Milestones in Ob/Gyn History
1500 |
First reported successful Cesarean section (mother and child surviving). |
Jacob Nufer |
1701 |
First successful ovariotomy. |
Robert Houston |
1795 |
Pueperal sepsis first proposed to be due to infectious contagion as a result of observational, epidemiologic study in Aberdeen, Scotland. |
Alexander Gordon |
1809 |
First ovarian cystectomy (Danville, Kentucky). |
Ephraim McDowell |
1812 |
First recorded vaginal hysterectomy (performed accidentally and unplanned). |
Palletta |
1813 |
First modern, documented total vaginal hysterectomy (though certainly not the first). |
C.J.M. Langenbeck |
1825 |
First ever blood transfusion, performed for postpartum hemorrhage. |
James Blundell |
1827 |
Fetal heart tone auscultated for the first time. |
John Creery Ferguson |
1833 |
First detailed account of fetal heart tones made. |
Evory Kennedy |
1843 |
First abdominal hysterectomy (the patient died). |
Charles Clay |
1847 |
Puerperal fever shown to be caused by infectious contagion through interventional trial proving that it could be prevented. |
Ignaz Semmelweis |
1849 |
Vesicovaginal fistula successfully treated with surgery. |
J. Marion Sims |
June, 1853 |
First successful adbominal hysterectomy (Lowell, Massachusetts) |
Walter Burnham |
Sept., 1853 |
First successful, planned abdominal hysterectomy (Lowell, Massachusetts) |
Gilman Kimbell |
1866 |
First human artificial insemination. |
J. Marion Sims |
1869 |
First operative hysteroscopy performed. |
D. Commander Pantaleoni |
1872 |
First oopherectomy for sepsis. |
Robert Lawson Tait |
1872 |
First bilateral oopherectomy for menorrhagia. |
Robert Lawson Tait |
1876 |
First successful Cesarean-Hysterectomy. |
Edoardo Porro |
1878 |
First cholecystotomy (patient died). |
J. Marion Sims |
1879 |
First successful cholecystotomy. |
Robert Lawson Tait |
1880 |
First removal of hydatid cust. |
Robert Lawson Tait |
1880 |
First appendectomy for acute appendicitis. |
Robert Lawson Tait |
1882 |
Classical Cesarean Section technique (including closing myotomy) first described. |
Max Sänger |
1883 |
First successful salpingectomy for ectopic pregnancy. |
Robert Lawson Tait |
1890 |
First successful series of vaginal cesarean sections reported. |
Alfred Duhrssen |
1898 |
First successful radical abdominal hysterectomy for cervical cancer. |
Ernst Wertheim |
1900 |
Transverse skin and fascial incision reported. |
Hermann Pfannenstiel (Gyn.) |
1900 |
Spinal anesthesia first used in labor. |
Oskar Kreis (Ob.) |
1901 |
Epidural anesthesia first used in labor. |
Walter Stoeckel (Ob.) |
1901 |
First successful laparascopy performed (through incision in vaginal fornix). |
Dimitri Oh (Gyn.) |
1921 |
Lower uterine segment incision for cesarean section shown to be superior. |
John Martin Munro Kerr |
1936 |
Sulphonamides first used to treat puerperal fever in Queen Charlotte's Hospital. |
Leonard Colebrook |
1941 |
First screening test for cancer introduced (for cervical cancer). |
Geroge Nicholas Papanicolau |
1942 |
Penicillin first used successfully in a human patient, Anne Miller, to treat septic abortion. |
Orvan Hess (Ob.) |
1943 |
Clinical efficacy and pharmicokinetics of Penicillin established (originally for treatment of syphilis). |
Wallace E. Herrell |
1944 |
Modern laparascopy technique introduced (insufflation, Trendelenburg position, etc.). |
Raoul Palmer (Gyn.) |
1953 |
Oxytocin synthesized (the first posterior pituitary hormone synthesized) |
Vincent du Vigneaud |
1958 |
Ultrasound developed (originally for obstetric use). |
Ian Donald |
1958 |
First solid tumor cured by chemotherapy (choriocarcinoma, methotrexate). |
Hertz and Li |
1960 |
Automatic insufflator invented for laparascopy. |
Kurst Semm (Gyn.) |
1978 |
In vitro fertilization first performed successfully. |
Patrick Christopher Steptoe |
1987 |
First laparascopic cholecystectomy performed (during a gynecologic laparascopy). |
Philippe Mouret |
Historic Reduction of Perinatal/Maternal Mortality
The above graph shows the downward trend in perinatal and maternal mortality from 1900 to 2000 in the United States. Perinatal mortality is the sum of fetal (from 22 weeks until delivery) and neonatal (until 28 days of age) mortality. Maternal mortality includes maternal deaths during pregnancy and within 42 days of delivery.
A combination of innovations over the last one hundred years have contributed to this progess, 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