As a newly qualified obstetrics‑gynecology consultant in India joining a high‑volume hospital, what essential knowledge and skills should I have for outpatient department (OPD) management, OPD procedures, and basic operating theatre (OT) surgeries?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: February 8, 2026 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Essential Competencies for a New OB-GYN Consultant in India

आपको एक high-volume Indian hospital में शुरुआत करने से पहले OPD में routine antenatal care, basic gynecological procedures, और OT में cesarean sections और common emergency surgeries में पूरी तरह confident होना जरूरी है। यह आपकी सबसे बड़ी priority होनी चाहिए क्योंकि Indian scenario में ये सबसे common और life-saving skills हैं।

OPD में Essential Clinical Skills

Antenatal Care (ANC) Management

आपको minimum 8 ANC visits का protocol follow करना होगा जो Indian guidelines के अनुसार mandatory है 1:

  • First trimester (12 weeks तक): Registration, baseline investigations (hemoglobin, blood group, HIV, HBsAg, VDRL), dating ultrasound, और risk stratification 1
  • Second trimester: Anomaly scan at 20 weeks, blood pressure monitoring हर visit पर, hemoglobin check, और high-risk cases की identification 1
  • Third trimester: हर 2-4 weeks visits, fetal growth monitoring, और delivery planning 1

Critical screening जो आप miss नहीं कर सकते:

  • Blood pressure measurement हर visit पर hypertensive disorders detect करने के लिए 1
  • Hemoglobin testing anemia के लिए 1
  • HbA1c testing उन mothers में जिनकी diabetes की history है 1
  • Aspirin 100-150 mg/day देना 16 weeks से पहले उन women को जिनमें preeclampsia का risk है 1
  • Calcium supplementation 1200 mg/day low calcium intake वाली population में 1

High-Risk Pregnancy Identification

आपको immediately identify करना होगा कि कौन सी patient को higher level facility में refer करना है 2:

  • Level II facility referral: Severe preeclampsia, placenta previa without prior surgery 3
  • Level III/IV facility referral: Placenta accreta spectrum, extreme hemorrhage risk, cardiac conditions, liver disease 2
  • Previous cesarean with placenta previa को हमेशा tertiary center में refer करें 2

Basic OPD Gynecological Procedures

आपको independently perform करने आने चाहिए:

  • Pap smear और cervical cancer screening
  • IUD insertion और removal
  • Endometrial biopsy
  • Colposcopy (if available)
  • Basic ultrasound interpretation for gynecological conditions

Labor Room और Delivery Management

Partograph का Proper Use

Partograph आपका सबसे important tool है labor monitoring के लिए 1:

  • Active phase (≥4 cm dilatation) पर start करें 1
  • हर 2 hours cervical dilatation check करें 1
  • Fetal heart rate हर 15-30 minutes active phase में 1
  • Alert line cross होने पर immediate action लें - यह prolonged labor का early warning है 1

Stage-wise Labor Management

Kala I (First Stage):

  • Latent phase में हर 4 hours monitoring 1
  • Active phase में हर 2 hours progress assessment 1
  • Fetal heart monitoring: latent phase में हर 30 minutes, active phase में हर 15-30 minutes 1

Kala II (Second Stage):

  • Fetal heart हर 5-15 minutes 1
  • Comfortable maternal positions allow करें 1
  • Episiotomy selective basis पर करें, routine नहीं 1

Kala III (Third Stage):

  • Active management mandatory है: Oxytocin 10 IU IM immediately after delivery 1
  • Controlled cord traction with counter-traction 1
  • Uterine massage after placenta delivery 1
  • Placenta completeness की careful inspection 1

Kala IV (Fourth Stage):

  • First hour में हर 15 minutes vital signs 1
  • Second hour में हर 30 minutes monitoring 1
  • Uterine tone और bleeding की continuous assessment 1

Essential OT Procedures

Cesarean Section - Step by Step

आपको independently perform करने आना चाहिए:

  1. Pfannenstiel incision - यह India में most common approach है
  2. Bladder dissection और lower segment entry - sharp dissection से बचें, blunt dissection prefer करें
  3. Baby delivery - gentle fundal pressure के साथ
  4. Placenta removal - controlled cord traction
  5. Uterine closure - double layer closure (though single layer भी acceptable है in some situations)
  6. Hemostasis verification - angles और extension sites carefully check करें
  7. Systematic closure - peritoneum closure optional है

Emergency Procedures जो आपको आने चाहिए

Life-saving procedures जो delay नहीं कर सकते:

  • Manual removal of placenta - retained placenta के लिए
  • Bimanual uterine compression - postpartum hemorrhage control के लिए
  • B-Lynch suture या uterine compression sutures - atonic PPH में
  • Cervical tear repair - proper visualization के साथ
  • Peripartum hysterectomy - last resort के रूप में, but आपको steps पता होने चाहिए

Common Gynecological Surgeries

Basic procedures जो high-volume hospital में common हैं:

  • Dilatation and curettage (D&C) - incomplete abortion, abnormal bleeding के लिए
  • Manual vacuum aspiration (MVA) - early pregnancy loss management
  • Bartholin's cyst/abscess drainage
  • Cervical polypectomy
  • Diagnostic laparoscopy - if trained

Critical Safety Protocols

Massive Transfusion Protocol

आपको hospital का blood bank protocol पता होना चाहिए 3:

  • Emergency blood release procedure
  • Massive transfusion activation criteria
  • Component therapy sequence

Referral और Transfer Protocols

Clear thresholds होनी चाहिए कब transfer करना है 3:

  • Level I facility से Level II: Severe preeclampsia, significant hemorrhage 3
  • Level II से Level III/IV: Placenta accreta, cardiac emergencies, need for ICU 2
  • Transport arrangements पहले से plan करें 3

Common Pitfalls से बचें

नए consultants जो mistakes करते हैं:

  1. Partograph ignore करना - यह medico-legal protection भी है 1
  2. High-risk cases को timely refer न करना - अपनी limitations accept करें 2
  3. Active management of third stage skip करना - यह PPH prevention का cornerstone है 1
  4. Inadequate documentation - हर decision document करें
  5. Solo practice without backup - initially senior colleague की availability ensure करें

Practical Preparation Steps

Joining से पहले:

  • Hospital के protocols, forms, और documentation system समझें
  • Blood bank, anesthesia, और pediatrics teams से introduce हो जाएं
  • Emergency equipment की location और functioning check करें
  • Referral centers के contact numbers और transfer protocols note करें
  • Medico-legal documentation requirements समझें

First few weeks में:

  • Senior colleagues के साथ cases observe करें
  • Initially supervised cesareans करें
  • OPD में complex cases senior को दिखाएं
  • Regular case discussions attend करें
  • Local disease patterns और patient expectations समझें

Indian context में specific considerations:

  • Patient load बहुत high होगा - efficient workflow develop करें
  • Language barriers हो सकती हैं - local language basics सीखें
  • Resource limitations होंगी - improvisation skills develop करें
  • Family involvement significant है - relatives को counseling में include करें
  • Medico-legal awareness रखें - proper consent और documentation critical है

यह comprehensive preparation आपको confident बनाएगी, लेकिन याद रखें कि initial months में help मांगना weakness नहीं है - patient safety हमेशा priority है।

References

1
Guideline

Pelayanan Kebidanan Dasar di Indonesia

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

2
Guideline

High-Risk Pregnancy Management Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

3
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Related Questions

What is the appropriate management of foreign body aspiration and foreign bodies in the nose, mouth, eye, and ear?
What oral prednisolone dosing regimen (dose, duration, and taper) is recommended for a child with acute arthritis?
In a child with a known fatty‑acid‑oxidation disorder who develops fatigue and hypoglycemia during a viral illness, what is the most effective measure to prevent metabolic decompensation in future illness episodes?
In a 60-year-old man with hypertension and a prosthetic aortic valve who is taking lisinopril, amlodipine, and warfarin, which medication requires dose adjustment after initiating first‑line anti‑tuberculosis therapy?
What is the recommended emergency management for a patient with suspected anaphylaxis, including intramuscular epinephrine dosing, positioning, supplemental oxygen, airway support, intravenous crystalloid resuscitation, adjunct antihistamine and corticosteroid therapy, repeat dosing criteria, observation duration, and prescription of an epinephrine auto‑injector?
In a patient with less than 50 % carotid artery stenosis and a recent subdural hematoma (SDH), is antiplatelet therapy indicated and when can it be safely started?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question