Obstetrics and Gynaecology

Introduction to the Department of Obstetrics and Gynecology, Zhejiang Provincial Tongde Hospital

The Department of Gynecology has more than 60 medical and nursing staff, including 38 doctors, 19 with senior professional titles, 3 doctors with doctoral degrees, 5 doctoral students, and 23 with master's degrees; 1 Zhejiang Provincial health leading talent, 1 provincial medical young talent, and 2 provincial candidates for training as renowned young and middle-aged clinical traditional Chinese medicine doctors.

The Department of Obstetrics and Gynecology integrates Western gynecology, traditional Chinese gynecology, family planning, and obstetrics. It is characterized by integrated traditional Chinese and Western medicine, minimally invasive technology, and high-quality obstetric services. It is a key innovative discipline of the Zhejiang Provincial Health and Family Planning Commission (diagnosis and treatment of intrauterine diseases), a key innovative discipline of the Zhejiang Provincial Administration of Traditional Chinese Medicine under the 13th Five-Year Plan (integrated traditional Chinese and Western medicine for intrauterine diseases), and a key specialty of the Zhejiang Provincial Administration of Traditional Chinese Medicine under the 13th Five-Year Plan (gynecology); a core member institution of the Zhejiang Major Diseases “Uterine Malignant Tumors” Diagnosis and Treatment Research Center; one of the first national training bases for direct-visualization artificial abortion surgery technology; the only national post-abortion care demonstration hospital in Zhejiang Province; the leading institution of the Gynecology Alliance of the Zhejiang Integrated Traditional Chinese and Western Medicine Medical Consortium; a standardized training base for traditional Chinese gynecology in Zhejiang Province; and the deputy chair institution of the Quality Control Center for the Traditional Chinese Gynecology Specialty of the Standardized Training Program for Traditional Chinese Medicine Residents in Zhejiang Province.

Western gynecology performs various difficult Class IV open and minimally invasive procedures, including laparoscopic, hysteroscopic, and vaginal operations. Combined laparoscopy and hysteroscopy for repair of cesarean-scar diverticula is a specialty procedure. Minimally invasive laparoscopic surgery for gynecologic tumors benefits more patients, and various advanced hysteroscopes provide the equipment foundation for difficult hysteroscopic procedures. The department established the first integrated traditional Chinese and Western medicine day-surgery ward in the province. The family-planning treatment team manages difficult and high-risk abortions and inductions; a disposable hysteroscopic observation and suction system makes surgery safer and more directly visualized. The main traditional Chinese gynecology conditions include pelvic inflammatory disease, conservative treatment of ectopic pregnancy, infertility, perimenopausal syndrome, recurrent miscarriage, and hyperemesis gravidarum. Coordinated treatment is also provided for preoperative conditioning and postoperative rehabilitation of Western gynecology and family-planning patients, and a perioperative traditional Chinese medicine enhanced-recovery system for gynecologic surgery has been established. Obstetrics provides systematic prenatal care, diagnosis and treatment of high-risk pregnancy, counseling on eugenics and healthy reproduction, individualized obstetric services, and postpartum rehabilitation and physiotherapy. It manages high-risk pregnant and postpartum women and patients with difficult, acute, critical, and severe illnesses from surrounding areas. Services include vaginal birth after cesarean, external cephalic version for breech presentation, and cosmetic closure of incisions. The department has extensive experience in integrated traditional Chinese and Western medicine diagnosis and treatment of high-risk pregnancies, including early-onset preeclampsia, pernicious placenta previa, intrahepatic cholestasis of pregnancy, fetal growth restriction, threatened preterm labor, pregnancy complicated by immune-system diseases, and neuropsychiatric diseases.

The Department of Obstetrics and Gynecology has more than 100,000 outpatient visits annually and nearly 5,000 discharged patients; patients come from all parts of the country. It undertakes more than 50 projects funded by the National Natural Science Foundation of China and at provincial, ministerial, departmental, and bureau levels, and has published more than 100 SCI-indexed and domestic papers.

From 2009—2012, it received the title of Zhejiang Provincial Women’s Civilized Post. In 2015, it received the title of National May 1st Women’s Civilized Post. In 2016, it received the title of Zhejiang Provincial Workers’ Pioneer. In 2024, the Department of Gynecology received the provincial March 8th Red-Flag Collective and the provincial Five-Star Youth Civilized Post titles.

Gynecologic specialty services:

1. Specialty outpatient clinic for cervical lesions. The three-step cervical cancer screening protocol is strictly followed: cervical liquid-based cytology (TCT) + human papillomavirus (HPV) — colposcopy — cervical biopsy. Early screening is conducted for cervical precancerous lesions and cervical cancer, and treatments include loop electrosurgical excision procedure (LEEP), cold-knife conization, cervical laser treatment, and open or laparoscopic radical hysterectomy for cervical cancer.

2. Family-planning outpatient clinic. Services include medical abortion, induced abortion and post-abortion contraception, management of difficult and high-risk abortions, removal of fractured, retained, or embedded intrauterine devices, and diagnosis and treatment of cesarean-scar pregnancy and pregnancies in other special locations.

3. Menopause outpatient clinic. Traditional Chinese medicine characteristics are organically combined with hormone replacement therapy to tailor treatment plans for menopausal patients, with regular follow-up and management.

4. Infertility outpatient clinic. Various examination and treatment methods, including hysterosalpingographic ultrasound, hysteroscopy and laparoscopy with surgery, endocrine therapy, and traditional Chinese medicine, are used to provide distinctive integrated traditional Chinese and Western medicine diagnosis and treatment for infertility.

5. Post Abortion Care outpatient clinic (Post Abortion Care, PAC). Pre-abortion contraceptive guidance and education and post-abortion follow-up are provided to minimize unintended abortions and post-abortion complications. This highlights the characteristics of a general hospital and has become a successful model for post-abortion care clinics in general hospitals nationwide; its experience has been promoted repeatedly at national professional conferences. It was among the first hospitals in the province to pass the assessment as a “National Post-Abortion Care Demonstration Hospital.”

6. Menstrual disorders outpatient clinic. Traditional Chinese medicine pattern differentiation is combined with modern medicine to treat amenorrhea, scanty menstruation, prolonged menstruation, intermenstrual bleeding, and other menstrual disorders, as well as various premenstrual and menstrual symptoms, such as premenstrual breast tenderness, menstrual headache, and emotional abnormalities during menstruation.

7. Pelvic-floor specialty outpatient clinic. The Pelvic Floor Treatment Center of the Department of Gynecology of Zhejiang Provincial Tongde Hospital is one of the leading standardized and specialized pelvic-floor treatment bases in the province, with distinctive integrated traditional Chinese and Western medicine characteristics. The center has advanced equipment, including pelvic-floor biofeedback and urodynamic testing devices. Several devices are the first of their kind in East China. The center integrates pelvic-floor function screening, diagnosis, treatment, and functional training and, combined with distinctive traditional Chinese medicine, effectively treats stress urinary incontinence, pelvic-organ prolapse, sexual dysfunction, incomplete postpartum uterine involution, postpartum rectus abdominis diastasis, and other conditions.

Obstetric specialties

I. Correction of malpresentation 1. External cephalic version for breech presentation. This is a long-lost obstetric technique in which manual manipulation through the abdomen turns a breech presentation into a cephalic presentation suitable for vaginal birth, effectively promoting vaginal delivery and reducing the cesarean-section rate. 2. Moxibustion for correction of malpresentation. This traditional Chinese medicine technique applies an ancient method in a new way. Zhiyin is the well point of the Bladder Meridian of Foot-Taiyang; stimulating Zhiyin activates the qi of the Bladder Meridian, regulates the qi of the Kidney Meridian, harmonizes fetal qi, and promotes spontaneous correction of fetal position.

II. Vaginal birth in a subsequent pregnancy after cesarean section. This changes the former dogmatic concept of “once a cesarean section, always a cesarean section.” After prenatal assessment, doctors, pregnant women, and families jointly discuss the advantages and disadvantages of vaginal birth in a subsequent pregnancy after cesarean section. It is relatively safe and may reduce maternal morbidity and neonatal wet lung, with benefits including a shorter hospital stay and fewer long-term complications.

III. Traditional Chinese medicine obstetric specialties. The department adheres to the inheritance and innovation of traditional Chinese medicine obstetric characteristics. Among provincial-level hospitals, it was among the first to formulate diagnosis-and-treatment standards and traditional Chinese medicine clinical pathways for obstetric conditions in which it has advantages. Traditional Chinese medicine, meridians, acupoint massage, and physiotherapy are used to treat fetal growth retardation, promote maternal milk secretion and postpartum uterine involution, and facilitate healing of perineal incisions.

IV. Individualized obstetric services 1. Integrated ward / warm doula-supported birth. Personalized, high-quality services are provided for expectant mothers, who welcome their babies with the joint companionship of family members and midwives. 2. Labor analgesia. Pharmacological analgesia (commonly called painless delivery) and non-pharmacological analgesia reduce labor pain and physical exhaustion and promote labor progress. 3. High-quality nursing. Services include bedside mother-and-infant care, early intelligent-care education for newborns, and a training camp for new parents.

V. Prevention and treatment of neonatal birth defects, prenatal screening, prenatal diagnosis, and consultation services at the fetal medicine outpatient clinic.