Gynaecology, Obstetrics and Reproductive Medicine

Ospedale San Raffaele

key figures 

CLINICAL SERVICES:

  • Gynaecologic Oncology and prevention
  • Urogynaecology and pelvic floor disease
  • Endometriosis and chronic pelvic pain
  • Pregnancy: physiology and pathology
  • Early pregnancy unit - Prenatal diagnosis
  • Reproductive surgery - Benign Gynaecology
  • Feto-maternal medicine
  • Fertility preservation and assisted reproductive techniques (ART)

PROCEDURES PERFORMED PER YEAR:

  • Over 1.300 major gynaecological surgeries  
  • 2.400 Deliveries
    • 33% Caesarean sections
    • 30% Vaginal deliveries with epidural analgesia
  • Over 1.500 cycles of medically assisted reproduction

The main expertise of the Gynaecology-Obstetrics and Reproductive Medicine Unit is the diagnosis, staging and treatment of gynaecological oncology, urogynaecology, endometriosis and a tertiary centre of obstetrics. It is widely regarded as a centre of reference and excellence on a national and international scale.

The Unit is also home to academic teachings in gynaecology and obstetrics within the Specialized Degree course in medicine and surgery and is the base for the School of Specialization in gynaecology and obstetrics of the Vita-Salute San Raffaele University.

It is the place for internships for the students of the Degree course in nursing and the Master in nursing and obstetric management for the coordination functions.

The Unit is also home to advanced training courses for medical specialists in Gynaecology and Obstetrics both in Italy and abroad.

 

treatmentS

Gynaecology

The Unit is the national reference centre for the surgical treatment of neoplasia of the female genital apparatus (benign and malignant); over 1.300 major surgeries are performed every year, with particular interest in endoscopic surgery and vaginal pelvic floor surgery. A dedicated chemotherapy service is carried out for gynaecological cancers.

Due to the advanced diagnostic equipment present in the hospital, the Unit represents a centre of international excellence.

Main Pathologies Treated:

  • Gynaecologic Oncology
    • Prevention, diagnosis and treatment of all cancer of the female reproductive tract
    • Rare gynecological cancers (trophoblast tumors and special ovarian tumors)
    • Check-up, prevention and gynecological treatment in patient with breast cancer
  • Urogynaecology
    • Diagnosis and treatment of pelvic floor dysfunctions
    • Vulvovaginal atrophy, from diagnosis to treatment
    • Congenital malformation of female genital tract such as Rokitansky syndrome
  • Benign Diseases
    • Uterine myomas
    • Endometriosis
    • Chronic Pelvic Pain
    • Adnexal masses

Top Procedures:

Laparotomic, Vaginal, Laparoscopic (CO2 Laser in Minimally Invasive Gynaecological Surgery), Hysteroscopic, and Robotic-assisted surgery.

Obstetrics

In addition to the normal activities in the delivery room, particular expertise was developed within the 'Pathology of Pregnancy' (diabetes, hypertension etc.) and in the clinical management of pregnancies at risk. Pregnant women are guaranteed an access to painless delivery with peridural analgesia without charge.

Courses of accompaniment at birth and meetings for the mother and the new-born are offered and, in addition, a specific clinic for psychological counselling and psychotherapy is active, both directed by a psychologist.

Prenatal Screening option is available using both non-invasive (nuchal translucency scan and maternal serum screening, cell-free foetal DNA-NIPT) and invasive examinations (amniocentesis, chorionic villus sampling).

Main Pathologies Treated:

  • Pathology of Pregnancy
    • Mellitus diabetes (type 1 and 2)
    • Cardiovascular diseases
    • Hypertension
    • Autoimmune diseases
    • Foetal malformations
    • Cancers in pregnancy
  • Early Pregnancy Unit
    • Recurrent pregnancy Loss
    • Ectopic Pregnancies
    • Foetal cardiovascular diseases in the first trimester  
  • Prenatal Diagnosis
    • First trimester screening for chromosomal abnormalities   
    • Second level ultrasound consultations

Foetal Surgery

The Unit offers a consolidated pathway from ultrasound investigations and prenatal diagnosis to foetal surgery and neonatal follow-up from both medical and surgical point of view. The multidisciplinary team involves an international consortium of leading experts including gynaecologists with expertise in all types of pelvic surgery, obstetricians with experience in foetal ultrasound and percutaneous procedures, paediatric anaesthesiologists, neonatologists, paediatricians, neurosurgeons, neuroradiologic and paediatric neurologists.

Medically Assisted Reproduction and Fertility Preservation

The Fertility Centre welcomes a large number of sterile couples every year, guaranteeing access to the most modern techniques (In Vitro Fertilisation - IVF, Intracytoplasmic Sperm Injection - ICSI). Alongside the traditional medical and surgical diagnostic methods, it is possible to access all the therapies currently available.

The centre performs over 1.500 ovulation induction cycles per year both for simple homologous intrauterine inseminations (IUI) and for more complex PMA techniques. Furthermore, it guarantees the highest standards of ethical and welfare integrity. Each couple receives a personalized treatment and all the staff of the team shares this philosophy.

Main Pathologies Treated:

  • Female and male infertility
  • Screening for specific genetic/gender disease
  • Reproductive endocrinology
  • Fertility preservation in women with an increased risk of ovarian failure (endometriosis, cancer, neurological and genetic diseases)

Top Procedures:

  • Assisted Reproductive Technique (ART III ° level)
    • Ovulation monitoring on spontaneous cycle
    • In-Vitro Fertilization cycles
    • Micromanipulation of gametes
    • Social Freezing
    • Oocyte Freezing
  • Preimplantation genetic diagnosis (PGD / PGS)
    • Oocyte and tissue cryopreservation
    • Fertility sparing surgery techniques     

 

NOTABLE ADVANCED TECHNOLOGICAL EQUIPMENT

  • Da VINCI Robot
  • CO2 LASER  
  • 3D System in Laparoscopy
  • Interventional Radiology (catheter embolization)
  • DWI MRI