Obstetrics and gynaecology is concerned with the care of pregnant woman, her unborn child and the management of diseases specific to women. The specialty combines medicine and surgery.
Most consultants within the specialty work in both obstetrics and gynaecology (O&G). Many have a major special interest in a particular area, such as high-risk obstetrics, fertility care or minimal access surgery. A smaller number of consultants work as sub specialists, with all of their work concentrated in a specific area of practice.
This is a varied specialty, mostly dealing with healthy women, where unexpected challenges can present themselves on a daily basis. Work includes a large number of hands-on procedures, both in obstetrics and gynaecology.
In gynaecology, patients range from those who have chronic disorders which are not life threatening (but interfere significantly with quality of life), to those where an acute emergency presentation is the first indication of a gynaecological problem.
Gynaecology is concerned with the well-being and health of the female reproductive organs and the ability to reproduce. It includes endocrinology, female urology and pelvic malignancy. The specialty spans paediatric and adolescent gynaecological problems through to later years.
In obstetrics most women, although pregnant, are otherwise fit and healthy. However, others will have acute or chronic medical problems that complicate their pregnancy and are under the specific care of an obstetrician.
Obstetrics and gynaecology is an exciting area. Many new techniques and procedures have been developed over the past 30 years, and transformed the health of women and babies. Improvements in ultrasound have made care of the baby in the womb a central part of the specialty. It is an evolving discipline with many research arms, both at clinical and molecular level.
Obstetrics
Within obstetrics, most of the care of low risk mothers and uncomplicated deliveries are performed by midwives.
About 35% of births are undertaken by an obstetrician, usually for more complex cases or if the baby becomes distressed during labour. Their work includes:
using instruments to assist delivery – including forceps or a ventouse (vacuum-assisted delivery)
performing caesarean sections, either as a planned or emergency procedure
Gynaecology
Within gynaecology procedures include:
carrying out surgical interventions following miscarriage
treating abnormal bleeding and polyps
major surgery for gynaecological cancers
minimal access surgery for problems including endometriosis
Keyhole or minimal access surgery is now commonplace and has many advantages.
Assisted reproduction (fertility treatment) has helped many thousands of women have a family, which would not have been possible in the last generation.
