein-rich and vitamin C-rich foods;dietary diversification; food fortification; d) Promoting practice of delayed cord clamping.

iv) Testing and Treatment of anemia using digital methods (Digital Invasive

Haemoglobinometer) in field settings, Sub Health Centres, Health and Wellness Centres;and Semi-auto analyzer in health facilities PHC and above; and point of care treatment.

Anemia Management protocols to be followed are mentioned in Operational Guidelines

for Anemia Mukt Bharat

v) Mandatory provision of Iron and Folic Acid fortified foods in government-fundedhealth programmes.

vi) Intensifying awareness, screening and treatment of non-nutritional causes ofanaemia in endemic pockets, with special focus on malaria, haemoglobinopathies and

fluorosis.

Medical Termination of Pregnancy Act: The new Medical Termination of Pregnancy

(Amendment) Act 2021 expands the access to safe and legal abortion services on therapeutic,eugenic, humanitarian and social grounds to ensure universal access to comprehensive care.

The new law, which came into force from 25 March 2021, will contribute towards endingpreventable maternal mortality to help meet the Sustainable Development Goals (SDGs).

Key amendments:

– Increasing the upper gestation limit from 20 to 24 weeks for special categoriesof women, including survivors of rape, victims of incest and other vulnerablewomen (differently abled women, minors, among others).

– The opinion of one provider needed for the termination of pregnancy up to 20weeks of gestation. Requirement of the opinion of two providers for thetermination of pregnancy from 20-24 weeks of gestation.

– Upper gestation limit to not apply in cases of substantial foetal abnormalitiesdiagnosed by a Medical -Board.

– Confidentiality clause. The name and other particulars of a woman whosepregnancy has been terminated cannot be revealed except to a personauthorised by law.

– Extended MTP services under the failure of contraceptive clause to unmarriedwomen to provide access to safe abortion based on a woman’s choice,irrespective of marital status.

Achievements:

-Active Participation in different Gynaecological Conferences- with 3 paperpresentation and 2 poster presentations NIGF at Gorakhpur in July 2024.

-Dr. Veena got third prize for her paper presentation on Innovative technique inepisiotomy in senior category.

– Scientific Deliberation By Dr. Hem J. Shobhane on PPROM

-Dr. Hema J. Shobhane participated as Chairperson in High Risk Pregnancy panel,participated as panelist on OI in hyporesponders.

-Breast feeding week Celebration in the department

– Monthly maternal Death review meeting

– Best Department Award at MLB medical College

– Maintainence of records and entry on 3 government portal- HMIS, U-WIN,MANTRA

– Press Meeting in August 2024 to celebrate :”Shodh Srijan Karyakram” – Anintiative to build scientific temperament in students.

– Fruits distribution to patients on 15th August

– Organistaion of endless CMEs on IUGR, Ca Cervix, Mullerian Anomalies,Ovulation Induction etc.

FACULTY DETAILS