Definition and Overview

An OB-GYN or a doctor specializing in obstetrics and gynecology is a medical professional responsible for the health, care and treatment of a woman’s reproductive and genital systems. They are the professionals to consult on matters relating to pregnancy, childbirth, postpartum period, the female reproductive systems (which includes the vagina, ovaries and uterus) and the female breasts.

A patient’s first appointment with an OB-GYN should begin before she turns 18. This is to ensure her reproductive and genital health as she matures. Follow-up consultations should be scheduled every year to monitor the progress of her health and diagnose common cancers in female patients, such as cervical and breast cancers, early.

When the patient becomes pregnant, follow-up consultations are scheduled more frequently to ensure her health and the normal, healthy development of her foetus.

Who Should Undergo and Expected Results

All women over the age of 18 should undergo annual OB-GYN follow-up consultations. Expecting mothers or patients who have just given birth should come in for more regular appointments during periods specified by the healthcare professional.

The expected result is receiving information on ways to maintain good reproductive and genital health, as well as good maternal and foetal health. Patients can also expect that any conditions affecting their reproductive and genital systems are discovered and treated promptly.

How is the Procedure Performed?

For women over 18 years old and not expecting a child, a follow-up consultation with the OB-GYN usually involves a Pap test. Patients are advised to refrain from douching and sexual activity 24 hours before the scheduled appointment. This test requires a cell sample taken from the cervix or vagina to determine if there are problems affecting these reproductive organs that can lead to cervical cancer. This test is perhaps the best way to determine precancerous conditions, as well as small, often hidden, tumors in the cervix that can cause serious problems in the future.

Patients are recommended to have a Pap test to check for cervical cancer once every three years (if they are over the age of 21) and once every five years (if the patient is 30 to 65 years old).

A breast exam can also be included in the annual follow-up consultation with an OB-GYN. Aside from feeling the patient’s breasts for suspicious lumps, the OB-GYN can also order a mammogram if the patient is over a certain age or at risk of developing breast cancer. HPV (human papillomavirus), HIV (human immunodeficiency virus), Chlamydia, gonorrhea and syphilis tests should be performed annually if the patient is sexually active or has a high risk of being exposed to sexually transmitted infections. Other routine tests that will be performed during an annual OB-GYN follow-up consultation are blood and urine tests.

A pelvic exam is also part of the consultation procedure, where the OB-GYN will examine the exterior of the patient’s vagina, including the vaginal opening and the vulva, for abnormalities that might signal a more serious condition.

The doctor will perform an internal exam using one or two gloved fingers into the patient’s vagina. The doctor will also place a hand on top of the patient’s lower abdomen to feel for the position of the cervix, womb, ovaries and fallopian tubes.

The consultation process for expectant mothers is different from a general follow-up consultation since there are two patients to consider: the mother and her child. After the first visit during the early stages of the first trimester of the pregnancy, the patient will often be scheduled for at least one follow-up every four weeks.

During these follow-up consultations in the first trimester, the doctor will check the patient’s blood pressure and weight, and provide information on diet, lifestyle and other habits that can improve the patient’s and the baby’s health.

The second trimester will require a follow-up visit with the OB-GYN every four weeks. The doctor will ask about spotting or bleeding from the vagina, if any contractions have been felt, or if the baby has started to move. The patient’s blood pressure and weight will be measured again. A urine test can also be ordered to check if the patient is suffering from a urinary tract infection or preeclampsia.

During the third trimester, the patient can come in for follow-up consultations once every two weeks. After the 36th week of gestation, the patient will need to come in for weekly visits. The doctor will check the patient’s blood pressure and weight, as well as monitor the levels of protein and sugar in the urine. The baby’s growth will also be monitored by measuring the patient’s belly. The patient’s cervix will also be checked to determine if dilation has already started. With some patients, a blood test can be ordered to check for anemia.

Possible Risks and Complications

Follow-up consultations with an OB-GYN are generally safe and should not pose any risk to the patient.

References:

  • Freund K. Approach to women's health. In: Goldman L, Ausiello D, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 245.

  • Schrager SB, Paladine HL, Cadwallader K. Gynecology. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 25.

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