Department of Obstetrics and Gynecology No 1

MEDICAL AND ADVISORY WORK

Responsible person for medical and advisory activity of the Department – Lakatosh Volodymyr Pavlovych, professor of the Chair of obstetrics and gynaecology № 1 of Bogomolets NMU, 0677943626

 

Clinical bases of the Department: Perinatal Center of Kyiv. 9 Predslavynska St.,  KCCH No. 18, gynecological ward, 17 T. Shevchenka Blvd.

The Kyiv Perinatal center is the first perinatal center in Ukraine which received high international recognition for the quality of rendering medical services.

 

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Diagnosis and skilled management of pregnant and parturient women from the high-risk group, provision of the necessary intensive care for the newborns with low and extremely low body weight. Over the past 12 years, the maternity hospital which is now the Perinatal Center is the leader in the number of births in Kyiv.

Management of prenatal care and delivery in the  Perinatal Center is going on under the supervision of the skilled medical personnel, who select an individual program of preparation for childbirth. Management of vaginal birth in women with a uterine scar has been introduced in the  perinatal center.

There is a medical-genetic consultation room, a psycho-prophylactic training room, a follow-up room, a consulting room that provides counseling services on a daily basis.

Powerful department of intensive care and neonatal intensive care is provided with modern equipment – kuvezes, the unique devices for prolonged artificial lung ventilation and monitoring of all vital body  functions, which allows treating and nursing children born in serious condition with a critically low body weight, as well as children having congenital malformations of the cardiovascular system.

The neonatal pathology ward in the Perinatal Center provides further nursing of the preterm infants without transferring to other children’s hospitals. In the ward children are provided with the  consultations of the related specialists, diagnostic examination, up-to-date treatment. Further, children are discharged home from the Perinatal Center under the district doctor  supervision with the follow-up care in a follow-up room.

The total number of beds in the  Perinatal Center of Kyiv amounts to 200.

In recent years, the Department, one of the first in Ukraine, began to study the molecular mechanisms of the of vascular disorder pathogenesis, microhemocirculatory disorders of the utero-placental complex with fetal development delay and overdue pregnancy. Based on this, for the first time modern methods for diagnosing and preventing gestosis have been developed and introduced into practice.

A new method for diagnosing postnatal hypoxia of the placenta has been developed and introduced. This allowed to elucidate some pathogenetic aspects of the developmental stages of microhemocirculatory disorders in the placenta with the development of placental insufficiency.

Criteria for early preclinical diagnosis and a method for predicting non-coordinated labor activity based on electrohysterography have been developed. A method  for correcting discoordinated labor activity at the beginning of the first stage of labor has been proposed for introduction into practice.

A system of computer analysis of cardiotocograms during pregnancy and childbirth has been developed and implemented.

The WHO-recommended Robson Cesarean section assessment system has been implemented.

The total number of beds in the gynecological ward of the KCCH No.18 amounts to 65.

The history of the ward is closely connected with the history of the Department of Obstetrics and Gynecology No. 1 of the NMU and is more than 100 years old. World-famous scientists – Lurie Alexander Yudymovych, Baksheyev Mykola Serhiyovych and others worked here.

 

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Clinical bases provide highly qualified specialized gynecological care in accordance with the MOH standards and recommendations of European associations in many areas:

  • benign tumors of the female genital organs
  • cervical pathology
  • pregnancy complications before 20 weeks
  • inflammatory diseases of female genital organs
  • menstrual irregularities.

To provide medical-diagnostic aid, advanced methods are used:

  • endoscopic: laparoscopy, hysteroscopy, colposcopy
  • ultrasound diagnostics using a vaginal sensor
  • physiotherapy: laser, magnetotherapy, ultrasound, phonophoresis, UVI

The ward  offers a full range of outpatient and in-patient surgical treatment and provides 24-hour emergency obstetric and gynecological care.

The staff of the ward performs the majority of planned and urgent laparoscopic and open surgical interventions in patients with various gynecological pathologies. The focus is on minimally invasive and organ-preserving surgeries using modern diagnostic and treatment methods.

The following surgical interventions are performed at clinical bases:

Surgeries performed laparoscopically:

supravaginal uterine amputation;

laparoscopically  assisted transvaginal hysterectomy;

uterine resection;

conservative myomectomy;

ovariocystectomy;

adnexectomy;

adhesiolysis;

removal of endometriotic foci;

salpingoneostomy;

contraceptive laparoscopic intervention in the fallopian tubes;

diagnostic laparoscopy;

Hysteroscopic surgery:

“Office” hysteroscopy;

removal of uterine polyps;

endometrial resection (ablation);

removal of submucous uterine myoma;

separation  of the uterine septum;

separation of intrauterine synechiae;

Vaginal access surgery:

cervical pathology cryotherapy;

Bartholin gland cyst and vaginal cysts removal;
plastic surgery of the uterine cervix;
plastic surgery for colpoptosis and prolapse  of the uterus;
vaginal removal of the uterus;
vaginal removal of the uterine myoma;
urinary incontinence surgery, including using special mesh prostheses.

Open access surgery:

metroplasty;

conservative myomectomy;

extirpation of the uterus with or without appendages;

supravaginal hysterectomy with and without appendages.

 

Methods  for laparoscopic surgery for uterine fibroids, ovarian tumors, ectopic pregnancy and infertility have been improved.

Laparoscopic surgery for the uterine appendages in the purulent-inflammatory processes of the organs of the pelvis minor has been improved. The advantages of laparoscopic operations in acute and chronic recurrent inflammatory processes of the internal genital organs before laparotomy access for restoration and preservation of reproductive function in young patients who have not yet given birth have been determined.

A new method for the treatment of atypical condyloma of the uterine cervix has been developed and introduced. A method for predicting the single ovary cyst formation

in women of reproductive age has been developed and introduced.

Unique operations of the highest complexity are performed on the basis of the gynecological ward: malformations of the genital organs, plastic surgery, etc.

A considerable experience (over 10 years) of laparoscopic surgery has been accumulated, which remains today the most advanced in the world.