Advancements in Obstetrics and Gynecology

By Celeste Nachnani


Accounting for successful childbirth is a crucial part of women’s healthcare. Due to modern technology, a monumental part of many people’s lives have become simple , ensuring that more mothers receive the gratification of holding their new loved ones. The advancing discipline of gynecology has caused the emergence of new treatments and innovations to arise.


In 1880, gynecology became its respected discipline in medicine, leading to the first ovarian cystectomy being performed in 1809 and the first vaginal hysterectomy being performed in 1812. In 1941, George Nicolas Papnicolau developed the first screening test for cervical cancer, known as the pap smear. In the 1900s, medical institutions started implementing prenatal care and guidance to reduce birth defects.


In the United States, a baby with a defect is born every 4.5 minutes. This is the leading cause of death among infants. Defects may arise due to several reasons including lifestyle, habits during pregnancy, and genetic abnormalities.


One large factor contributing to birth defects is substance abuse. In the 1970s, fetal alcohol spectrum disorder, conditions due to alcohol, were becoming increasingly popular. However, clinical trials were put into place to try to remediate the effects of fetal alcohol spectrum disorder. Exposure to x-ray radiation, mercury, and prescription drugs further trigger these effects.


Another form of a defect includes neural tube defects, which are structural abnormalities in the spinal cord. This can be avoided with the consumption of folic acid and prenatal vitamins during birth as prescribed by a doctor. They improve the chances of the delivery of a healthy baby by 70%.


In the 1970s, the understanding of fetal development improved due to the creation of prenatal ultrasound. Fetal echocardiograms were created to detect congenital birth defects, and prenatal diagnostic testing (chromosome testing) was performed. In the 1950s, doctors would test samples of amniotic fluid surrounding the fetus for abnormalities.


Some of the latest advancements in ultrasound technology include the creation of a volumetric ultrasound, elastography, contrast-enhanced ultrasound, and political reform surrounding women’s health care.

A volumetric ultrasound can create detailed images that can provide perspective on cardiac function, organ systems, and the development of any tumors. Elastography studies the mechanical characteristics of tissues. However, the FDA in the United States has only approved limited versions of this treatment, such as sonoelastography. Sonoelastography measures tissue stiffness and identifies conditions such as liver fibrosis, prostate cancer, and breast lumps. Contrast-enhanced ultrasound, primarily used in Europe, Canada, and China, utilizes contrast and pigmentation to scan organ systems such as the digestive tract and the heart. With further development, they may replace CT and MRI scans for cancer and more. Political reform regarding health care includes states requiring radiologists to inform women with dense breast tissue to attend the additional screening.


Another treatment being thoroughly studied and tested includes oropharyngeal milk administration to improve levels of salivary slgA, an immunoglobulin in infants. It is administered by placing milk drops on the skin of an infant’s mouth through a nasogastric or orogastric tube. Improving levels of this immunoglobulin is essential as it is an important antibody for infants. Infants with low birth weights are susceptible to not developing enough of this immunoglobulin. According to studies, this form of therapy can stimulate the immune system, augment intestinal maturation, and improve levels of this immunoglobulin.


All in all, there have been many successful inventions and methods that have arisen through the study of Obstetrics and Gynecology. The advancement of OBGYN technology such as volumetric ultrasounds, sonoelastography, and methods of milk-administration all contribute to the improvement of healthcare. This rapid advancement sparks hope for a future of more accessible medicine and enhanced healthcare for everyone.



Sources


(n.d.). Oropharyngeal Mother's Milk. Retrieved March 13, 2022, from https://relaped.com/wp-content/uploads/2019/05/garofalo2018_Oropharyngeal-Mother%E2%80%99s-Milk_State-of-the-science-and-influence-on-Necrotizing-Enterocolitis.pdf


Advances in Care for Birth Defects. (n.d.). Northwestern Medicine. Retrieved March 13, 2022, from https://www.nm.org/healthbeat/medical-advances/advances-in-care-birth-defects


Chen, LL., Liu, J., Mu, XH. et al. Oropharyngeal administration of mother’s own milk influences levels of salivary sIgA in preterm infants fed by gastric tube. Sci Rep 12, 2233 (2022). https://doi.org/10.1038/s41598-022-06243-2


The History of Modern Obstetrics and Gynecology. (2014, March 11). Obgyn North. Retrieved March 13, 2022, from https://obgynnorth.com/uncategorized/the-history-of-modern-obstetrics-and-gynecology/


Latest Advancements in Ultrasound Imaging Technology. (2019, May 7). Peconic Bay Medical Center. Retrieved March 13, 2022, from http://pbmchealth.org/news-events/blog/latest-advancements-ultrasound-imaging-technology


Oropharyngeal administration of mother's milk to prevent necrotizing enterocolitis in extremely low-birth-weight infants: theoretical perspectives. (n.d.). PubMed. Retrieved March 13, 2022, from https://pubmed.ncbi.nlm.nih.gov/25633403/



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