Obstetrics & Gynaecology – Selected projects

 

Ten Step Vaginal Hysterectomy – A modified operative technique for vaginal hysterectomy

 

This multinational study compares a traditional vaginal hysterectomy (the Heaney method) with a modified method, the so called “Ten-Step Vaginal Hysterectomy”, which is a result of the analysis of 6 different methods.

A study protocol has been elaborated and is available on demand. The pilot study showed a significant reduction of the operative time and of the need for pain killers.

 

 

Computerized labour monitoring

 

With this new development of a cervicometer, based on a GPS, the obstetrician can follow up the delivery without digital examination. It enables him to make decisions based on accurate and real-time information, resulting in significantly improved medical care.

Obstetrical units may join the project for clinical comparative studies through the NESA.

 

 

Anti-episiotomy campaign

 

Episiotomy is considered a common and simple procedure, but it is known to cause complications such as epidermal inclusion cysts or anal sphincter injuries.

It has been shown that women treated by private obstetricians had a 7-fold increased risk to have an episiotomy.

It seems that the performance of episiotomy does not meet most of the goals that were attributed to it. The NESA has therefore started an anti-episiotomy campaign. In case episiotomy is necessary, the NESA promotes a two-layered suturing.

In a pilot randomized prospective study it was shown that a two-layered continuous suturing avoiding the vaginal wall resulted in better anatomical results than the traditional three-layered suturing and caused less discomfort and pain.

 

 

A standardized evaluation of indications for caesarean section

 

One of the main obstacles when comparing statistics concerning caesarean sections from different institutions is the lack of data about indications and timing of the operations. After considering various statistical methods, the NESA has adopted the suggestions of Dr. Michael S. Robson, the master of obstetrics in Dublin, and will collect data from different institutions and countries. This will enable comparison and a dialogue concerning statistics and indications.

Please download Dr. Robson's article, "Classification of Caesarean Sections".

 

 

Certification

 

In accordance with the aim to introduce unified, evidence-based surgical methods, in 2007 the NESA started to certify hospitals that perform surgical methods promoted by the academy, such as the Misgav Ladach caesarean section and the Ten-Step Vaginal Hysterectomy (TSVH).

 

The following departments and hospitals have been certified by the NESA:

  • Gynaecolocigal Department of the University Hospital Perugia, Italy (Misgav Ladach, TSVH)
  • Gynaecolocigal Department of the Çukurova University Hospital, Adana, Turkey (Misgav Ladach, TSVH)
  • Gynaecolocigal Department of the General Hospital of Pula, Croatia (Misgav Ladach)
  • Maternity and Gynaecological Surgical Hospital, Ahmadabad, India (Misgav Ladach)
  • V. S. Public Hospital, Ahmadabad, India (Misgav Ladach)