Obstetrics (from the Latin obstare, "to stand by") is the surgical speciality dealing with the care of a woman and infants during pregnancy, childbirth and the puerperium (the period shortly after birth). Midwifery is the non-medical equivalent. Most obstetricians are also gynaecologists.
Gynecology or gynaecology refers to the surgical specialty dealing with health of the female reproductive system (uterus, vagina and ovaries). Literally, outside medicine, it means "the science of women". Almost all modern gynaecologists are also obstetricians; see Obstetrics and gynaecology.
The following are books published by Gryphon Editions in the Classics of Obstetrics and Gynecology Library. Included are books about pregnancy, child birth and midwifery . Each book in this series is bound in full genuine leather.
A Compendium of the Theory and Practice of Midwifery by Samuel Bard - 1990
The Principles of Gynecology by W Blair Bell - 1990
The Etiology, The Concept and the Prophylaxis of Childbed Fever by Ignac Fulop Semmelweis - 1990
Silver Sutures in Surgery; together with Clinical notes on uterine surgery by J Marion Sims - 1990
A Treatise on the Theory and Practice : A Collection of Preternatural Cases and Observations in Midwifery by William Smellie - 3 volumes - 1990
A Treatise on Etherization in Childbirth: Illustrated by Five Hundred and Eighty-one Cases by Walter Channing - 1991
Outlines of Principal Diseases of Females by Fleetwood Churchill - 1991
Labor Among Primitive Peoples by George J Englemann - 1991
The Obliquely Contracted Pelvis Containing also an Appendix of the Most Important Defects of the Female Pelvis by Franz Karl Naegele - 1991
Maternal Mortality In Philadelphia 1931-1933 by Philip F. Williams - 1991
Operative Gynecology by Howard Kelly - 2 volumes - 1992
The Diseases of Women with Child: and in Child-bed by Francois Mauriceau - 1992
The Practice of Contraception: An International Symposium and Survey - Margaret Sanger and Hannah M Stone (editors) - 1992
Emmenologia by John Freind - 1993
The History of Ancient Gynaecology by W. J. Stewart McKay - 1993
A Directory for Midwives: or A Guide for Women in their Conception, Bearing, and Suckling their Children by Nicholas Culpeper - 1994
Clinical Memoirs on the Diseases of Women by Gustave Louis Richard Bernutz and Ernest Goupil - 1994
Medical Essays, 1842-1882 by Oliver Wendell Holmes - 1994
Observations on Obstetric Auscultation: With an Analysis of the Evidences of Pregnancy by Evory Kennedy - 1994
A Treatise on the Art of Midwifery by Elizabeth Nihell - 1994
The Byrth of Mankynde: Otherwise Named the Woman's Booke by Eucharius Rosslin - 1994
An Essay Towards a Complete New System of Midwifery, Theoretical and Practical / The Descriptions, Causes and Methods of Removing, or Relieving the Disorders Peculiar to Pregnant and Lying-in Women by John Burton - 1995
Fecundity, Fertility, Sterility and Allied Topics by J Matthews (James Matthews) Duncan - 1995
Cases in Midwifery by William Giffard - 1995
Eternal Eve by Harvey Graham - 1995
A Treatise on Abdominal Palpations, As Applied to Obstetrics and Version by External Manipulations by A. Pinard - 1995
Contraception Its Theory, History and Practice: A Manual for the Medical and Legal Professions by Marie Carmichael Stopes - 1995
Extra-uterine Pregnancy by John S Parry - 1996
The Compleat Practice of Men and Women Midwives by Paul Portal - 1996
A Treatise on the Management of Pregnant and Lying-in Women, and the Means of Curing, but more Especially of Preventing the Principal Disorders to which they are Liable / Some new Directions Concerning the Delivery of the Child and Placenta in Natural Births by Charles White - 1996
The Expert Midwife: Or an Excellent and most Necessary Treatise on the Generation and Birth of Man by Jakob Ruff - 1997
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Obstetrics areas
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.
Induction
Induction is a method of artificially or prematurely stimulating labour in a woman. Reasons to induce can include pre-eclampsia, the birth mass, diabetes, and other various general medical conditions, such as renal disease. Induction may occur any time after 34 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. If a woman does not eventually labour by 41–42 weeks, induction may be performed, as the placenta may become unstable after this date.
Induction may be achieved via several methods:
Pessary of Prostin cream, prostaglandin E2
Intravaginal or oral administration of misoprostol
Cervical insertion of a 30-mL Foley catheter
Rupturing the amniotic membranes
Intravenous infusion of synthetic oxytocin (Pitocin or Syntocinon)
Labor
During labor itself, the obstetrician/doctor/intern/medical student under supervision may be called on to do a number of tasks. These tasks can include:
Monitor the progress of labor, by reviewing the nursing chart, performing vaginal examination, and assessing the trace produced by a fetal monitoring device (the cardiotocograph)
Accelerate the progress of labor by infusion of the hormone oxytocin
Provide pain relief, either by nitrous oxide, opiates, or by epidural anesthesia done by anaesthestists, an anesthesiologist, or a nurse anesthetist.
Surgically assisting labor, by forceps or the Ventouse (a suction cap applied to the fetus' head)
Caesarean section, if there is an associated risk with vaginal delivery, as such fetal or maternal compromise supported by evidence and literature. Caesarean section can either be elective, that is, arranged before labor, or decided during labor as an alternative to hours of waiting. True "emergency" Cesarean sections include abruptio placenta, and are more common in multigravid patients, or patients attempting a Vaginal Birth After Caeserean section (VBAC).
Postnatal
A woman in the Western world who is delivering in a hospital may leave the hospital as soon as she is medically stable and chooses to leave, which can be as early as a few hours postpartum, though the average for spontaneous vaginal delivery (SVD) is 1–2 days, and the average caesarean section postnatal stay is 3–4 days. During this time the mother is monitored for bleeding, bowel and bladder function, and baby care. The infant's health is also monitored.
What is gynecology?
Gynecology
is typically considered a consultant specialty. In some countries,
women must first see a general practitioner (GP; also known as a family
practitioner (FP)) prior to seeing a gynecologist. If their condition
requires training, knowledge, surgical technique, or equipment
unavailable to the GP, the patient is then referred to a gynecologist.
In the United States, however, law and many health insurance plans
allow/force gynecologists to provide primary care in addition to aspects
of their own specialty. With this option available, some women opt to
see a gynecological surgeon without another physician's referral.
As
in all of medicine, the main tools of diagnosis are clinical history
and examination. Gynecological examination is quite intimate, more so
than a routine physical exam. It also requires unique instrumentation
such as the speculum. The speculum consists of two hinged blades of
concave metal or plastic which are used to retract the tissues of the
vagina and permit examination of the cervix, the lower part of the
uterus located within the upper portion of the vagina. Gynecologists
typically do a bimanual examination (one hand on the abdomen and one or
two fingers in the vagina) to palpate the cervix, uterus, ovaries and
bony pelvis. It is not uncommon to do a rectovaginal exam for complete
evaluation of the pelvis, particularly if any suspicious masses are
appreciated. Male gynecologists often have a female chaperone (nurse or
medical student) for their examination. An abdominal and/or vaginal
ultrasound can be used to confirm any abnormalities appreciated with the
bimanual examination or when indicated by the patient's history.
Practice
As
with all surgical specialties, gynecologists may employ medical or
surgical therapies (or many times, both), depending on the exact nature
of the problem that they are treating. Pre- and post-operative medical
management will often employ many "standard" drug therapies, such as
antibiotics, diuretics, antihypertensives, and antiemetics.
Additionally, gynaecologists make frequent use of "specialized"
hormone-modulating therapies (such as Clomifene citrate and hormonal
contraception) to treat disorders of the female genital tract that are
responsive to pituitary and/or gonadal signals.
Surgery, however,
is the mainstay of gynecological therapy. For historical and political
reasons, gynecologists were previously not considered "surgeons",
although this point has always been the source of some controversy.
Modern advancements in both general surgery and gynecology, however,
have blurred many of the once rigid lines of distinction. The rise of
sub-specialties within gynaecology which are primarily surgical in
nature (for example urogynecology and gynecological oncology) have
strengthened the reputations of gynecologists as surgical practitioners,
and many surgeons and surgical societies have come to view
gynecologists as comrades of sorts. As proof of this changing attitude,
gynecologists are now eligible for fellowship in both the American and
Royal Colleges of Surgeons, and many newer surgical textbooks include
chapters on (at least basic) gynecological surgery.
Some of the more common operations that gynecologists perform include:
Dilation
and curettage (removal of the uterine contents for various reasons,
including partial miscarriage and dysfunctional uterine bleeding
refractive to medical therapy)
Hysterectomy (removal of the uterus)
Oophorectomy (removal of the ovaries)
Tubal ligation
Hysteroscopy
Diagnostic
laparoscopy - used to diagnose and treat sources of pelvic and
abdominal pain; perhaps most famously used to provide definitive
diagnosis of endometriosis.
Exploratory laparotomy - may be used to
investigate the level of progression of benign or malignant disease, or
to assess and repair damage to the pelvic organs.
Various surgical treatments for urinary incontinence, including cystoscopy and sub-urethral slings.
Surgical treatment of pelvic organ prolapse, including correction of cystocele and rectocele.
Appendectomy
- often performed to remove site of painful endometriosis implantation
and/or prophylactically (against future acute appendicitis) at the time
of hysterectomy or Cesarean section. May also be performed as part of a
staging operation for ovarian cancer.
Cervical Excision Procedures
(including cryosurgery, LLETZ, LEEP) - removal of the surface of the
cervix containing pre-cancerous cells which have been previously
identified on Pap smear.
Gynecology history
The
Kahun Gynecological Papyrus is the oldest known medical text, (dated to
about 1800 BCE) dealing with women's complaints—gynecological diseases,
fertility, pregnancy, contraception etc. The text is divided into
thirty-four sections, each section dealing with a specific problem and
containing diagnosis and treatment, no prognosis is suggested.
Treatments are non surgical, comprising applying medicines to the
affected body part or swallowing them. The womb is at times seen as the
source of complaints manifesting themselves in other body parts.
According
to the Suda, the ancient Greek physician Soranus practiced in
Alexandria and subsequently Rome. He was the chief representative of the
school of physicians known as "Methodists." His treatise Gynaikeia is
extant (first published in 1838, later by V. Rose as Gynecology, in
1882, with a 6th-century Latin translation by Moschio, a physician of
the same school).
Father of gynecology
In the United States, J. Marion Sims is often considered the father of American gynecology.
Sources and additional information: