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OSMU
Department of obstetrics and
gynecology
The subject of obstetrics.
Organization obstetrics
INTRODUCTION.
Professor, M. D., Konstantinova O. D.
PLAN
• Subject of OBGYN
• Organization of OBGYN
• Short History
• Sanitary and anti-epidemic regime
• Main indicators of obstetric services
SUBJECT of GYN
• Gynaecology or gynecology is the medical
practice dealing with the health of the female
reproductive system. Literally, outside medicine,
it means "the science of women «Almost all
mode
• Etymology The word "gynaecology" comes from
the Greek ancient Greek gyne, γυνή, modern
Greek gynaika, γυναίκα, meaning woman + logia
meaning study, so gynaecology literally is the
study of women.
3
SUBJECT OF OB
• Obstetrics (from the Latin obstare, "to stand
by") is the medical specialty dealing with the
care of all women's reproductive tracts and
their children during pregnancy (prenatal
period), childbirth and the postnatal period
• Obstetrician-gynecologist - provides medical
and preventive care for female population
from birth to death, conducts sanitary-
educational work..
4
• Obstetrics and Gynaecology(often abbreviated
to OB/GYN) are two surgical specialities
dealing with the female reproductive organs
and as such are often combined to form a
single medical speciality and postgraduate
training programm.
5
• Perinatology or Maternal-Fetal medicine
(MFM) is the branch of obstetrics that focuses
on the medical and surgical management of
high-risk pregnancies.
• Obstetricians who practice maternal-fetal
medicine are also known as perinatologists.
• This is a subspecialty to obstetrics and
gynecology mainly used for patients with high-
risk pregnancies.
6
• Obstetrics and gynecology medical/surgical
specialty concerned with the care of women from
pregnancy until after delivery and with the
diagnosis and treatment of disorders of the
female reproductive tract.
• The medical care of pregnant women (obstetrics)
and of female genital diseases (gynecology)
developed along different historical paths.
7
ORIGINS OF OBSTETRICS
• Gynecology as a branch of medicine dates back to Greco-
Roman civilization, if not earlier. The renewal of interest in
diseases of women is shown in the huge encyclopaedia of
gynecology issued in 1566 by Caspar Wolf of Zürich. The
earliest birth attendants were women. In ancient
mythology, goddesses (but not gods) were present at
deliveries. In “primitive” tribes studied by anthropologists
in the last century, the labouring woman would be
accompanied by her mother or other female relative.
• Prehistoric figures and ancient Egyptian drawings show
women giving birth in the sitting or squatting position.
Birthing stools and midwives are also mentioned in the Old
Testament.
8
ORIGINS OF OBSTETRICS
• The history of obstetrics is inextricably linked with the
history of midwifery. obstetrix was the Latin word for
midwife: it is thought to derive from obstare (to “stand
before”), because the attendant stood in front of the
woman to receive the baby. Only in the 20th century
did the subject taught in medical schools change its
name from “midwifery” to “obstetrics”, perhaps
because a Latin name seemed more academic than the
Anglo-Saxon, derived from mid, “with”, and wyf,
“woman”.
9
• obstetrics and gynecology The two great
advances that finally overcame such opposition
and made gynecologic surgery generally available
were the use of anesthesia and antiseptic
methods. The separate specialty of gynecology
had become fairly well established by 1880; its
union with the specialty of obstetrics, arising
from an overlap of natural concerns, began late in
the century and has continued to the present day.
10
ORIGINS OF OBSTETRICS
• In the 20th century, obstetrics developed chiefly in the areas of fertility
control and the promotion of healthy births. The prenatal care and
instruction of pregnant mothers to reduce birth defects and problem
deliveries was introduced about 1900 and was thereafter rapidly adopted
throughout the world. Beginning with the development of hormonal
contraceptive pills in the 1950s, obstetrician-gynecologists have also
become increasingly responsible for regulating women’s fertility and
fecundity. With the development of amniocentesis, ultrasound, and other
methods for the prenatal diagnosis of birth defects, obstetrician-
gynecologists have been able to abort defective fetuses and unwanted
pregnancies. At the same time, new methods for artificially implanting
fertilized embryos within the uterus have enabled obstetrician-
gynecologists to help previously infertile couples to have children.
• 11
indicators of maternity services
• registration of pregnancy (before 12 weeks of
gestation)
• Birth rate(per 1000 population)
• Premature termination of pregnancy (abortion up
to 21 weeks, stillbirth, premature birth between
22 and 37 weeks of pregnancy)
• Maternal mortality ( per 100,000 live births)
includes maternal deaths during pregnancy and
within 42 days of delivery.
12
• Perinatal mortality is the sum of fetal (from
22 weeks until delivery) and neonatal (until 28
days of age) mortality. (stillbirth, intrapartum,
neonatal, infant)
13
Perinatal/Maternal Mortality
• In the developed world, by contrast, in the second half of the 20th century attention
shifted from the mother to the fetus. Two developments allowed this to happen.
Fetal monitoring in labour became possible by detecting the fetal electrocardiogram
and by sampling fetal scalp blood.
• A combination of innovations over the last one hundred years have contributed to
this progress, including:
• • Antibiotics
• • The ability to safely transfuse blood products
• • The increasing safety of cesarean delivery and improved anesthesia techniques
• • The widespread use of uterotonics and safer methods of induction of labor
• • The introduction of corticosteroids to enhance fetal lung maturity
• • The widespread use of anti-D immune globulin to prevent Rh-allomunization
• • The practice of surveillance for and early intervention (i.e. delivery) in cases of
preeclampsia/hypertension
• • Advances in adult and neonatal intensive care
• • Introduction of ultrasonography and other advanced antenatal monitoring
techniques
• 14
•
Perinatal/Maternal Mortality
• In developing countries, however, maternal
mortality is still a major problem.
• Across the globe, one woman dies of
pregnancy every minute of every day. The
causes are sepsis, haemorrhage, hypertensive
disease, and unsafe abortion—the same
causes that were common 70 years ago.
15
maternity services are defined:-
-The Constitution of the Russian Federation-The
law on health protection of citizens of the
Russian Federation№323-
The family Code of the Russian Federation
-The legislation of the Russian Federation on
labor Obstetric neonatal service is operated
on:
- Federal level – MOH- Subject of the
Federation
16
The structure of maternity services
• Outpatient care:- Women's consultation,
obstetric centre,
• Medical clinic Inpatient care: Maternity
hospital, maternity ward
• Perinatal centre(maternity ward, pathology
of pregnancy, resuscitation and intensive
neonatal ward, the separation of the second
stage of nursing, the Department of
pathology of newborns)
• Center for prenatal diagnosis
17
Ministry of health order No. 572н
from 01.11.2012
• Standards of medical care woman and
child
• Organization of the work of Women's
consultation of Perinatal center
• Orders of rendering of medical aid in the
field of obstetric care
Sanitary and anti-epidemic regime
• Sanitary - epidemiological requirements for
organizations engaged in medical activities
(SANPIN 2010)-
in all departments of the requirements for the
prevention of nosocomial infections

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Organization and History of Obstetrics and Gynecology Services

  • 1. OSMU Department of obstetrics and gynecology The subject of obstetrics. Organization obstetrics INTRODUCTION. Professor, M. D., Konstantinova O. D.
  • 2. PLAN • Subject of OBGYN • Organization of OBGYN • Short History • Sanitary and anti-epidemic regime • Main indicators of obstetric services
  • 3. SUBJECT of GYN • Gynaecology or gynecology is the medical practice dealing with the health of the female reproductive system. Literally, outside medicine, it means "the science of women «Almost all mode • Etymology The word "gynaecology" comes from the Greek ancient Greek gyne, γυνή, modern Greek gynaika, γυναίκα, meaning woman + logia meaning study, so gynaecology literally is the study of women. 3
  • 4. SUBJECT OF OB • Obstetrics (from the Latin obstare, "to stand by") is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy (prenatal period), childbirth and the postnatal period • Obstetrician-gynecologist - provides medical and preventive care for female population from birth to death, conducts sanitary- educational work.. 4
  • 5. • Obstetrics and Gynaecology(often abbreviated to OB/GYN) are two surgical specialities dealing with the female reproductive organs and as such are often combined to form a single medical speciality and postgraduate training programm. 5
  • 6. • Perinatology or Maternal-Fetal medicine (MFM) is the branch of obstetrics that focuses on the medical and surgical management of high-risk pregnancies. • Obstetricians who practice maternal-fetal medicine are also known as perinatologists. • This is a subspecialty to obstetrics and gynecology mainly used for patients with high- risk pregnancies. 6
  • 7. • Obstetrics and gynecology medical/surgical specialty concerned with the care of women from pregnancy until after delivery and with the diagnosis and treatment of disorders of the female reproductive tract. • The medical care of pregnant women (obstetrics) and of female genital diseases (gynecology) developed along different historical paths. 7
  • 8. ORIGINS OF OBSTETRICS • Gynecology as a branch of medicine dates back to Greco- Roman civilization, if not earlier. The renewal of interest in diseases of women is shown in the huge encyclopaedia of gynecology issued in 1566 by Caspar Wolf of Zürich. The earliest birth attendants were women. In ancient mythology, goddesses (but not gods) were present at deliveries. In “primitive” tribes studied by anthropologists in the last century, the labouring woman would be accompanied by her mother or other female relative. • Prehistoric figures and ancient Egyptian drawings show women giving birth in the sitting or squatting position. Birthing stools and midwives are also mentioned in the Old Testament. 8
  • 9. ORIGINS OF OBSTETRICS • The history of obstetrics is inextricably linked with the history of midwifery. obstetrix was the Latin word for midwife: it is thought to derive from obstare (to “stand before”), because the attendant stood in front of the woman to receive the baby. Only in the 20th century did the subject taught in medical schools change its name from “midwifery” to “obstetrics”, perhaps because a Latin name seemed more academic than the Anglo-Saxon, derived from mid, “with”, and wyf, “woman”. 9
  • 10. • obstetrics and gynecology The two great advances that finally overcame such opposition and made gynecologic surgery generally available were the use of anesthesia and antiseptic methods. The separate specialty of gynecology had become fairly well established by 1880; its union with the specialty of obstetrics, arising from an overlap of natural concerns, began late in the century and has continued to the present day. 10
  • 11. ORIGINS OF OBSTETRICS • In the 20th century, obstetrics developed chiefly in the areas of fertility control and the promotion of healthy births. The prenatal care and instruction of pregnant mothers to reduce birth defects and problem deliveries was introduced about 1900 and was thereafter rapidly adopted throughout the world. Beginning with the development of hormonal contraceptive pills in the 1950s, obstetrician-gynecologists have also become increasingly responsible for regulating women’s fertility and fecundity. With the development of amniocentesis, ultrasound, and other methods for the prenatal diagnosis of birth defects, obstetrician- gynecologists have been able to abort defective fetuses and unwanted pregnancies. At the same time, new methods for artificially implanting fertilized embryos within the uterus have enabled obstetrician- gynecologists to help previously infertile couples to have children. • 11
  • 12. indicators of maternity services • registration of pregnancy (before 12 weeks of gestation) • Birth rate(per 1000 population) • Premature termination of pregnancy (abortion up to 21 weeks, stillbirth, premature birth between 22 and 37 weeks of pregnancy) • Maternal mortality ( per 100,000 live births) includes maternal deaths during pregnancy and within 42 days of delivery. 12
  • 13. • Perinatal mortality is the sum of fetal (from 22 weeks until delivery) and neonatal (until 28 days of age) mortality. (stillbirth, intrapartum, neonatal, infant) 13
  • 14. Perinatal/Maternal Mortality • In the developed world, by contrast, in the second half of the 20th century attention shifted from the mother to the fetus. Two developments allowed this to happen. Fetal monitoring in labour became possible by detecting the fetal electrocardiogram and by sampling fetal scalp blood. • A combination of innovations over the last one hundred years have contributed to this progress, including: • • Antibiotics • • The ability to safely transfuse blood products • • The increasing safety of cesarean delivery and improved anesthesia techniques • • The widespread use of uterotonics and safer methods of induction of labor • • The introduction of corticosteroids to enhance fetal lung maturity • • The widespread use of anti-D immune globulin to prevent Rh-allomunization • • The practice of surveillance for and early intervention (i.e. delivery) in cases of preeclampsia/hypertension • • Advances in adult and neonatal intensive care • • Introduction of ultrasonography and other advanced antenatal monitoring techniques • 14 •
  • 15. Perinatal/Maternal Mortality • In developing countries, however, maternal mortality is still a major problem. • Across the globe, one woman dies of pregnancy every minute of every day. The causes are sepsis, haemorrhage, hypertensive disease, and unsafe abortion—the same causes that were common 70 years ago. 15
  • 16. maternity services are defined:- -The Constitution of the Russian Federation-The law on health protection of citizens of the Russian Federation№323- The family Code of the Russian Federation -The legislation of the Russian Federation on labor Obstetric neonatal service is operated on: - Federal level – MOH- Subject of the Federation 16
  • 17. The structure of maternity services • Outpatient care:- Women's consultation, obstetric centre, • Medical clinic Inpatient care: Maternity hospital, maternity ward • Perinatal centre(maternity ward, pathology of pregnancy, resuscitation and intensive neonatal ward, the separation of the second stage of nursing, the Department of pathology of newborns) • Center for prenatal diagnosis 17
  • 18. Ministry of health order No. 572н from 01.11.2012 • Standards of medical care woman and child • Organization of the work of Women's consultation of Perinatal center • Orders of rendering of medical aid in the field of obstetric care
  • 19. Sanitary and anti-epidemic regime • Sanitary - epidemiological requirements for organizations engaged in medical activities (SANPIN 2010)- in all departments of the requirements for the prevention of nosocomial infections