fbpx
Wikipedia

Obstetrics

March 03, 2023

This article is about the medical specialty. For the health profession, see Midwifery.
Look up obstetrics in Wiktionary, the free dictionary.

Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period.[1] As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field.[2]

Obstetrician
Occupation
Names
  • Physician
  • Surgeon
Occupation type
Specialty
Activity sectors
Medicine, surgery
Description
Education required
Fields of
employment
Hospitals, clinics

Main areas

Prenatal care

Prenatal care is important in screening for various complications of pregnancy.[3] This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low-risk pregnancies:[4]

First trimester

Routine tests in the first trimester of pregnancy generally include:

Genetic screening for Down syndrome (trisomy 21) and Edwards syndrome (trisomy 18), the national standard in the United States, is rapidly evolving away from the AFP-quad screen, done typically in the second trimester at 16–18 weeks.[13] The newer integrated screen (formerly called F.A.S.T.E.R for First And Second Trimester Early Results) can be done at 10 plus weeks to 13 plus weeks with an ultrasound of the fetal neck (thicker nuchal skin correlates with higher risk of Down syndrome being present) and two chemicals (analytes), pregnancy-associated plasma protein A and human chorionic gonadotropin (pregnancy hormone level itself[14]). It gives an accurate risk profile very early. A second blood screen at 15 to 20 weeks refines the risk more accurately.[15] The cost is higher than an "AFP-quad" screen due to the ultrasound and second blood test, but it is quoted to have a 93% pick up rate as opposed to 88% for the standard AFP/QS. This is an evolving standard of care in the United States.[16][17][18]

 
Down Syndrome karyotype

Second trimester

  • MSAFP/quad. screen (four simultaneous blood tests) (maternal serum AFP, inhibin A, estriol, and βHCG) – elevations, low numbers or odd patterns correlate with neural tube defect risk and increased risks of trisomy 18 or trisomy 21[19]
  • Ultrasound either abdominal or transvaginal to assess cervix, placenta, fluid and baby[20]
  • Amniocentesis is the national standard (in what country) for women over 35 or who reach 35 by mid pregnancy or who are at increased risk by family history or prior birth history.[18]

Third trimester

  • Hematocrit (if low, the mother receives iron supplements)[21]
  • Group B Streptococcus screen. If positive, the woman receives IV penicillin or ampicillin while in labor—or, if she is allergic to penicillin, an alternative therapy, such as IV clindamycin or IV vancomycin.[18]
  • Glucose loading test (GLT) – screens for gestational diabetes; if > 140 mg/dL, a glucose tolerance test (GTT) is administered; a fasting glucose > 105 mg/dL suggests gestational diabetes.[22]

Most doctors do a sugar load in a drink form of 50 grams of glucose in cola, lime or orange and draw blood an hour later (plus or minus 5 minutes). The standard modified criteria have been lowered to 135 since the late 1980s.[23]

 
The result of an ultrasonography: a black and white image that shows a clear view of the interior abdomen

Fetal assessments

 
A dating scan at 12 weeks

Obstetric ultrasonography is routinely used for dating the gestational age of a pregnancy from the size of the fetus, determine the number of fetuses and placentae, evaluate for an ectopic pregnancy and first trimester bleeding, the most accurate dating being in first trimester before the growth of the foetus has been significantly influenced by other factors.[24] Ultrasound is also used for detecting congenital anomalies (or other foetal anomalies) and determining the biophysical profiles (BPP), which are generally easier to detect in the second trimester when the foetal structures are larger and more developed.[25] Specialised ultrasound equipment can also evaluate the blood flow velocity in the umbilical cord, looking to detect a decrease/absence/reversal or diastolic blood flow in the umbilical artery.[26]

X-rays and computerized tomography (CT) are not used, especially in the first trimester, due to the ionizing radiation, which has teratogenic effects on the foetus.[27] No effects of magnetic resonance imaging (MRI) on the foetus have been demonstrated,[28] but this technique is too expensive for routine observation. Instead, obstetric ultrasonography is the imaging method of choice in the first trimester and throughout the pregnancy, because it emits no radiation, is portable, and allows for realtime imaging.[29]

The safety of frequent ultrasound scanning has not been confirmed. Despite this, increasing numbers of women are choosing to have additional scans for no medical purpose, such as gender scans, 3D and 4D scans.[30] A normal gestation would reveal a gestational sac, yolk sac, and fetal pole.[31]

The gestational age can be assessed by evaluating the mean gestational sac diameter (MGD) before week 6, and the crown-rump length after week 6. Multiple gestation is evaluated by the number of placentae and amniotic sacs present.[32]

Other tools used for assessment include:

Diseases in pregnancy

Further information: Pre-existing disease in pregnancy

A pregnant woman may have a pre-existing disease, that may become worse or become a risk to the pregnancy, or to postnatal development of the offspring[38]

  • Diabetes mellitus and pregnancy deals with the interactions of diabetes mellitus (not restricted to gestational diabetes) and pregnancy.[39] Risks for the child include miscarriage, growth restriction, growth acceleration, foetal obesity (macrosomia), polyhydramnios and birth defects.[40]
  • Lupus and pregnancy confers an increased rate of foetal death in utero and spontaneous abortion (miscarriage), as well as of neonatal lupus.[41]
  • Thyroid disease in pregnancy can, if uncorrected, cause adverse effects on foetal and maternal well-being.[42] The deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neurointellectual development in the early life of the child.[43] Demand for thyroid hormones is increased during pregnancy, and may cause a previously unnoticed thyroid disorder to worsen.
  • Hypercoagulability in pregnancy is the propensity of pregnant women to develop thrombosis (blood [44] clots). Pregnancy itself is a factor of hypercoagulability (pregnancy-induced hypercoagulability), as a physiologically adaptive mechanism to prevent post partum bleeding.[45] However, when combined with an additional underlying hypercoagulable states, the risk of thrombosis or embolism may become substantial.[45]
  • Hyperemesis gravidarum in pregnancy occurs due to extreme, persistent nausea and vomiting during pregnancy.[46] If untreated, can lead to dehydration, weight loss, and electrolyte imbalances. Most women develop nausea and vomiting during the first trimester.[47] The cause of Hyperemesis gravidarum is not known. However, it is believed to be caused by a rapidly rising blood level of a hormone, human chorionic gonadotropin (HCG), which is released by the placenta.[48]
  • Preeclampsia is a condition that causes high blood pressure during pregnancy. If left untreated, it can be life-threatening.[49] In pregnant women, preeclampsia may occur after 20 weeks of pregnancy, often in women who have no history of high blood pressure. Symptoms of preeclampsia may include severe headache, vision changes and pain under the ribs.[50] However, in some women, symptoms may not occur, until they go for a routine prenatal visit.[51]

Induction and labour

Main articles: Induction (birth) and Childbirth
Further information: Pain management during childbirth

Induction is a method of artificially or prematurely stimulating labour in a woman.[52] Reasons to induce can include pre-eclampsia, foetal distress, placental malfunction, intrauterine growth retardation and failure to progress through labour increasing the risk of infection and foetal distresses.[53]

Induction may be achieved via several methods:

During labour, the obstetrician carries out the following tasks:

Complications and emergencies

Main article: Complications of pregnancy

The main emergencies include:

  • Ectopic pregnancy is when an embryo implants in the uterine (Fallopian) tube or (rarely) on the ovary or inside the peritoneal cavity. This may cause massive internal bleeding.[63]
  • Pre-eclampsia is a disease defined by a combination of signs and symptoms that are related to maternal hypertension.[64] The cause is unknown, and markers are being sought to predict its development from the earliest stages of pregnancy.[65] Some unknown factors cause vascular damage in the endothelium, causing hypertension.[66] If severe, it progresses to eclampsia, where seizures occur, which can be fatal.[67] Preeclamptic patients with the HELLP syndrome show liver failure and disseminated intravascular coagulation (DIC).[68] The only treatment is to deliver the foetus. Women may still develop pre-eclampsia following delivery.[69]
  • Placental abruption is where the placenta detaches from the uterus and the woman and foetus can bleed to death if not managed appropriately.[70]
  • Foetal distress where the foetus is getting compromised in the uterine environment.[71]
  • Shoulder dystocia where one of the foetus' shoulders becomes stuck during vaginal birth. There are many risk factors, including macrosmic (large) foetus, but many are also unexplained.[72]
  • Uterine rupture can occur during obstructed labour and endanger foetal and maternal life.[73]
  • Prolapsed cord can only happen after the membranes have ruptured.[74] The umbilical cord delivers before the presenting part of the foetus. If the foetus is not delivered within minutes, or the pressure taken off the cord, the foetus dies.[75]
  • Obstetrical hemorrhage may be due to a number of factors such as placenta previa, uterine rupture or tears, uterine atony, retained placenta or placental fragments, or bleeding disorders.[76]
  • Puerperal sepsis is an ascending infection of the genital tract.[77] It may happen during or after labour. Signs to look out for include signs of infection (pyrexia or hypothermia, raised heart rate and respiratory rate, reduced blood pressure), and abdominal pain, offensive lochia (blood loss) increased lochia, clots, diarrhea and vomiting.

Postpartum period

Further information: Postpartum period

The World Health Organization makes a distinction between the use of postpartum care when it concerns the care of the mother after giving birth, and postnatal care when the care of the newborn is concerned.[78]Postpartum care is provided to the mother following childbirth.

A woman in the Western world who gives birth in a hospital may leave the hospital as soon as she is medically stable, and chooses to leave, which can be as early as a few hours later, but usually averages a stay of one or two days; the average postnatal stay following delivery by caesarean section is three to four days.[79]

During this time the mother is monitored for bleeding, bowel and bladder function, and baby care. The infant's health is also monitored.[80]

Veterinary obstetrics

Main article: Veterinary obstetrics

History

 
Two midwives assisting a woman in labour on a birthing chair in the 16th century, from a work by Eucharius Rößlin

Prior to the 18th century, caring for pregnant women in Europe was confined exclusively to women, and rigorously excluded men.[81] The expectant mother would invite close female friends and family members to her home to keep her company during childbirth.[82]: 96–98  Skilled midwives managed all aspects of the labour and delivery.[83] The presence of physicians and surgeons was very rare and only occurred if a serious complication had taken place and the midwife had exhausted all measures at her disposal.[84] Calling a surgeon was very much a last resort and having men deliver women in this era was seen as offending female modesty.[85]: 1050–1051 [86]

Before the 18th century

See also: Women's medicine in antiquity

Prior to the 18th and 19th centuries, midwifery was well established but obstetrics was not recognized as a specific medical specialty. However, the subject matter and interest in the female reproductive system and sexual practice can be traced back to Ancient Egypt[87]: 122  and Ancient Greece.[88]: 11  Soranus of Ephesus sometimes is called the most important figure in ancient gynecology.[84] Living in the late first century A.D. and early second century, he studied anatomy and had opinions and techniques on abortion, contraception – most notably coitus interruptus – and birth complications. After his death, techniques and works of gynecology declined; very little of his works were recorded and survived to the late 18th century when gynecology and obstetrics reemerged as a medical specialism.[87]: 123 

18th century

The 18th century marked the beginning of many advances in European midwifery, based on better knowledge of the physiology of pregnancy and labour.[89] By the end of the century, medical professionals began to understand the anatomy of the uterus and the physiological changes that take place during labour.[90] The introduction of forceps in childbirth also took place at this time. All these medical advances in obstetrics were a lever for the introduction of men into an arena previously managed and run by women – midwifery.[85]: 1051–1052 

The addition of the male-midwife (or man-midwife) is historically a significant change to the profession of obstetrics.[91] In the 18th century medical men began to train in area of childbirth and believed with their advanced knowledge in anatomy that childbirth could be improved.[92] In France these male-midwives were referred to as accoucheurs, a title later used all over Europe. The founding of lying-in hospitals also contributed to the medicalization and male-dominance of obstetrics.[93] These early maternity hospitals were establishments where women would come to have their babies delivered, as opposed to the practice since time immemorial of the midwife attending the home of the woman in labour.[94] This institution provided male-midwives with endless patients to practice their techniques on and was a way for these men to demonstrate their knowledge.[95]

Many midwives of the time bitterly opposed the involvement of men in childbirth. Some male practitioners also opposed the involvement of medical men like themselves in midwifery and even went as far as to say that male-midwives only undertook midwifery solely for perverse erotic satisfaction. The accoucheurs argued that their involvement in midwifery was to improve the process of childbirth. These men also believed that obstetrics would forge ahead and continue to strengthen.[85]: 1050–1051 

19th century

18th-century physicians expected that obstetrics would continue to grow, but the opposite happened. Obstetrics entered a stage of stagnation in the 19th century, which lasted until about the 1880s.[82]: 96–98  The central explanation for the lack of advancement during this time was the rejection of obstetrics by the medical community.[96] The 19th century marked an era of medical reform in Europe and increased regulation over the profession. Major European institutions such as The College of Physicians and Surgeons[where?] considered delivering babies ungentlemanly work and refused to have anything to do with childbirth as a whole. Even when Medical Act 1858 was introduced, which stated that medical students could qualify as doctors, midwifery was entirely ignored.[97] This made it nearly impossible to pursue an education in midwifery and also have the recognition of being a doctor or surgeon. Obstetrics was pushed to the side.[85]: 1053–1055 

By the late 19th century, the foundation of modern-day obstetrics and midwifery began developing. Delivery of babies by doctors became popular and readily accepted, but midwives continued to play a role in childbirth.[92] Midwifery also changed during this era due to increased regulation and the eventual need for midwives to become certified.[98] Many European countries by the late 19th century were monitoring the training of midwives and issued certification based on competency. Midwives were no longer uneducated in the formal sense.[99]

As midwifery began to develop, so did the profession of obstetrics near the end of the century.[100] Childbirth was no longer unjustifiably despised by the medical community as it once had been at the beginning of the century. But obstetrics was underdeveloped compared to other medical specialities. Many male physicians would deliver children but very few would have referred to themselves as obstetricians. The end of the 19th century did mark a significant accomplishment in the profession with the advancements in asepsis and anaesthesia, which paved the way for the mainstream introduction and later success of the Caesarean section.[99][101]

Before the 1880s mortality rates in lying-hospitals would reach unacceptably high levels and became an area of public concern. Much of these maternal deaths were due to puerperal fever, then known as childbed fever. In the 1800s Dr. Ignaz Semmelweis noticed that women giving birth at home had a much lower incidence of childbed fever than those giving birth by physicians in lying-hospitals. His investigation discovered that washing hands with an antiseptic solution before a delivery reduced childbed fever fatalities by 90%.[102] So it was concluded that it was physicians who had been spreading disease from one labouring mother to the next. Despite the publication of this information, doctors still would not wash. It was not until the 20th century when advancements in aseptic technique and the understanding of disease would play a significant role in the decrease of maternal mortality rates among many populations.

History of obstetrics in America

The development of obstetrics as a practice for accredited doctors happened at the turn of the 18th century and thus was very differently developed in Europe and in the Americas due to the independence of many countries in the Americas from European powers. “Unlike in Europe and the British Isles, where midwifery laws were national, in America, midwifery laws were local and varied widely”.[103]

Gynaecology and Obstetrics gained attention in the American medical field at the end of the nineteenth century through the development of such procedures as the ovariotomy.[104] These procedures then were shared with European surgeons who replicated the surgeries. This was a period when antiseptic, aseptic or anaesthetic measures were just being introduced to surgical and observational procedures and without these procedures surgeries were dangerous and often fatal.[105] Following are two surgeons noted for their contributions to these fields include Ephraim McDowell and J. Marion Sims.[106]

Ephraim McDowell developed a surgical practice in 1795 and performed the first ovariotomy in 1809 on a 47-year-old widow who then lived on for 31 more years.[107] He had attempted to share this with John Bell whom he had practiced under who had retired to Italy. Bell was said to have died without seeing the document but it was published by an associate in Extractions of Diseased Ovaria in 1825.[108] By the mid-century the surgery was both successfully and unsuccessfully being performed. Pennsylvanian surgeons the Attlee brothers made this procedure very routine for a total of 465 surgeries – John Attlee performed 64 successfully of 78 while his brother William reported 387 – between the years of 1843 and 1883.[109] By the middle of the nineteenth century this procedure was successfully performed in Europe by English surgeons Sir Spencer Wells and Charles Clay as well as French surgeons Eugène Koeberlé, Auguste Nélaton and Jules Péan.[87]: 125 

J. Marion Sims was the surgeon responsible for being the first treating a vesicovaginal fistula[87]: 125  – a condition linked to many caused mainly by prolonged pressing of the foetus against the pelvis or other causes such as rape, hysterectomy, or other operations – and also having been doctor to many European royals and the 20th President of the United States James A. Garfield after he had been shot. Sims does have a controversial medical past. Under the beliefs at the time about pain and the prejudice towards African people, he had practiced his surgical skills and developed skills on slaves.[110] These women were the first patients of modern gynecology. One of the women he operated on was named Anarcha Westcott, the woman he first treated for a fistula.[110]

Historical role of gender

Women and men inhabited very different roles in natal care up to the 18th century.[111] The role of a physician was exclusively held by men who went to university, an overly male institution, who would theorize anatomy and the process of reproduction based on theological teaching and philosophy. Many beliefs about the female body and menstruation in the 17th and 18th centuries were inaccurate; clearly resulting from the lack of literature about the practice.[87]: 123–125  Many of the theories of what caused menstruation prevailed from Hippocratic philosophy.[88]: 16  Midwives, meaning "with woman", were those who assisted in the birth and care of both born and unborn children, a position historically held mainly by women.[112]

During the birth of a child, men were rarely present. Women from the neighbourhood or family would join in on the process of birth and assist in many different ways.[113] The one position where men would help with the birth of a child would be in the sitting position, usually when performed on the side of a bed to support the mother.[82]: 130 

Men were introduced into the field of obstetrics in the nineteenth century and resulted in a change of the focus of this profession.[114] Gynaecology directly resulted as a new and separate field of study from obstetrics and focused on the curing of illness and indispositions of female sexual organs.[115] This had some relevance to some conditions as menopause, uterine and cervical problems, and childbirth could leave the mother in need of extensive surgery to repair tissue.[116] But, there was also a large blame of the uterus for completely unrelated conditions. This led to many social consequences of the nineteenth century.[87]: 123–125 

See also

 
Wikimedia Commons has media related to Obstetrics.
 
Wikisource has the text of the 1911 Encyclopædia Britannica article "Obstetrics".

References

  1. ^ "What Is an Obstetrician? What They Do & When To See One". Cleveland Clinic. Retrieved 2022-04-29.
  2. ^ "Obstetrics and Gynecology Specialty Description". American Medical Association. Retrieved 24 October 2020.
  3. ^ Tulchinsky TH, Varavikova EA (March 2014). "Chapter 6 - Family Health". The new public health (Third ed.). Academic Press. pp. 311–379. doi:10.1016/B978-0-12-415766-8.00006-9. ISBN 978-0-12-415766-8.
  4. ^ Cantor, Amy G.; Jungbauer, Rebecca M.; Totten, Annette M.; Tilden, Ellen L.; Holmes, Rebecca; Ahmed, Azrah; Wagner, Jesse; Hermesch, Amy C.; McDonagh, Marian S. (2022). "Telehealth Strategies for the Delivery of Maternal Health Care: A Rapid Review". Annals of Internal Medicine. 175 (9): 1285–1297. doi:10.7326/M22-0737. ISSN 0003-4819. PMID 35878405. S2CID 251067668.
  5. ^ Christiano D (2019-10-30). Westphalen D (ed.). "RhoGAM Shot for Rh Incompatibility: Why You May Need It". Healthline. Retrieved 2022-04-29.
  6. ^ Rath L. "What Is a Coombs Test?". WebMD. Retrieved 2022-04-29.
  7. ^ Stang D (2019-01-29). Murrell D (ed.). "RPR Test". Healthline. Retrieved 2022-04-29.
  8. ^ Rath L. "Why Do I Need a Rubella Test?". WebMD. Retrieved 2022-04-29.
  9. ^ Mekaroonkamol P, Hashemi N (2021-04-03). Staros EB (ed.). "Hepatitis B Test: Reference Range, Interpretation, Collection and Panels". Medscape.
  10. ^ Fontenot HB, George ER (2014). "Sexually transmitted infections in pregnancy". Nursing for Women's Health. 18 (1): 67–72. doi:10.1111/1751-486X.12095. PMID 24548498.
  11. ^ CDCTB (2020-12-16). "Tuberculosis (TB) Fact Sheets- Tuberculin Skin Testing". Centers for Disease Control and Prevention. Retrieved 2022-04-29.
  12. ^ "Urinalysis: What It Is, Purpose, Types & Results". Cleveland Clinic. Retrieved 2022-04-29.
  13. ^ Cereda A, Carey JC (October 2012). "The trisomy 18 syndrome". Orphanet Journal of Rare Diseases. 7: 81. doi:10.1186/1750-1172-7-81. PMC 3520824. PMID 23088440.
  14. ^ Malone FD, Canick JA, Ball RH, Nyberg DA, Comstock CH, Bukowski R, et al. (November 2005). "First-trimester or second-trimester screening, or both, for Down's syndrome". The New England Journal of Medicine. 353 (19): 2001–2011. doi:10.1056/NEJMoa043693. PMID 16282175.
  15. ^ "Common Tests During Pregnancy". www.hopkinsmedicine.org. 2021-08-08. Retrieved 2022-04-29.
  16. ^ Carlson LM, Vora NL (June 2017). "Prenatal Diagnosis: Screening and Diagnostic Tools". Obstetrics and Gynecology Clinics of North America. 44 (2): 245–256. doi:10.1016/j.ogc.2017.02.004. PMC 5548328. PMID 28499534.
  17. ^ Zhang W, Mohammadi T, Sou J, Anis AH (2019). "Cost-effectiveness of prenatal screening and diagnostic strategies for Down syndrome: A microsimulation modeling analysis". PLOS ONE. 14 (12): e0225281. Bibcode:2019PLoSO..1425281Z. doi:10.1371/journal.pone.0225281. PMC 6892535. PMID 31800591.
  18. ^ a b c "Common Tests During Pregnancy". www.hopkinsmedicine.org. 2021-08-08. Retrieved 2022-04-28.
  19. ^ "Quad screen - Mayo Clinic". www.mayoclinic.org. Retrieved 2022-04-29.
  20. ^ "Prenatal Ultrasound Procedure Information". Cleveland Clinic. Retrieved 2022-04-29.
  21. ^ Uscher J. "Anemia in Pregnancy: Causes, Symptoms, and Treatment". WebMD. Retrieved 2022-04-29.
  22. ^ "Glucose challenge test - Mayo Clinic". www.mayoclinic.org. Retrieved 2022-04-29.
  23. ^ "Glucose tolerance test - Mayo Clinic". www.mayoclinic.org. Retrieved 2022-04-29.
  24. ^ Kansky C, Ramus RM (2021-06-15). Pierce Jr JG (ed.). "Basic Obstetric Ultrasound: Background, Indications, Contraindications". Medscape.
  25. ^ DeFrancesco V (January 2004). "Perinatology.". Clinical Engineering Handbook. Academic Press. pp. 410–416. doi:10.1016/B978-012226570-9/50102-2. ISBN 978-0-12-226570-9.
  26. ^ Rice SC (2018-01-09). Wilson DR (ed.). "Placental Insufficiency: Causes, Symptoms, and Diagnosis". Healthline. Retrieved 2022-04-29.
  27. ^ Shaw P, Duncan A, Vouyouka A, Ozsvath K (January 2011). "Radiation exposure and pregnancy". Journal of Vascular Surgery. Radiation Safety in Vascular Surgery. 53 (1 Suppl): 28S–34S. doi:10.1016/j.jvs.2010.05.140. PMID 20869193.
  28. ^ Alorainy IA, Albadr FB, Abujamea AH (2006). "Attitude towards MRI safety during pregnancy". Annals of Saudi Medicine. 26 (4): 306–309. doi:10.5144/0256-4947.2006.306. PMC 6074503. PMID 16885635.
  29. ^ Herbst MK, Tafti D, Shanahan MM (2022). "Obstetric Ultrasound". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 29261880. Retrieved 2022-04-29.
  30. ^ Edvardsson K, Small R, Persson M, Lalos A, Mogren I (October 2014). "'Ultrasound is an invaluable third eye, but it can't see everything': a qualitative study with obstetricians in Australia". BMC Pregnancy and Childbirth. 14 (1): 363. doi:10.1186/1471-2393-14-363. PMC 4287579. PMID 25336335.
  31. ^ Weissleder R, Harisinghani MG, Wittenberg J, Chen JW, eds. (2011). "Obstetric Imaging". Primer of Diagnostic Imagin (5th ed.). St. Louis, Mo.: Mosby. pp. 533–574. doi:10.1016/B978-0-323-06538-2.00010-X. ISBN 978-0-323-06538-2.
  32. ^ Khan AN, Sabih D, Sabih A (2021-04-26). "Early Pregnancy Loss (Embryonic Demise) Imaging: Practice Essentials, Ultrasonography".
  33. ^ Marino T (2021-06-14). Ramus RM (ed.). "Prenatal Diagnosis for Congenital Malformations and Genetic Disorders: Practice Essentials, Noninvasive Techniques, Invasive Techniques". Medscape.
  34. ^ "Chorionic villus sampling - Mayo Clinic". www.mayoclinic.org. Retrieved 2022-04-29.
  35. ^ Gomella TL, Cunningham MD, Eyal FG, Tuttle DJ (2013). Fetal Assessment. Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs (7 ed.). New York, NY: McGraw-Hill Education. Retrieved 2022-04-29.
  36. ^ Jobe AH (January 1984). "Fetal lung maturation and the respiratory distress syndrome.". Fetal Physiology and Medicine (Second ed.). Butterworth-Heinemann. pp. 317–351. doi:10.1016/B978-0-407-00366-8.50016-2. ISBN 978-0-407-00366-8.
  37. ^ "Nonstress test - Mayo Clinic". www.mayoclinic.org. Retrieved 2022-04-29.
  38. ^ Dunkin MA. "High-Risk Pregnancies: Symptoms, Doctors, Support, and More". WebMD. Retrieved 2022-04-29.
  39. ^ Moore T (2022-04-06). Griffing GT (ed.). "Diabetes Mellitus and Pregnancy: Practice Essentials, Gestational Diabetes, Maternal-Fetal Metabolism in Normal Pregnancy". Medscape.
  40. ^ Watson S (2017-10-12). Gill K (ed.). "Macrosomia: Symptoms, Causes, and Complications". Healthline. Retrieved 2022-04-29.
  41. ^ Khurana R, Wolf RE (2021-10-16). Talavera F, Singh AK (eds.). "Systemic Lupus Erythematosus and Pregnancy: Practice Essentials, Pathophysiology, Epidemiology". Medscape.
  42. ^ Friel LA. "Thyroid Disorders in Pregnancy - Gynecology and Obstetrics". MSD Manual Professional Edition. Retrieved 2022-04-29.
  43. ^ Alemu A, Terefe B, Abebe M, Biadgo B (November 2016). "Thyroid hormone dysfunction during pregnancy: A review". International Journal of Reproductive Biomedicine. 14 (11): 677–686. PMC 5153572. PMID 27981252.
  44. ^ Nichols KM, Henkin S, Creager MA (November 2020). "Venous Thromboembolism Associated With Pregnancy: JACC Focus Seminar". Journal of the American College of Cardiology. 76 (18): 2128–2141. doi:10.1016/j.jacc.2020.06.090. PMID 33121721. S2CID 226205234.
  45. ^ a b Page 264 in: Gresele P (2008). Platelets in haematologic and cardiovascular disorders: a clinical handbook. Cambridge, UK: Cambridge University Press. ISBN 978-0-521-88115-9.
  46. ^ "Hyperemesis Gravidarum: Symptoms & Treatment". Cleveland Clinic. Retrieved 2022-04-30.
  47. ^ "Morning sickness - Symptoms and causes". Mayo Clinic. Retrieved 2022-04-30.
  48. ^ Wint C (2018-07-17). Wilson DR (ed.). "Hyperemesis Gravidarum: Causes, Symptoms, and Diagnosis". Healthline. Retrieved 2022-04-28.
  49. ^ Gaither K (13 December 2019). "Preeclampsia". WebMD. Retrieved 2022-04-29.
  50. ^ "Preeclampsia - Symptoms and causes". Mayo Clinic. Retrieved 2022-04-29.
  51. ^ "4 Common Pregnancy Complications". www.hopkinsmedicine.org. 2021-08-08. Retrieved 2022-04-28.
  52. ^ Healthdirect Australia (2022-02-08). "Induced labour". www.pregnancybirthbaby.org.au. Retrieved 2022-04-29.
  53. ^ Surányim A (2000). Prenatal and postnatal evaluation of foetal renal hyperechogenicity in pregnancies complicated with pre-eclampsia and intrauterine growth retardation (Ph.D. thesis). University of Szeged. doi:10.14232/phd.2154.
  54. ^ Moldenhauer JS. "Prelabor Rupture of the Membranes (PROM) - Women's Health Issues". MSD Manual Consumer Version. Retrieved 2022-04-30.
  55. ^ "Prostin E2 Vaginal: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD". www.webmd.com. Retrieved 2022-04-30.
  56. ^ Ho PC, Ngai SW, Liu KL, Wong GC, Lee SW (November 1997). "Vaginal misoprostol compared with oral misoprostol in termination of second-trimester pregnancy". Obstetrics and Gynecology. 90 (5): 735–738. doi:10.1016/S0029-7844(97)00419-5. PMID 9351755. S2CID 21261210.
  57. ^ Adeniji OA, Oladokun A, Olayemi O, Adeniji OI, Odukogbe AA, Ogunbode O, et al. (February 2005). "Pre-induction cervical ripening: transcervical foley catheter versus intravaginal misoprostol". Journal of Obstetrics and Gynaecology. 25 (2): 134–139. doi:10.1080/01443610500040737. PMID 15814391. S2CID 24250115.
  58. ^ "Premature rupture of membranes". MedlinePlus Medical Encyclopedia. Bethesda (MD): U.S. National Library of Medicine. Retrieved 2022-04-30.
  59. ^ "Oxytocin 10 IU/ml Solution for infusion - Summary of Product Characteristics (SmPC) - (emc)". www.medicines.org.uk. Retrieved 2022-04-30.
  60. ^ Prior T, Lees C (2019). "Control and Monitoring of Fetal Growth.". Encyclopedia of Endocrine Diseases. Vol. 5. pp. 1–9. doi:10.1016/B978-0-12-801238-3.65414-4. ISBN 9780128122006. S2CID 81797258.
  61. ^ Lloyd-Thomas AR (January 1990). "Pain management in paediatric patients". British Journal of Anaesthesia. 64 (1): 85–104. doi:10.1093/bja/64.1.85. PMID 2405898.
  62. ^ Saint Louis H (2022-04-14). "Cesarean Delivery: Overview, Preparation, Technique". Medscape.
  63. ^ "Ectopic pregnancy - Symptoms and causes". Mayo Clinic. Retrieved 2022-04-30.
  64. ^ Lim KH, Steinberg G (2022-04-13). "Preeclampsia: Practice Essentials, Overview, Pathophysiology". Medscape.
  65. ^ Artal-Mittelmark R. "Stages of Development of the Fetus - Women's Health Issues". MSD Manual Consumer Version. Retrieved 2022-04-30.
  66. ^ "Hypertension: Causes, symptoms, and treatments". www.medicalnewstoday.com. 2021-11-10. Retrieved 2022-04-30.
  67. ^ Seppa N (2011-01-20). "Body & brain: Uncontrolled epilepsy can be fatal: Study finds more deaths in adults whose seizures persist". Science News. 179 (3): 8. doi:10.1002/scin.5591790305. ISSN 0036-8423.
  68. ^ Haram K, Svendsen E, Abildgaard U (February 2009). "The HELLP syndrome: clinical issues and management. A Review". BMC Pregnancy and Childbirth. 9 (1): 8. doi:10.1186/1471-2393-9-8. PMC 2654858. PMID 19245695.
  69. ^ "Preeclampsia: Symptoms, Causes, Treatments & Prevention". Cleveland Clinic. Retrieved 2022-04-30.
  70. ^ "Placental Abruption: Symptoms, Causes & Effects On Baby". Cleveland Clinic. Retrieved 2022-04-30.
  71. ^ Moldenhauer JS. "Fetal Distress - Women's Health Issues". MSD Manual Consumer Version. Retrieved 2022-04-30.
  72. ^ "Shoulder Dystocia: Signs, Causes, Prevention & Complications". Cleveland Clinic. Retrieved 2022-04-30.
  73. ^ Astatikie G, Limenih MA, Kebede M (April 2017). "Maternal and fetal outcomes of uterine rupture and factors associated with maternal death secondary to uterine rupture". BMC Pregnancy and Childbirth. 17 (1): 117. doi:10.1186/s12884-017-1302-z. PMC 5389173. PMID 28403833.
  74. ^ Sims ME (2014-01-01). "Legal Briefs: Iatrogenesis: Prolapsed Umbilical Cord After Artificial Rupture of the Membranes and Unskilled Stabilization". NeoReviews. 15 (1): e32–e36. doi:10.1542/neo.15-1-e32. ISSN 1526-9906.
  75. ^ "Umbilical Cord Prolapse: Causes, Diagnosis & Management". Cleveland Clinic. Retrieved 2022-04-30.
  76. ^ Smith JR (2022-04-01). "Postpartum Hemorrhage: Practice Essentials, Problem, Epidemiology". Medscape.
  77. ^ Demisse GA, Sifer SD, Kedir B, Fekene DB, Bulto GA (March 2019). "Determinants of puerperal sepsis among post partum women at public hospitals in west SHOA zone Oromia regional STATE, Ethiopia (institution BASEDCASE control study)". BMC Pregnancy and Childbirth. 19 (1): 95. doi:10.1186/s12884-019-2230-x. PMC 6423770. PMID 30885159.
  78. ^ "WHO Technical Consultation on Postpartum Care". World Health Organization. 2010. Retrieved 30 June 2020.
  79. ^ Jones E, Taylor B, MacArthur C, Pritchett R, Cummins C (February 2016). "The effect of early postnatal discharge from hospital for women and infants: a systematic review protocol". Systematic Reviews. 5: 24. doi:10.1186/s13643-016-0193-9. PMC 4746909. PMID 26857705.
  80. ^ "Types of Delivery for Pregnancy". Cleveland Clinic. Retrieved 2022-04-30.
  81. ^ Kotlar B, Gerson E, Petrillo S, Langer A, Tiemeier H (January 2021). "The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review". Reproductive Health. 18 (1): 10. doi:10.1186/s12978-021-01070-6. PMC 7812564. PMID 33461593.
  82. ^ a b c Gelis J (1991). History of Childbirth. Boston: Northeastern University Press.
  83. ^ Healthdirect Australia (2021-05-23). "What do midwives do?". www.pregnancybirthbaby.org.au. Retrieved 2022-04-30.
  84. ^ a b Adatara P, Amooba PA, Afaya A, Salia SM, Avane MA, Kuug A, et al. (April 2021). "Challenges experienced by midwives working in rural communities in the Upper East Region of Ghana: a qualitative study". BMC Pregnancy and Childbirth. 21 (1): 287. doi:10.1186/s12884-021-03762-0. PMC 8033657. PMID 33836689.
  85. ^ a b c d Bynum WF, Porter R, eds. (1993). Companion Encyclopedia of the History of Medicine. London and New York: Routledge.
  86. ^ Carr I (May 2000). "Some Obstetrical History: Dying to Have a Baby - the History of Childbirth" (PDF). University of Manitoba: Women’s Health. Retrieved 20 May 2012.
  87. ^ a b c d e f McGrew RE (1985). Encyclopedia of Medical History. New York: McGraw-Hill Book Company.
  88. ^ a b Hufnagel GL (2012). A History of Women's Menstruation from Ancient Greece to the Twenty-first Century: Psychological, Social, Medical, Religious, and Educational Issues. Lewiston, New York: Edwin Mellen Press.
  89. ^ International Confederation of Midwives (2022-01-31). "The Origins of Midwifery". ICM. Retrieved 2022-04-30.
  90. ^ Gasner A, Aatsha PA (2022). "Physiology, Uterus". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 32491507. Retrieved 2022-04-30.
  91. ^ Rhodes P (2004-09-23). "Leake, John (1729–1792), man-midwife". Oxford Dictionary of National Biography. Oxford Dictionary of National Biography (online ed.). Oxford University Press. doi:10.1093/ref:odnb/16239. ISBN 978-0-19-861412-8. (Subscription or UK public library membership required.)
  92. ^ a b Aziato L, Omenyo CN (March 2018). "Initiation of traditional birth attendants and their traditional and spiritual practices during pregnancy and childbirth in Ghana". BMC Pregnancy and Childbirth. 18 (1): 64. doi:10.1186/s12884-018-1691-7. PMC 5842514. PMID 29514607.
  93. ^ Al-Gailani S (2018). "Hospital Birth". In Kassell L, Hopwood N, Flemming R (eds.). Reproduction. Reproduction: Antiquity to the Present Day. Cambridge: Cambridge University Press. pp. 553–566. doi:10.1017/9781107705647.046. ISBN 978-1-107-06802-5. S2CID 239583227. Retrieved 2022-04-30.
  94. ^ Sialubanje C, Massar K, Hamer DH, Ruiter RA (September 2015). "Reasons for home delivery and use of traditional birth attendants in rural Zambia: a qualitative study". BMC Pregnancy and Childbirth. 15 (1): 216. doi:10.1186/s12884-015-0652-7. PMC 4567794. PMID 26361976.
  95. ^ Martell LK (2000). "The hospital and the postpartum experience: a historical analysis". Journal of Obstetric, Gynecologic, and Neonatal Nursing. 29 (1): 65–72. doi:10.1111/j.1552-6909.2000.tb02757.x. PMID 10660278.
  96. ^ Aborigo RA, Reidpath DD, Oduro AR, Allotey P (January 2018). "Male involvement in maternal health: perspectives of opinion leaders". BMC Pregnancy and Childbirth. 18 (1): 3. doi:10.1186/s12884-017-1641-9. PMC 5749010. PMID 29291711.
  97. ^ "The Midwives' Registration Bill". The Lancet. Originally published as Volume 2, Issue 3602. 140 (3602): 631–634. 1892-09-10. doi:10.1016/S0140-6736(01)86961-0. ISSN 0140-6736.
  98. ^ Midwives voices, midwives realities. Findings from a global consultation on providing quality midwifery care (PDF). Switzerland: World Health Organization. 1991. ISBN 978-9241510547.
  99. ^ a b Drife J (May 2002). "The start of life: a history of obstetrics". Postgraduate Medical Journal. 78 (919): 311–315. doi:10.1136/pmj.78.919.311. PMC 1742346. PMID 12151591..
  100. ^ Rabinerson D, Horowitz E (May 2007). "[The evolution of midwifery]". Harefuah. 146 (5): 380–4, 405. PMID 17674557.
  101. ^ Low J (2009). (PDF). Journal of Obstetrics and Gynecology Canada. 31 (12): 1131–1136. doi:10.1016/S1701-2163(16)34373-0. PMID 20085678. Archived from the original (PDF) on January 23, 2013. Retrieved May 20, 2012.
  102. ^ Caplan CE (1995). . McGill Journal of Medicine. 1 (1). Archived from the original on 2012-07-07.
  103. ^ Roth J. Pregnancy & Birth: The History of Childbearing Choices in the United States. Human Service Solutions.
  104. ^ Baskett TF (29 March 2019). "Houstoun, Robert (1678–1734)". Eponyms and Names in Obstetrics and Gynaecology. Cambridge University Press. p. 194. doi:10.1017/9781108421706.154. ISBN 978-1-108-33671-0.
  105. ^ Lavers A, Yip WS, Sunderland B, Parsons R, Mackenzie S, Seet J, Czarniak P (2018). "Surgical antibiotic prophylaxis use and infection prevalence in non-cosmetic breast surgery procedures at a tertiary hospital in Western Australia-a retrospective study". PeerJ. 6: e5724. doi:10.7717/peerj.5724. PMC 6202972. PMID 30386692. Table 2: Types of procedures and association with surgical site infections (SSI). P-values were obtained from Fisher's Exact test, unless otherwise specified.
  106. ^ Vernon LF (August 2019). "J. Marion Sims, MD: Why He and His Accomplishments Need to Continue to be Recognized a Commentary and Historical Review". Journal of the National Medical Association. 111 (4): 436–446. doi:10.1016/j.jnma.2019.02.002. PMID 30851980. S2CID 73725863.
  107. ^ Rutkow IM (August 1999). "Ephraim McDowell and the world's first successful ovariotomy". Archives of Surgery. 134 (8): 902. doi:10.1001/archsurg.134.8.902. PMID 10443816.
  108. ^ "Iceman Ötzi may have had tummy trouble when he died". New Scientist. 229 (3056): 17. January 2016. Bibcode:2016NewSc.229...17.. doi:10.1016/s0262-4079(16)30115-4. ISSN 0262-4079.
  109. ^ Sieber WK (September 1970). "Total prosthetic transplantation of the inferior vena cava, with venous drainage restoration of the one remaining kidney on the graft, successfully performed on a child with Wilms' tumor". Journal of Pediatric Surgery. 5 (6): 694–695. doi:10.1016/s0022-3468(70)80085-9. ISSN 0022-3468.
  110. ^ a b "Dr. J Marion Sims: The Father of Modern Gynecology". International Wellness Foundation. 12 February 2014.
  111. ^ Giuliano P (May 2018). "Gender: A Historical Perspective". In Averett SL, Argys LM, Hoffman SD (eds.). The Oxford Handbook of Women and the Economy. Oxford University Press. doi:10.1093/oxfordhb/9780190628963.013.29.
  112. ^ O'Malley-Keighran MP, Lohan G (December 2016). "Encourages and guides, or diagnoses and monitors: Woman centred-ness in the discourse of professional midwifery bodies". Midwifery. 43: 48–58. doi:10.1016/j.midw.2016.10.007. PMID 27846406.
  113. ^ "Situation of women and children in Nigeria". www.unicef.org. Retrieved 2022-04-30.
  114. ^ Bäcklund I (2006). "Modifiers describing women and men in nineteenth-century English". In Kytö M, Rydén M, Smitterberg E (eds.). Nineteenth-Century English. Cambridge: Cambridge University Press. pp. 17–55. doi:10.1017/cbo9780511486944.002. ISBN 9780511486944.
  115. ^ Adaikan G (January 2020). "Female sexual dysfunction". In Arulkumaran S, Ledger W, Denny L, Doumouchtsis S (eds.). Oxford Textbook of Obstetrics and Gynaecology. Oxford University Press. pp. 743–752. doi:10.1093/med/9780198766360.003.0060. ISBN 978-0-19-876636-0.
  116. ^ "Uterine Prolapse: Causes, Symptoms, Diagnosis & Treatment". Cleveland Clinic. Retrieved 2022-04-30.

March 03, 2023
obstetrics, this, article, about, medical, specialty, health, profession, midwifery, this, article, technical, most, readers, understand, please, help, improve, make, understandable, experts, without, removing, technical, details, september, 2010, learn, when,. This article is about the medical specialty For the health profession see Midwifery This article may be too technical for most readers to understand Please help improve it to make it understandable to non experts without removing the technical details September 2010 Learn how and when to remove this template message Look up obstetrics in Wiktionary the free dictionary Obstetrics is the field of study concentrated on pregnancy childbirth and the postpartum period 1 As a medical specialty obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology OB GYN which is a surgical field 2 ObstetricianOccupationNamesPhysician SurgeonOccupation typeSpecialtyActivity sectorsMedicine surgeryDescriptionEducation requiredDoctor of Medicine M D Doctor of Osteopathic medicine D O Bachelor of Medicine Bachelor of Surgery M B B S Bachelor of Medicine Bachelor of Surgery MBChB Fields ofemploymentHospitals clinics Contents 1 Main areas 1 1 Prenatal care 1 1 1 First trimester 1 1 2 Second trimester 1 1 3 Third trimester 1 1 4 Fetal assessments 2 Diseases in pregnancy 2 1 Induction and labour 2 2 Complications and emergencies 2 3 Postpartum period 2 4 Veterinary obstetrics 3 History 3 1 Before the 18th century 3 2 18th century 3 3 19th century 3 4 History of obstetrics in America 3 5 Historical role of gender 4 See also 5 ReferencesMain areas EditPrenatal care Edit Prenatal care is important in screening for various complications of pregnancy 3 This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low risk pregnancies 4 3D ultrasound of 3 inch 76 mm fetus about 14 weeks gestational age Fetus at 17 weeks Fetus at 20 weeksFirst trimester Edit Routine tests in the first trimester of pregnancy generally include Complete blood count Blood type Rh negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease 5 Indirect Coombs test AGT to assess risk of hemolytic disease of the newborn 6 Rapid plasma reagin test to screen for syphilis 7 Rubella antibody screen 8 HBsAg test to screen for hepatitis B 9 Testing for chlamydia and gonorrhea when indicated 10 Mantoux test for tuberculosis 11 Urinalysis and culture 12 HIV screenGenetic screening for Down syndrome trisomy 21 and Edwards syndrome trisomy 18 the national standard in the United States is rapidly evolving away from the AFP quad screen done typically in the second trimester at 16 18 weeks 13 The newer integrated screen formerly called F A S T E R for First And Second Trimester Early Results can be done at 10 plus weeks to 13 plus weeks with an ultrasound of the fetal neck thicker nuchal skin correlates with higher risk of Down syndrome being present and two chemicals analytes pregnancy associated plasma protein A and human chorionic gonadotropin pregnancy hormone level itself 14 It gives an accurate risk profile very early A second blood screen at 15 to 20 weeks refines the risk more accurately 15 The cost is higher than an AFP quad screen due to the ultrasound and second blood test but it is quoted to have a 93 pick up rate as opposed to 88 for the standard AFP QS This is an evolving standard of care in the United States 16 17 18 Down Syndrome karyotype Second trimester Edit MSAFP quad screen four simultaneous blood tests maternal serum AFP inhibin A estriol and bHCG elevations low numbers or odd patterns correlate with neural tube defect risk and increased risks of trisomy 18 or trisomy 21 19 Ultrasound either abdominal or transvaginal to assess cervix placenta fluid and baby 20 Amniocentesis is the national standard in what country for women over 35 or who reach 35 by mid pregnancy or who are at increased risk by family history or prior birth history 18 Third trimester Edit Hematocrit if low the mother receives iron supplements 21 Group B Streptococcus screen If positive the woman receives IV penicillin or ampicillin while in labor or if she is allergic to penicillin an alternative therapy such as IV clindamycin or IV vancomycin 18 Glucose loading test GLT screens for gestational diabetes if gt 140 mg dL a glucose tolerance test GTT is administered a fasting glucose gt 105 mg dL suggests gestational diabetes 22 Most doctors do a sugar load in a drink form of 50 grams of glucose in cola lime or orange and draw blood an hour later plus or minus 5 minutes The standard modified criteria have been lowered to 135 since the late 1980s 23 The result of an ultrasonography a black and white image that shows a clear view of the interior abdomen Fetal assessments Edit A dating scan at 12 weeks Obstetric ultrasonography is routinely used for dating the gestational age of a pregnancy from the size of the fetus determine the number of fetuses and placentae evaluate for an ectopic pregnancy and first trimester bleeding the most accurate dating being in first trimester before the growth of the foetus has been significantly influenced by other factors 24 Ultrasound is also used for detecting congenital anomalies or other foetal anomalies and determining the biophysical profiles BPP which are generally easier to detect in the second trimester when the foetal structures are larger and more developed 25 Specialised ultrasound equipment can also evaluate the blood flow velocity in the umbilical cord looking to detect a decrease absence reversal or diastolic blood flow in the umbilical artery 26 X rays and computerized tomography CT are not used especially in the first trimester due to the ionizing radiation which has teratogenic effects on the foetus 27 No effects of magnetic resonance imaging MRI on the foetus have been demonstrated 28 but this technique is too expensive for routine observation Instead obstetric ultrasonography is the imaging method of choice in the first trimester and throughout the pregnancy because it emits no radiation is portable and allows for realtime imaging 29 The safety of frequent ultrasound scanning has not been confirmed Despite this increasing numbers of women are choosing to have additional scans for no medical purpose such as gender scans 3D and 4D scans 30 A normal gestation would reveal a gestational sac yolk sac and fetal pole 31 The gestational age can be assessed by evaluating the mean gestational sac diameter MGD before week 6 and the crown rump length after week 6 Multiple gestation is evaluated by the number of placentae and amniotic sacs present 32 Other tools used for assessment include Fetal screening is used to help assess the viability of the fetus as well as congenital abnormalities 33 Fetal karyotype can be used for the screening of genetic diseases This can be obtained via amniocentesis or chorionic villus sampling CVS 34 Foetal haematocrit for the assessment of foetal anemia Rh isoimmunization or hydrops can be determined by percutaneous umbilical blood sampling PUBS which is done by placing a needle through the abdomen into the uterus and taking a portion of the umbilical cord 35 Fetal lung maturity is associated with how much surfactant the fetus is producing Reduced production of surfactant indicates decreased lung maturity and is a high risk factor for infant respiratory distress syndrome 36 Typically a lecithin sphingomyelin ratio greater than 1 5 is associated with increased lung maturity Nonstress test NST for fetal heart rate 37 Oxytocin challenge testDiseases in pregnancy EditFurther information Pre existing disease in pregnancy A pregnant woman may have a pre existing disease that may become worse or become a risk to the pregnancy or to postnatal development of the offspring 38 Diabetes mellitus and pregnancy deals with the interactions of diabetes mellitus not restricted to gestational diabetes and pregnancy 39 Risks for the child include miscarriage growth restriction growth acceleration foetal obesity macrosomia polyhydramnios and birth defects 40 Lupus and pregnancy confers an increased rate of foetal death in utero and spontaneous abortion miscarriage as well as of neonatal lupus 41 Thyroid disease in pregnancy can if uncorrected cause adverse effects on foetal and maternal well being 42 The deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neurointellectual development in the early life of the child 43 Demand for thyroid hormones is increased during pregnancy and may cause a previously unnoticed thyroid disorder to worsen Hypercoagulability in pregnancy is the propensity of pregnant women to develop thrombosis blood 44 clots Pregnancy itself is a factor of hypercoagulability pregnancy induced hypercoagulability as a physiologically adaptive mechanism to prevent post partum bleeding 45 However when combined with an additional underlying hypercoagulable states the risk of thrombosis or embolism may become substantial 45 Hyperemesis gravidarum in pregnancy occurs due to extreme persistent nausea and vomiting during pregnancy 46 If untreated can lead to dehydration weight loss and electrolyte imbalances Most women develop nausea and vomiting during the first trimester 47 The cause of Hyperemesis gravidarum is not known However it is believed to be caused by a rapidly rising blood level of a hormone human chorionic gonadotropin HCG which is released by the placenta 48 Preeclampsia is a condition that causes high blood pressure during pregnancy If left untreated it can be life threatening 49 In pregnant women preeclampsia may occur after 20 weeks of pregnancy often in women who have no history of high blood pressure Symptoms of preeclampsia may include severe headache vision changes and pain under the ribs 50 However in some women symptoms may not occur until they go for a routine prenatal visit 51 Induction and labour Edit Main articles Induction birth and Childbirth Further information Pain management during childbirth Induction is a method of artificially or prematurely stimulating labour in a woman 52 Reasons to induce can include pre eclampsia foetal distress placental malfunction intrauterine growth retardation and failure to progress through labour increasing the risk of infection and foetal distresses 53 Induction may be achieved via several methods Disturbance of cervical membranes 54 Pessary of Prostin cream prostaglandin E2 55 Intravaginal or oral administration of misoprostol 56 Cervical insertion of a 30 mL Foley catheter 57 Rupturing the amniotic membranes 58 Intravenous infusion of synthetic oxytocin Pitocin or Syntocinon 59 During labour the obstetrician carries out the following tasks Monitor the progress of labour by reviewing the nursing chart performing vaginal examination and assessing the trace produced by a foetal monitoring device the cardiotocograph 60 Provide pain relief either by nitrous oxide opiates or by epidural anaesthesia done by anaesthestists an anaesthesiologist or a nurse anaesthetist 61 Caesarean section if there is an associated risk with vaginal delivery as such foetal or maternal compromise 62 Complications and emergencies Edit Main article Complications of pregnancy The main emergencies include Ectopic pregnancy is when an embryo implants in the uterine Fallopian tube or rarely on the ovary or inside the peritoneal cavity This may cause massive internal bleeding 63 Pre eclampsia is a disease defined by a combination of signs and symptoms that are related to maternal hypertension 64 The cause is unknown and markers are being sought to predict its development from the earliest stages of pregnancy 65 Some unknown factors cause vascular damage in the endothelium causing hypertension 66 If severe it progresses to eclampsia where seizures occur which can be fatal 67 Preeclamptic patients with the HELLP syndrome show liver failure and disseminated intravascular coagulation DIC 68 The only treatment is to deliver the foetus Women may still develop pre eclampsia following delivery 69 Placental abruption is where the placenta detaches from the uterus and the woman and foetus can bleed to death if not managed appropriately 70 Foetal distress where the foetus is getting compromised in the uterine environment 71 Shoulder dystocia where one of the foetus shoulders becomes stuck during vaginal birth There are many risk factors including macrosmic large foetus but many are also unexplained 72 Uterine rupture can occur during obstructed labour and endanger foetal and maternal life 73 Prolapsed cord can only happen after the membranes have ruptured 74 The umbilical cord delivers before the presenting part of the foetus If the foetus is not delivered within minutes or the pressure taken off the cord the foetus dies 75 Obstetrical hemorrhage may be due to a number of factors such as placenta previa uterine rupture or tears uterine atony retained placenta or placental fragments or bleeding disorders 76 Puerperal sepsis is an ascending infection of the genital tract 77 It may happen during or after labour Signs to look out for include signs of infection pyrexia or hypothermia raised heart rate and respiratory rate reduced blood pressure and abdominal pain offensive lochia blood loss increased lochia clots diarrhea and vomiting Postpartum period Edit Further information Postpartum period The World Health Organization makes a distinction between the use of postpartum care when it concerns the care of the mother after giving birth and postnatal care when the care of the newborn is concerned 78 Postpartum care is provided to the mother following childbirth A woman in the Western world who gives birth in a hospital may leave the hospital as soon as she is medically stable and chooses to leave which can be as early as a few hours later but usually averages a stay of one or two days the average postnatal stay following delivery by caesarean section is three to four days 79 During this time the mother is monitored for bleeding bowel and bladder function and baby care The infant s health is also monitored 80 Veterinary obstetrics Edit Main article Veterinary obstetricsHistory Edit Two midwives assisting a woman in labour on a birthing chair in the 16th century from a work by Eucharius Rosslin Prior to the 18th century caring for pregnant women in Europe was confined exclusively to women and rigorously excluded men 81 The expectant mother would invite close female friends and family members to her home to keep her company during childbirth 82 96 98 Skilled midwives managed all aspects of the labour and delivery 83 The presence of physicians and surgeons was very rare and only occurred if a serious complication had taken place and the midwife had exhausted all measures at her disposal 84 Calling a surgeon was very much a last resort and having men deliver women in this era was seen as offending female modesty 85 1050 1051 86 Before the 18th century Edit See also Women s medicine in antiquity Prior to the 18th and 19th centuries midwifery was well established but obstetrics was not recognized as a specific medical specialty However the subject matter and interest in the female reproductive system and sexual practice can be traced back to Ancient Egypt 87 122 and Ancient Greece 88 11 Soranus of Ephesus sometimes is called the most important figure in ancient gynecology 84 Living in the late first century A D and early second century he studied anatomy and had opinions and techniques on abortion contraception most notably coitus interruptus and birth complications After his death techniques and works of gynecology declined very little of his works were recorded and survived to the late 18th century when gynecology and obstetrics reemerged as a medical specialism 87 123 18th century Edit The 18th century marked the beginning of many advances in European midwifery based on better knowledge of the physiology of pregnancy and labour 89 By the end of the century medical professionals began to understand the anatomy of the uterus and the physiological changes that take place during labour 90 The introduction of forceps in childbirth also took place at this time All these medical advances in obstetrics were a lever for the introduction of men into an arena previously managed and run by women midwifery 85 1051 1052 The addition of the male midwife or man midwife is historically a significant change to the profession of obstetrics 91 In the 18th century medical men began to train in area of childbirth and believed with their advanced knowledge in anatomy that childbirth could be improved 92 In France these male midwives were referred to as accoucheurs a title later used all over Europe The founding of lying in hospitals also contributed to the medicalization and male dominance of obstetrics 93 These early maternity hospitals were establishments where women would come to have their babies delivered as opposed to the practice since time immemorial of the midwife attending the home of the woman in labour 94 This institution provided male midwives with endless patients to practice their techniques on and was a way for these men to demonstrate their knowledge 95 Many midwives of the time bitterly opposed the involvement of men in childbirth Some male practitioners also opposed the involvement of medical men like themselves in midwifery and even went as far as to say that male midwives only undertook midwifery solely for perverse erotic satisfaction The accoucheurs argued that their involvement in midwifery was to improve the process of childbirth These men also believed that obstetrics would forge ahead and continue to strengthen 85 1050 1051 19th century Edit 18th century physicians expected that obstetrics would continue to grow but the opposite happened Obstetrics entered a stage of stagnation in the 19th century which lasted until about the 1880s 82 96 98 The central explanation for the lack of advancement during this time was the rejection of obstetrics by the medical community 96 The 19th century marked an era of medical reform in Europe and increased regulation over the profession Major European institutions such as The College of Physicians and Surgeons where considered delivering babies ungentlemanly work and refused to have anything to do with childbirth as a whole Even when Medical Act 1858 was introduced which stated that medical students could qualify as doctors midwifery was entirely ignored 97 This made it nearly impossible to pursue an education in midwifery and also have the recognition of being a doctor or surgeon Obstetrics was pushed to the side 85 1053 1055 By the late 19th century the foundation of modern day obstetrics and midwifery began developing Delivery of babies by doctors became popular and readily accepted but midwives continued to play a role in childbirth 92 Midwifery also changed during this era due to increased regulation and the eventual need for midwives to become certified 98 Many European countries by the late 19th century were monitoring the training of midwives and issued certification based on competency Midwives were no longer uneducated in the formal sense 99 As midwifery began to develop so did the profession of obstetrics near the end of the century 100 Childbirth was no longer unjustifiably despised by the medical community as it once had been at the beginning of the century But obstetrics was underdeveloped compared to other medical specialities Many male physicians would deliver children but very few would have referred to themselves as obstetricians The end of the 19th century did mark a significant accomplishment in the profession with the advancements in asepsis and anaesthesia which paved the way for the mainstream introduction and later success of the Caesarean section 99 101 Before the 1880s mortality rates in lying hospitals would reach unacceptably high levels and became an area of public concern Much of these maternal deaths were due to puerperal fever then known as childbed fever In the 1800s Dr Ignaz Semmelweis noticed that women giving birth at home had a much lower incidence of childbed fever than those giving birth by physicians in lying hospitals His investigation discovered that washing hands with an antiseptic solution before a delivery reduced childbed fever fatalities by 90 102 So it was concluded that it was physicians who had been spreading disease from one labouring mother to the next Despite the publication of this information doctors still would not wash It was not until the 20th century when advancements in aseptic technique and the understanding of disease would play a significant role in the decrease of maternal mortality rates among many populations History of obstetrics in America Edit The development of obstetrics as a practice for accredited doctors happened at the turn of the 18th century and thus was very differently developed in Europe and in the Americas due to the independence of many countries in the Americas from European powers Unlike in Europe and the British Isles where midwifery laws were national in America midwifery laws were local and varied widely 103 Gynaecology and Obstetrics gained attention in the American medical field at the end of the nineteenth century through the development of such procedures as the ovariotomy 104 These procedures then were shared with European surgeons who replicated the surgeries This was a period when antiseptic aseptic or anaesthetic measures were just being introduced to surgical and observational procedures and without these procedures surgeries were dangerous and often fatal 105 Following are two surgeons noted for their contributions to these fields include Ephraim McDowell and J Marion Sims 106 Ephraim McDowell developed a surgical practice in 1795 and performed the first ovariotomy in 1809 on a 47 year old widow who then lived on for 31 more years 107 He had attempted to share this with John Bell whom he had practiced under who had retired to Italy Bell was said to have died without seeing the document but it was published by an associate in Extractions of Diseased Ovaria in 1825 108 By the mid century the surgery was both successfully and unsuccessfully being performed Pennsylvanian surgeons the Attlee brothers made this procedure very routine for a total of 465 surgeries John Attlee performed 64 successfully of 78 while his brother William reported 387 between the years of 1843 and 1883 109 By the middle of the nineteenth century this procedure was successfully performed in Europe by English surgeons Sir Spencer Wells and Charles Clay as well as French surgeons Eugene Koeberle Auguste Nelaton and Jules Pean 87 125 J Marion Sims was the surgeon responsible for being the first treating a vesicovaginal fistula 87 125 a condition linked to many caused mainly by prolonged pressing of the foetus against the pelvis or other causes such as rape hysterectomy or other operations and also having been doctor to many European royals and the 20th President of the United States James A Garfield after he had been shot Sims does have a controversial medical past Under the beliefs at the time about pain and the prejudice towards African people he had practiced his surgical skills and developed skills on slaves 110 These women were the first patients of modern gynecology One of the women he operated on was named Anarcha Westcott the woman he first treated for a fistula 110 Historical role of gender Edit Women and men inhabited very different roles in natal care up to the 18th century 111 The role of a physician was exclusively held by men who went to university an overly male institution who would theorize anatomy and the process of reproduction based on theological teaching and philosophy Many beliefs about the female body and menstruation in the 17th and 18th centuries were inaccurate clearly resulting from the lack of literature about the practice 87 123 125 Many of the theories of what caused menstruation prevailed from Hippocratic philosophy 88 16 Midwives meaning with woman were those who assisted in the birth and care of both born and unborn children a position historically held mainly by women 112 During the birth of a child men were rarely present Women from the neighbourhood or family would join in on the process of birth and assist in many different ways 113 The one position where men would help with the birth of a child would be in the sitting position usually when performed on the side of a bed to support the mother 82 130 Men were introduced into the field of obstetrics in the nineteenth century and resulted in a change of the focus of this profession 114 Gynaecology directly resulted as a new and separate field of study from obstetrics and focused on the curing of illness and indispositions of female sexual organs 115 This had some relevance to some conditions as menopause uterine and cervical problems and childbirth could leave the mother in need of extensive surgery to repair tissue 116 But there was also a large blame of the uterus for completely unrelated conditions This led to many social consequences of the nineteenth century 87 123 125 See also Edit Wikimedia Commons has media related to Obstetrics Wikisource has the text of the 1911 Encyclopaedia Britannica article Obstetrics Henry Jacques Garrigues who introduced antiseptic obstetrics to North America Maternal fetal medicine Obstetrical nursingReferences Edit What Is an Obstetrician What They Do amp When To See One Cleveland Clinic Retrieved 2022 04 29 Obstetrics and Gynecology Specialty Description American Medical Association Retrieved 24 October 2020 Tulchinsky TH Varavikova EA March 2014 Chapter 6 Family Health The new public health Third ed Academic Press pp 311 379 doi 10 1016 B978 0 12 415766 8 00006 9 ISBN 978 0 12 415766 8 Cantor Amy G Jungbauer Rebecca M Totten Annette M Tilden Ellen L Holmes Rebecca Ahmed Azrah Wagner Jesse Hermesch Amy C McDonagh Marian S 2022 Telehealth Strategies for the Delivery of Maternal Health Care A Rapid Review Annals of Internal Medicine 175 9 1285 1297 doi 10 7326 M22 0737 ISSN 0003 4819 PMID 35878405 S2CID 251067668 Christiano D 2019 10 30 Westphalen D ed RhoGAM Shot for Rh Incompatibility Why You May Need It Healthline Retrieved 2022 04 29 Rath L What Is a Coombs Test WebMD Retrieved 2022 04 29 Stang D 2019 01 29 Murrell D ed RPR Test Healthline Retrieved 2022 04 29 Rath L Why Do I Need a Rubella Test WebMD Retrieved 2022 04 29 Mekaroonkamol P Hashemi N 2021 04 03 Staros EB ed Hepatitis B Test Reference Range Interpretation Collection and Panels Medscape Fontenot HB George ER 2014 Sexually transmitted infections in pregnancy Nursing for Women s Health 18 1 67 72 doi 10 1111 1751 486X 12095 PMID 24548498 CDCTB 2020 12 16 Tuberculosis TB Fact Sheets Tuberculin Skin Testing Centers for Disease Control and Prevention Retrieved 2022 04 29 Urinalysis What It Is Purpose Types amp Results Cleveland Clinic Retrieved 2022 04 29 Cereda A Carey JC October 2012 The trisomy 18 syndrome Orphanet Journal of Rare Diseases 7 81 doi 10 1186 1750 1172 7 81 PMC 3520824 PMID 23088440 Malone FD Canick JA Ball RH Nyberg DA Comstock CH Bukowski R et al November 2005 First trimester or second trimester screening or both for Down s syndrome The New England Journal of Medicine 353 19 2001 2011 doi 10 1056 NEJMoa043693 PMID 16282175 Common Tests During Pregnancy www hopkinsmedicine org 2021 08 08 Retrieved 2022 04 29 Carlson LM Vora NL June 2017 Prenatal Diagnosis Screening and Diagnostic Tools Obstetrics and Gynecology Clinics of North America 44 2 245 256 doi 10 1016 j ogc 2017 02 004 PMC 5548328 PMID 28499534 Zhang W Mohammadi T Sou J Anis AH 2019 Cost effectiveness of prenatal screening and diagnostic strategies for Down syndrome A microsimulation modeling analysis PLOS ONE 14 12 e0225281 Bibcode 2019PLoSO 1425281Z doi 10 1371 journal pone 0225281 PMC 6892535 PMID 31800591 a b c Common Tests During Pregnancy www hopkinsmedicine org 2021 08 08 Retrieved 2022 04 28 Quad screen Mayo Clinic www mayoclinic org Retrieved 2022 04 29 Prenatal Ultrasound Procedure Information Cleveland Clinic Retrieved 2022 04 29 Uscher J Anemia in Pregnancy Causes Symptoms and Treatment WebMD Retrieved 2022 04 29 Glucose challenge test Mayo Clinic www mayoclinic org Retrieved 2022 04 29 Glucose tolerance test Mayo Clinic www mayoclinic org Retrieved 2022 04 29 Kansky C Ramus RM 2021 06 15 Pierce Jr JG ed Basic Obstetric Ultrasound Background Indications Contraindications Medscape DeFrancesco V January 2004 Perinatology Clinical Engineering Handbook Academic Press pp 410 416 doi 10 1016 B978 012226570 9 50102 2 ISBN 978 0 12 226570 9 Rice SC 2018 01 09 Wilson DR ed Placental Insufficiency Causes Symptoms and Diagnosis Healthline Retrieved 2022 04 29 Shaw P Duncan A Vouyouka A Ozsvath K January 2011 Radiation exposure and pregnancy Journal of Vascular Surgery Radiation Safety in Vascular Surgery 53 1 Suppl 28S 34S doi 10 1016 j jvs 2010 05 140 PMID 20869193 Alorainy IA Albadr FB Abujamea AH 2006 Attitude towards MRI safety during pregnancy Annals of Saudi Medicine 26 4 306 309 doi 10 5144 0256 4947 2006 306 PMC 6074503 PMID 16885635 Herbst MK Tafti D Shanahan MM 2022 Obstetric Ultrasound StatPearls Treasure Island FL StatPearls Publishing PMID 29261880 Retrieved 2022 04 29 Edvardsson K Small R Persson M Lalos A Mogren I October 2014 Ultrasound is an invaluable third eye but it can t see everything a qualitative study with obstetricians in Australia BMC Pregnancy and Childbirth 14 1 363 doi 10 1186 1471 2393 14 363 PMC 4287579 PMID 25336335 Weissleder R Harisinghani MG Wittenberg J Chen JW eds 2011 Obstetric Imaging Primer of Diagnostic Imagin 5th ed St Louis Mo Mosby pp 533 574 doi 10 1016 B978 0 323 06538 2 00010 X ISBN 978 0 323 06538 2 Khan AN Sabih D Sabih A 2021 04 26 Early Pregnancy Loss Embryonic Demise Imaging Practice Essentials Ultrasonography Marino T 2021 06 14 Ramus RM ed Prenatal Diagnosis for Congenital Malformations and Genetic Disorders Practice Essentials Noninvasive Techniques Invasive Techniques Medscape Chorionic villus sampling Mayo Clinic www mayoclinic org Retrieved 2022 04 29 Gomella TL Cunningham MD Eyal FG Tuttle DJ 2013 Fetal Assessment Neonatology Management Procedures On Call Problems Diseases and Drugs 7 ed New York NY McGraw Hill Education Retrieved 2022 04 29 Jobe AH January 1984 Fetal lung maturation and the respiratory distress syndrome Fetal Physiology and Medicine Second ed Butterworth Heinemann pp 317 351 doi 10 1016 B978 0 407 00366 8 50016 2 ISBN 978 0 407 00366 8 Nonstress test Mayo Clinic www mayoclinic org Retrieved 2022 04 29 Dunkin MA High Risk Pregnancies Symptoms Doctors Support and More WebMD Retrieved 2022 04 29 Moore T 2022 04 06 Griffing GT ed Diabetes Mellitus and Pregnancy Practice Essentials Gestational Diabetes Maternal Fetal Metabolism in Normal Pregnancy Medscape Watson S 2017 10 12 Gill K ed Macrosomia Symptoms Causes and Complications Healthline Retrieved 2022 04 29 Khurana R Wolf RE 2021 10 16 Talavera F Singh AK eds Systemic Lupus Erythematosus and Pregnancy Practice Essentials Pathophysiology Epidemiology Medscape Friel LA Thyroid Disorders in Pregnancy Gynecology and Obstetrics MSD Manual Professional Edition Retrieved 2022 04 29 Alemu A Terefe B Abebe M Biadgo B November 2016 Thyroid hormone dysfunction during pregnancy A review International Journal of Reproductive Biomedicine 14 11 677 686 PMC 5153572 PMID 27981252 Nichols KM Henkin S Creager MA November 2020 Venous Thromboembolism Associated With Pregnancy JACC Focus Seminar Journal of the American College of Cardiology 76 18 2128 2141 doi 10 1016 j jacc 2020 06 090 PMID 33121721 S2CID 226205234 a b Page 264 in Gresele P 2008 Platelets in haematologic and cardiovascular disorders a clinical handbook Cambridge UK Cambridge University Press ISBN 978 0 521 88115 9 Hyperemesis Gravidarum Symptoms amp Treatment Cleveland Clinic Retrieved 2022 04 30 Morning sickness Symptoms and causes Mayo Clinic Retrieved 2022 04 30 Wint C 2018 07 17 Wilson DR ed Hyperemesis Gravidarum Causes Symptoms and Diagnosis Healthline Retrieved 2022 04 28 Gaither K 13 December 2019 Preeclampsia WebMD Retrieved 2022 04 29 Preeclampsia Symptoms and causes Mayo Clinic Retrieved 2022 04 29 4 Common Pregnancy Complications www hopkinsmedicine org 2021 08 08 Retrieved 2022 04 28 Healthdirect Australia 2022 02 08 Induced labour www pregnancybirthbaby org au Retrieved 2022 04 29 Suranyim A 2000 Prenatal and postnatal evaluation of foetal renal hyperechogenicity in pregnancies complicated with pre eclampsia and intrauterine growth retardation Ph D thesis University of Szeged doi 10 14232 phd 2154 Moldenhauer JS Prelabor Rupture of the Membranes PROM Women s Health Issues MSD Manual Consumer Version Retrieved 2022 04 30 Prostin E2 Vaginal Uses Side Effects Interactions Pictures Warnings amp Dosing WebMD www webmd com Retrieved 2022 04 30 Ho PC Ngai SW Liu KL Wong GC Lee SW November 1997 Vaginal misoprostol compared with oral misoprostol in termination of second trimester pregnancy Obstetrics and Gynecology 90 5 735 738 doi 10 1016 S0029 7844 97 00419 5 PMID 9351755 S2CID 21261210 Adeniji OA Oladokun A Olayemi O Adeniji OI Odukogbe AA Ogunbode O et al February 2005 Pre induction cervical ripening transcervical foley catheter versus intravaginal misoprostol Journal of Obstetrics and Gynaecology 25 2 134 139 doi 10 1080 01443610500040737 PMID 15814391 S2CID 24250115 Premature rupture of membranes MedlinePlus Medical Encyclopedia Bethesda MD U S National Library of Medicine Retrieved 2022 04 30 Oxytocin 10 IU ml Solution for infusion Summary of Product Characteristics SmPC emc www medicines org uk Retrieved 2022 04 30 Prior T Lees C 2019 Control and Monitoring of Fetal Growth Encyclopedia of Endocrine Diseases Vol 5 pp 1 9 doi 10 1016 B978 0 12 801238 3 65414 4 ISBN 9780128122006 S2CID 81797258 Lloyd Thomas AR January 1990 Pain management in paediatric patients British Journal of Anaesthesia 64 1 85 104 doi 10 1093 bja 64 1 85 PMID 2405898 Saint Louis H 2022 04 14 Cesarean Delivery Overview Preparation Technique Medscape Ectopic pregnancy Symptoms and causes Mayo Clinic Retrieved 2022 04 30 Lim KH Steinberg G 2022 04 13 Preeclampsia Practice Essentials Overview Pathophysiology Medscape Artal Mittelmark R Stages of Development of the Fetus Women s Health Issues MSD Manual Consumer Version Retrieved 2022 04 30 Hypertension Causes symptoms and treatments www medicalnewstoday com 2021 11 10 Retrieved 2022 04 30 Seppa N 2011 01 20 Body amp brain Uncontrolled epilepsy can be fatal Study finds more deaths in adults whose seizures persist Science News 179 3 8 doi 10 1002 scin 5591790305 ISSN 0036 8423 Haram K Svendsen E Abildgaard U February 2009 The HELLP syndrome clinical issues and management A Review BMC Pregnancy and Childbirth 9 1 8 doi 10 1186 1471 2393 9 8 PMC 2654858 PMID 19245695 Preeclampsia Symptoms Causes Treatments amp Prevention Cleveland Clinic Retrieved 2022 04 30 Placental Abruption Symptoms Causes amp Effects On Baby Cleveland Clinic Retrieved 2022 04 30 Moldenhauer JS Fetal Distress Women s Health Issues MSD Manual Consumer Version Retrieved 2022 04 30 Shoulder Dystocia Signs Causes Prevention amp Complications Cleveland Clinic Retrieved 2022 04 30 Astatikie G Limenih MA Kebede M April 2017 Maternal and fetal outcomes of uterine rupture and factors associated with maternal death secondary to uterine rupture BMC Pregnancy and Childbirth 17 1 117 doi 10 1186 s12884 017 1302 z PMC 5389173 PMID 28403833 Sims ME 2014 01 01 Legal Briefs Iatrogenesis Prolapsed Umbilical Cord After Artificial Rupture of the Membranes and Unskilled Stabilization NeoReviews 15 1 e32 e36 doi 10 1542 neo 15 1 e32 ISSN 1526 9906 Umbilical Cord Prolapse Causes Diagnosis amp Management Cleveland Clinic Retrieved 2022 04 30 Smith JR 2022 04 01 Postpartum Hemorrhage Practice Essentials Problem Epidemiology Medscape Demisse GA Sifer SD Kedir B Fekene DB Bulto GA March 2019 Determinants of puerperal sepsis among post partum women at public hospitals in west SHOA zone Oromia regional STATE Ethiopia institution BASEDCASE control study BMC Pregnancy and Childbirth 19 1 95 doi 10 1186 s12884 019 2230 x PMC 6423770 PMID 30885159 WHO Technical Consultation on Postpartum Care World Health Organization 2010 Retrieved 30 June 2020 Jones E Taylor B MacArthur C Pritchett R Cummins C February 2016 The effect of early postnatal discharge from hospital for women and infants a systematic review protocol Systematic Reviews 5 24 doi 10 1186 s13643 016 0193 9 PMC 4746909 PMID 26857705 Types of Delivery for Pregnancy Cleveland Clinic Retrieved 2022 04 30 Kotlar B Gerson E Petrillo S Langer A Tiemeier H January 2021 The impact of the COVID 19 pandemic on maternal and perinatal health a scoping review Reproductive Health 18 1 10 doi 10 1186 s12978 021 01070 6 PMC 7812564 PMID 33461593 a b c Gelis J 1991 History of Childbirth Boston Northeastern University Press Healthdirect Australia 2021 05 23 What do midwives do www pregnancybirthbaby org au Retrieved 2022 04 30 a b Adatara P Amooba PA Afaya A Salia SM Avane MA Kuug A et al April 2021 Challenges experienced by midwives working in rural communities in the Upper East Region of Ghana a qualitative study BMC Pregnancy and Childbirth 21 1 287 doi 10 1186 s12884 021 03762 0 PMC 8033657 PMID 33836689 a b c d Bynum WF Porter R eds 1993 Companion Encyclopedia of the History of Medicine London and New York Routledge Carr I May 2000 Some Obstetrical History Dying to Have a Baby the History of Childbirth PDF University of Manitoba Women s Health Retrieved 20 May 2012 a b c d e f McGrew RE 1985 Encyclopedia of Medical History New York McGraw Hill Book Company a b Hufnagel GL 2012 A History of Women s Menstruation from Ancient Greece to the Twenty first Century Psychological Social Medical Religious and Educational Issues Lewiston New York Edwin Mellen Press International Confederation of Midwives 2022 01 31 The Origins of Midwifery ICM Retrieved 2022 04 30 Gasner A Aatsha PA 2022 Physiology Uterus StatPearls Treasure Island FL StatPearls Publishing PMID 32491507 Retrieved 2022 04 30 Rhodes P 2004 09 23 Leake John 1729 1792 man midwife Oxford Dictionary of National Biography Oxford Dictionary of National Biography online ed Oxford University Press doi 10 1093 ref odnb 16239 ISBN 978 0 19 861412 8 Subscription or UK public library membership required a b Aziato L Omenyo CN March 2018 Initiation of traditional birth attendants and their traditional and spiritual practices during pregnancy and childbirth in Ghana BMC Pregnancy and Childbirth 18 1 64 doi 10 1186 s12884 018 1691 7 PMC 5842514 PMID 29514607 Al Gailani S 2018 Hospital Birth In Kassell L Hopwood N Flemming R eds Reproduction Reproduction Antiquity to the Present Day Cambridge Cambridge University Press pp 553 566 doi 10 1017 9781107705647 046 ISBN 978 1 107 06802 5 S2CID 239583227 Retrieved 2022 04 30 Sialubanje C Massar K Hamer DH Ruiter RA September 2015 Reasons for home delivery and use of traditional birth attendants in rural Zambia a qualitative study BMC Pregnancy and Childbirth 15 1 216 doi 10 1186 s12884 015 0652 7 PMC 4567794 PMID 26361976 Martell LK 2000 The hospital and the postpartum experience a historical analysis Journal of Obstetric Gynecologic and Neonatal Nursing 29 1 65 72 doi 10 1111 j 1552 6909 2000 tb02757 x PMID 10660278 Aborigo RA Reidpath DD Oduro AR Allotey P January 2018 Male involvement in maternal health perspectives of opinion leaders BMC Pregnancy and Childbirth 18 1 3 doi 10 1186 s12884 017 1641 9 PMC 5749010 PMID 29291711 The Midwives Registration Bill The Lancet Originally published as Volume 2 Issue 3602 140 3602 631 634 1892 09 10 doi 10 1016 S0140 6736 01 86961 0 ISSN 0140 6736 Midwives voices midwives realities Findings from a global consultation on providing quality midwifery care PDF Switzerland World Health Organization 1991 ISBN 978 9241510547 a b Drife J May 2002 The start of life a history of obstetrics Postgraduate Medical Journal 78 919 311 315 doi 10 1136 pmj 78 919 311 PMC 1742346 PMID 12151591 Rabinerson D Horowitz E May 2007 The evolution of midwifery Harefuah 146 5 380 4 405 PMID 17674557 Low J 2009 Caesarean section past and present PDF Journal of Obstetrics and Gynecology Canada 31 12 1131 1136 doi 10 1016 S1701 2163 16 34373 0 PMID 20085678 Archived from the original PDF on January 23 2013 Retrieved May 20 2012 Caplan CE 1995 The Childbed Fever Mystery and the Meaning of Medical Journalism McGill Journal of Medicine 1 1 Archived from the original on 2012 07 07 Roth J Pregnancy amp Birth The History of Childbearing Choices in the United States Human Service Solutions Baskett TF 29 March 2019 Houstoun Robert 1678 1734 Eponyms and Names in Obstetrics and Gynaecology Cambridge University Press p 194 doi 10 1017 9781108421706 154 ISBN 978 1 108 33671 0 Lavers A Yip WS Sunderland B Parsons R Mackenzie S Seet J Czarniak P 2018 Surgical antibiotic prophylaxis use and infection prevalence in non cosmetic breast surgery procedures at a tertiary hospital in Western Australia a retrospective study PeerJ 6 e5724 doi 10 7717 peerj 5724 PMC 6202972 PMID 30386692 Table 2 Types of procedures and association with surgical site infections SSI P values were obtained from Fisher s Exact test unless otherwise specified Vernon LF August 2019 J Marion Sims MD Why He and His Accomplishments Need to Continue to be Recognized a Commentary and Historical Review Journal of the National Medical Association 111 4 436 446 doi 10 1016 j jnma 2019 02 002 PMID 30851980 S2CID 73725863 Rutkow IM August 1999 Ephraim McDowell and the world s first successful ovariotomy Archives of Surgery 134 8 902 doi 10 1001 archsurg 134 8 902 PMID 10443816 Iceman Otzi may have had tummy trouble when he died New Scientist 229 3056 17 January 2016 Bibcode 2016NewSc 229 17 doi 10 1016 s0262 4079 16 30115 4 ISSN 0262 4079 Sieber WK September 1970 Total prosthetic transplantation of the inferior vena cava with venous drainage restoration of the one remaining kidney on the graft successfully performed on a child with Wilms tumor Journal of Pediatric Surgery 5 6 694 695 doi 10 1016 s0022 3468 70 80085 9 ISSN 0022 3468 a b Dr J Marion Sims The Father of Modern Gynecology International Wellness Foundation 12 February 2014 Giuliano P May 2018 Gender A Historical Perspective In Averett SL Argys LM Hoffman SD eds The Oxford Handbook of Women and the Economy Oxford University Press doi 10 1093 oxfordhb 9780190628963 013 29 O Malley Keighran MP Lohan G December 2016 Encourages and guides or diagnoses and monitors Woman centred ness in the discourse of professional midwifery bodies Midwifery 43 48 58 doi 10 1016 j midw 2016 10 007 PMID 27846406 Situation of women and children in Nigeria www unicef org Retrieved 2022 04 30 Backlund I 2006 Modifiers describing women and men in nineteenth century English In Kyto M Ryden M Smitterberg E eds Nineteenth Century English Cambridge Cambridge University Press pp 17 55 doi 10 1017 cbo9780511486944 002 ISBN 9780511486944 Adaikan G January 2020 Female sexual dysfunction In Arulkumaran S Ledger W Denny L Doumouchtsis S eds Oxford Textbook of Obstetrics and Gynaecology Oxford University Press pp 743 752 doi 10 1093 med 9780198766360 003 0060 ISBN 978 0 19 876636 0 Uterine Prolapse Causes Symptoms Diagnosis amp Treatment Cleveland Clinic Retrieved 2022 04 30 Retrieved from https en wikipedia org w index php title Obstetrics amp oldid 1126180115, wikipedia, wiki, book, books, library,

article

, read, download, free, free download, mp3, video, mp4, 3gp, jpg, jpeg, gif, png, picture, music, song, movie, book, game, games.