Obstetrics is a branch of gynaecology. It deals with the natural and pathological processes in mother and child during pregnancy, childbirth and puerperium.

Overview

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Obstetrics - Further information

What is the field of “obstetrics” about?

An important part of obstetrics is the prenatal diagnosis. By means of various non-invasive tests and procedures, chromosomally caused defects can be detected at an early stage. This is done, for example, in the form of maternal blood samples or early ultrasound. Positive screening for possible malformations may also require invasive tests and examinations - for example in the form of amniotic fluid puncture or umbilical cord puncture.

On the basis of these examination results, the expected course of pregnancy of the individual patients can be estimated quite accurately. Especially in problematic cases, interdisciplinary cooperation between obstetricians is important, for example with midwives, anesthetists, neonatologists, geneticists, psychologists, social workers, physiotherapists and nutritionists. This way, the well-being of mother and child can be ensured.

Risk factors in the field of obstetrics

In recent years, two risk factors in particular have become more important in the area of obstetrics: On the one hand, more and more women of advanced age are having children, and on the other hand there is an increase in obesity in pregnant women (Schneider & Husslein & Schneider 2016). This poses various challenges for doctors working in this field, mostly specialists in gynaecology, as well as midwives. For mothers, these risks can take the form of hypertensive (increased blood pressure) pregnancy diseases and diabetes mellitus type 2. In the fetus, however, intrauterine growth disorders and premature birth dominate.

Early pregnancy and miscarriage

About 50 percent of all fertilized eggs do not develop into healthy pregnancies. In most cases, these pregnancies end unnoticed as early miscarriages, often in the form of delayed menstruation. Furthermore, about 15 percent of all clinically diagnosed pregnancies end in an early miscarriage (up to the 13th week of pregnancy). As the mother gets older, the frequency of miscarriages increases. Three or more consecutive miscarriages are referred to as "habitual miscarriages". Although this can be a random sequence of sporadic miscarriages, special (pathological) causes must be searched for here. At the earliest in the 4th week of pregnancy, a small amniotic cavity within the uterus can be shown in vaginal ultrasound, visible as a small black dot. A positive heart action of an embryo can be detected at the earliest from the 5th/6th week of pregnancy onwards. From this point on, regular check-ups and preventive examinations should take place.

Important diseases of the mother during pregnancy

  • metabolic diseases during pregnancy (such as diabtes mellitus type 1 and type 2 or thyroid diseases)
  • Diseases of the cardiovascular system (vena cava syndrome, which manifests itself in the form of dizziness and shortness of breath or thrombosis)
  • Diseases of the gastrointestinal tract (e.g. pregnancy-related nausea and vomiting of varying severity)
  • Hematological diseases (in the form of anemia)
  • Isolated pregnancy thrombocytopenia (the number of thrombocytes in the blood falls significantly below the normal limit)
  • Diseases of the urinary tract (asymptomatic bacteriuria, cystitis, the most frequent pathogens here are E.coli bacteria)
  • Hypertensive pregnancy diseases (repeated occurrence of blood pressure values of >140/90 mmHg)

Possible infections during pregnancy include for example: Rubella, parvovirus, herpes infection, cytomegaly (CMV), toxoplasmosis, chlamydia, group B streptococci, HIV and hepatitis infections.

Further tasks in the field of obstetrics

Careful supervision during a high-risk pregnancy (due to the age or state of health of the mother, a multiple pregnancy or the state of health of the child), as well as the treatment of possible complications in the course of the pregnancy, are also important tasks of obstetrics. In rare cases, premature placental separation, blood group incompatibilities or anomalies of the amniotic fluid may occur.

The management and monitoring of the birth, or its initiation in the event of a significant missed delivery date (over 40 percent of all pregnant women give birth later than the calculated delivery date), also falls within the area of responsibility of obstetrics. This ranges from admission to the delivery room to possible pain relief and examination of the newborn. Surgery may also be necessary: For example in the form of a planned caesarean section (abdominal surgical delivery) or in emergencies during birth (vaginal surgical delivery) - in the form of vacuum extraction or forceps delivery, or with the aid of the kiwi suction cup. This may become necessary, for example, in the event of a prolapsed umbilical cord or a birth standstill, e.g. due to weak labour or a head/pelvis disorder. The follow-up care of the mother may also require (minor) surgical interventions, for example in the case of a vaginal or perineal tear. 

What makes our doctors specialists in obstetrics?

In the Leading Medicine Guide, only selected highly qualified medical experts and specialists with high professional expertise are presented. All physicians listed in the specialist area of obstetrics have completed several years of specialist training in gynaecology and have excellent experience. They meet the strict criteria of the Leading Medicine Guide.

Literature

  • Lasch, Lidia, und Sabine Fillenberg. Basiswissen Gynäkologie und Geburtshilfe. Berlin, Heidelberg: Springer Berlin Heidelberg, 2017. Print. Springer-Lehrbuch.
  • Schneider, Henning, Peter-Wolf Husslein, und Karl-Theo Maria Schneider, Hrsg. Die Geburtshilfe. 5. Aufl. Berlin ; Heidelberg: Springer, 2016. Web. Springer Reference Medizin.