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.

Induction

An obstetrician may recommend a woman have her labour induced if it is felt that continuation would be more dangerous to her, the foetus, or both. Reasons to induce include:

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• pre-eclampsia
• IUGR
• diabetes
• other general medical condition, such as renal disease

Induction can occur any time after 24 weeks of gestation if the risk to the fetus or mother is greater than the risk of delivering a premature fetus regardless of lung maturity. Prior to 32 weeks gestation steroids are given to the mother to help mature the fetus's lungs.

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If a woman does not eventually labour by 41-42 weeks, induction is performed, as the placenta becomes unstable after this date.

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Induction is achieved by 3 methods:

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• pessary of Prostin cream, prostaglandin E₂
• surgical induction, by piercing the amnion
• infusion of oxytocin