History of the Clinic
The Prague Obstetrics Clinic and orphanage was established in Prague in Apolinářská street in the Foundation building for the clerical by the church of St. Apolinář. This was according to the decision of emperor Joseph II in 1784 in the frame of establishing public health institutions by the directives given in 1781. After adapting the building to its new function, the first birth took place in 1789. At that time this building was also a teaching facility of practical obstetrics for future doctors, wound-healers, and midwives. In the 4th decade of the 19th century, the capacity of the facility was no longer large enough for the number of pregnant patients admitted and the increasing numbers of students of obstetrics. In 1861 the National Committee of the Czech Kingdom was to ensure a new facility with a greater capacity. In 1863, they selected architect Josef Hlávka (1831-1908) to design and construct this new facility. Although there were financial, technical, and personal obstacles, one of the most modern obstetric hospitals in Europe was built, with a capacity of 3,000 births per year. The structure was and continues to be admired both from the functional standpoint as well as for its architecture, and it is also a national historical monument. The Obstetrics Clinic was opened in 1875 and had a 367-bed capacity. The building contained 2 German Obstetrics Clinics, a Midwife Clinic, and an anonymous ward. The First Czech Department of Obstetrics was established after the subdivision of the Prague University into Czech and German parts in 1883, and was chaired by professor Jan Streng. The Gynecological part of the 1st Department was established in 1898 and placed into the so-called anniversary pavilion in the General Faculty Hospital (in what is now the street U Nemocnice 2). The 2nd Department of Obstetrics and Gynecology was established in 1920 and placed into the Obstetrics Clinic in Apolinářská street, after moving the school for midwives elsewhere. The first chairman was professor Václav Rubeška. Both Czech departments led the direction and development of Obstetrics and Gynecology in the country, and were rivals in a positive sense. The German Obstetrics and Gynecology Clinic dissolved after the end of World War II in 1945.
The basic obligations of a clinical institution include medical care, teaching, and scientific research.
In the area of medical care this department is the largest in its field in the Czech Republic and the range of its activities covers the entire field of Obstetrics and Gynecology. Our department is the main regional center for the field of Obstetrics and Gynecology and is also a regional Perinatology Center for Prague and Central Bohemia. In several areas, it is the referral center for the entire CzechRepublic.
In 1999, there were 3,400 deliveries, of which 812 were premature. 20% of the total deliveries were by cesarean section and 2.5% were by forceps. In the scope of prenatal diagnosis 1,120 invasive prenatal examinations were performed. Cardiotocographic examinations were performed in 32,850 pregnancies. The perinatal mortality rate of our department has reached 5.8 per mille which is an excellent result when considering the fact that 30% are pathological pregnancies and premature deliveries, and the national perinatal mortality rate is 5.1 per mille. We took care of 300 newborns requiring intensive care, of which 120 were in the birth weight range of 500-1500 grams. The results of our neonatal care, especially in the lowest birth weight categories, are among the best in the Czech Republic and are comparable to the results of advanced countries.
In the last year we performed 5,101 gynecologic operations, of which 1,101 were large abdominal operations (including 86 pelvic and paraaortal lymphadenectomies), 750 laparoscopies, and 123 laparoscopically assisted vaginal hysterectomies. Because there is a definite trend toward endoscopic surgery, one ward of our department has been renovated and it includes 3 new endoscopic operating rooms.
There is a long-term tradition of oncological, senological, and urogynecological diagnostics and surgery. At the Oncology ward, we treated 221 newly diagnosed malignant tumors. The Center for Assisted Reproduction, Ultrasound, and the Center of Fetal Medicine, all have very good results.
We have several specialized outpatient clinics covering: high risk and pathological pregnancy, pediatric gynecology, endocrinology, sterility and infertility, menopausal problems, a center for oncological prevention, oncology, urogynecology, endoscopy, and internal medicine (for the care of high risk patients before and after surgery, for high risk and pathological pregnancies especially patients with diabetes, cardiopathy, and other internal complications).
Our physiotherapists have an increasing workload, using special exercises for patients after gynecological and obstetric operations, and rehabilitation exercises for oncological patients as well as for pregnant patients in preparingfor labor.
We must also not forget to mention the clinical laboratories ? the cytology laboratory and the blood gas laboratory. Two outpatient gynecology clinics are also a part of our department, one is the clinic on Karlovo Náměstí and the other is in Klimentská street.
In 1999 at our department, 117,340 outpatient examinations were performed and 35,113 patients were treated on an outpatient basis.
This is a brief summary of the quantity of medical care offered, but new diagnostic and therapeutic methods are constantly coming into use, especially in the areas of ultrasound, endoscopy, neonatology, urogynecology, and endocrinology, and this has to do with the rapid development of medical technology and pharmaceutical advances.
Also let us not forget to mention the improved relationships between patient and doctor, midwife, and nurse, from the perspectives of ethics and humanity, so that not only is the patient cared for at a high standard in terms of specialization, but also in terms of interpersonal contact.
The department must also fill its demanding obligations as a teaching institution, in undergraduate as well as postgraduate education. Each year we ensure the instruction of about 600-700 5th and 6th year medical students, 50-60 students of stomatology, 60 bachelor?s degree students, and also the instruction of midwives and nurses. In the 6th year of the study of medicine, there is a state exam in Obstetrics and Gynecology.
Regular clinical seminars for the clinical employees and specialists, lectured by our department?s doctors as well as leading Czech and foreign specialists, form the basis of postgraduate education.
Our department also organizes special postgraduate courses in the areas of ultrasound, perinatology, neonatology, prenatal diagnosis, urogynecology, oncology, endoscopy, and endocrinology. The department?s teaching staff lectures at the Institute for the Continuing Education of Doctors and also at national postgraduate seminars organized by the medical board. For the growth of the department staff, in specialization as well as socially, collaboration within the state and also on the international level is very important. Our department has a long history of collaboration with other university institutions especially in Switzerland, Germany, and in the United States. Many of our department?s doctors have been and are participating in short-term and long-term clerkships at well known Obstetrics and Gynecology institutions in those countries. Each year we have clerkships during school vacations for Czech students as well as for foreign students. Instruction is ensured by the First Faculty of Medicine of Charles University in cooperation with the General Faculty Hospital in Prague. Without the cooperation of these two organizations, instruction would be impossible.
One of the main components of work at this department is scientific research although at an institution with surgical orientation and many other obligations, this can be difficult. The department is the holder of several grants.
The department?s doctors lecture and publish both here and abroad, some are members of editorial boards of our journals as well as international journals, and some are members of national and international scientific associations. In 1999, we had 204 publications, of which 3 were textbooks.
One of our fundamental and long time tasks is the selection of young specialists, their specialized and scientific training, so that a new generation will be able to replace the generation leaving. We also educate doctors in the frame of postdoctoral studies in biomedicine. Our doctors are chairmen and members of examintion committees of doctoral dissertations.
Our department is located in a beautiful building (in the care of historical monuments) in the center of Prague, within easy access of public transportation. It has a long tradition and a long line of several leading specialists in the field. However, we are still unsatisfied, mostly with the pace of modernization of the interior and of the renewal of top medical technology.
Using state funds, 3 key wards have been renovated and new equipment has been bought, but this is still not sufficient for this department to be comparable in its interior and equipment to similar university institutions in advanced countries.
Our wish is that patients would come to our department not only for superb specialized care but also that their hospital stay after giving birth or after a difficult operation would be in a pleasant and modern environment.
Since September 1, 1998, the 1st and 2nd Departments of Obstetrics and Gynecology have merged thus forming the Department of Obstetrics and Gynecology of the General Faculty Hospital and First Faculty of Medicine of Charles University in Prague 2, in Apolinářská street. After completion of the renovation in Apolinářská street, the wards of the gynecological part of the 1st Department in the anniversarypavilion will be moved, and their space will serve other medical specialties.
In the year 2000, it is 125 years since the construction of this architectural historical structure in Apolinářská street, and since 1998 this building contains only one Department of Obstetrics and Gynecology (for the first time since its origin). With the recent merging of the two departments as well as their more than 100-year history and tradition, the opening of 3 newly renovated wards represents the greatest investment into this structure since its establishment. The turn of the millennium is the proper time to remember the historical significance of the departments that have ceased to be and to demonstrate the present state and the future of the newly established institution