Axel5)Obstetrics and Gynaecology: A Comprehensive Guide

Obstetrics and Gynaecology: A Comprehensive Guide

Obstetrics and gynaecology are crucial fields in medicine that deal with pregnancy, childbirth, and female reproductive health. Obstetrics focuses on the care of pregnant women and the management of childbirth, while gynaecology deals with conditions affecting the female reproductive system. Proper antenatal care, awareness of pre-existing health issues, early detection of infections, and managing complications during labour are essential aspects of maternal health. Additionally, contraception and gynaecological health play significant roles in reproductive well-being. This video provides a comprehensive overview of these topics, covering essential aspects of obstetrics and gynaecology.

Antenatal Care

Antenatal care is vital for ensuring the health of both the mother and the developing baby. It begins with pre-pregnancy counselling, where prospective parents receive advice on maintaining a healthy lifestyle and identifying risk factors that may affect pregnancy. Throughout pregnancy, a woman experiences physiological changes, including hormonal shifts, weight gain, and changes in cardiovascular function. Regular antenatal check-ups help in monitoring the mother’s and baby’s well-being, screening for potential complications, and managing any structural abnormalities.

Screening for aneuploidy, a condition involving chromosomal abnormalities like Down syndrome is an essential part of antenatal care. The use of anti-D immunoglobulin in Rh-negative mothers prevents complications arising from Rh incompatibility. A well-structured antenatal care timetable ensures regular check-ups and timely interventions if needed.

Common Antenatal Issues

Pregnancy is often accompanied by minor symptoms such as nausea, heartburn, and fatigue, but some conditions require medical attention. Hyperemesis gravidarum is an extreme form of nausea and vomiting that may lead to dehydration and weight loss. Thromboprophylaxis is necessary for preventing venous thromboembolism (VTE), a condition where blood clots form in the veins, increasing the risk of complications.

Women with pre-existing health conditions need special care during pregnancy. Hypertension, if unmanaged, can lead to complications like preeclampsia. Anaemia is another common condition, requiring iron supplementation to maintain maternal and fetal health. Conditions such as hyperthyroidism, jaundice, renal disease, and malaria can also impact pregnancy outcomes and require careful management. Psychiatric conditions, epilepsy, HIV, connective tissue diseases, and infections like rubella and measles, can pose risks to both mother and child.

Infections During Pregnancy

Certain ante/perinatal infections can severely affect fetal development. Syphilis, cytomegalovirus (CMV), parvovirus B19, toxoplasmosis, hepatitis B and E, and listeria infections can lead to birth defects or miscarriage if not treated promptly. Other infections such as herpes simplex, chlamydia, gonorrhoea, Clostridium infections, tuberculosis (TB), Group B Streptococcus, and ophthalmia neonatorum can be transmitted from mother to baby and require timely intervention.

Complications During Pregnancy

Pregnant women may experience various complications that require medical attention. Abdominal pain in pregnancy has multiple causes, and differentiating between normal pain and complications is crucial. Pre-eclampsia is a dangerous condition characterized by high blood pressure and protein in the urine, which can lead to HELLP syndrome, a life-threatening complication affecting the liver and blood cells. Oligohydramnios (low amniotic fluid) and polyhydramnios (excess amniotic fluid) can impact fetal development. Babies that are small for gestational age may require additional monitoring to ensure proper growth.

Labour and Delivery

Labour is a complex process that requires careful management. While normal labour progresses naturally, sometimes induction is necessary when the pregnancy extends beyond term or complications arise. Pain relief options, including epidurals and analgesics, help manage discomfort during labour. Close monitoring of both mother and baby ensures the safety of the delivery process.

In some cases, complications arise, such as multiple pregnancies, which involve additional risks, or breech presentation, where the baby is positioned incorrectly for delivery. Meconium-related problems, caused by the baby passing its first stool before birth, can lead to respiratory distress. Reduced fetal movements are an alarming sign that requires immediate evaluation.

Certain perinatal complications, such as prematurity and postmaturity, affect newborns. Birth injuries, including fractures and nerve damage, may occur during delivery. Some babies require specialized neonatal care to ensure healthy development.

Labour Complications

Labour can present several challenges. Retained placenta, where the placenta does not detach naturally, may lead to excessive bleeding and require manual removal. Instrumental vaginal delivery, using forceps or vacuum extraction, may be necessary in certain situations. Caesarean sections are performed when vaginal delivery poses risks to the mother or baby. Unfortunately, complications such as stillbirth can occur, requiring emotional and medical support for affected families.

Other labour-related problems include placenta abnormalities like vasa praevia, where fetal blood vessels cross the cervix, posing risks during delivery. Perineal tears and episiotomies are common and may require surgical repair. Puerperal psychosis is a severe postpartum mental health condition that needs urgent intervention.

Obstetric Emergencies

Certain conditions during and after labour require immediate medical intervention. Sepsis in the puerperium, a life-threatening infection, needs urgent treatment. Eclampsia, characterized by seizures due to severe pre-eclampsia, poses risks to both mother and baby. Placental abruption, where the placenta detaches from the uterus prematurely, and cord prolapse, where the umbilical cord slips into the birth canal before the baby, are emergencies requiring prompt action. Shoulder dystocia, where the baby’s shoulders get stuck during delivery, can lead to complications.

Other emergencies include uterine rupture, which threatens both maternal and fetal survival, and postpartum haemorrhage, a leading cause of maternal mortality. Amniotic fluid embolism is a rare but fatal condition where amniotic fluid enters the mother’s bloodstream, causing severe complications. Disseminated intravascular coagulation (DIC) is a clotting disorder that can lead to excessive bleeding.

Contraception and Family Planning

Contraception plays a vital role in reproductive health. The combined pill, patches, and rings provide hormonal birth control options. Condoms offer protection against sexually transmitted infections (STIs) in addition to preventing pregnancy. The progesterone-only pill, injectable contraceptives, and implantable contraceptives are suitable for women who cannot take estrogen-based contraceptives.

Intrauterine devices (IUDs), such as the intrauterine system (IUS) and copper IUD, provide long-term contraception. Emergency contraception is available for preventing unintended pregnancies after unprotected sex. Postpartum contraception is crucial for family planning after childbirth. Special considerations must be made for certain populations, including adolescents, women with epilepsy, and transgender or nonbinary individuals.

Obstetrics and gynaecology encompass a vast range of topics, from pregnancy care to labour complications, gynaecological conditions, and contraception. Proper antenatal care, timely detection of infections, and management of pre-existing conditions are crucial in ensuring maternal and fetal well-being. Labour and delivery require careful monitoring to minimize risks, while obstetric emergencies demand immediate intervention to prevent severe complications. Understanding contraception options allows individuals to make informed choices regarding reproductive health. By increasing awareness and access to medical care, maternal and reproductive health outcomes can be significantly improved.

"Thanks for watching!

If you enjoyed this video, please like, subscribe, and hit the bell icon so you never miss an update.

Drop a comment with your thoughts.

And I'll see you in the next one!"