Gynecology is the smallest section in the surgery division at The Children’s Hospital. Over the past two years, the department has become a permanent part of the scene at The Children’s Hospital by virtue of regularly scheduled clinics, presence in the operating rooms, and regular interaction at an administrative/program planning level. Growth of the service has been modest, but steady. Increased demand for adolescent gynecological services is
anticipated over the next several years.

William Schlaff, MD
with thirteen-year-old Amanda

Department Activities
The department of Gynecology at The Children’s Hospital has continued to grow in areas of clinical care; educational support both within the hospital and to surrounding communities; and research activities. The department continues to provide a broad spectrum of gynecology services each week in the Adolescent Medicine Clinic at The Children’s Hospital. Issues involving pediatric vulva disorders, menstrual disorders, ovulation dysfunction, contraception, cervical dysplasia, pelvic pain and adnexal masses are addressed. Annual patient visits in 2001 and 2002 have increased by approximately 85% compared to visits in 2000. In 2001, a second clinic time was added to accommodate the increased volume. Intradepartmental referrals from Gastro-enterology, Hematology, Oncology and Endocrinology have steadily increased. An expanding referral base from the metro area, outlying regions and bordering states has been established in the last two years.

Twenty-four hour consultation service to the inpatient hospital and the Emergency Department at Children’s is provided. Consultation services have been extended to the Colorado Adolescent Maternity Program

(CAMP). CAMP is a multidisciplinary prenatal and postnatal program that addresses critical issues in adolescent maternal and child health. The department of Gynecology assists the child advocacy division in physical evaluation of suspected sexual trauma patients.

Surgical cases have seen an average increase of 60% in the two-year period compared to 2000. Increasing relationships with the departments of Pediatric Surgery and Urology have led to an increase in co-managed surgical procedures for patients requiring multidiscipline therapies. A total of nine procedures were performed in 2001 and 17 procedures in 2002. They included vaginoscopic evaluation of genital bleeding, laparoscopic evaluation of abdominal pain and treatment of endometriosis, congenital anomaly revision of the genital tract, repair of traumatic genital tract lacerations, removal of ovarian tumors with preservation of remaining ovarian function.

The department has increased its role in community support for activities in child advocacy through Stephen Scott’s, MD, role as a member of the March of Dimes Political Action Committee.

Since January 1, 2001 the Department of Gynecology has provided numerous lectures related to pediatric and adolescent gynecology disorders at The Children’s Hospital and to pediatric and family practices and regional groups.

Clinical training includes instruction in adolescent gynecology for third-year residents of the University of Colorado Health Sciences Center Department of Gynecology. First-year adolescent medicine fellows from The Children’s Hospital receive clinical training during clinic and operating room time. The department’s faculty provides Grand Rounds lectures to the pediatric departments of The Children’s Hospital and Denver Health Medical Center.

Research topics continue to develop in association with the department of Adolescent Medicine at The Children’s Hospital. Current areas of research include evaluating the effect of cervical dysplasia and its treatments on the cervical and vaginal environment, and how the timing of the administration of hormonal contraception affects bleeding patterns and long-term compliance.

Quality Performance Activities
Best practice consensus meetings are held monthly by the Gynecology and Adolescent Medicine departments. Quarterly, beginning in 2003, the University of Colorado department of Obstetrics and Gynecology will devote its gynecology morbidity and mortality conference to pediatric gynecology cases from The Children’s Hospital. Since 2000, Dr. Scott has been a member of the Clinical Outcomes Committee that monitors quality parameters within The Children’s Hospital.

Over the next several years, we hope to significantly expand our clinical activities and to develop collaborative programs with other groups at The Children’s Hospital. We anticipate involvement in the planning process and development of the new Children’s Hospital on the Fitzsimons campus.



Family-Centered Postpartum Care for New Moms

Each year, The Children’s Hospital admits more than 600 infants to our newborn intensive care nurseries. Often the mothers of these babies are predisposed to postpartum complications. About half of these new mothers live within a reasonable traveling distance to The Children’s Hospital and travel back and forth to the nursery to visit their babies. They can receive postpartum care from their own care provider. However, the remaining half live in bordering states or outlying areas, sometimes hundreds of miles from the hospital. They stay in temporary accommodations, such as the Ronald McDonald House, while their babies are in the intensive care nursery. Follow-up postpartum visits to their own care provider can be difficult. In 2002, The Children’s Hospital established the New Mothers Clinic to meet the needs of these women.

Providing postpartum care for mothers with babies in the intensive care nursery is a natural extension of Children’s commitment to family-centered care. The availability of high-quality, convenient OB/GYN care, just downstairs from the newborn nurseries, eases some of the stress and concern for the family around the birth of their newest member.