Prof. Guo Quanqing (1908-1984), Obstetrics and Gynecology , Second-Class Professor , Former Head of Obstetrics and Gynecology, Renji Hospital , Founding Figure of Chinese Obstetrics and Gynecology

Introduction
   In the field of obstetrics and gynecology in China, there was a trailblazer whose legacy is instrumental in shaping of Renji Hospital. He not only established the Department of Obstetrics and Gynecology at Renji Hospital but also developed the discipline across China.

  His career was marked by quiet dedication—understated yet profound. Without flamboyant heroics or dramatic legends, his story was woven from a deep devotion to medicine and tender care for every life he encountered. Like a radiant guiding light, he illuminated the path for countless patients seeking aid, offering them hope and renewed life.

   He never accepted defeat in medical challenges. Through steadfast action, he embodied dedication and sacrifice. Through steadfast action, he embodied the essence of dedication and sacrifice. His existence echoed the silent vow of healing—a testament to quiet perseverance.

Journey in Medicine
   Today’s Dingxiang, a land blessed with serene natural beauty, was Guo Quanqing’s birthplace. Born here in 1908, he exhibited brilliance and diligence from a young age. After secondary school, he resolved to pursue medicine, excelling academically before gaining admission to Shandong’s Qilu University Medical School.

   For Guo Quanqing, medical school provided a vital foundation, immersing him in rigorous studies that shaped his future career.. Studies at Qilu were arduous; its rigorous academic environment tested every student’s endurance, perseverance, and resolve. The curriculum spanned medicine, biology, chemistry, anatomy, and beyond, laying a robust foundation for his future career.

   Graduating in 1933 with an M.D., Guo immersed himself in research and clinical work at Qilu University Hospital and Peking Union Medical College Hospital. He spearheaded pivotal clinical studies in obstetrics and gynecology, pioneering novel techniques that propelled the discipline forward.

   Years later, he moved south to Shanghai. In 1944, he founded the Shanghai Wai Liu Advanced Midwifery School (initially located at 130 West Beijing Road) and served as its inaugural principal. The campus expanded to 1212 Xietu Road before merging with Jianmin Midwifery School in 1952, eventually forming part of Shanghai Municipal Midwifery School. Throughout this period, Guo dedicated himself wholly to clinical practice and teaching, nurturing generations of exceptional medical talents.

   Concurrently, in 1945, Guo formally joined Renji Hospital as its first Head of Obstetrics and Gynecology, catalyzing the department’s growth. He introduced China’s first modern prenatal management system, leveraging his expertise to cultivate an elite clinical team.

   At a time when gynecological diseases remained global enigmas, Guo relentlessly explored innovative treatments, refined surgical precision, and elevated public awareness of women’s health. His actions brought acclaim to Renji Hospital and cemented its obstetrics and gynecology department as a beacon of excellence.

Challenging Tradition and Protecting Women’s Rights

   In 1948, Guo Quanqing decided to write a medical book titled Practical Contraception. The preface of the book included the following passage:

   “The purpose of publishing this book is not to promote contraception, nor to serve inappropriate objectives. We hope this book can convey the correct knowledge of contraception to readers, aiming to maintain health and prevent unwanted pregnancies. This need is particularly evident among couples who choose contraception for birth control, as they already have enough or too many children, and their health or financial situation cannot support more. We believe that scientific and safe contraceptive knowledge is something every couple should and must possess. Sometimes, the lack of a small amount of correct knowledge can become the dividing line between happiness and suffering. It may affect a couple’s relationship, bringing harmony or discord; it may make a family happier and more harmonious, or it may fill it with stress and conflict. Therefore, publishing this book, Practical Contraception, is highly necessary.”

   In old China, the publication of this book was a bold attempt to challenge tradition and protect women’s rights. Guo Quanqing integrated his rich medical experience and advanced medical techniques into the book, using simple and accessible language to explain the principles and methods of contraception in detail. This provided women with more protection and choices. Upon its release, Practical Contraception received widespread acclaim and was hailed as “an important reference for China’s reproductive health care.” It directly improved people’s quality of life and laid a solid foundation for the formulation and implementation of China’s family planning policy.

   At the time, the book’s impact exceeded Guo Quanqing’s expectations. The book became an essential reference for newlyweds across Shanghai.

   This book was China’s earliest household pamphlet on contraceptive methods and the concept of family planning. Through his actions, Guo Quanqing fought for dignity and rights for Chinese women. He empowered women to make informed choices and pursue greater autonomy in their lives. This also enabled more women to take control of their own destinies, undoubtedly reflecting societal progress.

   Advancing Surgical Skills and Pioneering China’s Obstetrics and Gynecology Field

   In 1949, Guo Quanqing developed the transvaginal hysterectomy in China, showcasing his exceptional professional skills and profound understanding of medical principles.

   Today, the transvaginal hysterectomy is a common procedure and an effective treatment for various gynecological conditions, including uterine fibroids, adenomyosis, and early-stage cervical cancer. Unlike traditional open abdominal surgery, this procedure is performed through the vagina, leaving no abdominal incision. As a result, it causes less trauma and allows for faster postoperative recovery. However, it requires advanced surgical skills and a thorough familiarity with the relevant anatomical structures.

   In 1950, Guo Quanqing was the first in China to perform transvaginal tubal ligation, a contraceptive procedure involving tubal occlusion. This procedure involves placing a small surgical ring in the fallopian tubes to “block” them, thereby achieving contraception. At the time, this was considered a highly advanced technique.

   In 1951, Guo Quanqing began performing posterior colpotomy exploration, a procedure often used in the diagnosis and treatment of uterine and ovarian diseases. The doctor makes an incision in the patient’s posterior vaginal fornix and explores the uterus and ovaries through this incision. This surgery requires detailed preoperative examination and scientific evaluation to determine whether the patient needs the procedure and the specific approach to take.

   Due to his outstanding achievements, Guo Quanqing was appointed head of the obstetrics and gynecology department at Shanghai Second Medical College in 1952. From then on, he was not only a leader of the department but also took on the responsibility of advancing China’s obstetrics and gynecology field. Additionally, he served as a member of the Academic Committee of Shanghai Second Medical College, deputy director of the Second Medical Department, director of the Obstetrics and Gynecology Teaching and Research Office, and head of the Obstetrics and Gynecology Department. These roles reflected his commitment to medical education, research, and social responsibility.

   Subsequently, Guo Quanqing embarked on more innovative attempts and explorations, step by step driving the development of China’s obstetrics and gynecology field and the construction of its disciplinary system.

   In 1957 alone, he achieved multiple breakthroughs. That year, Guo Quanqing performed China’s first transvaginal radical hysterectomy for cervical cancer, a highly complex surgical procedure that involves removing the patient’s cervix, surrounding tissues, and related lymph nodes to treat the disease.

   Guo Quanqing also guided his student, Jia Shigan, in inventing the fetal head vacuum extractor, which was widely used in assisted delivery. This method uses a vacuum extractor to help the fetus pass through the birth canal, effectively increasing the survival rate of newborns. In the same year, he successfully performed a mitral valve separation surgery on a pregnant patient.

   In the early years of the People’s Republic of China, uterine prolapse was a common gynecological condition, particularly among married women with multiple births or those suffering from malnutrition. It was especially prevalent in rural areas, causing many women to endure long-term pain and discomfort.

   In 1961, Guo Quanqing developed the transvaginal correction surgery for uterine prolapse, marking a significant breakthrough in the treatment of this condition in China. This made it possible to address uterine prolapse on a national scale.

   Later, Guo Quanqing led medical teams to remote rural areas in China to conduct and oversee uterine prolapse prevention and treatment efforts. As a doctor, in addition to using surgical methods to solve problems, Guo Quanqing began researching new treatment approaches and experimenting with non-surgical methods such as medication and uterine supports. While these methods were not perfect, they indeed helped many women resolve their daily life issues.

   Over time, Guo Quanqing’s treatment plans gained wider adoption, improving the lives of more and more women. They no longer had to endure the pain and inconvenience caused by uterine prolapse and could enjoy healthier and better lives.

Cross-Disciplinary Clinical Exploration and Innovation

   Guo Quanqing believed that innovation and solving clinical problems should not be confined to a single field but should integrate multiple disciplines, drawing on various methods and experiences. In the medical field, different disciplines influence each other, and it is essential to foster communication and collaboration to address the challenges and difficulties faced collectively. Additionally, new technologies and methods should be applied to clinical practice as much as possible and undergo clinical validation to ensure their effectiveness and safety.

   In the field of cardiac surgery, Guo Quanqing observed that with the continuous improvement of obstetric techniques and the widespread application of technologies such as blood transfusion and antibiotics, maternal mortality rates had significantly decreased, effectively safeguarding the health and safety of mothers and infants. However, maternal deaths caused by factors such as heart disease remained a pressing issue in obstetrics and gynecology.

   At that time, cardiac surgery had emerged in China and could serve as an effective new treatment for obstetric patients with heart disease. The mitral valve separation surgery, an important treatment method in cardiac surgery, was widely used but remained underutilized in obstetrics and gynecology.

   Statistics showed that there were only about 100 reported cases of cardiac surgery applications in obstetrics and gynecology at the time. Guo Quanqing believed that there was significant room for exploration and development in this field. In this process, collaboration and communication between obstetrics and cardiac surgery became crucial. Obstetricians could learn from the surgical techniques and treatment plans of cardiac surgery, especially in addressing issues related to childbirth, anesthesia, and bleeding that involve the heart. A comprehensive assessment and management of cardiac conditions should be emphasized. Simultaneously, cardiac surgeons could better understand the characteristics and treatment needs of obstetric diseases, enabling them to provide more individualized and refined care for obstetric patients with heart conditions.

   In Guo Quanqing's view, collaboration and communication between obstetrics and cardiac surgery could better ensure the health and safety of pregnant women, providing strong support for the comprehensive advancement of medical development. This also promoted interdisciplinary exchange and cooperation in medicine worldwide, a shared goal of innovation and development for humanity.

   In 1958, Guo Quanqing, along with experts Yao Yongbao and Liu Dilin, published *The Application of Cardiac Surgery in Obstetrics*, reporting the achievements of the obstetrics and gynecology department at Renji Hospital in this field, which had a significant impact in the industry.

   During his interactions with the gastroenterology department, Guo Quanqing, Liu Defu, and Pan Jiaxiang co-authored a paper in 1958 titled *Acute Abdominal Pain Caused by Digestive System Diseases in Obstetrics*. The paper analyzed and categorized the issues caused by acute abdominal pain in pregnant women and proposed different treatment methods and surgical guidelines for various types of acute abdominal pain. This provided clinicians with clearer treatment strategies and operational guidance, better integrating acute abdominal pain caused by digestive system diseases into obstetrics, which garnered considerable attention at the time.

   Guo Quanqing believed that interdisciplinary collaboration and exchange were essential in medical research, clinical practice, and medical education. For example, studying the mechanisms and treatment methods of diseases might require the integration of professional knowledge and techniques from multiple departments. In clinical practice, borrowing treatment plans and operational techniques from other departments could better serve patients. In medical education, it was also necessary to break away from single-discipline teaching models, strengthen the intersection and integration of medical knowledge, and cultivate medical talents with a holistic perspective. 

Dedicated to Eugenics and Medical Innovation

   Throughout his life, Guo Quanqing was involved in numerous innovations in obstetrics and gynecology. New methods and approaches, such as the “Human Milk Bank” and the “Cao’s Maneuver for Breech Presentation,” were popularized under his leadership.

   For the average person, the term “Human Milk Bank” might sound unfamiliar.

   A “Human Milk Bank” is a special facility designed to assist mothers who are unable to meet their infants’ dietary needs. Here, mothers can leave their babies to be cared for by professionals. The milk bank operates like a small hospital, equipped with top-notch facilities and staffed by trained medical personnel. They provide the necessary nutrition and care to ensure every infant receives proper attention and support. When mothers fall ill, lose their husbands, or lack the financial means to care for their babies, the milk bank becomes a reliable source of relief, solely aimed at ensuring better care for more infants. Under Guo Quanqing’s advocacy, Shanghai became one of the first regions in China to establish Human Milk Banks.

   Additionally, Guo Quanqing actively promoted the “Cao’s Maneuver for Breech Presentation,” significantly reducing the rate of difficult deliveries and safeguarding the health of countless mothers. Breech delivery refers to a situation where the baby is positioned with its buttocks facing the mother’s pelvic outlet during birth. Without timely intervention, this can lead to difficult deliveries, endangering both mother and child. The Cao’s Maneuver for Breech Presentation is a specialized method designed to correct and manage breech deliveries, facilitating smoother births.

Pioneering New Technologies

   Guo Quanqing always kept a close eye on international advancements in technology.

   As early as the 1940s, he began closely monitoring the development of contraceptive drugs abroad.

   By 1960, the oral contraceptive “Enovid,” produced in the United States, was officially launched. Its main components were ethinyl estradiol (a type of estrogen) and norethynodrel (a type of progesterone). These hormones inhibited the secretion of gonadotropins from the anterior pituitary gland, thereby suppressing ovulation and achieving contraception. Although the drug quickly gained FDA approval and was widely used, its high levels of sex hormones led to a range of adverse symptoms and side effects in users.

   In the 1950s, China’s reproductive health situation was dire. Many young women died from complications caused by improper contraception, resulting in numerous tragedies. At the time, there was a strong societal call for the development of contraceptive drugs. Against this backdrop, domestic research institutions began exploring the development of a Chinese version of the oral contraceptive. Initially, many teams attempted to replicate the American “Enovid.” However, due to limitations in technology, drug quality, and production processes, they encountered numerous challenges.

   As research progressed, China’s contraceptive drug development teams began to innovate. By using traditional Chinese medicinal ingredients, adopting new synthetic routes, and studying various additives and formulations, they creatively developed low-dose oral contraceptives tailored to China’s specific needs. This laid a solid foundation for the production and widespread use of contraceptives in China.

   In 1963, the obstetrics and gynecology research group at Renji Hospital applied to establish a specialized laboratory to conduct research on contraceptive drugs and methods, with “endocrine level testing” being a key focus. In 1964, Renji Hospital established China’s first Women’s Family Planning Research Laboratory. After the laboratory was established, Professor Guo Quanqing quickly invited a group of researchers, including Professor Xiao Bilian, to participate in the experiments.

   The laboratory began observing the clinical effects and side reactions of contraceptive drugs and conducted experimental research on endocrine and endometrial changes. They continuously explored the mechanisms of contraceptive action and the minimum effective dosage, ultimately successfully developing a low-dose oral contraceptive, which was at the forefront of international research at the time.

   Simultaneously, Professor Guo Quanqing and Professor Xiao Bilian’s team innovatively joined multiple contraceptive research groups to study different types of contraceptive drugs, exploring their clinical efficacy, safety, and pharmacology. Their efforts paid off, leading to the development of products such as the No. 1 and No. 2 short-term oral contraceptives and the compound megestrol contraceptive injection.

   With these achievements, the research team led clinical teams to distribute the drugs in rural areas and conduct follow-ups with long-term users. The follow-ups included investigations into post-medication amenorrhea, fertility recovery after discontinuation, the health of offspring, and chromosomal analysis to ensure the safety of the drugs.

   As these contraceptive products were promoted and used nationwide, China’s family planning efforts were significantly advanced.

Compiling Clinical Experience and Academic Contributions

   In addition to developing new products, Guo Quanqing actively compiled clinical practices and summarized his experiences. He published numerous academically influential papers and edited the Obstetrics and Gynecology Handbook. He also contributed to the compilation of China’s first unified textbook on Obstetrics and Gynecology, as well as the Chinese Medical Encyclopedia sections on family planning and obstetrics and gynecology.

   The publication of these works played a crucial role in advancing the field of obstetrics and gynecology in China. They also showcased and disseminated the experiences and achievements of Renji Hospital’s obstetrics and gynecology department, driving innovation and progress in the field and significantly improving the health of women and children.

   On September 27, 1984, Professor Guo Quanqing passed away due to illness at the age of 76.

   As an outstanding representative in the history of modern Chinese medical development, Guo Quanqing was undoubtedly one of the key figures in obstetrics and gynecology research and clinical practice. His contributions and achievements have greatly benefited women and children in China, setting an example and model for generations of medical professionals in the field.

Editor: 
Chen Qing @ ShanghaiDoctor.cn

Note: Chinese Sources from “The Path of Benevolent Medicine” which was published in 2024. It records 90 important medical figures in the history of Renji Hospital. Yewen Renyi (ShanghaiDoctor.cn) team was one of the major writer of the book and is authorized by Renji hospital to create English version on the website of ShanghaiDoctor.cn