The department of Obstetrics and Gynecology is one of the largest tertiary centers in Jordan. It is considered the main referral center in the north of Jordan, providing a high level medical services for more than 1.5 million people.
Scope of Obstetrics and Gynecology department.
Our department is composed of 10 highly qualified consultants, passionate to deliver a high standard medical care in maternity services, fetomaternal medicine, general genecology, oncogynecology, and reproductive medicine. In addition to the clinical work, we have daily teaching commitments for undergraduate and postgraduate students which include clinical rounds and academic supervision of research work. Furthermore, our staff is committed to serve the surrounding community by actively participating in national conferences and raising awareness of common diseases between the local community.
Our labour ward unit provides a respectful medical services for about 3000 deliveries every year. The facility consists of eight labor, delivery, recovery rooms and two dedicated obstetric operating rooms, as well as a triage/monitoring area. Many of these deliveries are complicated and difficult cases referred from the surrounding hospitals. That was very clear during the COVID 19 pandemic lockdown, where all pregnant women with COVID 19 from the north of Jordan were referred to our department; to receive the best medical services. Our maternity services also include pre conception visits, antenatal clinics, and breast feeding classes antenatally and postnatally.
In oncology, the department includes four certified gynecologic oncologists, offering highly skilled, state-of-the art care for women with cancers of the female reproductive tract. The Department offers a comprehensive range of inpatient and outpatient services, including medical and surgical treatment for cancer or precancerous conditions of the reproductive tract. The department's physicians are experts in their fields. They provide innovative and advanced medical and surgical treatment options for patients coping with both pre-cancerous and malignant conditions, including cancer of the cervix, ovary, uterus, vulva, and vagina.This involves all aspects of the surgical management of gynecologic cancer together with coordination of subsequent chemotherapy and radiation therapy, if indicated.
Colposcopic evaluation of the cervix is also available at the outpatient clinics.
In Fetomaternal medicine, the department has three professional specialists conducting three high risk pregnancy clinics and three fetal clinics where they care for women who have obstetric, medical, surgical or genetic complications of pregnancy and can assist in consultation or co-management of complicated conditions before (pre-conception counseling) or during pregnancy. As a tertiary care centre, in addition to providing services for women with low risk pregnancies it acts as a referral centre for high risk women who need special care. Fetal medicine clinic is available for early detection of fetal anomalies and fetal well being including high order multiple pregnancies. The centre also performs diagnostic tests (Amniocentesis and CVS) and interventional procedures like intrauterine fetal blood transfusion and selective fetal reduction. Comprehensive fetal ultrasound by fetal maternal sub specialist makes the department a leader in the field.
The In-Vitro Fertilization Centre manages complex problems related to infertility and related issues, including recurrent pregnancy loss, abnormal uterine bleeding, endometriosis and risk of genetic disorders in offspring. The centre includes two talented consultants where they perform more than 150 IVF procedures each year, in addition to other methods of reproductive technique assistance like IUI. They also provide a wide range of management to infertile couples including interventional hysteroscopic and laparoscopic procedures. Furthermore, the centre provides services of sperms and embryos freezing.
In general gynecology, we provide both preventive gynecological care and diagnostic services for women. Preventive care includes Pap smear testing and contraceptive counseling. General gynecologic operations are conducted for benign disorders including hysterectomy (Abdominal, vaginal and Laparoscopic), myomectomy, ovarian cystectomy, vaginal wall repair, and tubal ligation.
Although currently we don't have subspecialists in pelvic urogynecology, we provide simple work up and we direct patients to the best available service. We are looking forward to expand our service to include Pelvic and urogynecology by accepting and sponsoring four new postgraduate fellows for training in these fields outside Jordan.
The department receives and serves nearly 15,000 ambulatory visits per year and more than 3500 patients are admitted to the 32 inpatient beds annually.
Our outpatient service has three consultant rooms and 18 examining room capable of running 6 clinics per day from 8am till 4 pm. Our service is supported by a strong residency teaching program that accepts 6-10 residence per year in 5-year program.
We are unique in the region in dealing with critically ill mothers referred from different places in the north of Jordan like abnormally implanted placenta, active bleeding, severe thrombocytopenia, end stage renal disease and ARDS due to the presence of high risk pregnancy specialists and the availability of ICU and blood banks.
The department of obstetrics and gynecology is recognized nationally for excellence in teaching, clinical service, and research, being reflected in the active participation of our staff in the authorship of basic and clinical research in international journals, receipt of research funds and training grants, election to leadership positions in Jordanian Medical Council and active participation in national conferences.
GRADUATE EDUCATION
Graduate Education program coordinates the graduate residency training in a carefully balanced program of primary care and tertiary care residency. We prepare resident for careers in primary care medicine as well as for competitive fellowship positions. A structured, didactic curriculum complements the Jordanian broad clinical training. Formal teaching conferences as well as informal teaching rounds combined to enhance the educational process. Residents are certified in neonatal life support and adult life support course by serial lectures in this field. The program is fully accredited by Jordanian Medical Council for Graduate Medical Education. We are looking in the future to expand our education to include several subspecialty fellowships. Every year we admit at least 2 residents from the surrounding courtiers like Iraq, Syria, Yemen, Morocco, Saudi Arabia.
UNDERGRADUATE MEDICAL EDUCATION
The department participate actively in teaching 4th year medical students an introductory course to the Obstetrics and Gynecology field. During this experience, students begin to learn the art of clinical medicine through patient interviews and observation in various clinical sites.
In the fifth year of the medical education, each student spends a total of eight weeks where they get introduced to identification and recognising symptoms and signs of the common gynecologic disorders.
In the sixth year of the medical education, each student spends a total of eight weeks where they learn how to mange common gynecologic disorders and know when to send patients to a tertiary place.
Before graduation, students learn to provide developmentally appropriate care for the woman. This is accomplished through clinical experiences in primary care clinics and practices, specialty clinics, and inpatient unit. A specially designed didactic curriculum and case discussion series, with faculty tutors, enhance and solidify the clinical experience.
We accept medical students from different universities from outside Jordan to conduct an elective course in our department.
In Summary
So, the scope of our department is medical care, education, research as well as active participation in national plans for medical and educational development.
Most common diagnosis:
Early pregnancy disorders
Miscarriages (missed, threatened, inevitable, complete, incomplete), Ectopic pregnancy, Pregnancy of unknown location, and Molar pregnancy (complete, partial, placental site)
Antenatal disorders
Urinary tract infection, preterm labour, Preterm premature rupture of membranes, gestational diabetes, Hypertension in pregnancy, Anemia in pregnancy, small for age babies, large for age babies, malpresentation.
Labour conditions
Labour( active, latent), PPROM, Antepartum HG (placenta abruption, placenta previa), Failure to progress, Postpartum hemorrhage, caesarean section.
General gynecology
Menorrhagia, pelvic pain, Fibroid, ovarian cysts, Prolapse (anterior, posterior, uterine), Incontinence (stress, urge)
Reproductive medicine
Amenorrhea, Menopause, Precocious puberty, infertility
Oncology
Cervical cancer, ovarian cancer, uterine cancer, vulvar canver.
Fetal medicine
Chromosomal anomalies, genetic anomalies, structural anomalies, fetal anemia, hydramnios, multiple pregnancy
Maternal medicine
Epileptic mothers, diabetic mothers, HT mothers, renal impairments
Most common procedures
Pap smear
Colposcopic exam
Endometrial biopsy
IUCD insertion and removal
Implanon insertion and removal
1st trimester ultrasound
2nd trimester ultrasound
Anomaly scan
Growth and wellbeing scan
Hysteroscopy
Removal of polyps
Laparoscopy diagnostic
Laparoscopic (cystectomy, salpingectomy, tubal ligation)
Hysterectomy
Myomectomy
Anterior colporrhaphy
Posterior colporrhaphy
Vaginal hysterectomy
Vaginal deliveries with and without episiotomy
Repair of genital tear
Vaccum delivery
Forceps delivery
Caesarean section with and without tubal ligation
Amniocentesis
CVS
Amnioreduction
Fetal reduction
Intrauterine blood transfusion.
Methotrexate for ectopic pregnancy
Dilatation and currettage
Administration of chemotherapy (IV or intrathecal)
