Antenatal Corticosteroid (ACS)
Prepared for: Bangladesh EmONC FacilitiesSource references: WHO, RCOG, ACOG, OGSB protocols 1) Bangladesh — National / OGSB Practical Summary Indication: Drugs & regimen (choose either): Timing / Target Window: Repeat Dosing: Mechanism & Benefits: Contraindications / Cautions: Other notes: 2) International Guideline Positions WHO (2022): RCOG (Green-top 74, 2025): ACOG (Committee Opinion 713, 2017, reaffirmed […]
Non-descent Vaginal Hysterectomy (NDVH)
Prepared by : Prof. Dr. Kh. Shahnewaj, FRCOGDate: 4ᵗʰ October 2025Institution: Department of Obstetrics & Gynaecology, Kumudini Women’s Medical College, MirzapurAdapted from: FOGSI, AAGL, SOGC, ACOG, and RCOG GuidelinesVersion: 1.0 Purpose & Scope Indications (FOGSI and International Consensus) Exclusion Criteria Preoperative Workup Informed Consent Counselling should include: Operative Protocol (Stepwise) Conversion Criteria Conversion from vaginal […]
Osteoporosis and Fragility Fractures
Introduction Osteoporosis is a disease characterised by low bone mass and structural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Osteoporosis leads to nearly 9 million fractures annually worldwide (Johnell and Kanis, 2006), and over 300,000 patients present with fragility fractures to hospitals in the UK each year. […]
Management of Breech Presentation
Information should be given to women with breech presentation ➢ Women with a breech presentation at term should be offered external cephalic version (ECV) unless there is an absolute contraindication. They should be advised on the risks and benefits of ECV and the implications for mode of delivery.➢ Women who have a breech presentation at […]
Abnormal Uterine Bleeding
1. Definition & classification (quick) AUB = bleeding from the uterus that is abnormal in frequency, regularity, duration, or volume (outside pregnancy). Use FIGO PALM-COEIN classification for etiology: Polyp, Adenomyosis, Leiomyoma, Malignancy/hyperplasia (structural) — Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified (non-structural). 2. Triage / initial priorities (all settings) Urgent if very heavy bleeding […]
Polycystic Ovarian Syndrome (PCOS)
1. Bangladesh Context (OGSB / DGHS practice-based protocol) PCOS is common in reproductive-aged women in Bangladesh; management is adapted to resource settings and affordability. Diagnosis (Based on Rotterdam Criteria – 2003, adopted in Bangladesh) Need ≥2 of 3: Exclude other causes (thyroid disease, hyperprolactinemia, non-classical CAH, androgen-secreting tumor). Management – Stepwise 2. RCOG Guidance (Green-top […]
Shoulder Dystocia
Background Shoulder dystocia is defined as a vaginal cephalic delivery that requires additional obstetric manoeuvres to deliver the fetus after the head has delivered and gentle traction has failed.Shoulder dystocia occurs when either the anterior, or less commonly the posterior, fetal shoulder impacts on the maternal symphysis, or sacral promontory, respectively.Incidences between 0.58% and 0.70%.Maternal […]
Evidence-Based Guidelines: Evaluation of Adnexal Mass
Introduction Adnexal masses can be benign or malignant, ranging from simple functional cysts to ovarian carcinomas. The clinical challenge is distinguishing benign from malignant lesions to ensure timely intervention while avoiding unnecessary surgery. Purpose and Scope This guideline provides evidence-based information to assist clinicians with the initial assessment and appropriate management of suspected ovarian masses. […]
Menopausal Hormone Therapy (MHT)
Menopause: Permanent cessation of monthly menstruation for at least 12 months at the end of reproductive life due to loss of ovarian function. Average age is 51 years (range 45–55). MHT/HRT is sometimes used to treat symptoms of menopause due to estrogen deficiency. Indications of MHT: Relieving menopause symptoms (hot flushes, night sweats, sleep problems, […]
Umbilical Cord Prolapse
Hospital Protocol: Management of Umbilical Cord Prolapse Purpose: To provide a clear, evidence-based, stepwise approach for the recognition and management of umbilical cord prolapse (UCP), aiming to reduce perinatal morbidity and mortality through timely and appropriate intervention. Scope: Applies to all obstetric and neonatal care providers (obstetricians, anesthetists, midwives, nurses, neonatologists, support staff) working in […]