Department Of Obstetrics And Gynaecology – Korle Bu Teaching Hospital
The department of Obstetrics and Gynaecology – korle bu teaching hospital provides 240 beds for Obstetrics and 114
beds for Gynaecology. The department is divided into five units. A senior consultant heads each unit with other consultants and doctors equally distributed among the units.
The consultants on a unit are permanent while the other doctors rotate through the units. Each unit has its specific clinic, theatre and grand ward round days. The units go on call on fixed working days and rotate the weekend duties. The on call day is also the obstetrics clinic day for the unit. The unit on call attends to all patients in the Obstetric and Gynaecology wards as well as those coming in as emergencies and those admitted to the labour wards.
Core Functions Service:
The department serves mainly as a referral centre for the southern part of the nation, which has a population of over 10 million.
Training:
It also serves as the foremost training facility for medical students and professions allied to medicine. These include:
– Medical students from University of Ghana Medical School.
– Nursing students from nursing training school from Korle Bu, University of Ghana and other private and state nursing schools
– Postgraduate medical Trainees of the Ghana College of physicians and surgeons, and West African College of Surgeons.
Research:
The department undertakes research in all its specialties and also does collaborative research works with other institutions such as university of Ghana and Ministry of Health and external health institutions.
Antenatal Clinic
Each of the five obstetric units has a fixed antenatal clinic day which is also the duty day for the unit. On each clinic day new patients are booked and old patients are followed up. Early pregnancy cases are seen at the gynaecology clinic and are transferred to the antenatal clinic at fourteen to twenty weeks gestation. Patients seen at the antenatal clinic must belong to at least one of the following groups:
Pregnancy with medical disorders eg. Sickle Cell Disease, Diabetes, Anemia, Heart Disease, Asthma, Hypertensive Disease, Rhesus Negative.
– Previous Caesarean section and instrumental deliveries.
– Grand multiparity (Para 5 or more)
– Multiple pregnancy
– Short nulliparous women ( Nulliparous with height 1.54m or less)
– Elderly nulliparous women (age 35 years or more)
– Teenagers (age 16 years or less)
– Previous stillbirth, neonatal death, preterm delivery or intrauterine growth restriction.
– Pregnancy following treated infertility, myomectomy, fistula repair and pelvic floor repair.
– Previous abnormalities of the third stage.
– Consultantsbooking.
– Staff of Korle Bu Teaching Hospital and their spouses.
– Emergencies
– Referred cases which meet our criteria
Admission To Antenatal Wards
During the course of providing antenatal care all patients with complications of pregnancy that cannot be safely managed on outpatient basis are admitted to the antenatal wards for further investigations and appropriate management
Labour Wards
There are two labour wards attached to the six storey maternity block. There is one on the first floor and another on the second floor. Patients are admitted to the labour wards from home, the antenatal wards and referral units.
There are operating theatres located on the labour wards. These theatres are served by a five-bed recovery ward. Both labour wards have a doctor’s rest room so that twenty four-hour cover can be provided by doctors. There is an ultrasound scanning machine on the first floor labour ward.
The two labour wards are served by the neonatal intensive care unit (NICU) which is located on the third floor. Twenty-four hour neonatologist cover is provided at the NICU.
The paediatricians are called to be present at delivery when the birth of a baby with low Apgar scores is anticipated. Babies who are delivered in the absence of the paediatricians and are found to have problems are immediately sent to the NICU. All preterm babies, macrosomic babies and infants of diabetic mothers are sent to the NICU, regardless of their Apgar scores, for neonatological assessment.
Post Natal Visits
Mothers are first seen at the post natal clinic two weeks after delivery and then six weeks post delivery. Those with special problems are seen more frequently.
Gynaecology Unit
The gynaecology unit has three wards that are used by the five obstetrics and gynaecology teams. Two of these wards are for patients who are admitted as emergency cases and the third is for patients admitted for elective surgery. Patients are seen on a daily basis at the out patients department. Each team has a fixed clinic day.
Emergency cases are seen in the emergency room by the on call team. Patients are admitted from here to the emergency lying-in wards for surgery or for further investigations and treatment.
Patients seen at the clinic who need elective surgery are placed on waiting lists of variable length depending on the type of surgery and the urgency of the case. The patient is reviewed by the anaesthetist at the anaesthesia clinic held at the surgical block. The patient is admitted to the ward only after she had been declared fit for surgery by the anaesthetist.
Obstetrics And Gynaecology Operations
Minor Procedure
– Evacuation of incomplete abortion
– Dilatation of the cervix
– Excision of Endometriotic lesion
Medium Procedoure
– Suction Aspiration for Molar Pregnancy
– Cone Biopsy
– Marsupialization of Bartholins cyst
– Excision of Bartholins
– E.U.A with Endometrial/Cervical Biopsy
– Vacuum/Forceps Delivery
– Cervical Cerclage Suture
Major Procedure
– Caesarean Section
– Vaginal Hysterectomy + Colporrhaphy
– Amputation of the cervix
– Abdominal Hysterectomy
– Myomectomy
– Ovarian Cystectomy
– Oophorectomy
– Tubal Surgery
– Laparotomy for unruptured Ectopic Gestation
– Exporatory Laparotomy
– Third degree Perineal tear
– Vulvectomy
– VVF repair
– Meig-Wertheim’s Hysterectomy
– Caesarean Hysterectomy
– Reconstruction of Congenital anomalies of Genital Tract
– Diagnostic and Therapeutic laparoscopic surgeries