Department of Obstetrics & Gynaecology
The Department of Obstetrics & Gynaecology located in the Caroline Chisholm
Centre, Liverpool Health Service, is the largest department of the Division of Women's
& Child Health. An excellent Level 6 tertiary referral obstetrical and gynaecological
service is provided to a large, multiculturally diverse and expanding population. It is a
teaching department for the School of Obstetrics & Gynaecology and the University of
New South Wales - one of Australia's leading universities. The Obstetrics Department
presently services just over 3000 confinements per annum with an anticipated growth rate
to 4000 confinements per annum during the next decade.
Services provided by the Department of Obstetrics & Gynaecology include:
General Obstetrics & Gynaecology Outpatient Services
A broad range of maternity care options are available to women and their families. An
efficient outpatient clinic layout, equipped with necessary investigative equipment
assists the running of outpatient obstetrical and gynaecological services. The Department
provides general and high-risk obstetric clinics, as well as general and subspecialty
gynaecological clinics.
There are daily general obstetrics clinics for low and moderate risk mothers, with services being delivered by obstetricians,
staff specialists, registrars and midwives within a hospital or community setting. These
services are supported by Shared Care, where women receive the majority of their antenatal
and postnatal follow-up care, from a general practitioner in their local community.
Midwives may also carry a clinical caseload of clients and offer a continuum of care
through the antenatal, intrapartum and postnatal period. The needs of the high number of
women from non-English speaking backgrounds are catered for by utilising interpreter
services and bilingual staff, who provide language specific education, support and
follow-up to the women and their families. Staff undergo cultural awareness training to
assist the provision of culturally sensitive services that reflect the needs of our
community. Midwives also utilise their full range of knowledge and skills as primary
health care providers, to improve the health outcomes for single and adolescent young
women and Aboriginal and Torres Strait Islander women.
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High Risk Obstetrics
There is an increased complexity of high risk pregnancies being managed in Liverpool
Health Service as South Western Sydney has a high perinatal mortality rate when compared
to other metropolitan hospitals in Area health Services. A multidisciplinary team of
obstetricians, physicians and Allied Health professionals conduct twice weekly specialist
clinics for women with gestational diabetes, thyroid problems, high risk pregnancies,
hypertension and renal disease. Programs have been developed to assist the drug and
alcohol dependent pregnant woman. If needed, hospitalisation occurs, but increasingly,
ambulatory care is being encouraged as it allows for mothers to remain in their home
environment with the family. Only severely affected mothers require hospitalisation and
sometimes-early delivery to safeguard the health of both mother and child.
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Feto Maternal Unit
A Feto Maternal Medicine Unit has been established, providing services Monday to
Friday. It provides both elective and emergency assessment of the pregnancy in order to
facilitate appropriate management of the high-risk pregnancy for mother, family and the
community, as well as providing prenatal diagnostic services. The Unit is equipped with
sophisticated high quality ultrasound machines and monitoring systems. An Area wide
Clinical Genetics Service supports the Unit.
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Gynaecological Endoscopy Unit
The Unit provides training and treatment with minimally invasive surgery for women
with gynaecological tumours or disorders. Diagnostic hysteroscopy and laparoscopy are
performed almost daily, and advanced laparoscopic surgery is often performed as a day only
or a 1-day stay procedure. Women who have had laparoscopic surgery are discharged back
home early, minimising the separation from the family and risk of hospital infection.
The Unit is well equipped with video endoscopic facilities, contributing to and advancing the variety of laparoscopic surgery
performed. Some cancer surgeries are being performed by this laparoscopic approach, thus
minimising the suffering of women from major abdominal surgery.
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Gynaecological Oncology Unit
The Unit is staffed by three young, qualified gynaecological oncologists. They provide
cancer surgery and management to all patients with suspected cancer or cancers. It is a
tertiary referral service for all district hospitals in SWSAHS, thereby looking after all
the female patients with gynaecological cancer in the South Western Sydney area.
Other Subspecialty Services - Colposcopy, Urogynaecology & Menstrual Disorders
The Department has other tertiary referral subspecialty services being provided to the
women living in the Area, that until recently were only available in the city hospitals.
For example, colposcopic clinics for women with abnormal smears; urogynaecology clinic for
women with bladder trouble; and a menstrual disorders clinic are now offered by the
Division.
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Labour Ward
Childbirth facilities in the delivery suite are beautifully decorated with a home-like
atmosphere, so that labouring mothers can delivery their babies in the presence of their
family, promoting a family centred approach to childbirth. Sophisticated monitoring
equipment and resuscitative machines are available if needed, or whenever an emergency
arises to safeguard the high-risk mothers and their babies. Obstetrics anaesthesia
services are provided to assist pain management of women in labour and are supported by
midwives accredited to perform the Epidural Top-up procedure. Midwives are also accredited
to conduct episiotomy and perineal repair.
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Antenatal and Postnatal Wards
Antenatal and postnatal care facilities are designed as motel type accommodation with
single or twin share rooms, with ensuite bathrooms. Mothers and babies room in together.
Mothers and babies are discharged home 6 to 48 hours after delivery with continuing care,
support and education being provided at home initially by midwives and ongoing by early
childhood and primary health nurses in the community. By way of accredited skill
enhancement programs, such as Midwife Initiated Discharge and Neonatal Health Assessment,
midwives are able to assist the medical team to achieve smooth discharge and transition to
community care for mother and infant.
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