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.

Prenatal Care

Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests:

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First trimester

• complete blood count (CBC)
• blood type and general antibody screen (for transfusion purposes)
• Rh- patients should receive RhoGam at 28 weeks.
• Rapid plasma reagent (RPR) which screens for syphilis
• Rubella antibody screen
• Hepatitis B surface antigen
• Gonorrhea and Chlamydia culture
• PPD for tuberculosis
• Pap smear
• Urinalysis and culture
• HIV screen (voluntary)
• Group B Streptococcus screen -- will receive IV penicillin if positive (if mother is allergic, she will be taken to be desensitized and continue to receive standard doses of IV penicillin)

Second trimester

• MSAFP/triple screen (maternal serum alpha-fetoprotein) - elevation correlated with neural tube defects and decrease correlated with Down's syndrome
• ultrasound
• amniocentesis in older patients

Third trimester

• hematocrit (if low, mother will receive iron supplementation)
• glucose loading test (GLT) - screens for gestational diabetes; if > 140 mg/dL, a glucose tolerance test (GTT) is administered; if fasting glucose > 105 mg/dL, gestational diabetes is suggestive.