Obstetrics

Obstetrics (from the Latin obstare, "to stand by") is the surgical specialty dealing with the care of a woman and her offspring during pregnancy, childbirth and the puerperium (the period shortly after birth). Almost all modern obstetricians are also gynaecologists; see Obstetrics and gynaecology.

Complications

See Complications of Pregnancy

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Fetal assessments

;Common:

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• ultrasound is used for many functions:
• Dating the gestational age of a pregnancy, most accurate in first trimester
• Detecting fetal anomalies in the second trimester
• biophysical profiles (BPP)
• Blood flow velocity in umbilical cord -- decrease/absence/reversal or diastolic blood flow in the umbilical artery is worrisome.
• Congenital anomalies can be diagnosed with second trimester ultrasound
• Fetal karyotype for the screening of genetic diseases can be obtained via amniocentesis or chorionic villus sampling (CVS)

;Uncommon:

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• Fetal hematocrit for the assessment of fetal 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.
• 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 neonatal respiratory distress syndrome (NRDS). Typically a lecithin:sphingomyelin ratio greater than 1.5 is associated with increased lung maturity.
• Nonstress test (NST) for fetal heart rate
• Oxytocin challenge test