How to choose Obstetrician – obgyn

An overview of the obstetrician – Gynecologist (obgyn)

As an overview for the obstetrician – gynecologist, the definitions for the corresponding terms are tackled below to further understand who they are and what they do.

obstetrician-obgyn

Obstetrics and gynecology

Obstetrics is a branch of medical study which is combined with gynecology under the discipline of obstetrics and gynecology as a medical field. OB/GYN focuses on the following specialties:

  • Pregnancy labor and childbirth
  • Severe and protracted medical conditions
  • Adolescent gynecology
  • Urinary tract conditions
  • Behavioral disorders
  • Cancer
  • Chiropractic care during pregnancy
  • Operative gynecology
  • Postpartum period

Obstetrician

An obstetrician is a health care practitioner who underwent specialized training in the following areas:

  • Integrated management of pregnancy
  • Assists during labor and delivery
  • Puerperium – the time – period between childbirth and the returning of the uterus to its normal size
  • Manages various postpartum complications


Gynecologist

Pregnancy week by week

A gynecologist is type of medical physician who attained specialized education in the following fields:

  • Health of the female reproductive system (i.e, vagina, uterus, and ovaries)
  • Diagnosis and treatment for diseases and disorders
  • Surgical care

Obstetrician – Gynecologist

An obstetrician – gynecologist (Ob – Gyne for short) is a physician specialist who attained an expertise on the detection and management of obstetrical and gynecological complications.

Finding and choosing the right Obstetrician – Gynecologist (obgyn)

When finding and choosing the right obstetrician – gynecologist, consider the one that can be trusted with one’s private female parts, the one whom feels comfortable to talk to.

Advantages of having an Obstetrician – Gynecologist

  • Knows how to treat major complications such as preeclampsia, placenta previa, and the like
  • Patient access to medical technology and equipment
  • Opportunity for a genetic counseling
  • Proper surgical training if caesarian delivery is necessary

Disadvantages of having an Obstetrician – Gynecologist

  • Recommendation to various surgical incisions, such as episiotomy, even if it is unnecessary
  • Possibility to undergo labor induction – labor induction is the artificial way to start childbirth. Inducing labor is achieved by providing pain relievers, stripping the cervical membranes, intravaginal administration, trans – cervical Foley catheter about 30 – mL, artificial rupture of membranes (AROM), intravenous therapy of synthetic oxytocin
  • Access to assisted delivery which involves using forceps to widen the vaginal opening and a mild suction to assist the newborn’s head throughout the birth canal (vacuum assisted vaginal delivery)
  • Birthing location is in a medical hospital rather than a birthing center or in the comfort of an expectant mother’s home
  • Expensive cost for prenatal care and child delivery

Services provided by the Obstetrician – Gynecologist (obgyn)

An obstetrician gynecologist can serve as a primary physician and a consultant at the same time. They offer medical care, surgical procedures, and even consultations. With that being, enlisted below are the following health services they provide:

  • Labor and birth care
  • Yearly gynecological examination
  • Birth control methods and contraceptive counseling session
  • Detection and treatment for sexually transmitted diseases (STDs)
  • Routinely Papanicolau smear testing
  • Treatments for severe and chronic medical disorders
  • Infertility testing and diagnosis
  • Reproduction examinations and diagnosis
  • Family planning
  • Cancer screening
  • Menopause management

What to expect when visiting the Ob – Gyne

An obstetrician – gynecologist practice either in a private office, in a medical facility, or a clinic setting with or without an assistant or group of physicians; enlisted below are the following things to expect when visiting their medical clinic:

Pre – natal care

Pre – natal care serves as the primary screening which requires routinely visits with a variety of examinations and laboratory testing such as:

First trimester

  • Complete blood count (CBC)
  • Blood group (commonly known as blood type)
  • Prenatal health maintenance
  • Antibody screening and identification – indirect anti – globulin for newborns with Hemolytic disease; and rho (D) immune globulin human (RhoGAM) at 28 weeks for Rh D negative antenatal patients to prevent Rhesus disease
  • Rapid plasma reagin test (RPR) for patients with syphilis
  • Rubella (German measles) immune status IgG antibody
  • Hepatitis B virus serologic test
  • Gonorrhea and Chlamydia culture (also called as DNA probe)
  • Purified protein derivative skin test (PPD test for short) – for patients with latent tuberculosis
  • Papanicolaou smear test
  • Urinalysis and urine culture test
  • Human immunodeficiency virus screening test (HIV screen for short)

Second trimester

  • Quadruple screen test – four consecutive blood tests which include maternal serum alpha – fetoprotein screening (MSAFP), Hormone Inhibin A, Estriol, human Chorionic Gonadotrophin (hCG). These are done to detect high levels of blood, low count, and abnormal patterns which are linked to the potential to have neural tube defects such as Down and Edwards syndrome (trisomy 13 and 18)
  • Either abdominal or transvaginal ultrasound imaging – to check the current status of the cervix, placenta, amniotic fluid, and the developing baby
  • Amniocentesis (widely known as amniotic fluid test, abbreviated as AFT) – for patients age 35 and above who are expecting mid – pregnancy

Third trimester

  • Hematocrit test (Hct) – a type of blood test which measures the percentage and the total blood volume that is composed of red blood cells (RBCs). For low results, an Ob – Gyne will recommend iron supplements
  • Group B Streptococcus infection screening – for a positive result, an Ob – Gyne will provide IV penicillin or ampicillin during labor; for allergic patients, IV clindamycin or vancomycin
  • Glucose loading test (GLT) – for patients with gestational diabetes. Glucose tolerance test (GTT) for patients with > 140 mg/dL and a fasting blood glucose test for patients with > 105 mg/dL

Preventative care for inter – current diseases

Inter current diseases refers to the (which are not mainly caused by pregnancy) conditions which may worsen or impose risks during the course of gestation. Such inter – current diseases are:

  • Gestational diabetes mellitus (widely known as glucose intolerance) – imposes miscarriage, intrauterine growth restriction, fetal growth acceleration, macrosomia (fetal obesity), polyhydramios (excess amniotic fluid), various birth defects
  • Systemic lupus erythematosus – imposes stillbirth, miscarriage, and neonatal lupus
  • Thyroid disease – can cause harmful effects on both the mother and the baby if left untreated. These effects can also extend even after gestation where the newborn’s neuro – intellectual development will be affected
  • Hypercoagulability – imposes the development of blood clots

Maternal emergencies and complications

Having an obstetrician – gynecologist gives an expectant mother the easy access to run to them in case of emergencies and complications such as the following enlisted below:

  • Ectopic pregnancy – is when the embryo abnormally implants itself in the fallopian tube, ovary, or peritoneal cavity
  • Pre – eclampsia – toxemia – a combination of pregnancy complications which are linked to hypertension
  • Placental abruption – the detachment of placenta in the uterine wall, the fetus may bleed to death if immediate treatment is not given
  • Fetal distress
  • Shoulder dystocia – is an abnormal position where the unborn baby’s shoulders is burrowed deep in the pelvis which may lead to fetal macrosomia (excessive fetal birth weight)
  • Uterine rupture
  • Umbilical cord prolapse – is when the umbilical cord is dangling out of the uterus even before the baby – to – be is present
  • Obstetric hemorrhage
  • Puerperal sepsis (also known as postpartum infections) – is the infection of the genital tract which may occur during the course and right after labor

Fetal assessments

  • Fetal screening
  • Fetal karyotyping – a type of prenatal test which involves collecting the chorionic villi, amniotic fluid, fetal blood, and
  • Fetal hematocrit – to assess anemia, Rh incompatibility and pediatric hydrops fetalis
  • Percutaneous umbilical blood sampling (PUBS) – which involves inserting a needle through the abdomen and into the uterus to take a portion of the umbilical cord
  • Non – stress test (NST) – a noninvasive test to check the fetal heart rate
  • Oxytocin challenge (also called as contraction stress test)
  • Assessment of fetal lung maturity

Apart from that, enlisted below are other tools used during fetal assessments:

  • Obstetric ultrasonography – is an imaging instrument used to determine the gestational age, fetal size, number of fetuses and placentae; to check if there are any pregnancy complications (congenital and fetal anomalies)
  • Mean sac diameter (MSD) – sonographic measurement to determine the size of the amniotic sac
  • Gender scan (also called as sexing)

Post – natal care

Post – natal care is provided after parturition, during the critical phase in the lives of mothers (particularly first – time mothers) and newborn babies. Post – natal care monitors both parties to check the following:

  • Evaluating the patient’s general condition
  • Measuring the vital signs (i.e, pulse rate, body temperature, blood pressure, and respiratory rate sometimes pain)
  • Fundal height measurement – measuring the size of the uterus
  • Checking the dressing, intact, pus, and hematoma – for patients who underwent episiotomy
  • Lochia (vaginal discharge right after birth) examination – the lochia’s color, amount, and odor will be examined
  • Urodynamic testing – the checking of the bladder’s function. The patient will be catheterized for 12 hours followed by a local anesthesia then general anesthesia with a 24 – 48 hour interval
  • Stool analysis test – checking the bowel movement and amount of bowels defecated
  • Newborn screening tests

The educational background of an Obstetrician – Gynecologist (obgyn)

An obstetrician – gynecologist have completed the following training requirements that are set by the board of obstetrics and gynecology.

Training requirements

  • Graduated from an approved medical institute
  • Completed 4 years of residency training which include: obstetrics, gynecology, gynecologic oncology, ultrasonography, and various precautionary methods
  • Primary and preventive care experience for at least 6 months of residency. This include diagnosis and management of sexual dysfunction in postmenopausal breast; inpatient / outpatient and ambulatory care and coverage; performance and interpretation of diagnostic pelvic and transvaginal ultrasonography
  • Escalation in patient responsibility training each year
  • Training as chief senior resident during the final year of residency

Board certification

Once the abovementioned requirements are attained, physicians will take certifying examinations given by the board of obstetrics and gynecology. Physicians who pass the board examination are mandated to subspecialty certification.

  • Gynecologic oncology – focuses on the consultation and complete management for patients with gynecologic cancer; provides knowledge on cancer treatments, diagnosis, and problems of oncology
  • Maternal and fetal medicine – focuses on the care and consultation for patients with pregnancy problems; provides knowledge on medical and surgical complications for both parties, up-to-date methods to diagnosis and treatment, and newborn adaptation to extra – uterine life
  • Reproductive endocrinology and infertility
  • – focuses on complex disorders related to reproductive endocrinology and infertility
  • Urogynecology and reconstructive pelvic surgery – is considered as a surgical subspecialty which focuses on the urinary tract health and its corresponding surgery; provides knowledge on complex yet mild pelvic conditions, pelvic floor dysfunction, reconstructive pelvic surgery, and urinary tract infections and disorders