All about pregnancy signs and symptoms of pregnancy pregnancy tests home pregnancy test pregnancy stages first trimester of pregnancy second trimester of pregnancy third trimester of pregnancy calculating pregnancy due date prenatal diagnosis healthy pregnancy diet nutrition during pregnancy exercise during pregnancy spotting during pregnancy bleeding during pregnancy smoking during pregnancy sex during pregnancy prenatal care teenage pregnancy twins and multiple births childbirth obstetrics pregnancy ultrasound Chinese lunar pregnancy calendar (Chinese gender chart) fertility charting ovulation: calendar, prediction, test getting pregnant gender selection prenatal tests genetic screening genetic counseling birth control (contraception, pregnancy prevention) male condoms female condoms diaphragm cervical cap birth control pills Norplant Depo Provera spermicides emergency contraceptive pill (morning-after pill) natural family planning intrauterine device (IUD) birth control patch sterilization (vasectomy) fertility awareness method (FAM) abstinence pre-eclampsia, eclampsia HELLP syndrome intrauterine growth restriction (IUGR) premature birth stillbirth Caesarean section preterm labor Rh incompatibility (erythroblastosis fetalis) ectopic pregnancy pregnancy diabetes (gestational diabetes) group B strep morning sickness (NVP) hyperemesis gravidarum miscarriage (spontaneous abortion) postpartum hemorrhage pregnancy-induced hypertension Pica
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ObstetricsCObstetrics 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). Obstetricians work to ensure that pregnancy culminates in the delivery of a healthy baby, without impairing the health of the mother. The mother's medical history and health status are initially evaluated. Physical examination discloses the mother's uterine size and estimates the length of her pregnancy. If the obstetrician detects abnormalities, prenatal testing may need to be done on the fetus.
An important modern development has been ultrasonography, which allows the obstetrician to non-invasively diagnose intra-uterine conditions. Delivery of the baby is helped by the use of a Friedman's chart, which shows the patterns of cervical dilation. The care of women during childbirth was originally in the hands of women, but in the 16th cent. physicians grew interested in the field. Of special importance were the invention of the delivery forceps by Peter Chamberlen in the 17th cent. and the introduction of anesthesia in the 19th cent. The adoption of antiseptic methods according to the theories of Joseph Lister and Ignaz Semmelweis reduced the incidence of infection in childbirth and made possible successful cesarean section. Obstetrics is often combined with gynecology as a medical specialty.
Antenatal careIn 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 foetus 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 foetus is too small for its gestational age. Causes can be intrinsic (in the foetus) or extrinsic (usually placental problems). IUGR refers to fetal growth that is less than 10% of what is expected at that gestational age.
InductionAn 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:
- 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. If a woman does not eventually labour by 41-42 weeks, induction is performed, as the placenta becomes unstable after this date. Induction is achieved by 3 methods: pessary of Prostin cream, prostaglandin E2; surgical induction, by piercing the amnion; infusion of oxytocin.
LabourDuring labour itself, the obstetrician may be called on to do a number of things:
- monitor the progress of labour, by reviewing the nursing chart, performing vaginal examination, and assessing the trace produced by a foetal monitoring device (the cardiotocograph)
- accelerate the progress of labour by infusion of the hormone oxytocin
- provide pain relief, either by nitrous oxide (nowadays uncommon), opiates, or by epidural anesthesia done by anaethestists)
- surgically assisting labour, by forceps or the Ventouse (a suction cap applied to the foetus' head)
- Caesarean section, if vaginal delivery is decided against or appears too difficult. Caesarean section can either be elective, that is, arranged before labour, or decided during labour as an alternative to hours of waiting. True "emergency" Cesarean sections (where minutes count) are a rarity.
- In the US, obstetric routine often includes a medically unncecessary circumcision of nonconsenting newborn with no diagnosis of pathology despite this being out of their field of expertise, in exchange for a fee, without anaesthesia. This procedure removes the healthy normal functional erogenous foreskin of the male (obstetricians are not qualified to operate on males). This this is not medically necessary, it is not surgery but cutting, and since it mutilates a normal penis it is a mutilation, and inflicts horrendous torturous pain therefore circumcision is technically mutilative torturous cutting, not therapeutic surgery.
Emergencies in obstetricsTwo main emergencies are eclampsia and ectopic pregnancy. Ectopic pregnancy is when an embryo implants in the Fallopian tube or (rarely) on the ovary or inside the peritoneal cavity. Tubal pregnancies are very dangerous, as at about 4-10 weeks the tube bursts, causing massive internal bleeding. Ectopic pregnancy must be considered in any woman with abdominal pain who has the slightest chance of being pregnant. Diagnosis is by a positive pregnancy test and a uterus empty on ultrasound. Treatment is by laparoscopy, and the tube is incised and excavated. 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. The only treatment for eclampsia, or advancing pre-eclampsia is delivery, either by induction or Caesarean section. Women can be stabilised temporarily with magnesium sulphate. Delivery as early as 28 weeks is not unknown.
More information on pregnancyPregnancy - Pregnancy is period of time between fertilization of the ovum (conception) and birth, during which mammals carry their developing young in the uterus (see embryo).
Pregnancy signs and symptoms - During pregnancy a woman's body undergoes a number of changes to allow the fetus to develop inside the womb. The symptoms of pregnancy vary from woman to woman.
Pregnancy tests - A pregnancy test is a test of blood or urine used to determine whether a woman is pregnant. There are two types of pregnancy tests - blood and urine tests.
Home pregnancy test - A home pregnancy test measures the presence of the hormone human chorionic gonadotropin (hCG) in your urine. All home pregnancy test kits test your pregnancy on the basis of your urine sample.
Pregnancy stages - There are three stages of pregnancy called trimesters. Each trimester is three months. The word "trimester" comes from a Latin word meaning "three months long."
First trimester of pregnancy - First trimester pregnancy is the early stage of pregnancy from conception to 12 weeks gestation, or about 14 weeks from the first day of the last normal menstrual period (LNMP).
Second trimester of pregnancy - In the second trimester the embryo, now known as a fetus, is recognisable as human in form, but is not developed enough to be viable if born. The second trimester is often called the planning trimester.
Third trimester of pregnancy - The third trimester of pregnancy lasts from 28 weeks after your last menstrual period (LMP) until the birth, which usually occurs between the 38th and 42nd weeks of pregnancy.
Calculating pregnancy due date - The due date is usually computed from the first day of the last regular period. In the calendar, this can be figured by taking that date, subtracting three months, and adding seven days.
Prenatal diagnosis - Prenatal diagnosis is the process of detecting and diagnosing fetal abnormalities before birth. A targeted prenatal diagnosis is done when there is a concrete suspicion that there might be a particular disorder.
Healthy pregnancy diet - A balanced diet is key to having a healthy pregnancy. Pregnancy places substantial demands on the availability of iron in the body.
Nutrition during pregnancy - Nutrition is an essential component of prenatal care. During pregnancy, your body needs more nutrients in order to provide a baby with what it needs. Eat enough food to gain weight at the rate recommended by your health care provider.
Exercise during pregnancy - Exercise plays an important role in promoting health and well-being for pregnant women. Excessive levels of physical activity in pregnancy can reduce fetal growth and increase the risk of preterm delivery.
Spotting during pregnancy - Spotting is light bleeding similar to your period and it can happen at any time during pregnancy, but it is most common during the first trimester.
Bleeding during pregnancy - Bleeding from the vagina in early pregnancy is very common. First trimester bleeding is any vaginal bleeding during the first 3 months of pregnancy.
Smoking during pregnancy - Cigarette smoking during pregnancy can cause serious health problems to an unborn child. Many complications of pregnancy are more likely to occur in smokers.
Sex during pregnancy - Sex and sexual intercourse are not harmful during pregnancy. For most women and their partners, sex during pregnancy is fine as long as both partners consent and are comfortable.
Prenatal care - Prenatal care is the health care that a woman receives before her baby is born. Prenatal care is provided for women during the period between conception and birth of the baby.
Teenage pregnancy - Teenage pregnancy is a pregnancy that occurs in an adolescent. Babies born to teenagers are at risk for neglect and abuse.
Twins and multiple birth - Multiple pregnancies are on the rise in recent years with more and more twins and other types of multiples being born. A multiple birth is when more than one human baby results from a single pregnancy.
Childbirth - Childbirth (also called labour, birth, or parturition) is the culmination of pregnancy, the emergence of a child from its mother's uterus.
Obstetrics - Obstetrics 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).
Pregnancy ultrasound - Pregnancy ultrasound is a method of imaging the fetus and the female pelvic organs during pregnancy.
Chinese lunar pregnancy calendar - The Chinese pregnancy calendar was allegedly discovered about 700 years ago. The accuracy of the chart has been proved by thousands of people and is believed to be 99 percent accurate.
Fertility charting - Fertility charting allows you to predict ovulation, pinpoint your most fertile time in your cycle, and increase your chances of becoming pregnant.
Ovulation: calendar, prediction, test - Ovulation is the process of discharging a mature ovum (egg) from an ovary after a Graafian follicle - representing the final stage of follicular development before ovulation - has been formed.
Getting pregnant - The best or most fertile time to get pregnant is the period of ovulation in your menstrual cycle. Most women ovulate (release an egg from the ovary) about two weeks before their period.
Gender selection - There are three main techniques of sex selection: pre-natal testing and termination of pregnancy, pre-implantation genetic testing of embryos, and sperm sorting.
Prenatal tests - Prenatal tests are one of the many ways your practitioner can check on the well-being of your growing baby and find out whether you're at risk for complications.
Genetic screening - Genetic screening is a process used to find out what diseases or birth defects a child might inherit from his or her parents.
Genetic counseling - Genetic counseling is the process of determining the risk you have of passing on an inheritable disease to your baby.
Birth control (contraception, pregnancy prevention) - Birth control is the practice of preventing or reducing the probability of pregnancy without abstaining from sexual intercourse; the term is also sometimes used to include abortion.
Male condoms - Condoms are thin barriers made of latex, plastic, or natural membranes. The male condom fits over a man's penis. The female condom fits inside a woman's vagina.
Female condoms - The female condom is a polyurethane sheath or pouch about 17 cm (6.5 inches) in length. It is worn by a woman during sex.
Diaphragm - A diaphragm is a rubber disc a woman places into her vagina. The diaphragm blocks a man's semen from entering the cervix (the opening to the womb).
Cervical cap - The cervical cap is a small latex cup that a woman inserts into her vagina before sexual intercourse. The cervical cap fits snugly over the woman's cervix.
Birth control pills - The birth control pill is a small, usually white, tablet that is taken orally (by mouth). The pill usually comes in a packet that has days marked off for a cycle lasting about a month.
Norplant - Contraceptive implants (Norplant?) are six match stick size implants inserted into the upper arm. Norplant is a form of progestin that is placed under the skin.
Depo Provera - Depo Provera is a hormone, much like the progesterone a woman produces during the last two weeks of each monthly cycle. Depo-Provera or progesterone stops the woman's ovaries from releasing an egg.
Spermicides - Spermicides are chemicals that make the sperm unable to function. Spermicide can be used alone or with other birth control methods to reduce the risk of pregnancy.
Emergency contraceptive pill - Emergency contraception is the use of certain methods after unprotected intercourse to prevent pregnancy.
Natural family planning - Natural family planning is defined as the understanding and use of the natural phases of fertility and infertility by a couple in order to either achieve or avoid pregnancy.
Intrauterine device (IUD) - An intrauterine device (intra meaning within, and uterine meaning of the uterus), is a birth control device also known as an IUD or a coil.
Birth control patch - The birth control patch is a thin plastic patch (1 3/4 inch square) placed directly on the skin of the woman. It is a hormonal method of contraception obtained by prescription.
Sterilization (vasectomy) - Sterilization is a surgical technique leaving a male or female unable to procreate. It is a method of birth control.
Fertility awareness method (FAM) - Fertility awareness is a means of understanding a woman's reproductive cycle by observing and writing down fertility signs.
Abstinence - Periodic abstinence is a way that sexually active women prevent pregnancy by becoming familiar with their fertility patterns and abstaining from vaginal intercourse on the days they think they could become pregnant.
Pre-eclampsia, eclampsia - Pre-eclampsia is a condition which only occurs during pregnancy. It causes high blood pressure, protein leaks from the kidneys, and other symptoms may develop.
HELLP Syndrome - The HELLP syndrome is a complication of pregnancy featuring a combination of abnormal conditions including emolysis, elevated liver enzymes, and low platelet count.
Intrauterine growth restriction - Intrauterine growth restriction (IUGR) refers to the condition in which a foetus is unable to grow to its genetically determined potential size to a degree that may affect the health of the foetus.
Premature birth - Premature birth is defined medically as a birth occurring earlier than 37 weeks. Infants born prematurely have an increased risk of death in the first year of life.
Stillbirth - Stillbirth refers to the death of a baby after 24 weeks of pregnancy but before birth. A pregnancy that ends before the twentieth week is called a miscarriage rather than a stillbirth.
Caesarean section - A Caesarean section (Cesarean section AE), is a surgical procedure to deliver one or more babies through an incision in the mother's abdomen and uterus.
Preterm labor - Preterm labor, or premature labor, is when the uterus (womb) contracts and the cervix opens earlier than normal.
Rh incompatibility - Rh incompatibility is a condition that occurs when the mother of a fetus or newborn has Rh-negative blood type and the fetus or newborn has Rh-positive blood.
Ectopic pregnancy - An ectopic pregnancy is one in which the fertilized ovum is implanted in any tissue other than the uterine wall.
Pregnancy diabetes (gestational diabetes) - Gestational diabetes is a condition in which the glucose level is elevated and other diabetic symptoms appear during pregnancy in a woman who has not previously been diagnosed with diabetes.
Group B strep - Group B streptococcus (group B strep) is a type of bacteria that causes infection among newborns, pregnant women or women after childbirth.
Morning sickness (NVP) - Morning sickness, also called nausea and vomiting of pregnancy (NVP), affects between 50 and 85 percent of all pregnant women.
Hyperemesis gravidarum - Hyperemesis gravidarum means excessive vomiting during pregnancy. The severe vomiting associated with hyperemesis gravidarum requires medical attention.
Miscarriage (spontaneous abortion) - Miscarriage is the term used for a pregnancy that ends on it's own, within the first 20 weeks of gestation.
Postpartum hemorrhage - Postpartum bleeding (severe postpartum bleeding) is the loss of more than a pint of blood within the first 24 hours after delivering a baby.
Pregnancy-induced hypertension - Pregnancy-induced hypertension (also referred to as toxemia, preeclampsia and eclampsia) is a condition that may develop during the second half of a woman's pregnancy.
Pica - Pica is a pattern of eating non-nutritive substances (such as dirt or paper), lasting for at least one month.