Obstetrics

Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field. Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low-risk pregnancies: Image:Ultrasound_image_of_a_fetus.jpg|[[3D ultrasound]] of {{convert|3|in|mm|adj=on}} fetus (about 14 weeks [[Gestational age (obstetrics)|gestational age]]) Image:Sucking his thumb and waving.jpg|Fetus at 17 weeks Image:3dultrasound 20 weeks.jpg|Fetus at 20 weeks Routine tests in the first trimester of pregnancy generally include: Complete blood count Blood type Rh-negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease. Indirect Coombs test (AGT) to assess risk of hemolytic disease of the newborn Rapid plasma reagin test to screen for syphilis Rubella antibody screen HBsAg test to screen for hepatitis B Testing for chlamydia (and gonorrhea when indicated Mantoux test for tuberculosis Urinalysis and culture HIV screen Genetic screening for Down syndrome (trisomy 21) and Edwards syndrome (trisomy 18), the national standard in the United States, is rapidly evolving away from the AFP-quad screen, done typically in the second trimester at 16–18 weeks. The newer integrated screen (formerly called F.A.S.T.E.R for First And Second Trimester Early Results) can be done at 10 plus weeks to 13 plus weeks with an ultrasound of the fetal neck (thicker nuchal skin correlates with higher risk of Down syndrome being present) and two chemicals (analytes), pregnancy-associated plasma protein A and human chorionic gonadotropin (pregnancy hormone level itself). It gives an accurate risk profile very early. A second blood screen at 15 to 20 weeks refines the risk more accurately.