Obstetrics

The field of medicine dealing with the care of all women’s reproductive tracts and their children during pregnancy, childbirth and the postnatal period is called obstetrics. A physician who specializes in this field is called an obstetrician. Obstetrics is closely associated with gynecology.

Before the 18th century, treating pregnant women was exclusively done by female midwives. Male physicians were included only if the situation was complicated beyond the control of midwives.

During the 18th century, the anatomy of the uterus and the physiological changes taking place during labor was understood by the medical community and male practitioners started taking a more active role in obstetrics.

However, in the beginning of the 19th century, obstetrics was rejected by the medical community and was labeled ungentlemanly. These ideologies changed towards the latter part of the 19th century, thus allowing the opening up in the field as it exists today. Anesthesia and asepsis techniques were improved, as well.

Today:

  • Prenatal care is handled by obstetricians.
  • Lab tests and physical exams are performed to screen for pregnancy complications.
  • Various tests are done during the three trimesters to monitor the health of the mother and the child.

1st trimester

  • Complete blood count.
  • Blood type.
  • General antibody screen.
  • Rapid plasma reagin.
  • Rubella antibody screen.
  • Hepatitis B surface antigen.
  • Urinalysis and culture.
  • Group B Streptococcus screen.
  • HIV, Gonorrhea and chlamydis culture screening,
  • Pap smear.

2nd trimester

  • MSAFP/ quad screen.
  • Ultrasound. (abdominal/ transvaginal )
  • Amniocentesis.

3rd trimester

  • Hematocrit.
  • Glucose load test. (To screen for gestational diabetes.)

In the 1st visit the medical history of the mother is checked and a physical exam is done. The gestational age and the growth of the fetus is checked during every visit. The fetus is palpated by the obstetrician using Leopold maneuver to find the position of the baby.

The blood pressure of the mother is monitored in all cases. (It is 140/90 in normal pregnancies.) When the blood pressure is high it can lead to pre-eclampsia or edema.

The viability of the fetus and the congenital problems are checked through fetal screening. Obstetricians also offer genetic counseling to families with a risk of having a baby with genetic conditions. Imaging, obstetric ultrasonography etc. are other items utilized to monitor pregnancies.

Obstetrics also deals with pregnancy complications and interconnected diseases. Labor is induced if the mother or fetus are at risk. After the birth of the child both the mother and the fetus are monitored until they are stable and healthy before being discharged from the hospital.