Obstetrics

The Department of Obstetrics at our hospital is the center for critical and difficult cases in the Jiaodong Peninsula. Every year, it handles a large number of referral and consultation assignments from Jiaodong areas extending west to Linyi and Rizhao and east to Yantai and Weihai, and it receives a large number of consultations and referrals of critically ill pregnant women from surrounding areas each year. Across its three campuses, the Department of Obstetrics currently has 109 beds, an annual outpatient volume of more than 60,000 visits, and more than 5,000 deliveries. In the early 1970s, the Department of Obstetrics established separate high-risk pregnancy and general groups, thereby establishing the concept of high-risk pregnancy. In the 1990s, it established groups for gestational diabetes mellitus and hypertensive disorders of pregnancy. By 2000, the specialist groups for gestational diabetes mellitus, hypertensive disorders of pregnancy, and critical obstetric illnesses had reached a certain scale, forming a professional technical team led by Chief Physician Ye Yuanhua and composed of professionals with a high level of expertise and technical competence. It already had a very high level of diagnostic and treatment capability and held a leading position in China. In the hypertensive disorders of pregnancy group, relatively low doses of magnesium sulfate are used to prevent seizures in patients with preeclampsia, with good results. Ultrasound and laboratory testing technologies are used to assess maternal and fetal status and select the appropriate time to terminate the pregnancy, thereby ensuring the greatest possible safety and a good prognosis for both mother and fetus; since 1997, our hospital has taken the lead in the province in screening for gestational diabetes mellitus, after which the program was promoted in Qingdao and surrounding areas and implemented as a routine screening item for all pregnant women. Pregnant women with high-risk factors undergo screening and management before pregnancy and in early pregnancy; early diagnosis and early control of blood glucose have reduced the occurrence of maternal and infant complications during pregnancy, delivery, and the postpartum period. For critical patients, including those with fatty liver of pregnancy, pregnancy complicated by acute pancreatitis, and other severe medical and surgical comorbidities such as pregnancy complicated by hematologic diseases including aplastic anemia, thrombocytopenia, and leukemia, as well as patients with severe postpartum hemorrhage or DIC, the Department has also established a rescue-treatment protocol based on life-support treatment, symptomatic and supportive treatment using continuous renal replacement therapy, an artificial-liver blood-purification system, and other technologies, and active treatment of the primary disease. This has greatly improved the effectiveness of rescue efforts and markedly reduced maternal mortality. For patients with pernicious placenta previa, in 2015 the Department of Obstetrics, together with the Department of Interventional Medicine, began using abdominal aortic balloon occlusion during surgery for pernicious placenta previa. This technique uses femoral artery puncture to place an indwelling abdominal aortic balloon catheter and temporarily occlude the abdominal aorta during surgery, thereby controlling intraoperative blood loss from pernicious placenta previa, improving the safety of surgery for pernicious placenta previa, reducing complications related to massive intraoperative bleeding, improving patient prognosis, strengthening our hospital’s ability to manage such complex critically ill patients, and improving the quality of obstetric care. For consecutive years, the Department of Obstetrics has successfully hosted national- and provincial-level training courses on the early diagnosis and treatment of amniotic fluid embolism, hypertensive disorders of pregnancy, gestational diabetes mellitus, and the rescue of critically ill obstetric patients.

2. Talent Structure

The Department of Obstetrics has strong professional human resources and has developed into a high-level medical, teaching, and research group with a full range of specialties, headed by a doctoral supervisor and supported by a large number of high-quality young and middle-aged technical professionals who form its backbone. The discipline currently has 45 full-time physicians and a well-structured talent team, including 10 holders of doctoral degrees and 33 holders of master’s degrees; personnel with master’s or higher degrees account for 95.5% of the total. There are 3 holders of senior professional titles and 9 holders of associate-senior professional titles. The department has 1 doctoral supervisor, 5 master’s supervisors, and 1 member of the editorial board of the Chinese Journal of Perinatal Medicine.

3. Professional Features

(1) General Obstetrics

The Department of Obstetrics at our hospital established its general obstetrics group in the 1970s and currently has 68 beds. It has dedicated professional technical staff. It conducts monitoring of maternal and fetal status during labor, observation and management of labor, and the diagnosis and management of common intrapartum and postpartum complications such as uterine atony, placental adhesion, placenta accreta, and amniotic fluid embolism; management of postpartum hemorrhage and complex lacerations of the soft birth canal; neonatal blood-gas analysis, neonatal management, neonatal asphyxia resuscitation and post-resuscitation management, management during pregnancy and labor of pregnancies complicated by uterine fibroids and ovarian tumors, and related surgery. It has extensive clinical experience in these areas and has established an antenatal nutrition clinic to provide nutritional guidance and counseling during pregnancy. In particular, its forceps-assisted delivery techniques and its techniques for managing pregnancies complicated by gynecological tumors, such as uterine fibroids, ovarian tumors, and cervical tumors, rank among the leading practices in the province.

(2) Fetal Medicine and Prenatal Diagnosis

In April 2011, with the strong support of the hospital leadership, the Department of Obstetrics began performing amniocentesis for prenatal diagnosis, amniotic-fluid cell culture, and chromosomal karyotype analysis. More than 300 cases have been completed to date; the success rate of amniotic-fluid cell culture was high, and rapid chromosomal karyotype analysis (FISH) was also introduced. In 2011, the Department began chorionic-villus culture and chromosomal karyotype analysis. Beginning in October 2011, it conducted second-trimester prenatal screening using peripheral blood, and more than 2,000 cases have now been screened. Each year, it performs tens of thousands of second-trimester ultrasound screenings. In December 2011, it began systematic prenatal diagnostic ultrasound examinations, and since the work began, it has completed more than 1,800 prenatal diagnostic ultrasound examinations. Prenatal ultrasound diagnosis of various congenital fetal defects has reached an advanced level in China. Each year, ultrasound confirms approximately 1,000 or more cases of fetal malformations, effectively preventing the birth of infants with severe malformations. At the same time, our hospital has also been at the forefront of molecular genetic diagnosis; it purchased a genetic hearing-loss gene testing instrument and launched a genetic hearing-loss gene testing program. In 2011, it began noninvasive prenatal testing of fetal DNA in the peripheral blood of pregnant women. On this basis, in March 2012, with the strong support of the hospital leadership, it established the Prenatal Diagnosis Center of the Affiliated Hospital of Qingdao University Medical College and obtained the relevant national qualifications. The center comprises departments including genetic counseling, clinical obstetric puncture, imaging diagnosis (ultrasound), a biochemical and immunology laboratory, and a cytogenetics laboratory. Since its formal establishment, the center has now become a diagnostic center in Qingdao and surrounding areas for congenital fetal diseases and some chromosomal genetic diseases. Its work is at a leading level within the province and has made a positive contribution to improving the quality of the city’s birth population.

While carrying out prenatal diagnosis, our Department of Obstetrics has also conducted extensive work in the diagnosis and treatment of complex twin pregnancies, fetal growth restriction, and fetal intrauterine hemolysis, and is at a leading level within the province. For complex twin pregnancies, it provides an ultrasound report of chorionicity in early pregnancy, performs second-trimester ultrasound detection of twin-to-twin transfusion syndrome and selective fetal growth restriction, and performs amniocentesis with drainage of amniotic fluid for twin-to-twin transfusion syndrome, as well as puncture of the amniotic membrane to prolong gestation. These measures have prolonged the gestational age of pregnant women with twin-to-twin transfusion syndrome and increased neonatal survival. For fetal growth restriction and selective fetal growth restriction in complex twin pregnancies, the Department can achieve early diagnosis and begin treatment as early as possible. For fetal intrauterine hemolysis, it conducts regular testing of maternal blood-group antibodies during pregnancy to enable early detection and provides plasma-exchange treatment. After birth, newborns undergo a complete hemolysis workup and receive exchange transfusion. The Department is currently at a leading level within the province.

(3) Maternal Medicine

The department is the center for critical and difficult cases in the Jiaodong Peninsula. Every year, it handles a large number of referral and consultation assignments from Jiaodong areas extending west to Linyi and Rizhao and east to Yantai and Weihai, and it receives a large number of consultations and referrals of critically ill pregnant women from surrounding areas each year. For hypertensive disorders of pregnancy, relatively low doses of magnesium sulfate are used to prevent seizures in patients with preeclampsia, with good results. Ultrasound and laboratory testing technologies are used to assess maternal and fetal status and select the appropriate time to terminate the pregnancy, thereby ensuring the greatest possible safety and a good prognosis for both mother and fetus; since 1997, our hospital has taken the lead in the province in screening for gestational diabetes mellitus, after which the program was promoted in Qingdao and surrounding areas and implemented as a routine screening item for all pregnant women. Pregnant women with high-risk factors undergo screening and management before pregnancy and in early pregnancy; early diagnosis and early control of blood glucose have reduced the occurrence of maternal and infant complications during pregnancy, delivery, and the postpartum period. For critical patients, including those with fatty liver of pregnancy, pregnancy complicated by acute pancreatitis, and other severe medical and surgical comorbidities such as pregnancy complicated by hematologic diseases including aplastic anemia, thrombocytopenia, and leukemia, as well as patients with severe postpartum hemorrhage or DIC, the department has also established a rescue-treatment protocol based on life-support treatment, symptomatic and supportive treatment using continuous renal replacement therapy, an artificial-liver blood-purification system, and other technologies, and active treatment of the primary disease. This has greatly improved the effectiveness of rescue efforts and markedly reduced maternal mortality. For patients with pernicious placenta previa, in 2015 the Department of Obstetrics, together with the Department of Interventional Medicine, began using abdominal aortic balloon occlusion during surgery for pernicious placenta previa. This technique uses femoral artery puncture to place an indwelling abdominal aortic balloon catheter and temporarily occlude the abdominal aorta during surgery, thereby controlling intraoperative blood loss from pernicious placenta previa, improving the safety of surgery for pernicious placenta previa, reducing complications related to massive intraoperative bleeding, improving patient prognosis, strengthening our hospital’s ability to manage such complex critically ill patients, and improving the quality of obstetric care. For consecutive years, the Department of Obstetrics has successfully hosted national- and provincial-level training courses on the early diagnosis and treatment of amniotic fluid embolism, hypertensive disorders of pregnancy, gestational diabetes mellitus, and the rescue of critically ill obstetric patients. It has also conducted extensive work and research on subclinical hypothyroidism complicating pregnancy and thrombophilic diseases such as systemic lupus erythematosus and nephrotic syndrome, earning broad praise from patients and placing the maternal medicine subspecialty of our Department of Obstetrics at the forefront nationwide.

4. Medical Technology

After years of accumulation, our department has become the obstetrics center with the strongest overall capabilities in the Jiaodong Peninsula region. In 2012, the Department of Obstetrics at our hospital was selected as one of the first 10 clinical key specialties in Shandong Province and ranked third, placing our department’s professional service capacity, technical level, talent team, and research capacity at a leading level within the province. The Department of Obstetrics currently has 3 holders of senior professional titles and 9 holders of associate-senior professional titles, including 1 doctoral supervisor. It is the center for critical and difficult cases in the Jiaodong Peninsula and every year handles a large number of referral and consultation assignments from Jiaodong areas extending west to Linyi and Rizhao and east to Yantai and Weihai, as well as a large number of consultations and referrals of critically ill pregnant women from surrounding areas. The Prenatal Diagnosis Center comprises departments including genetic counseling, clinical obstetric puncture, imaging diagnosis (ultrasound), a biochemical and immunology laboratory, and a cytogenetics laboratory. Since its formal establishment, the center has now become a diagnostic center in Qingdao and surrounding areas for congenital fetal diseases and some chromosomal genetic diseases. Its work is at a leading level within the province and has made a positive contribution to improving the quality of the city’s birth population.

5. Research and Teaching

In recent years, the department has undertaken 3 projects funded by the National Natural Science Foundation, more than 10 research projects commissioned by provincial- and municipal-level local governments and by public institutions and enterprises, won 3 provincial- and municipal-level research awards, and served as editor-in-chief or deputy editor-in-chief of 4 books. In recent years, it has published more than 200 academic papers in publicly available academic journals in China and abroad, of which more than 60 were indexed by SCI, MED, or ISTP, including 10 papers with an impact factor above 5. Two projects were appraised as being at an internationally advanced level or a domestically leading level. Six new technologies and projects have been developed.

The department is a deputy-chair institution of the Perinatal Medicine Branch of the Shandong Medical Association; it holds a deputy-chair position in the Obstetrics and Gynecology Branch of the Qingdao Medical Association and is a deputy-chair institution of the Perinatal Medicine Branch of the Qingdao Medical Association. It participated in formulating the national clinical treatment pathways and clinical treatment guidelines for hypertensive disorders of pregnancy.

The Department of Obstetrics is a doctoral training site at Qingdao University and undertakes the teaching of Qingdao University undergraduate students, graduate students, and international students. In teaching practice, it adheres to development and innovation, has implemented multimedia and bilingual teaching, and has achieved notable results. In total, it has trained 2,400 undergraduate students, more than 30 master’s students, and 5 doctoral students. It has held continuing medical education courses and academic exchange activities at various levels many times. In recent years, the teaching and research office has repeatedly been named an Advanced Collective in Teaching and an Advanced Collective of Exemplary Teacher Ethics. Many individuals have successively been named Excellent Postgraduate Supervisors of Shandong Province, Excellent Postgraduate Supervisors of Qingdao University, Excellent Teachers of Qingdao University, and Qingdao University Models of Teacher Ethics.