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.
In obstetric practice, the obstetrician will see a pregnant woman on a regular basis as her pregnancy progresses. The exact schedule varies depending on resources and risk factors, such as diabetes.
The main rationale for these visits is surveillance for diseases of pregnancy which are detectable. Some examples are:
- pre-eclampsia. The blood-pressure and urine of a pregnant woman is checked at every opportunity to check for this.
- placenta praevia. On ultrasound, the placenta is visible obstructing the birth canal
- abnormal presentation (late pregnancy only). The fetus may be feet-first (breech), side-on (transverse), or at an angle (oblique presentation)
- IUGR (Intrauterine Growth Restriction), this is a general designation, where the fetus is too small for its gestational age. Causes can be intrinsic (in the fetus) or extrinsic (usually placental problems). IUGR refers to fetal growth that is less than 10% of what is expected at that gestational age.
Emergencies in obstetrics
Two main emergencies are ectopic pregnancy and (pre)eclampsia.
- Ectopic pregnancy is when an embryo implants in the Fallopian tube or (rarely) on the ovary or inside the peritoneal cavity. This may cause massive internal bleeding.
- Pre-eclampsia is a disease caused by mysterious toxins secreted by the placenta. These toxins act on the vascular endothelium, causing hypertension and proteinuria. If severe, it progresses to fulminant pre-eclampsia, with headaches and visual disturbances. This is a prelude to eclampsia, where a convulsion occurs, which is often fatal.
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