"Obstetrics and Gynaecology at Medway is a very dynamic department with 12 motivated consultants supported by junior doctors, offering a vast array of O&G services."
Miss Padma Vankayalapati – College Tutor, Fetal medicine, Maternal medicine
About O&G at Medway
Maternity & obstetrics
The obstetric unit is busy dealing with high risk pregnancies with around 5000 deliveries every year. The two maternity wards (20 – 24 beds) close to the Labour Ward are combined ante-natal (Pearl ward) and post-natal wards (Kent ward) with “transitional care” for babies needing extra midwifery and medical care, but who do not need full SCBU care.
We are offer Level 3 neonatal services with around 150 in-utero transfers per annum accepting babies from 23 weeks onwards.
For normal pregnancies, ante-natal care is provided almost entirely in the community by community midwives. High risk pregnancies are seen in consultant led clinics and any urgent reviews occur in our Maternity Care unit or maternity triage.
Consultant clinics are held at Medway Maritime, Sheppey General and Sittingbourne Memorial Hospitals. These clinics are for mothers who have risk factors or where a problem develops during the pregnancy. We have a number of specialist antenatal clinics for diabetes, hypertension, obstetric cholestasis, perinatal mental health, medical maternal disorders and a VBAC clinic.
We also now have an appointed consultant physician in Acute and Obstetric Medicine who plays a crucial role and contributes to the care of pregnant women with complex medical problems.
A consultant led perineal clinic also runs weekly were women with a history of OASIS are seen and offered endoanal ultrasound and manometry.
There are 10 single delivery rooms, a 2 bedded MECU (Obstetric HDU), a dedicated Obstetric Theatre and second theatre for daily elective caesarean section lists.
The delivery rooms are well-equipped with fetal monitoring equipment including central monitoring and there is a blood gas analyser for fetal blood sampling and umbilical cord blood samples.
Obstetric medical cover is provided by a SpR (ST3+ or equivalent), an ST1/2 or F2 and by the Consultant on-call.
In-utero (and ex-utero) transfers from surrounding districts in West Kent and further afield are readily accepted as Medway has a Level 3 NICU. There is Midwifery Led unit located on same floor which caters to low risk women.
We have a very busy Fetal Medicine unit which provides tertiary level services, receiving referrals from all over Kent. All women are offered at least three scans in their pregnancy; a dating scan at 12 weeks were women are also screened for aneuploidies as well as risk of developing placental dysfunction, an anomaly scan with a cervical assessment at around 20 weeks and a 36 weeks growth scan for fetal well-being.
A number of clinics also run weekly including clinics for placental disorders, hypertension, preterm and multiple pregnancy. Fetal echocardiography services are provided with fetal echoes and a visiting Fetal cardiologist as well as availability to geneticist. Invasive procedures are carried out regularly including Chorionic villous sampling, amniocentesis, intrauterine fetal blood transfusion for anaemic babies, and foeticide for termination of pregnancy for fetal abnormality cases.
There is also a dedicated research team working within the department with lots of opportunities to get involved.
Consultant Gynaecology clinics are held at Medway Maritime, Sittingbourne and Sheppey Hospitals including specialist infertility, endometriosis, urogynae, vulval disorders and sexual dysfunction clinics.
We offer a number of outpatient services in minor procedures and rapid access clinics including colposcopy, hysteroscopy and biopsy, vulvoscopy and vulval biopsy, insertion of mirena and urodynamics.
We also have a busy Early Pregnancy unit with full scanning lists every day from Monday to Friday led by an experienced nurse. We have started offering outpatient Manual Vacuum Aspiration as part of the treatment for miscarriage
An Emergency Gynaecology Clinic has emergency slots daily between 9 – 5 pm and is run by one of the doctors accepting referrals from A&E, GPs or from the early pregnancy unit.
Most consultants have one major and one day case operating list per week with the majority of benign gynaecology surgeries being done laparoscopically. There are opportunities to practice advanced laparoscopic skills, hysteroscopy skills and urogynaecology surgeries.
We have one gynae ward accepting emergency and elective admissions which also has a Gynae Assessment unit where A&E referrals can be seen, and transvaginal scanning can be done if needed.
There is a rolling junior doctor rota consisting of 8 senior registrars, 8 junior registrars, 11 SHOs and 2 FY1 doctors.
There are 13 consultants on a separate rota with a consultant on site between 8.30am and 6.30 pm and non-resident from 6.30 pm till 08.30am.
There is protected teaching for different grades of trainees.
Consultants, special interests and other roles
- Weekly department consultant led teaching.
Protected teaching for different grades of trainees.
Mix of multidisciplinary meetings including Gynae oncology, high risk obstetrics, joint neonatal meetings