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Obstetrics

Obstetrics is a pivotal branch of medicine focused on pregnancy, childbirth, and the postpartum period. In Australia, obstetric care is designed to support women through both low and high-risk pregnancies, ensuring the health and safety of both the mother and the child.

Statistics Relevant to Australian Obstetrics

  • Birth Rates: Approximately 300,000 babies are born in Australia each year.
  • Caesarean Section Rates: About 32% of all births in Australia are via caesarean section,
  • Preterm Birth Rates: Around 8% of Australian births occur prematurely, defined as births that occur before 37-weeks of gestation.
  • Maternal Mortality Rates: Australia has one of the lowest maternal mortality rates in the world, reflecting the high standards of obstetric care.

Low-risk obstetrics deals with the management and care of pregnancies that do not present significant health threats to the mother or the baby. These pregnancies are expected to proceed without major complications. Key aspects include:

  • Routine Prenatal Care: Regular check-ups are crucial, including physical exams, blood tests, and ultrasounds, to monitor the baby’s development and the mother’s health. These appointments help identify any minor issues before they become serious.
  • Educational Support: Providing information on healthy pregnancy habits, labour, delivery options, and postpartum care.
  • Delivery Preparation: Discussing birth plans, pain relief options, and preparation for a natural vaginal delivery.

High-risk obstetrics involves pregnancies that have an increased risk of complications that could affect the mother, the baby, or both. These pregnancies require additional monitoring, tests, and interventions. Conditions that might lead to a high-risk pregnancy include:

  • Pre-existing Medical Conditions: Such as high blood pressure, diabetes, kidney disease, autoimmune diseases, and obesity.
  • Pregnancy-Induced Conditions: Including gestational diabetes, preeclampsia, and HELLP syndrome (haemolysis, elevated liver enzymes, and low platelet count).
  • Age-Related Risks: Increased risks are associated with teenage pregnancies and pregnancies in women over the age of 35.
  • Multiple Pregnancies: Twins, triplets, or higher multiple gestations significantly increase the complexity and risks of pregnancy.

Women should be aware of several conditions and symptoms during pregnancy, which may indicate the need for special care:

  • Gestational Diabetes: Diagnosed through glucose testing, typically around 24-28 weeks of gestation.
  • Pregnancy Induced Hypertension: Blood pressure generally becomes low during pregnancy due to hemodynamic changes. However, some patients might experience blood pressure increases during pregnancy. This is called gestational hypertension or Pregnancy Induced Hypertension. If not well controlled, this can lead to mother and baby complications. Medication to control your blood pressure and close monitoring of you and baby is required during pregnancy to achieve best results.
  • Preeclampsia: Is a known complication during pregnancy. Some pregnant women get high blood pressure along with swelling on the body associated with changes in liver and kidney blood tests.
    Pre-eclamsia can affect a baby’s growth. Close monitoring of your health and Baby’s well being is monitored closely. Usually delivery is induced or Caesarean section is planned at the right time to achieve a good outcome.
  • Preterm Labour: Unfortunately preterm labour is one of the main reasons for perinatal morbidity and mortality. When labour starts early (before 36 weeks of pregnancy) it is called preterm labour. Symptoms include regular contractions, pressure in the pelvis, lower back pain, and changes in cervical length, bleeding, ruptured membranes etc.
  • Cervical length
    Miscarriage: Symptoms can include vaginal spotting or bleeding, pain or cramping in the abdomen or lower back, and fluid or tissue passing from the vagina.
  • Obstetric Ultrasounds: Ultrasound has a major role in Obstetrics. The role of scan has evolved over the years. In early pregnancy, ultrasound helps to know viability, location of pregnancy and making a diagnosis of twin pregnancies, and any pathology like ovarian cysts or abnormal uterine shape. Later, regular scans are performed to check the baby’s development, detect congenital abnormalities, assess the placental position, and monitor the baby’s growth.
  • Caesarean Section: Performed when a vaginal delivery would put the mother or baby at risk due to medical complications.

Conclusion

Obstetrics is a crucial area of healthcare that supports women throughout their pregnancy journey, from conception to postpartum care. Dr Mane is focussed is on providing personalised care tailored to the needs of each woman, whether her pregnancy is considered low or high risk.

Regular engagement with healthcare providers, adherence to recommended prenatal care, awareness of potential symptoms, and understanding the available medical interventions are essential for a healthy pregnancy and childbirth experience.

By staying informed and proactive, expectant mothers can significantly contribute to a positive and safe pregnancy outcome.

Dr Shree Mane is a Sydney Obstetrician and Gynaecologist, and Fertility Medicine sub-specialist with 30+ years of experience. She has achieved specialist registration in India, the United Kingdom and Australia.

She consults and operates across Western Sydney and offers Saturday appointments, as well as telehealth bookings.

If you have a question about a condition or treatment, or would like to book an appointment, please contact us and one of our friendly staff members will happily assist you.

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