Dr. Maitrayee Chennu: Empowering Women through Innovative OB-GYN Care (Part - 2)

Dr. Maitrayee: In my practice, I handle a wide variety of obstetric and gynecological cases. On the obstetrics side, I provide care for women throughout their pregnancies, including routine prenatal check-ups, managing high-risk pregnancies, and overseeing labor and delivery. I also support patients who need fertility treatments or family planning counseling.

In gynecology, I treat conditions such as fibroids, endometriosis, pelvic inflammatory disease, and menstrual irregularities. I also provide care for women experiencing menopause and help manage conditions like polycystic ovary syndrome (PCOS) and ovarian cysts.

Laparoscopic surgery is often a key part of my practice, where I perform minimally invasive surgeries for a range of gynecological conditions. My aim is always to ensure the best outcomes for my patients, using the most appropriate treatment modality for each case.

Dr. Maitrayee: India has made significant progress in reducing maternal mortality, but the rate remains higher than global averages. The MMR in India was estimated at around 113 deaths per 100,000 live births (as of 2021), which is an improvement from previous decades but still higher than the global average of 211 per 100,000 (according to the WHO).

I would say that the major reason for this is a lack of awareness. The primary causes of maternal mortality in India include complications such as hemorrhage, sepsis, eclampsia, and obstructed labor. There are notable regional disparities, with rural areas often facing higher mortality rates due to limited access to skilled care, poor infrastructure, and delayed referral to specialized centers.

Dr. Maitrayee: In cases of severe postpartum hemorrhage (PPH), my priority is stabilizing the patient. This involves a sequence of steps like administering IV fluids and blood products to address hypovolemia. Massaging of the uterus to help it contract and stop bleeding. Using uterotonic medications like oxytocin or misoprostol to promote uterine contraction. If bleeding continues, I may need to consider surgical intervention, such as a B-Lynch suture, uterine artery ligation, iliac artery ligation, or even a hysterectomy in extreme cases. Close monitoring and coordination with the anesthesia team are essential to ensuring the patient’s stability.

Dr. Maitrayee: Managing high-risk pregnancies requires careful monitoring and a proactive approach. I work closely with my patients to manage conditions such as gestational diabetes, hypertension, and multiple pregnancies. I believe in personalized care, so I assess the patient’s unique health status and create a tailored plan that ensures the best possible outcome for both mother and baby.

For complex gynecological cases, I take a multidisciplinary approach when necessary. I collaborate with other specialists, such as endocrinologists, surgeons, oncologists, and radiologists, to provide comprehensive care. Whether it’s managing advanced endometriosis or performing complex surgeries, I ensure that every patient receives the most appropriate treatment based on their individual diagnosis and needs.

Dr. Maitrayee: In the operating room, a calm mind with preparedness and quick decision-making are crucial. If there’s unexpected bleeding, I take immediate steps to control the hemorrhage, such as using hemostatic agents or converting to an open approach if necessary.

If equipment malfunctions, I have a backup plan in place, whether it’s using alternative tools or transitioning to a different method of surgery. I believe that effective communication with my surgical team is key to managing emergencies efficiently.

Dr. Maitrayee: I maintain open communication with the ICU team if there’s any indication that the patient might require intensive monitoring post-surgery. Everything is well documented in the patient’s chart to avoid confusion. This may involve patients with high-risk comorbidities, severe hemorrhage, or complex procedures. I provide them with a detailed handover of the patient’s condition and surgical history, and I stay involved in their care through regular updates.

Dr. Maitrayee: Robotic-assisted surgery has allowed me to offer greater precision, particularly for complex cases. The enhanced visualization and greater dexterity offered by robotic systems reduce the risk of complications and improve surgical outcomes. For patients, this means less post-operative pain, faster recovery, and minimal scarring. I use robotics primarily for complex gynecological surgeries, and I’ve found that it can make a significant difference in patient recovery times.

Dr. Maitrayee: As women approach menopause, I recommend them to focus on maintaining a healthy lifestyle with regular exercise, a balanced diet rich in supplements like calcium and vitamin D, and good sleep hygiene. It's also important to manage stress and stay emotionally resilient, as menopause can bring physical and emotional changes. Talking openly with a healthcare provider about symptoms and treatment options is key to making the transition smoother. Support from family and friends can also be incredibly valuable.

Dr. Maitrayee: For mild dysmenorrhea, I recommend over-the-counter pain relievers like NSAIDs (ibuprofen) and lifestyle changes, such as regular exercise and heat therapy. For more severe cases, hormonal treatments like birth control pills or IUDs can be effective in regulating periods and reducing cramping. In cases of underlying conditions like endometriosis, I might consider more advanced treatments, including surgery if necessary.

Dr. Maitrayee: I would encourage aspiring medical professionals to stay curious, embrace lifelong learning, and maintain empathy in all patient interactions. Medicine is a constantly evolving field, and it’s crucial to keep up with the latest research and techniques. At the same time, being compassionate and patient-centered will allow you to truly make a difference in your patient’s lives. Finally, finding a niche or specialization that resonates with you can help create a fulfilling career.