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.

Imaging, monitoring and care

In present society, medical science has developed a number of procedures to monitor pregnancy.

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Antenatal record

On the first visit to her gynecologist or midwife, the pregnant woman is asked to carry out the antenatal record, which constitutes a medical history and physical examination.

Related Topics:
Gynecologist - Midwife - Antenatal record - Medical history - Physical examination

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On subsequent visits, the gestational age (GA) is rechecked with each visit.

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Symphysis-fundal height (SFH; in cm) should equal gestational age after 20 weeks of gestation, and the fetal growth should be plotted on a curve during the antenatal visits.

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The fetus is palpated by the midwife or obstetrician using Leopold maneuver to determine the position of the baby.

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Blood pressure should also be monitored, and may be up to 140/90 in normal pregnancies. High blood pressure indicates hypertension and possibly pre-eclampsia, if severe swelling (edema) and spilled protein in the urine are also present.

Related Topics:
Blood pressure - Hypertension - Pre-eclampsia - Edema

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Fetal screening is also used to help assess the viability of the fetus, as well as congenital problems. Genetic counseling is often offered for families who may be at an increased risk to have a child with a genetic condition.

Related Topics:
Fetal screening - Genetic counseling

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Amniocentesis at around the 20th week is usually done for women 35 or older to check for Down's Syndrome and other chromosome abnormalities in the fetus.

Related Topics:
Amniocentesis - Down's Syndrome - Chromosome

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Even earlier than amniocentesis is performed, the mother may undergo the triple test, nuchal screening, nasal bone, alpha-fetoprotein screening and Chorionic villus sampling, also to check for disorders such as Down Syndrome. Amniocentesis is a prenatal genetic screening of the fetus, which involves inserting a needle through the mother's abdominal wall and uterine wall, to extract fetal DNA from the amniotic fluid. There is a risk of miscarriage and fetal injury with amniocentesis since it involves penetrating the uterus with the baby still in utero.

Related Topics:
Triple test - Nuchal screening - Nasal bone - Alpha-fetoprotein - Chorionic villus sampling

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Imaging

Imaging is another important way to monitor a pregnancy. The mother and fetus are also usually imaged in the first trimester of pregnancy. This is done to predict problems with the mother; confirm that a pregnancy is present inside the uterus; guess the gestational age; determine the number of fetuses and placentae; evaluate for an ectopic pregnancy and first trimester bleeding; and assess for early signs of anomalies.

Related Topics:
Fetus - Uterus - Gestational age - Placenta - Ectopic pregnancy

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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 fetus. Instead, ultrasound is the imaging method of choice in the first trimester and throughout the pregnancy, since it emits no radiation, is portable, and allows for realtime imaging.

Related Topics:
X-ray - Computerized tomography - Ionizing radiation - Teratogen - Ultrasound - Radiation

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Ultrasound imaging may be done at any time throughout the pregnancy, but usually happens at the 12th week (dating scan) and the 20th week (detailed scan).

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A normal gestation would reveal a gestational sac, yolk sac, and fetal pole.

Related Topics:
Gestational sac - Yolk sac - Fetal pole

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The gestational age can be assessed by evaluating the mean gestation sac diameter (MGD) before week 6, and the crown-rump length after week 6.

Related Topics:
Gestational age - Mean gestation sac diameter

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Multiple gestation is evaluated by the number of placentae and amniotic sacs present.

Related Topics:
Multiple gestation - Placenta - Amniotic sac

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Pregnancy has different cultural aspects related to the perception of the body, the relationship with partner and to the meaning of the event.

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