Obstetrics & Gynocology
The Department of Obstetrics & Gynaecology of University of Malaya is a clinical department of the Faculty of Medicine, University of Malaya and was formed in 1964. Since its inception the department has been actively involved in providing undergraduate and postgraduate teaching as well as providing excellent health care services in the field of Obstetrics & Gynaecology. Over the years this department had become a major tertiary referral centre for the various Obstetrics & Gynaecological problem in Malaysia.
The department was formed in 1964 – one year after the founding of the Faculty of Medicine in the University of Malaya. The foundation chair was held by Professor Donald P.C Chan who held the post till 23rd May 1971. He was succeeded by Professor T.A Sinnathhuray who held the chair till his retirement on 15th January 1989. Since then the chair was held by Professor V.Sivanerasaratnam till March 2004. Subsequently, Professor Siti Zawiah was appointed to the Chair till today.
Ever since its formation, the department has been involved in teaching undergraduate medical course leading to the degree in Bachelor of Surgery (MBBS). Since 1988 the postgraduate Masters in Obstetrics & Gynaecology was introduced and many young medical specialists in Obstetrics & Gynaecology had graduated and now serving the public and ensuring safer motherhood throughout Malaysia. The department also helps in providing lectures and supervision to basic and post basic nursing students.
At the moment, the department has 24 academic staffs (3 Professors, 3 Associate Professors, 12 Lecturers and 6 Trainee Lecturers) and 15 supporting staffs. It is also recognized by the Royal College of Obstetricians and Gynaecologists as a training center for the membership examination.
INTRODUCTION TO THE OBSTETRIC UNIT
A) CLINICS AND WARDS
i) Antenatal Clinic
The antenatal clinic caters for all pregnant women in the Klang Valley. In particular we booked in high risks pregnant cases referred by the general practitioner or other centres in the surrounding areas. These include all primigravida, grandmultipara and patients who have had complications or operative deliveries during previous pregnancies or have medical complications during the present pregnancy. These mothers are advised to book as early as possible. At the booking visit, details of the present and past obstetric, medical, surgical, family, social and marital history, menstrual pattern and contraception are noted.
Blood investigations carried out at the booking visit include a full blood count, blood grouping and Rhesus typing, RPR test and Hepatitis B Serology. Screening for HIV is also carried out for those who have consented after counselling. Urine is routinely tested for albumin and sugar.
A complete and systematic physical examination is carried out including height and weight. The blood pressure, weight and the presence of oedema or pallor are noted. Particular attention is paid to the thyroid gland, breasts, cardiovascular and respiratory systems. An abdominal palpation is carried out to assess the fundal height and to check the presentation, lie and engagement of the presenting part. The presence of foetal heart is assessed with a Pinard stethoscope or a Daptone. Ultrasound examinations are done at booking and when indicated.
In the absence of any complications, the patient is followed up every four weeks until the 28th week, fortnightly until the 36th week and then weekly until delivery. At each follow-up visit, the urine is tested for albumin and sugar. An abdominal palpation is carried out mentioned above.
Haemoglobin count is routinely checked at booking and at 32 weeks gestation. All patients are given prophylactic iron, folic acid and general advice regarding hygiene, nutrition, exercise, breast care and breastfeeding. If complications arise, they are admitted to the antenatal wards.
ii) Labour Ward
On admission, a history is taken. If the patient is in labour, an enema is given. The patient is then sent into the delivery room. During the pelvic examination, an artificial rupture of membranes is carried out if there is an indication. The partogram is used to monitor all patients in labour.