Clinic of Obstetrics and Gynaecology of the Regional Hospital in Pardubice, PLC (PKN)

Head of the Clinic: Doc. MUDr. Milan Košťál, CSc.

Gynaecology and Obstetrics is a basic medical discipline. Its development in the PKN is linked to the national conception of the gynaecology and obstetrics. Within the region PKN provides super-specialized care in below stated areas of the discipline and intermediate care in perinatology. The content of the discipline is prevention, diagnostics, treatment, follow-up, assessment functions and research.

Present of the Clinic of Obstetrics and Gynaecology of the PKN

Obstetrics and Gynaecology Department of the hospital in Pardubice was opened in 1930.

If I talk about its present I must mention an excellent work of the previous generations of nurses, midwives, doctors and heads of the department. There were following chief physicians standing successively in the head of the department Prof. Dr. Gála (1930-59), Dr. Hanousek J. (1959-63), Dr. Kleisl (1963-77), Dr. Michl (1977-84), Dr. Bezděk (1984-85), Dr. Hanousek L. (1985-2007). In 2003 the building was completely reconstructed to its present form. The great credit of this reconstruction belongs to MUDr. Hanousek and the Head Nurse Zita Hamašová.

In 2008 the Obstetrics and Gynaecology Department met demanding criteria and was changed into the Clinic of Obstetrics and Gynaecology by the decision of the Ministry of Health and the Ministry of Education. This change expressed the close relationship with the Faculty of Health Studies of the University of Pardubice during education of Bachelors and Masters in the area of nursing and midwifery, and also a significant contribution during education of medical students from the Faculty of Medicine in Hradec Kralove.

At present there are 14 full time and 11 part time doctors working at the Clinic. The Clinic has 78 standard beds and 3 intensive obstetrics care beds. It provides high quality care both in the obstetrics area (in 2013 it appeared among 5 most desirable maternity hospitals in the Czech Republic according to the Hospodarske noviny newspaper) and gynaecology area. In 2012 we had 1475 deliveries resulting in the birth of 1519 newborns. Thanks to a new ultrasound device Toshiba we managed to improve both gynaecology examination and especially the examination of pregnant women with focus on congenital developmental defects and possible defects of the fetus development during pregnancy. We also have a probe for 3D imaging (three-dimensional). This probe does not differ from the regular two-dimensional probe (only the transducers are not arranged in a row but in the matrix). Such a probe enables to scan entire volume of data in relatively short time, so that it is even possible to display in real time, which is known as 4D imaging. Such imaging is used, next to its diagnostic reasons, for the pleasure of our mothers, whom we print images of a face of an unborn child.

We work closely with the Department of Medical Genetics headed by Dr. Bělobrádková. Prenatal diagnostics is increasingly shifting to the first trimester. In line with current trends the combined first trimester screening (unlike the triple test conducted at the beginning of the second trimester) has become the most important method in a diagnosis of aneuploidy. The pregnant women with the positive test (ultrasound examination together with blood testing) are offered to undergo invasive testing, i.e. chorionic villous sampling, which confirms or excludes the suspicion. The result is known the same day. Amniocentesis still remains the part of the diagnosis of aneuploidy. Newly we offer the possibility of still very expensive but non-invasive fetal karyotyping determination of fetal DNA in mother’s blood. Mothers are offered genetic counseling during any kind of personal or family stress.

In gynecology we offer full range of services including the most radical oncogynecological operations of external genitals, vagina, cervix, uterus and ovaries (87 in 2012). We provide oncogynecological operation including pelvic and paraaortic lymphadenectonomy. As a part of our extensive range of surgeries we provide laparoscopic procedures; the equipment to perform diagnostic and surgical hysteroscopy is of a high standard. The Chief Physician, MUDr. Hanousek, who built the training centre for hysteroscopy, continues to educate junior doctors in this endoscopic technique.

Our nationwide domain is an implementation of operations using vaginal access. Quick recovery and cosmetically advantageous operation (without a scar on the abdomen) favors this surgical technique. We remove the uterus via vaginal access in 90% of cases, in about 12% of cases using laparoscopy. In 2009, at our Clinic in cooperation with surgeons we removed the gall bladder, uterus and adnexa via vaginal access using hybrid Natural Orifice Surgery method for the first time in the Czech Republic.

We also provide a wide range of reconstructive surgeries of the pelvic floor after descent of the small pelvic organs including supporting of the pelvic floor by plastic materials (mesh). In case of problems with incontinence we provide urodynamic testing using a new device. For suitable patients we introduce the tape under the urethra (104 operations in 2012).

In addition to specialized urogynecological clinic of the Chief Physician, Doctor Germund Hensel, there is also the climacteric medicine clinic led by Prof. MUDr. J. Donat, DrSc. who has gained recognition in this field also in abroad. In 2009 we opened a new clinic for infertile couples and became a cooperating centre of the Centre of Assisted Reproduction Pronatal in Prague (Head: doc. MUDr. Mardesic T., CSc.). Our Clinic offers to our clients the whole range of the most advanced techniques of assisted reproduction.

Besides the scientific activities, presenting and publication of the results of our Clinic (including publications with IF) we participate in organization of national and international congresses (ESC in Prague, 2008). Prof. MUDr. J. Donat, DrSc. has long been the chief editor of the journal Climacteric Medicine. Lessons of Bachelor’s study program ‘Nursing and Midwifery’ and also follow-up Master’s studies ‘Perioperative care in gynecology and obstetrics’ take place at the Clinic.

Outside of professional care of women we also strive to continually improve the environment at our Clinic so that the future and current mothers, as well as our patients, are satisfied. There is a wireless internet available at the entire department, superior rooms are equipped with refrigerators, and TV could be watched in all rooms. Visits to the Clinic could be done anytime and it is not necessary to register for deliveries.

A great reward for us is hundreds of thank-you letters, which we greatly appreciate. At the same time, however, we are obliged to keep the level of ultimate care of women coming not only from our region and further develop it according to the latest medical knowledge.

doc. MUDr. Milan Košťál, CSc.Head of the Clinic of
Obstetrics and Gynaecology of the PKN