Obstetrics-Gynecology

Overview of the department

The Department of Obstetrics and Gynecology, Fukui University, is responsible for advanced medical practice as a core hospital of an obstetric/gynecological medical network that covers the Kaga Plain, Fukui Prefecture, and the north area of Kyoto Prefecture. Furthermore, general obstetric/gynecological care is provided for residents of adjacent areas in cooperation with regional hospitals.

Consultation system

In the Kaga Plain, Fukui Prefecture, and the north area of Kyoto Prefecture, there is an obstetric/gynecological medical network based on a close relationship among hospitals. In this network, individual hospitals play unique roles.
Team practice is conducted. A team consists of several staff. Medical care is provided through a team-based system.

Characteristics of medical care divisions

Perinatal Care Division

1) Our hospital is a principal training institute for specialists in perinatal maternal/fetal diseases, certified by the Japan Society of Perinatal and Neonatal Medicine.
2) As a core hospital in the above medical network, we are responsible for the treatment of women with high-risk pregnancies requiring advanced management based on referrals from individual hospitals.
3) We have developed a safe surgical procedure for placenta previa and adhesive placenta, which are the primary causes of death in pregnant women. Currently, we are making efforts to promote the widespread application of this procedure in Japan.
4) In the Okuetsu area, normal delivery is managed in cooperation with Fukui Katsuyama General Hospital. “Convenience” and “advanced medical practice” are simultaneously provided for the residents.

Malignancy Care Division

1) Our hospital is a medical facility certified as a training institute for specialists in gynecological tumors by the Japan Society of Obstetrics and Gynecology, as a first in Fukui Prefecture. Two specialists in gynecological tumors, two specialists in cytodiagnosis, and four cancer treatment-certified physicians comprise a team.
2) Staff who are familiar with high-level pelvic procedures (refer to “Advanced medical practice”), chemotherapy/radiotherapy, and pathological diagnosis provide medical services in cooperation with specialists in pathology and diagnostic imaging. Furthermore, they are making efforts to educate specialists in oncology.

Gynecological Care Division

1) Concerning benign diseases, minimally invasive surgery is provided using high-level techniques/procedures. Transvaginal/laparoscopic surgery is performed (refer to “Advanced medical practice”).
2) Favorable treatment results have been obtained by combining a conventional method with TVM surgery using mesh for pelvic organ prolapse and urination disorder in cooperation with the Department of Urology in our hospital.

Infertility/Recurrent Abortion Care Division

1) For patients with infertility, we promote natural pregnancy as much as possible. Simultaneously, advanced reproductive techniques, such as in vitro fertilization/micro-fertilization and frozen/thawed embryo transplantation, are positively performed, if necessary (recent pregnancy rate per ovum collection: approximately 20%).
2) For patients with recurrent abortion, anticoagulant therapy to improve uterine blood flow in the first pregnancy trimester is applied. The continuation of pregnancy/delivery have been successfully achieved in approximately 85% of patients.

Health Care Division for Middle-aged/Aged Females

Outpatient services for middle-aged/aged females’ health care, involving climacteric disorder, are provided in cooperation with the Department of Comprehensive Medical Care.

Advanced medical practice

Perinatal Care Division

We have developed and successfully performed a safe procedure of Cesarean section for placenta previa/adhesive placenta. Placenta previa/adhesive placenta is an important factor leading to maternal mortality (a pregnant woman died in Fukushima Prefecture, and the attending physician was arrested); therefore, a safe procedure of Cesarean section for this abnormality was developed. Currently, this procedure is performed in referred patients, and we are making efforts to introduce it into various hospitals in Japan and promote its widespread application.

Malignancy Care Division

1) To treat patients with cervical carcinoma, remote metastasis is controlled using chemotherapy before surgery, and systematic extended total hysterectomy is performed, considering autonomic-nerve preservation.
2) Before surgery, FES-PET is introduced to accurately diagnose cancer.
3) Thermochemotherapy for advanced ovarian cancer is introduced.

Gynecological Care Division

1) Myoma in an area adjacent to the uterine cavity is removed using a hysteroscope. Although high-level skills are required, this is the most minimally invasive technique among all procedures for hysteromyoma.
2) Laparoscopic surgery is positively introduced to minimize invasiveness.

Infertility/Recurrent Abortion Care Division

1) When marked sperm abnormalities are present, micro-fertilization (TESE-ICSI), in which sperm collected from the testis are directly infused into an ovum, is conducted in cooperation with specialists in urology.
2) To decrease the number of twins or triplets resulting from in vitro fertilization, single blastocyst implantation, in which an in vitro-fertilized embryo (blastocyst) that has been cultured for 5 to 6 days is transferred into the uterus, is performed.

Our original examinations associated with advanced medical practice

FES-PET is a PET procedure to visualize female hormone receptors, which was developed in our university. Currently, it is being applied as an advanced medical technique.