| Prenatal Diagnosis and
Counselling
The PDC service works closely with the Department & Laboratory of Prenatal Diagnosis
at Tsan Yuk Hospital, the University of Hong Kong. It was the tertiary referral centre in
Kowloon before the decentralization of service in 1991. Diagnostic procedures including
detailed mid-trimester anomaly obstetric ultrasound scans, chorionic villus biopsy,
amniocentesis, and cordocentesis are performed regularly on outpatient basis. More special
diagnostic procedure such as first-trimester nuchal fold scanning, biochemical markers for
Down's syndrome are also available. Fetal therapeutic procedures such as in utero shunting
for chylothorax and bladder outlet obstruction are carried out in indicated cases. The PDC
team pays particular attention to counselling. A nurse specialist in PDC functions as the
key person in coordinating the diagnostic and counselling of patients in group or
individually if required. Monthly quality control meeting is conducted to monitor
administrative and service outcome.
Ambulatory Obstetric Care
A day ward with 10 daybeds is assigned for day care management of obstetrical problems.
This can facilitate the observation and monitoring of pregnant women with raised blood
pressure as day cases. Oral glucose tolerance test and blood sugar profiles can also be
done on site. Pregnancies requiring antenatal electronic fetal heart monitoring are
catered for at the day ward and discharged if findings are satisfactory.
Midwives Clinic
The Midwives Clinic provides antenatal care for low risk pregnant women. Women seen in the
Midwives Clinic are taken care by a team of midwives throughout the pregnancy until 40
week gestation unless if any problem arises requiring medical intervention. The Midwives
Clinic collaborates closely with medical staff to ensure safe maternal and fetal outcomes.
Sub-fertility and Assisted Reproduction
 
A comprehensive service is provided for the investigation and treatment of couples with
fertility difficulties. Referrals are channeled directly for consultation at sub-fertility
clinics without going through the general gynaecology clinic. The Department is equipped
with investigative procedures for both male and female infertility factors at secondary
and some at tertiary levels. A laboratory for assisted reproductive technologies funded by
the TWGHs was established and treatment cycles have been started since mid 1998. It is the
third of this kind among public hospitals, with the other two laboratories being housed at
the Prince of Wales Hospital in the New Territories and at the Queen Mary Hospital in Hong
Kong Island. Equipments are available at our ART laboratory for in vitro fertilization,
embryo transfer, frozen embryo and intra-cytoplasmic injection of sperm. Since its
commencement treatment modalities such as controlled ovarian hyper-stimulation with
intra-uterine insemination, outpatient transvaginal oocyte retrieval, fresh and frozen
embryo transfers produce results comparable with established centres. Individual
counselling sessions are conducted weekly by specialist-in-charge and nurse with special
training. Couples are provided with verbal as well as written information to enhance
understanding and allay anxiety.
Office Gynaecological Surgical Procedures
A day centre for special gynaecological outpatient services provides self-contained
facilities for the management of a wide range of common Gynaecological conditions.
The colposcopy clinic will receive patients with abnormal cervical smears directly for
confirmative diagnosis using digital imaging colposcopy, colposcopically-directed cervical
biopsy and occasionally contact micro-colpo-hysteroscopy. Surgical procedures available
for the management of cervical intra-epithelial neoplasia include cryosurgery, loop
electrocautery excision and laser therapy.
The hysteroscopy clinic performs outpatient hysteroscopy for the investigation of women
with abnormal vaginal bleeding using no anaesthesia. Vabra aspiration is employed to
obtain endometrial biopsy for histological diagnosis. This clinic will be integrated in
future with the abnormal bleeding clinic (ABC) to fulfil the function of a one-stop clinic
for the management of women with pre- and post-menopausal bleeding. It also intends to
develop outpatient endometrial ablative/destructive procedures and the insertion of
progestagen intra-uterine devices.
Other procedures include:
Urodynamic clinic- A urodynamic machine has been acquired recently through donation
fund. This will ease the congested waiting list for women with urinary incontinence.
Osteoporosis clinic- Bone density measurements can be obtained by using either the
Department's Ultrasound Bone Scanner or the Well Women Clinic's DEXA bone absorptiometer.
Early Pregnancy Complication clinic- In house radio-immunoassay is available for beta-
human gonadotrophin for the monitoring of women with miscarriages or ectopic pregnancies.
|
