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The Perinatal Mental Health Unit offers high quality clinical care to women with mental health problems and addictions during pregnancy.
The Perinatal Mental Health Unit was created to accompany women with mental health problems and addictions during pregnancy and the postpartum period, in a multidisciplinary manner and from an intersectional feminist perspective that guarantees women's human rights. The Mental Health and Gestation Team is comprised of professionals from the fields of psychiatry, psychology, neonatology, obstetrics, nursing and social work.
The Unit has obstetrics and psychiatry outpatient clinics, and also sees patients admitted during pregnancy or the postpartum period.
The scope of the speciality is broad, dealing with disorders during pregnancy, childbirth and the postpartum period; abortion; weaning; adoption; and integrating research into clinical practice. The most important functions are:
- Pregnancy planning in women undergoing psychopharmacological treatment or those suffering from mental health problems and/or previous addictions.
- Rapid consultation for pregnant women taking psychotropic medications or recreational drugs.
- Seeking advice from other professionals on the most effective and safe treatment during pregnancy.
- Establishing a treatment plan for women suffering from mental health problems and/or addiction during pregnancy, childbirth and the postpartum period.
- Care for perinatal bereavement and mental disorders brought about by an interrupted pregnancy.
- Treatment of postpartum depression and attachment disorders.
- Working with social services to provide a holistic approach and to ensure the protection of mother and child.
- Fighting against stigma.
- The training of staff from various disciplines.
- Research integrated into clinical practice.
Treatments related to this speciality:
- Psychotherapy
- Pharmacological treatment
- Social intervention
Departments associated with this speciality
- Psychiatry
- Obstetrics
- Social Work
- Neonatology
The Social Obstetrics Unit offers clinical assistance during pregnancy to women and families at risk of social vulnerability.
The Social Obstetrics Unit was created to accompany women at risk of social vulnerability during pregnancy and the postpartum period in a multidisciplinary and coordinated manner.
The unit’s objective is to improve any unfavourable social environment that affects and aggravates a health problem. And, above all, to help women and their families adjust to the new situation they will face after childbirth. Coordination between the Obstetrics, Social Work and Neonatology Departments during pregnancy, with early detection of the need for social support, facilitates and promotes this objective.
The team is comprised of professionals from the fields of social work, obstetrics, neonatology, nursing, psychology and psychiatry. Weekly meetings are held in order to ascertain the specific circumstances of each family and to be able to promote social support and early coordination with the local social work department in the primary care centres.
In recent years, a great effort has been made to integrate a biopsychosocial approach to the care of pregnant women at risk of social vulnerability and to include research in clinical practice.
Social situations associated with this speciality:
- Teenage pregnancies
- Gender-based violence
- Psychological intervention
The Obstetrics and Reproductive Medicine Department cares for pregnant women, prioritising the health of the mother and the future baby above all else, while always respecting the wishes of the mother such as her preference for a natural birth or a C-section.
For women who want to have children and require technical assistance, we also have a cutting edge assisted reproduction laboratory. We also store the frozen eggs of women who have been diagnosed with cancer; provide treatment and support to women who have suffered consecutive miscarriages; and offer gynaecological treatment to girls, teenagers and women who are entering the menopause or who have a health problem.
The Obstetrics and Reproductive Medicine Department is a leading centre for prenatal diagnostics and intrauterine surgery.
The Obstetrics and Reproductive Medicine Department offers world-leading treatment, teaching and research.
The Reproductive Medicine Unit has the required technology and infrastructure in order to treat all issues related to human reproduction.
The Obstetrics Unit cares for women before, during and after their pregnancy. Its absolute priority is to meet the needs of each woman at all times. In a moment as important as the birth, the unit listens to the mother and provides her with everything she needs in order to take the decisions that she feels are correct.
Delayed cord clamping, which entails letting the newborn's umbilical cord continue beating after birth, is promoted to reduce the chance of the baby suffering from anaemia during its first year of life. We also promote skin-to-skin contact, also known as the kangaroo method, in which the newborn is placed in direct contact with the mother’s skin.
Services offered by the unit:
The Department prides itself on its ability to provide foetal treatments in serious cases in which the future baby requires surgery during the pregnancy. Vall d’Hebron Hospital is the leading centre for very high risk pregnancies, and it also has vast experience in the ultrasound monitoring of high and low risk pregnancies.
In addition, pregnant mothers with serious illnesses can give birth with the peace of mind of being in a hospital with all the necessary specialities in case any complications arise.
For all these reasons, our Department is considered a tertiary level, highly qualified centre.
We treat a high number of very high risk patients from all over Catalonia, the rest of Spain as well as from other countries.
We are also one of the hospitals accredited by the European Board and College of Obstetrics and Gynaecology (the only one in Spain), for the quality of our care, teaching and research.
Maternal Pathology and Pregnancy
Placental Insufficiency Unit
Prematurity Prevention Unit
Diabetes and Pregnancy Unit
Mental Health and Pregnancy Unit
Social Obstetrics Unit
Placenta Accreta Unit
The Foetal Medicine and Surgery Unit monitors pregnancies in which the future baby will require special care, such as in cases of multiple births or twins, or when the future baby has a health problem. We are specialists in intrauterine surgery, and our experience makes us a reference point in Catalonia, Spain and around the world.
In the Foetal Medicine and Surgery Unit, we use cutting edge technology to treat the future baby and the mother.
We provide personalised care for the mother, monitor her pregnancy and offer her the most appropriate treatment. We also work alongside professionals from other specialist areas, assessing the mother together and ensuring the health of the future baby before it is born.
We have an Intensive Medicine and Intermediate Obstetric Care Department that works to address any possible health complications in the women. With regards to the future baby, we perform diagnostics with cutting edge technology and offer intrauterine treatments, with the help of some of the leading neonatology units in Spain.
Types of pregnancies and complications treated by this Unit:
We also perform all kinds of foetal surgeries, with the Unit being a figurehead in the fetoscopic treatment of spina bifida, congenital diaphragmatic hernia, monochorionic gestation, foetal valvuloplasty, etc.
- Foetal echocardiogram: this procedure is carried out when it is suspected, through a basic ultrasound scan, that the future baby may suffer from a heart malformation, or if any malformations occurred in a previous pregnancy. It is performed via the abdomen, just like any other ultrasound scan. This procedure generally takes place after 15 weeks of the pregnancy. It is recommended if the future baby is not developing normally in the uterus, or if the mother is taking certain drugs or suffers from any disorders that may increase the risk of congenital heart disease.
- Foetal neurosonography: this procedure is carried out when it is suspected, through a basic ultrasound scan, that there may be an abnormality in the brain of the future baby, or if any cerebral malformations have occurred in previous pregnancies. It is performed via the abdomen, just like any other ultrasound scan. If the future baby is upside down, the procedure can be carried out through the vagina.
- Amniocentesis: this consists of obtaining a sample of amniotic fluid in order to perform different studies (genetic, infection or metabolic). The mother's abdomen is punctured using ultrasound control in order to access the amniotic cavity and obtain a small sample of amniotic fluid.
- 3D/4D ultrasound: a 3D ultrasound is used to create a reconstruction of part of the future baby’s body, allowing for it to be studied in greater depth. A 4D ultrasound adds movement to the 3D images, offering a more complete perspective of the body part.
- Foetal MRI: this test helps us to study certain abnormalities that have been detected in an ultrasound scan.
All paediatric specialities: maxillofacial surgery, urology, child orthopaedics, neurosurgery, ophthalmology, neurology and radiodiagnosis.
The Prematurity Prevention Unit is responsible for assessing and attending to pregnant women who are at risk of having a premature birth.
The majority of pregnant women (9 in every 10) give birth after 37 weeks of pregnancy, which is known as a “full term birth”. 1 in every 10 women, however, have a premature birth and give birth before these 37 weeks have elapsed. If a baby is born a few weeks before it is due, its health ought not to be affected. However, if it is very premature, certain complications may arise.
This Unit accompanies women throughout the pregnancy, monitoring the first six months and performing treatments to try and avoid a premature birth. Once women reach 34-37 weeks of pregnancy, the majority are discharged from the Unit. They then continue to be monitored in the Obstetrics Unit, where the team's midwives will follow-up the pregnancy until birth.
The Prematurity Prevention Unit collaborates with the Pathological Anatomy and Neonatology Department to carry out a more appropriate monitoring of each woman in accordance with her medical history.
We also offer pre-conception (pre-pregnancy) counselling to women, helping them to plan their pregnancy and receive some helpful tips. Women who have been referred by gynaecologists and midwives, as well as those who are seeking a second opinion on the course of their pregnancy, receive help and advice in this unit.
One of the most important tasks undertaken by the Unit is the performance of clinical trials, with some of these being published in specialist medical journals. The most notable procedures are the measurement of the length of the cervix (neck of the uterus) and the use of the cervical pessary, which is an instrument that is inserted into the vagina to correct uterine prolapse in women who have a short cervix, preventing them from suffering a premature birth.
The Unit is run by a consultant obstetrician and supported by specialist obstetricians and midwives. We also organise training sessions for other doctors, medical students at the Autonomous University of Barcelona and locums (fellowship).
The Paediatric and Adolescent Gynaecology Unit offers specialist care to children and adolescents, supported by professionals from other areas and units at the hospital. We deal with changes to the menstrual cycle and also advise on contraceptive methods and treat patients with various disorders.
The Unit works with Paediatric Endocrinology and Social Paediatrics, as well as other paediatric services such as Oncohaematology, Hepatology and Pneumology.
It sees cases such as:
Apart from advising on adolescent contraception methods, the Unit gives individual treatments and follow-up tailored to each patient and, if needed, refers their case to other specialists at the hospital.
It also offers:
We deal with diagnosis and treatment of sexual hormone disruption. We also offer advice on contraceptive and reproductive methods to patients with high risk conditions, such as congenital heart disease or early menopause.
The Gynaecological Endocrinology Unit works with other units and specialists, such as: Cardiology (Congenital Heart Disease Unit), Paediatric Endocrinology, Assisted Reproduction and the Gynaecology and Obstetrics Ultrasound Unit. It also has sub-specialist and multi-disciplinary appointments, such as paediatric and adolescent gynaecology.
It deals with treatment of the following:
Our work here at the Diabetes and Pregnancy Unit is to monitor the pregnancies of women who are diabetic or who develop diabetes during their pregnancy. We offer coordinated care with endocrinologists and specialists in the management of the disease.
When someone suffers from diabetes, their body cannot properly process food and obtain energy from it, which leads to high levels of sugar (glucose) in the blood. High levels of glucose in the blood over long periods of time have been shown to cause damage to blood vessels, as a result of which the body’s organs can no longer function properly.
Having diabetes before pregnancy (pre-gestational diabetes) or developing diabetes during pregnancy (gestational diabetes) are two situations requiring specialist care.
The Diabetes and Pregnancy Unit consists of a multi-disciplinary team that includes endocrinologists, diabetes educators, obstetricians and midwives. We offer specialist educational information on diabetes and glucose-monitoring in mothers-to-be.
We attend to pregnant women with type 1 or type 2 diabetes and women who develop diabetes during pregnancy. We also work together to detect possible complications and improve the health of our female patients and their future babies.
Our Unit has taken part in several clinical studies and trials through the Spanish Diabetes and Pregnancy Group (GEDE) and launched a gestational diabetes screening programme.
The Unit is jointly coordinated by the endocrinology team (Dr Anna Casteras and Dr Olga Simó) and the obstetrics teams (Dr María Goya and Dr Mireia Vargas); in addition, we are also supported by specialist midwives and diabetes educators.
Training is also provided for other doctors, medical students at the Autonomous University of Barcelona and locums (fellowship).
At the Prenatal Diagnosis Unit (UPD) we detect the existence of congenital defects, disorders or malformations that the foetus may show as it develops, as early as possible. Depending on each case, and always on an individual basis, we advise families during the various stages of the pregnancy and help them to make decisions.
Up to 3% of newborns may have some kind of congenital anomaly or defect. These disorders may be structural or functional, familiar or sporadic, hereditary or not, and may occur in low risk as well as high risk pregnancies for various reasons:
In these cases, the pregnancy is monitored much more closely, so that the appearance of any anomaly is detected as soon as possible.
The following tools are used:
We tare active in all stages of the pregnancy:
We work very closely with the following units:
The Obstetrics Ultrasound Unit carries out all the necessary ultrasound scans on women and their future babies during pregnancy. Scans are most typically taken once per trimester during pregnancy, although there is no established number, as they are taken whenever they are considered necessary by the gynaecology professional.
The following ultrasound explorations are carried out during pregnancy:
First-trimester ultrasound: this is carried out between the first 11 and 13 weeks. This ultrasound, together with the previous blood analysis, is used for determining whether there is a risk of aneuploidy or early preeclampsia.
Aneuploidy is a complication that can cause birth defects in the foetus owing to an abnormal number of chromosomes in the blood. And early preeclampsia is a disease which, among other complications, can lead to premature births caused by high blood pressure.
Morphological ultrasound: this is carried out between the first 18 and 22 weeks. This ultrasound checks whether the foetus and all its organs are developing correctly and is used for ruling out malformations. In addition, here at the Vall d’Hebron we also carry out a vaginal exploration to measure the cervical length of the uterus and predict the risk of a premature birth; also a Doppler exploration, an ultrasound scan that enables us to see the blood flow of the mother’s uterine arteries and thereby assess the risk of preeclampsia.
Screening foetal echocardiography: this is carried out between the first 15 and 18 weeks. This ultrasound is only required for women at risk of foetal cardiopathy, a foetal-heart malformation.
Follow-up ultrasound: these ultrasounds are always carried out when required by the Department or an external referral. They may be used for assessing risks such as:
The Obstetrics Ultrasound Unit, as a cross-disciplinary service, is taking part in several studies with competitive public funding, led by our Department's specialists in our Prematurity Prevention, Placental Insufficiency, Foetal Medicine and Placenta Accreta Units. It recently joined the Cesarean Scar Pregnancy (CSP) Registry.
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