Obstetrics & Gynecologic History

www.obgynhistory.com

Milestones in Ob/Gyn History

Last updated Apr 2008

1500

First reported successful Cesarean section (mother and child surviving).

Jacob Nufer

1701

First successful ovariotomy. 

Robert Houstoun

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

1846

Ether first administered to a woman in labor.

Crawford Williamson Long

1847

Puerperal fever shown to be caused by infectious contagion through interventional trial proving that it could be prevented.

Ignaz Semmelweis

1847

Chloroform first used as an anesthetic, used during labor. 

James Young Simpson

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

1894

Use of rubber gloves in surgery popularized.

Hunter Robb (Gyn.)

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 laparoscopy 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 laparoscopy 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 laparoscopy.

Kurst Semm (Gyn.)

1978

In vitro fertilization first performed successfully.

Patrick Christopher Steptoe

1987

First laparascopic cholecystectomy performed (during a gynecologic laparoscopy).

Philippe Mouret


Historic Reduction of Perinatal/Maternal Mortality

Click on image for larger version
rates.001.jpg

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