Muhimbili National Hospital – Mloganzila

THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

OBSTETRICS AND GYNECOLOGY DEPARTMENT

The Obstetrics and Gynaecology Department provides modern comprehensive diagnostic and treatment modalities in a caring environment for women throughout all seasons of life.  The  available  specialized medical team offers advanced maternity services for normal and high risk pregnancies, postpartum and family planning services  and   infertility screening and treatments. 

This Department has  two  units  ;

Obstetric services

Regarding  obstetric  services,   the  department  is  well equipped for handling all types of high risk pregnancies and emergencies related to pregnancy and labor,  besides  the routine obstetric care for uncomplicated pregnancies. Services are available in the labor room with obstetricians and a team of well-trained staff round the clock. Intrapartum monitoring with electronic devices is routinely provided.  The  available  gynaecologists   are well experienced in both  non – operative  and  operative  deliveries. 

 There  is  an  “Antenatal Services for High Risk Pregnancies”.  This  clinic  helps  in  managing  complicated pregnancies for women with hypertension, diabetes, multiple pregnancy and heart disease complicating pregnancy, intrauterine growth restriction (IUGR), pregnancy with renal and hepatic failure etc.  Intensive fetal monitoring facilities including cardiotocogram (CTG), and obstetric ultrasonography provide essential diagnostic information for treatment of complicated cases. Overall  services  which  are  being  provided  include  the  following: evaluation and Management of recurrent miscarriages,  screening and management of preterm labor and PPROM,  management of critically ill obstetric patients (ie.HELLP syndrome, APH , eclampsia, obstetric shock), management of pregnancies complicated with maternal disorders(like hypertension, diabetes, cardiac diseases, collagen vascular disorders, haematologic disorders, etc.) and  management of pregnancies associated with gynaecologic conditions such as fibroids, ovarian tumors, prolapsed uterus etc.

Gynaecological services

With  gynaecological  services,  routine and complicated surgeries related to female genital tract  are  managed. The  following  procedures  are  performed: hysteroscopy procedures (ie. septum resection, myomectomy, polypectomy, tubal cannulation), Radical hysterectomy, Radical vulvectomy, Debulking/cytoreduction surgeries for ovarian malignancies, Total Abdominal hysterectomy, Salpingectomy for ectopic  pregnancies, Transvaginal  hysterectomy  and  Ovarian and tubal surgeries for treatment of infertility

The  following  diagnostic tests  and  procedures  are  performed: Cervical cancer screening (by VIA, PAP smear),  Colposcopy and colposcopy-guided biopsy,  LEEP biopsy  and  Cryocauterization. Patients are screened for cervical neoplasia by VIA, or PAP smear collection. An Ayre’s spatula is used to scrape cells from ectocervix and then a thin smear is prepared on a glass slide. The smear is immediately fixed and sent for cytologic analysis. Any abnormality of Pap smear is further evaluated with colposcopy,  and and early lesions are treated by cryocauterisation or Loop Electrode Excision Procedure (LEEP). Colposcopy is the procedure by which cervix is visualized under magnification by using a colposcope. It is usually indicated once there are abnormal cells detected on Pap smear testing. It helps to identify the abnormal areas on the cervix and to direct the biopsy from those specific areas. Cryocauterisation  is a simple and safe procedure to treat cervical erosion and does not require any anaesthesia. A cryoprobe is first cooled by nitrous oxide and then touched to the abnormal cervical area. This freezes and kills the cells, resulting in the sloughing of the abnormal tissue. Patient is sent home the same day. LEEP utilizes a thin wire loop to remove the cervical transformation zone through electrocautery. It allows samples to be collected for additional tissue analysis and treats the condition at the same setting. Soon to be started. 

Other  services  available are postnatal  clinic  and  infertility clinic. Postpartum clinic provides advice on contraception. We have facilities for insertion of intrauterine devices and sterilization. During  infertility  clinic, The couple is evaluated for various male and female factors. Male factor evaluation is done in conjunction with urologists.  Patients requiring further assisted reproductive techniques are referred to reputed IVF centers in the region

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