From the Research
The FOGSI guidelines for obstetric and gynecological care provide comprehensive recommendations for healthcare providers in India, prioritizing morbidity, mortality, and quality of life as the primary outcomes. These guidelines cover a wide range of topics including antenatal care, labor management, gynecological conditions, and reproductive health. For antenatal care, FOGSI recommends at least four antenatal visits for uncomplicated pregnancies, with the first visit ideally before 12 weeks, as supported by recent studies 1. Iron supplementation (100mg elemental iron and 500mcg folic acid daily) is recommended throughout pregnancy. For gestational diabetes screening, a 75g oral glucose tolerance test is advised between 24-28 weeks. In labor management, the guidelines recommend active management of the third stage using oxytocin 10 IU intramuscularly after delivery of the anterior shoulder. For postpartum hemorrhage prevention, misoprostol 600mcg orally or sublingually can be used when oxytocin is unavailable.
Regarding gynecological care, FOGSI provides protocols for managing conditions like abnormal uterine bleeding, polycystic ovary syndrome, and menopausal symptoms, with recent updates on hypertension in pregnancy emphasizing the importance of distinguishing between pre-existing and gestational hypertension 2, 3. For contraception, the guidelines emphasize informed choice and recommend postpartum IUD insertion within 48 hours of delivery when appropriate. FOGSI also addresses infertility management, recommending a structured approach beginning with basic investigations before proceeding to advanced reproductive technologies. Additionally, FOGSI has provided recommendations for human papillomavirus vaccination, emphasizing its importance in preventing cervical cancer 4.
Key aspects of the FOGSI guidelines include:
- Antenatal care: at least four visits, iron supplementation, and gestational diabetes screening
- Labor management: active management of the third stage and postpartum hemorrhage prevention
- Gynecological care: protocols for managing various conditions and emphasis on human papillomavirus vaccination
- Contraception: informed choice and postpartum IUD insertion
- Infertility management: structured approach with basic investigations and advanced reproductive technologies.
These guidelines are regularly updated to incorporate evidence-based practices while considering the specific healthcare context in India, with recent studies informing recommendations on hypertension in pregnancy and human papillomavirus vaccination 1, 2, 4, 3.