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.
117-412: 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 people with low-risk pregnancies: Routine tests in the first trimester of pregnancy generally include: Genetic screening for Down syndrome (trisomy 21) and Edwards syndrome (trisomy 18), the national standard in
234-420: A gestational sac , yolk sac , and fetal pole . The gestational age can be assessed by evaluating the mean gestational sac diameter (MGD) before week 6, and the crown-rump length after week 6. Multiple gestation is evaluated by the number of placentae and amniotic sacs present. Other tools used for assessment include: A pregnant woman may have a pre-existing disease , that may become worse or become
351-405: 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 later, but usually averages a stay of one or two days; the average postnatal stay following delivery by caesarean section is three to four days. During this time the mother is monitored for bleeding , bowel and bladder function, and baby care. The infant 's health
468-491: A public health emergency of international concern, marking the second such declaration in the last two years due to the virus's transmission. The WHO's Constitution states that its objective "is the attainment by all people of the highest possible level of health". The WHO fulfils this objective through its functions as defined in its Constitution: As of 2012 , the WHO has defined its role in public health as follows: Since
585-410: A controversial medical past. Under the beliefs at the time about pain and the prejudice towards African people, he had practiced his surgical skills and developed skills on slaves. These women were the first patients of modern gynecology. One of the women he operated on was named Anarcha Westcott , the woman he first treated for a fistula. Women and men inhabited very different roles in natal care up to
702-495: A convention concerning the bubonic plague was signed by sixteen of the nineteen states attending the Venice conference. While Denmark , Sweden-Norway , and the US did not sign this convention, it was unanimously agreed that the work of the prior conferences should be codified for implementation. Subsequent conferences, from 1902 until the final one in 1938, widened the diseases of concern for
819-481: A delivery reduced childbed fever fatalities by 90%. So it was concluded that it was physicians who had been spreading disease from one labouring mother to the next. Despite the publication of this information, doctors still would not wash. It was not until the 20th century when advancements in aseptic technique and the understanding of disease would play a significant role in the decrease of maternal mortality rates among many populations. The development of obstetrics as
936-774: A forum for scientific or policy discussions related to health. Its official publication, the World Health Report , provides assessments of worldwide health topics. The WHO has played a leading role in several public health achievements, most notably the eradication of smallpox , the near- eradication of polio , and the development of an Ebola vaccine . Its current priorities include communicable diseases , such as HIV/AIDS , Ebola , malaria and tuberculosis ; non-communicable diseases such as heart disease and cancer ; healthy diet , nutrition, and food security ; occupational health ; and substance abuse . The agency advocates for universal health care coverage, engagement with
1053-758: A growing uterus during pregnancy that causes increased stress on the lumbar and pelvic regions of the mother, thereby, resulting in postural changes and reduced lumbopelvic muscle strength leading to pelvic instability and pain. It is unclear whether specific hormones in pregnancy are associated with complication development. PGP can result in poor quality of life, predisposition to chronic pain syndrome, extended leave from work, and psychosocial distress . Many treatment options are available based on symptom severity. Non-invasive treatment options include activity modification, pelvic support garments, analgesia with or without short periods of bed rest, and physiotherapy to increase strength of gluteal and adductor muscles reducing stress on
1170-443: A lever for the introduction of men into an arena previously managed and run by women – midwifery. The addition of the male-midwife (or man-midwife) is historically a significant change to the profession of obstetrics. In the 18th century medical men began to train in area of childbirth and believed with their advanced knowledge in anatomy that childbirth could be improved. In France these male-midwives were referred to as accoucheurs ,
1287-616: A practice for accredited doctors happened at the turn of the 18th century and thus was very differently developed in Europe and in the Americas due to the independence of many countries in the Americas from European powers. "Unlike in Europe and the British Isles, where midwifery laws were national, in America, midwifery laws were local and varied widely". Gynaecology and Obstetrics gained attention in
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#17328487404801404-528: A resolution on disability prevention and rehabilitation , with a focus on community-driven care. 1977 and 1978: The first list of essential medicines was drawn up, and a year later the ambitious goal of " Health For All " was declared. 1986: The WHO began its global programme on HIV/AIDS . Two years later preventing discrimination against patients was attended to and in 1996 the Joint United Nations Programme on HIV/AIDS (UNAIDS)
1521-429: A resolution passed on the subject, Alger Hiss , the secretary general of the conference, recommended using a declaration to establish such an organization. Sze and other delegates lobbied and a declaration passed calling for an international conference on health. The use of the word "world", rather than "international", emphasized the truly global nature of what the organization was seeking to achieve. The constitution of
1638-437: A risk to the pregnancy, or to postnatal development of the offspring Induction is a method of artificially or prematurely stimulating labour in a woman. Reasons to induce can include pre-eclampsia , foetal distress, placental malfunction, intrauterine growth retardation and failure to progress through labour increasing the risk of infection and foetal distresses. Induction may be achieved via several methods: During labour,
1755-467: A routine examination or following an episode of abnormal vaginal bleeding, often in the second trimester of pregnancy. Most diagnosis of placenta previa occurs during the second-trimester. Treatments are adapted according to their severity and the mother's state of health, from strict monitoring to cesarean section. Placenta accreta is an abnormal adherence of the placenta to the uterine wall. Specifically, placenta accreta involves abnormal adherence of
1872-501: A series of conferences that took place until 1938, about 87 years. The first conference, in Paris, was almost solely concerned with cholera , which would remain the disease of major concern for the ISC for most of the 19th century. With the cause , origin, and communicability of many epidemic diseases still uncertain and a matter of scientific argument, international agreement on appropriate measures
1989-407: A serious complication had taken place and the midwife had exhausted all measures at her disposal. Calling a surgeon was very much a last resort and having men deliver women in this era was seen as offending female modesty. Prior to the 18th and 19th centuries, midwifery was well established but obstetrics was not recognized as a specific medical specialty. However, the subject matter and interest in
2106-487: A set of several different infections that may be caused by transplacental infection: Babies can also become infected by their mother during birth . During birth, babies are exposed to maternal blood and body fluids without the placental barrier intervening and to the maternal genital tract. Because of this, blood-borne microorganisms ( hepatitis B , HIV ), organisms associated with sexually transmitted disease (e.g., gonorrhoea and chlamydia ), and normal fauna of
2223-532: A surgical practice in 1795 and performed the first ovariotomy in 1809 on a 47-year-old widow who then lived on for 31 more years. He had attempted to share this with John Bell whom he had practiced under who had retired to Italy. Bell was said to have died without seeing the document but it was published by an associate in Extractions of Diseased Ovaria in 1825. By the mid-century the surgery was both successfully and unsuccessfully being performed. Pennsylvanian surgeons
2340-459: A title later used all over Europe. The founding of lying-in hospitals also contributed to the medicalization and male-dominance of obstetrics. These early maternity hospitals were establishments where women would come to have their babies delivered, as opposed to the practice since time immemorial of the midwife attending the home of the woman in labour. This institution provided male-midwives with endless patients to practice their techniques on and
2457-790: Is pain in the area between the posterior iliac crest and gluteal fold beginning peri or postpartum caused by instability and limitation of mobility. It is associated with pubic symphysis pain and sometimes radiation of pain down the hips and thighs. For most pregnant individuals, PGP resolves within three months following delivery, but for some it can last for years, resulting in a reduced tolerance for weight bearing activities. PGP affects around 45% of individuals during pregnancy: 25% report serious pain and 8% are severely disabled. Risk factors for complication development include multiparity, increased BMI, physically strenuous work, smoking, distress, history of back and pelvic trauma, and previous history of pelvic and lower back pain. This syndrome results from
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#17328487404802574-418: Is also monitored. Prior to the 18th century, caring for pregnant women in Europe was confined exclusively to women , and rigorously excluded men. The expectant mother would invite close female friends and family members to her home to keep her company during childbirth . Skilled midwives managed all aspects of the labour and delivery. The presence of physicians and surgeons was very rare and only occurred if
2691-407: Is also used for detecting congenital anomalies (or other foetal anomalies) and determining the biophysical profiles (BPP), which are generally easier to detect in the second trimester when the foetal structures are larger and more developed. X-rays and computerized tomography (CT) are not used, especially in the first trimester, due to the ionizing radiation , which has teratogenic effects on
2808-544: Is an elevated demand for insulin during pregnancy which leads to increased insulin production from pancreatic beta cells . The elevated demand is a result of increased maternal calorie intake and weight gain, and increased production of prolactin and growth hormone. Gestational diabetes increases risk for further maternal and fetal complications such as development of pre-eclampsia, need for cesarean delivery, preterm delivery, polyhydramnios, macrosomia, shoulder dystocia, fetal hypoglycemia, hyperbilirubinemia, and admission into
2925-414: Is complicated, and is often treated by a team effort of dietary supplementation, iron therapy, and continuous assessment of mother and fetal indices in a multidisciplinary approach. As an additional measure, emphasis is placed on the astute determination of the respective triggering points, and the application of optimal prenatal care to better maternal and fetal outcome. Levels of hemoglobin are lower in
3042-470: Is considered high-risk (about 6-8% of pregnancies in the USA) and in extreme cases may be contraindicated . High-risk pregnancies are the main focus of doctors specialising in maternal-fetal medicine . Serious pre-existing disorders which can reduce a woman's physical ability to survive pregnancy include a range of congenital defects (that is, conditions with which the woman herself was born, for example, those of
3159-627: Is defined as fetal loss or death after 20 weeks gestation. Early stillbirth is between 20 and 27 weeks gestation, while late stillbirth is between 28 and 36 weeks gestation. A term stillbirth is when the fetus dies 37 weeks and above. This phenomenon can go beyond grief and can lead to worries about strange maternal feelings or postpartum treatment regarding complications of childbirth. Such parents would require more than empathy; generally, adequate medical programs should be considered for parents having such unbearable grief. Along with psychiatric help, counseling , and peer support , which should be useful in
3276-543: Is diagnosed by the following criteria: greater than 3 vomiting episodes per day, ketonuria, and weight loss of more than 3 kg or 5% of body weight. There are several non-modifiable and modifiable risk factors that predispose women to development of this condition such as female fetus, psychiatric illness history, high or low BMI pre-pregnancy, young age, African American or Asian ethnicity, type I diabetes, multiple pregnancies, and history of pregnancy affected by hyperemesis gravidarum. There are currently no known mechanisms for
3393-491: Is done in time after careful observation. The implementation of preventive measures, which include pre-conception counseling to deal with the modifiable risk factors, can significantly contribute to the reduction of incidents of placental abruption. Knowing the long-term impacts on the mother and the baby after giving birth is essential. Continuous research and evidence-based approaches help in providing management that works. Collaboration between healthcare providers and patients
3510-557: Is now on the verge of extinction, thanks to a Global Vaccination Drive. The World Health Organization (WHO) stated the eradication programme has saved millions from deadly disease. Between 1990 and 2010, WHO's help has contributed to a 40% decline in the number of deaths from tuberculosis, and since 2005, over 46 million people have been treated and an estimated 7 million lives saved through practices advocated by WHO. These include engaging national governments and their financing, early diagnosis, standardising treatment, monitoring of
3627-505: Is often accompanied by PID (pelvic inflammatory disease) or salpingectomy (surgery). Miscarriage is the loss of a pregnancy prior to 20 weeks. In the UK, miscarriage is defined as the loss of a pregnancy during the first 23 weeks. Comprehensive support, consists of the consultation of the genomics as well as the provision of the medical or surgical operations required. The psychological relevance of family members, relatives, and friends to
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3744-423: Is the core of the outcomes of placenta abruption. Placenta previa is a condition that occurs when the placenta fully or partially covers the cervix. Placenta previa can be further categorized into complete previa, partial previa, marginal previa, and low-lying placenta, depending on the degree to which the placenta covers the internal cervical os. Placenta previa is primarily diagnosed by ultrasound, either during
3861-454: Is the presence of severe and persistent vomiting, causing dehydration and weight loss. It is similar although more severe than the common morning sickness . It is estimated to affect 0.3–3.6% of pregnant women and is the greatest contributor to hospitalizations under 20 weeks of gestation. Most often, nausea and vomiting symptoms during pregnancy resolve in the first trimester, however, some continue to experience symptoms. Hyperemesis gravidarum
3978-465: Is the second most common cause of maternal death in developed countries after bleeding. Anemia is a globally recognized complication of pregnancy worldwide and is a condition with a low hemoglobin amount in one of the trimesters. Such physiological modifications are more pronounced among individuals who suffer from undernutrition as well as chronic diseases associated with hemoglobin rehoming, like sickle cell anemia. Prevention of anemia during pregnancy
4095-417: Is very similar to treatment of non-gravid heart failure patients, however, safety of the fetus must be prioritized. For example, for anticoagulation due to increased risk for thromboembolism, low molecular weight heparin which is safe for use during pregnancy is used instead of warfarin which crosses the placenta. Hypothyroidism (commonly caused by Hashimoto's disease ) is an autoimmune disease that affects
4212-555: The Caesarean section . Before the 1880s mortality rates in lying-hospitals would reach unacceptably high levels and became an area of public concern. Much of these maternal deaths were due to puerperal fever , then known as childbed fever. In the 1800s Ignaz Semmelweis noticed that women giving birth at home had a much lower incidence of childbed fever than those giving birth by physicians in lying-hospitals. His investigation discovered that washing hands with an antiseptic solution before
4329-473: The International Classification of Diseases (ICD). The agency's work began in earnest in 1951 after a significant infusion of financial and technical resources. The WHO's official mandate is to promote health and safety while helping the vulnerable worldwide. It provides technical assistance to countries, sets international health standards, collects data on global health issues, and serves as
4446-565: The US Centers for Disease Control and Prevention (CDC), the United Nations Children's Fund (UNICEF), and smaller organizations. As of 2011 , it has been working to immunize young children and prevent the re-emergence of cases in countries declared "polio-free". In 2017, a study was conducted as to why Polio Vaccines may not be enough to eradicate the Virus & conduct new technology. Polio
4563-815: The USSR , called on the World Health Assembly to undertake a global initiative to eradicate smallpox, resulting in Resolution WHA11.54. 1965: The first report on diabetes mellitus and the creation of the International Agency for Research on Cancer . 1966: The WHO moved its headquarters from the Ariana wing at the Palace of Nations to a newly constructed headquarters elsewhere in Geneva. 1967: The WHO intensified
4680-998: The United Nations Development Programme (UNDP), and the World Bank . 1975: The WHO launched the Special Programme for Research and Training in Tropical diseases (the TDR). Co-sponsored by UNICEF , UNDP, and the World Bank, it was established in response to a 1974 request from the WHA for an intensive effort to develop improved control of tropical diseases. The TDR's goals are, firstly, to support and coordinate international research into diagnosis, treatment and control of tropical diseases; and, secondly, to strengthen research capabilities within endemic countries. 1976: The WHA enacted
4797-572: The World Health Assembly finished on 24 July 1948, having secured a budget of US$ 5 million (then £1,250,000 ) for the 1949 year. G. Brock Chisholm was appointed director-general of the WHO, having served as executive secretary and a founding member during the planning stages, while Andrija Štampar was the assembly's first president. Its first priorities were to control the spread of malaria , tuberculosis and sexually transmitted infections , and to improve maternal and child health , nutrition and environmental hygiene. Its first legislative act
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4914-532: The female reproductive system and sexual practice can be traced back to Ancient Egypt and Ancient Greece. Soranus of Ephesus sometimes is called the most important figure in ancient gynecology. Living in the late first century AD and early second century, he studied anatomy and had opinions and techniques on abortion, contraception – most notably coitus interruptus – and birth complications. After his death, techniques and works of gynecology declined; very little of his works were recorded and survived to
5031-419: The genito-urinary tract (e.g., Candida ) are among those commonly seen in infection of newborns. Furthermore, vaccination, commitment to safe birth practices, and prenatal screening and treatment of infections are also strategic measures that can help reduce the risk of newborn infections. Factors increasing the risk (to either the pregnant individual, the fetus/es, or both) of pregnancy complications beyond
5148-528: The heart or reproductive organs, some of which are listed above) and diseases acquired at any time during the woman's life. Obstetric complications are those complications that develop during pregnancy. A woman may develop an infection, syndrome or complication that is not unique to pregnancy and that may have existed before pregnancy. Pregnancy often is complicated by preexisting and concurrent conditions. Though these pre-existing and concurrent conditions may have great impact on pregnancy, they are not included in
5265-441: The placenta and cause (perinatal) infection. Often microorganisms that produce minor illness in the mother are very dangerous for the developing embryo or fetus. This can result in spontaneous abortion or major developmental disorders . For many infections, the baby is more at risk at particular stages of pregnancy. Problems related to perinatal infection are not always directly noticeable. The term TORCH complex refers to
5382-400: The 18th century. The role of a physician was exclusively held by men who went to university, an overly male institution, who would theorize anatomy and the process of reproduction based on theological teaching and philosophy. Many beliefs about the female body and menstruation in the 17th and 18th centuries were inaccurate; clearly resulting from the lack of literature about the practice. Many of
5499-620: The American medical field at the end of the nineteenth century through the development of such procedures as the ovariotomy. These procedures then were shared with European surgeons who replicated the surgeries. This was a period when antiseptic, aseptic or anaesthetic measures were just being introduced to surgical and observational procedures and without these procedures surgeries were dangerous and often fatal. Following are two surgeons noted for their contributions to these fields include Ephraim McDowell and J. Marion Sims . Ephraim McDowell developed
5616-503: The Attlee brothers made this procedure very routine for a total of 465 surgeries – John Attlee performed 64 successfully of 78 while his brother William reported 387 – between the years of 1843 and 1883. By the middle of the nineteenth century this procedure was successfully performed in Europe by English surgeons Sir Spencer Wells and Charles Clay as well as French surgeons Eugène Koeberlé , Auguste Nélaton and Jules Péan . J. Marion Sims
5733-600: The Health Organization of the League of Nations. After World War II , the United Nations absorbed all the other health organizations, to form the WHO. During the 1945 United Nations Conference on International Organization, Szeming Sze , a delegate from China, conferred with Norwegian and Brazilian delegates on creating an international health organization under the auspices of the new United Nations. After failing to get
5850-655: The ISC, and included discussions of responses to yellow fever , brucellosis , leprosy , tuberculosis , and typhoid . In part as a result of the successes of the Conferences, the Pan-American Sanitary Bureau (1902), and the Office International d'Hygiène Publique or " International office of Public Hygiene " in english(1907) were soon founded. When the League of Nations was formed in 1920, it established
5967-880: The US, and in 1.5% of mothers in Canada. In the immediate postpartum period (puerperium), 87% to 94% of women report at least one health problem. Long-term health problems (persisting after six months postpartum) are reported by 31% of women. In 2016, complications of pregnancy, childbirth, and the puerperium resulted globally in 230,600 deaths, down from 377,000 deaths in 1990. The most common causes of maternal mortality are maternal bleeding , postpartum infections including sepsis, hypertensive diseases of pregnancy , obstructed labor , and unsafe abortion . Complications of pregnancy can sometimes arise from abnormally severe presentations of symptoms and discomforts of pregnancy , which usually do not significantly interfere with activities of daily living or pose any significant threat to
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#17328487404806084-635: The United Nations together with the exchange of letters related thereto, and taking into account the respective co-ordinating responsibilities of both organizations, it is recognized by the World Health Organization that the International Atomic Energy Agency has the primary responsibility for encouraging, assisting and co-ordinating research and development and practical application of atomic energy for peaceful uses throughout
6201-730: 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
6318-480: The WHO over the organization's unwillingness to share the penicillin recipe. They would not return until 1956. 1950: A mass tuberculosis inoculation drive using the BCG vaccine gets under way. 1955: The malaria eradication programme was launched, although objectives were later modified. (In most areas, the programme goals became control instead of eradication.) 1958: Viktor Zhdanov , Deputy Minister of Health for
6435-590: The WHO was to report as to whether RTS,S /AS01, were a viable malaria vaccine . For the time being, insecticide -treated mosquito nets and insecticide sprays are used to prevent the spread of malaria, as are antimalarial drugs – particularly to vulnerable people such as pregnant women and young children. In 1988, WHO launched the Global Polio Eradication Initiative to eradicate polio . It has also been successful in helping to reduce cases by 99% since WHO partnered with Rotary International ,
6552-425: The WHO's role and priorities in public health, ranging from narrowing its mandate to strengthening its independence and authority. During the 1970s, WHO had dropped its commitment to a global malaria eradication campaign as too ambitious, it retained a strong commitment to malaria control. WHO's Global Malaria Programme works to keep track of malaria cases, and future problems in malaria control schemes. As of 2012,
6669-498: The World Health Organization was signed by all 51 countries of the United Nations, and by 10 other countries, on 22 July 1946. It thus became the first specialized agency of the United Nations to which every member subscribed. Its constitution formally came into force on the first World Health Day on 7 April 1948, when it was ratified by the 26th member state. The WHO formally began its work in September 1, 1948. The first meeting of
6786-565: The basis for global prevention, treatment, and support the plan to fight the AIDS pandemic . 2006: The WHO launches the Global action plan for influenza vaccines 2016: The Global action plan for influenza vaccines ends with a report which concludes that while substantial progress has been made over the 10 years of the Plan, the world is still not ready to respond to an influenza pandemic. 2016: Following
6903-423: The beginning of the century. But obstetrics was underdeveloped compared to other medical specialities. Many male physicians would deliver children but very few would have referred to themselves as obstetricians. The end of the 19th century did mark a significant accomplishment in the profession with the advancements in asepsis and anaesthesia , which paved the way for the mainstream introduction and later success of
7020-575: The bereaved ones is also a necessity. The most effective tools that can be used to minimize the psychological implications of the mourners include autopsy and bereavement counseling . Approximately 80% of pregnancy loss occurs in the first trimester, with a decrease in risk after 12 weeks gestation. Some variables, such as the mother's being older or chromosomal abnormalities , possess a higher likelihood of causing multiple miscarriages . Spontaneous abortions can be further categorized into complete, inevitable, missed, and threatened abortions: Stillbirth
7137-535: The birth of a child would be in the sitting position, usually when performed on the side of a bed to support the mother. Men were introduced into the field of obstetrics in the nineteenth century and resulted in a change of the focus of this profession. Gynaecology directly resulted as a new and separate field of study from obstetrics and focused on the curing of illness and indispositions of female sexual organs. This had some relevance to some conditions as menopause, uterine and cervical problems, and childbirth could leave
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#17328487404807254-499: The breast, occurs in 20% of lactating individuals. Some infections are vertically transmissible , meaning that they can affect the child as well. Peripartum cardiomyopathy is a heart failure caused by a decrease in left ventricular ejection fraction (LVEF) to <45% which occurs towards the end of pregnancy or a few months postpartum. Symptoms include shortness of breath in various positions and/or with exertion, fatigue, pedal edema, and chest tightness. Risk factors associated with
7371-424: The budget and activities. The WHO is funded primarily by contributions from member states (both assessed and voluntary), followed by private donors. Its total approved budget for 2020–2021 is over $ 7.2 billion, while the approved budget for 2022–2023 is over $ 6.2 billion. The budget is $ 6.83 billion for 2024–2025. The International Sanitary Conferences (ISC), the first of which was held on 23 June 1851, were
7488-879: The cause of this condition. This complication can cause nutritional deficiency, low pregnancy weight gain, dehydration, and vitamin, electrolyte, and acid-based disturbances in the mother. It has been shown to cause low birth weight, small gestational age, preterm birth, and poor APGAR scores in the infant. Treatments for this condition focus on preventing harm to the fetus while improving symptoms and commonly include fluid replacement and consumption of small, frequent, bland meals. First-line treatments include ginger and acupuncture. Second-line treatments include vitamin B 6 +/- doxylamine, antihistamines, dopamine antagonists, and serotonin antagonists. Third-line treatments include corticosteroids, transdermal clonidine, and gabapentin. Treatments chosen are dependent on severity of symptoms and response to therapies. Pelvic girdle pain (PGP) disorder
7605-611: The continuing effects of nuclear disasters in Chernobyl and Fukushima . They believe WHO must regain what they see as independence. Independent WHO held a weekly vigil from 2007 to 2017 in front of WHO headquarters. However, as pointed out by Foreman in clause 2 it states: In particular, and in accordance with the Constitution of the World Health Organization and the Statute of the International Atomic Energy Agency and its agreement with
7722-409: The control of placenta accreta. Moreover, early detection and response to the health problems arising from multiple pregnancies can help both the expectant parents and medical care providers deal with this particular aspect of reproductive health consciously. Since the embryo and fetus have little or no immune function , they depend on the immune function of their mother. Several pathogens can cross
7839-690: The development of this complication include maternal age over 30 years, multi gestational pregnancy, family history of cardiomyopathy, previous diagnosis of cardiomyopathy, pre-eclampsia , hypertension , and African ancestry. The pathogenesis of peripartum cardiomyopathy is not yet known, however, it is suggested that multifactorial potential causes could include autoimmune processes, viral myocarditis, nutritional deficiencies, and maximal cardiovascular changes during which increase cardiac preload. Peripartum cardiomyopathy can lead to many complications such as cardiopulmonary arrest, pulmonary edema , thromboembolisms , brain injury, and death. Treatment of this condition
7956-415: The diagnosis and clinical management to be complicated. Several contributors may result in placental abruption. This includes: pre-existing maternal factors (e.g., smoking , hypertension , advanced age), as well as pregnancy-related factors such as multiple pregnancies or the presence of in-utero infections . Identifying risk factors beforehand in order to take steps and make quick reactions to minimize
8073-437: The eventual need for midwives to become certified. Many European countries by the late 19th century were monitoring the training of midwives and issued certification based on competency. Midwives were no longer uneducated in the formal sense. As midwifery began to develop, so did the profession of obstetrics near the end of the century. Childbirth was no longer unjustifiably despised by the medical community as it once had been at
8190-429: The fetus as well. Gestational diabetes is when a woman, without a previous diagnosis of diabetes , develops high blood sugar levels during pregnancy . There are many non-modifiable and modifiable risk factors that lead to the devopment of this complication. Non-modifiable risk factors include a family history of diabetes, advanced maternal age, and ethnicity. Modifiable risk factors include maternal obesity. There
8307-435: The fetus or placenta , but may have serious consequences on the mother as well. Ectopic pregnancy is implantation of the embryo outside the uterus. This form of complicated pregnancy, which is a non-implication of a normally fertilized egg at any spot other than the uterus, involves operation failure, which can cause life-threatening conditions. However, the underlying reasons for this are not exactly known. This phenomenon
8424-416: The fetus, as well as secondary to maternal physiological changes including a decrease in respiratory volumes and urinary stasis due to an enlarging uterus. Pregnant individuals are more severely affected by, for example, influenza , hepatitis E , herpes simplex and malaria . The evidence is more limited for coccidioidomycosis , measles , smallpox , and varicella . Mastitis , or inflammation of
8541-586: The fiftieth anniversary of WHO's founding. He, did, however, accept that more had to be done to assist maternal health and that progress in this area had been slow. 2000: The Stop TB Partnership was created along with the UN's formulation of the Millennium Development Goals . 2001: The measles initiative was formed, and credited with reducing global deaths from the disease by 68% by 2007. 2002: The Global Fund to Fight AIDS, Tuberculosis and Malaria
8658-604: The foetus. No effects of magnetic resonance imaging (MRI) on the foetus have been demonstrated, but this technique is too expensive for routine observation. Instead, obstetric ultrasonography is the imaging method of choice in the first trimester and throughout the pregnancy, because it emits no radiation , is portable, and allows for realtime imaging. The safety of frequent ultrasound scanning has not been confirmed. Despite this, increasing numbers of women are choosing to have additional scans for no medical purpose, such as gender scans, 3D and 4D scans. A normal gestation would reveal
8775-449: The following list. World Health Organization The World Health Organization ( WHO ) is a specialized agency of the United Nations responsible for global public health . It is headquartered in Geneva , Switzerland, and has six regional offices and 150 field offices worldwide. Only sovereign States can participate, and it is the largest intergovernmental health organization at
8892-449: The global smallpox eradication campaign by contributing $ 2.4 million annually to the effort and adopted a new disease surveillance method, at a time when 2 million people were dying from smallpox per year. The initial problem the WHO team faced was inadequate reporting of smallpox cases. WHO established a network of consultants who assisted countries in setting up surveillance and containment activities. The WHO also helped contain
9009-432: The health of the birthing person or fetus. For example, morning sickness is a fairly common mild symptom of pregnancy that generally resolves in the second trimester, but hyperemesis gravidarum is a severe form of this symptom that sometimes requires medical intervention to prevent electrolyte imbalances from severe vomiting. The following problems originate in the mother, however, they may have serious consequences for
9126-399: The international level. The WHO's purpose is to achieve the highest possible level of health for all the world's people, defining health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." The main functions of the World Health Organization include: to promote the control of epidemic and endemic diseases; to provide and improve
9243-526: The last European outbreak in Yugoslavia in 1972 . After over two decades of fighting smallpox, a Global Commission declared in 1979 that the disease had been eradicated – the first disease in history to be eliminated by human effort. 1974: The Expanded Programme on Immunization and the control programme of onchocerciasis was started, an important partnership between the Food and Agriculture Organization (FAO),
9360-565: The late 18th century when gynecology and obstetrics reemerged as a medical specialism. The 18th century marked the beginning of many advances in European midwifery , based on better knowledge of the physiology of pregnancy and labour. By the end of the century, medical professionals began to understand the anatomy of the uterus and the physiological changes that take place during labour. The introduction of forceps in childbirth also took place at this time. All these medical advances in obstetrics were
9477-399: The late 1980s. Obstetric ultrasonography is routinely used for dating the gestational age of a pregnancy from the size of the fetus , determine the number of fetuses and placentae , evaluate for an ectopic pregnancy and first trimester bleeding, the most accurate dating being in first trimester before the growth of the foetus has been significantly influenced by other factors. Ultrasound
9594-449: The late 20th century, the rise of new actors engaged in global health—such as the World Bank , the Bill & Melinda Gates Foundation, the U.S. President's Emergency Plan for AIDS Relief ( PEPFAR ) and dozens of public-private partnerships for global health—have weakened the WHO's role as a coordinator and policy leader in the field; subsequently, there are various proposals to reform or reorient
9711-408: The likelihood of unfavorable outcomes for the mother or the fetus is essential. The therapy techniques of placental rupture are based on the fetal gestation age and the status of both the mother and the baby. Instant delivery should be medically warranted for full-term babies (36 weeks or more) and in case of distress. Milder cases with immature embryos being monitored closely, any necessary intervention
9828-474: The lumbar spine. Invasive surgical management is considered a last-line treatment if all other treatment modalities have failed and symptoms are severe. Potential severe hypertensive states of pregnancy are mainly: Women who have chronic hypertension before their pregnancy are at increased risk of complications such as premature birth , low birthweight or stillbirth . Women who have high blood pressure and had complications in their pregnancy have three times
9945-477: The monitoring of public health risks, coordinating responses to health emergencies, and promoting health and well-being generally. The WHO is governed by the World Health Assembly (WHA), which is composed of its 194 member states. The WHA elects and advises an executive board made up of 34 health specialists; selects the WHO's chief administrator, the director-general (currently Tedros Adhanom Ghebreyesus of Ethiopia ); sets goals and priorities; and approves
10062-428: The most severe cases, maternal or fetal mortality. Common complications of pregnancy include anemia, gestational diabetes, infections, gestational hypertension and pre-eclampsia. Presence of these types of complications can have implications on monitoring lab work, imaging, and medical management during pregnancy. Severe complications of pregnancy, childbirth, and the puerperium are present in 1.6% of mothers in
10179-420: The mother and fetus can include pre-eclampsia, anemia, miscarriage, low birth weight, still birth, congestive heart failure , impaired neurointellectual development, and if severe, congenital iodine deficiency syndrome . This complication is treated by iodine supplementation, levothyroxine which is a form of thyroid hormone replacement, and close monitoring of thyroid function. The following problems occur in
10296-651: The mother in need of extensive surgery to repair tissue. But, there was also a large blame of the uterus for completely unrelated conditions. This led to many social consequences of the nineteenth century. Complications of pregnancy Complications of pregnancy are health problems that are related to, or arise during pregnancy . Complications that occur primarily during childbirth are termed obstetric labor complications , and problems that occur primarily after childbirth are termed puerperal disorders . While some complications improve or are fully resolved after pregnancy, some may lead to lasting effects, morbidity, or in
10413-493: The neonatal intensive care unit. The increased risk is correlated with the how well the gestational diabetes is controlled during pregnancy with poor control associated with worsened outcomes. A multidisciplinary approach is used to treat gestational diabetes and involves monitoring of blood-glucose levels, nutritional and dietary modifications, lifestyle changes such as increasing physical activity, maternal weight management , and medication such as insulin. Hyperemesis gravidarum
10530-476: The normal level of risk may be present in the pregnant individual's medical profile either before they become pregnant or during the pregnancy. These pre-existing factors may related to the individual's genetics, physical or mental health, their environment and social issues, or a combination of those. Some common biological risk factors include: Some common environmental risk factors during pregnancy include: Some disorders and conditions can mean that pregnancy
10647-462: The obstetrician carries out the following tasks: The main emergencies include: The World Health Organization makes a distinction between the use of postpartum care when it concerns the care of the mother after giving birth, and postnatal care when the care of the newborn is concerned. Postpartum care is provided to the mother following childbirth. A woman in the Western world who gives birth in
10764-421: The other organization has or may have a substantial interest, the first party shall consult the other with a view to adjusting the matter by mutual agreement. The nature of this statement has led some groups and activists including Women in Europe for a Common Future to claim that the WHO is restricted in its ability to investigate the effects on human health of radiation caused by the use of nuclear power and
10881-546: The perceived failure of the response to the West Africa Ebola outbreak , the World Health Emergencies programme was formed, changing the WHO from just being a "normative" agency to one that responds operationally to health emergencies. 2020: the World Health Organization announced that it had classified the novel coronavirus outbreak as a public health emergency of international concern. The novel coronavirus
10998-640: The placenta. Due to abnormal adherence of the placenta to the uterine wall, cesarean delivery is often indicated, as well as cesarean hysterectomy. Multiple births may become monochorionic , sharing the same chorion , with resultant risk of twin-to-twin transfusion syndrome . Monochorionic multiples may even become monoamniotic , sharing the same amniotic sac , resulting in risk of umbilical cord compression and entanglement . In very rare cases, there may be conjoined twins , possibly impairing function of internal organs. Control of multiple pregnancies, such as special prenatal care and birth plans, can help in
11115-421: The placental trophoblast to the uterine myometrium. Placenta accreta risk factors include placenta previa, abnormally elevated second-trimester AFP and free β-hCG levels, and advanced gestational parent age, specifically over the age of 35. Furthermore, prior cesarean delivery is one of the most common risk factors for placenta accreta, due to the presence of a uterine scar leading to abnormal decidualization of
11232-423: The policies aimed at limiting the risk of transmission among high-risk populations. In addition, it is early diagnosis and management of maternal infections are among the main methods to flatline vertical transmission and fetal aberrations. A pregnant woman is more susceptible to certain infections . This increased risk is caused by an increased immune tolerance in pregnancy to prevent an immune reaction against
11349-527: The process of assisting parents who have lost their children. Placental abruption defined as the separation of the placenta from the uterus prior to delivery, is a major cause of third trimester vaginal bleeding and complicates about 1% of pregnancies. Symptomatic presentations are variable: Some women can entirely ignore the symptoms, while others have mild bleeding or abdominal discomfort and pain. Hence, though symptom severity variance and precipitous placental separation are not relevant, they can still cause
11466-461: The rejection of obstetrics by the medical community. The 19th century marked an era of medical reform in Europe and increased regulation over the profession. Major European institutions such as The College of Physicians and Surgeons considered delivering babies ungentlemanly work and refused to have anything to do with childbirth as a whole. Even when Medical Act 1858 was introduced, which stated that medical students could qualify as doctors, midwifery
11583-473: The risk more accurately. The cost is higher than an "AFP-quad" screen due to the ultrasound and second blood test, but it is quoted to have a 93% pick up rate as opposed to 88% for the standard AFP/QS. This is an evolving standard of care in the United States. Most doctors do a sugar load in a drink form of 50 grams of glucose in cola, lime or orange and draw blood an hour later (plus or minus 5 minutes). The standard modified criteria have been lowered to 135 since
11700-659: The risk of developing cardiovascular disease compared to women with normal blood pressure who had no complications in pregnancy. Monitoring pregnant women's blood pressure can help prevent both complications and future cardiovascular diseases. Venous thromboembolism , consisting of deep vein thrombosis and pulmonary embolism , is a major risk factor for postpartum morbidity and mortality, especially in highly developed countries. A combination of pregnancy-exacerbated hypercoagulability and additional risk factors such as obesity and thrombophilias makes pregnant women vulnerable to thrombotic events T.he prophylactic measures that include
11817-528: The teaching and training in public health, the medical treatment of disease and related matters; and to promote the establishment of international standards for biological products. The WHO was established on April 7, 1948, and formally began its work on September 1, 1948. It incorporated the assets, personnel, and duties of the League of Nations ' Health Organization and the Paris-based Office International d'Hygiène Publique , including
11934-450: The theories of what caused menstruation prevailed from Hippocratic philosophy. Midwives , meaning "with woman", were those who assisted in the birth and care of both born and unborn children, a position historically held mainly by women. During the birth of a child, men were rarely present. Women from the neighbourhood or family would join in on the process of birth and assist in many different ways. The one position where men would help with
12051-489: The third trimesters. According to the United Nations (UN) estimates, approximately half of pregnant individuals develop anemia worldwide. Anemia prevalences during pregnancy differed from 18% in developed countries to 75% in South Asia; culminating to a global rate of 38% of pregnancies worldwide. Treatment varies due to the severity of the anaemia, and can be used by increasing iron containing foods, oral iron tablets or by
12168-423: The thyroid and increase thyroid hormone demand. For example, during pregnancy, there is increased urinary iodine excretion as well as increased thyroxine binding globulin and thyroid hormone degradation which all increase thyroid hormone demands. This condition can have a profound effect during pregnancy on the mother and fetus. The infant may be seriously affected and have a variety of birth defects. Complications in
12285-833: The thyroid by causing low thyroid hormone levels. Symptoms of hypothyroidism can include low energy, cold intolerance, muscle cramps, constipation, and memory and concentration problems. It is diagnosed by the presence of elevated levels of thyroid stimulation hormone or TSH. Patients with elevated TSH and decreased levels of free thyroxine or T4 are considered to have overt hypothyroidism. While those with elevated TSH and normal levels of free T4 are considered to have subclinical hypothyroidism. Risk factors for developing hypothyroidism during pregnancy include iodine deficiency, history of thyroid disease, visible goiter, hypothyroidism symptoms, family history of thyroid disease, history of type 1 diabetes or autoimmune conditions, and history of infertility or fetal loss. Various hormones during pregnancy affect
12402-457: The usage of low molecular weight heparin, in fact, can significantly reduce risks associated with surgery, particularly in high-risk patients. Awareness among healthcare givers and prompt response in early identification and management of venous thromboembolism during pregnancy and the postpartum period are both crucial for prompt response . Deep vein thrombosis, a form of venous thromboembolism, has an incidence of 0.5 to 7 per 1,000 pregnancies, and
12519-486: The use of parenteral iron . Pregnancy is a critical period for the expectant mom to experience additional dangers associated with infections. Moreover, a mother and baby's health is exposed to danger when she is in this condition. The prenatal physiology complexity and immunity modulation inherently increase the risk of influenza , hepatitis E , and cytomegalovirus transmission. Avoidance actions like vaccines and strict infectious control protocols can be given priority in
12636-488: The world without prejudice to the right of the World Health Organization to concern itself with promoting, developing, assisting and co-ordinating international health work, including research, in all its aspects. The key text is highlighted in bold, the agreement in clause 2 states that the WHO is free to perform any health-related work. 1947: The WHO established an epidemiological information service via telex . 1949: The Soviet Union and its constituent republics quit
12753-500: Was a new strain of coronavirus that had never been detected in humans before. The WHO named this new coronavirus " COVID-19 " or "2019-nCov". 2022: The WHO suggests formation of a Global Health Emergency Council, with a new global health emergency workforce, and recommends revision of the International Health Regulations. 2024: WHO has declared the spread of mpox (formerly monkeypox) in several African countries
12870-410: Was a way for these men to demonstrate their knowledge. Many midwives of the time bitterly opposed the involvement of men in childbirth. Some male practitioners also opposed the involvement of medical men like themselves in midwifery and even went as far as to say that male-midwives only undertook midwifery solely for perverse erotic satisfaction. The accoucheurs argued that their involvement in midwifery
12987-526: Was concerning the compilation of accurate statistics on the spread and morbidity of disease. The logo of the World Health Organization features the Rod of Asclepius as a symbol for healing. In 1959, the WHO signed Agreement WHA 12–40 with the International Atomic Energy Agency (IAEA), which says: whenever either organization proposes to initiate a programme or activity on a subject in which
13104-469: Was difficult to reach. Seven of these international conferences, spanning 41 years, were convened before any resulted in a multi-state international agreement. The seventh conference, in Venice in 1892, finally resulted in a convention. It was concerned only with the sanitary control of shipping traversing the Suez Canal , and was an effort to guard against importation of cholera. Five years later, in 1897,
13221-416: Was drawn up to improve the resources available. 2005: The WHO revises International Health Regulations (IHR) in light of emerging health threats and the experience of the 2002/3 SARS epidemic , authorizing WHO, among other things, to declare a health threat a Public Health Emergency of International Concern . 2006: The WHO endorsed the world's first official HIV/AIDS Toolkit for Zimbabwe, which formed
13338-475: Was entirely ignored. This made it nearly impossible to pursue an education in midwifery and also have the recognition of being a doctor or surgeon. Obstetrics was pushed to the side. By the late 19th century, the foundation of modern-day obstetrics and midwifery began developing. Delivery of babies by doctors became popular and readily accepted, but midwives continued to play a role in childbirth. Midwifery also changed during this era due to increased regulation and
13455-698: Was formed. 1988: The Global Polio Eradication Initiative was established. 1995: The WHO established an independent International Commission for the Certification of Dracunculiasis Eradication (Guinea worm disease eradication; ICCDE). The ICCDE recommends to the WHO which countries fulfil requirements for certification. It also has role in advising on progress made towards elimination of transmission and processes for verification. 1998: The WHO's director-general highlighted gains in child survival, reduced infant mortality , increased life expectancy and reduced rates of "scourges" such as smallpox and polio on
13572-461: Was the surgeon responsible for being the first treating a vesicovaginal fistula – a condition linked to many caused mainly by prolonged pressing of the foetus against the pelvis or other causes such as rape, hysterectomy, or other operations – and also having been doctor to many European royals and the 20th President of the United States James A. Garfield after he had been shot. Sims does have
13689-400: Was to improve the process of childbirth. These men also believed that obstetrics would forge ahead and continue to strengthen. 18th-century physicians expected that obstetrics would continue to grow, but the opposite happened. Obstetrics entered a stage of stagnation in the 19th century, which lasted until about the 1880s. The central explanation for the lack of advancement during this time was
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