Obstetrics Definitions 1 Flashcards
Cyanosis of the hands and feet of the baby, common after birth, and due to peripheral vasoconstriction.
acrocyanosis
to ensure labour progression and intervene to decrease labour dystocia, particularly in the first stage. Its main components are: patient education, strict labour diagnosis, early amniotomy, regular assessment of progress, prompt administration of oxytocin, one-to-one reassurance and support, pain relief and hydration.
active management of labour
Uterine contractions due to release of oxytocin from the posterior lobe of the pituitary gland, especially during suckling; more intense in multiparas. They promote involution of the uterus
afterpains (after-birth pains)
Aspiration of a sample of amniotic fluid through the mother’s abdomen for diagnosis of fetal maturity and/or disease by assay of the constituents of the fluid; when performed in the second trimester for genetic counselling (usually at 16-18 weeks) the fetal loss rate is 0.5%.
amniocentesis
A smooth membrane enclosing the fetus and amniotic fluid; it is loosely fused with the outer chorionic membrane
amnion
A lighted tubular instrument which is introduced through the internal os in late pregnancy and in labour; it enables an inspection of the colour and amount of amniotic fluid through the intact membranes, and also facilitates fetal blood sampling if the membranes are ruptured
amnioscope
Fluid surrounding and protecting the fetus within the amniotic sac.
amniotic fluid
After 20weeks gestation, the main source of amniotic fluid is the fetal kidneys (urine) and cleared by fetal swallowing. Any disruptions to these mechanisms will result in major changes of liquor volume. It is measured by cord-free Deepest Vertical Pool (DVP) or Amniotic Fluid Index (AFI).
Term used when there is virtually no liquor.
oligohydramnias
Some of the causes of oligohydramnios are idiopathic, ruptured membranes, renal agenesis, polycystic kidneys, FGR and post-term fetus
Term used to describe excessive liquor volume.
polyhydramnias
Causes of polyhydramnios include maternal diabetis mellitus, idiopathic, multiple pregnancy, fetal GIT atresias and macrosomia
Entry of amniotic fluid into the maternal venous circulation. Fetal squamous cells, hair, and vernix become impacted in the pulmonary arterioles, and thromboplastic substances cause intravascular coagulation
amniotic fluid embolism
Surgical rupture of the membranes to induce or augment labour
amniotomy
A maternal haemoglobin value below 11.5 g/dl in the first trimester or below 10.5 g/dl in later pregnancy. The World Health Organization recommends that the haemoglobin concentration should not fall below 11.0 g/dl at any time in pregnancy
anaemia
Absence of the brain and vault of the skull, the cerebellum and basal ganglia are sometimes present
anencephalus
Bleeding from or in to the genital tract, occurring from the 24th week of gestation to the birth of the baby
antepartum haemorrhage
A numerical scoring system usually applied at 1 and 5 minutes after birth to evaluate the condition of the baby, based on heart rate, respiration, muscle tone, reflexes and colour
apgar score
Apnoea which occurs in preterm infants due to immaturity of respiratory control mechanisms.
apnoea of prematurity
The pigmented zone of skin around the nipple, which contains sebaceous glands. The nipple and areola become further pigmented during pregnancy.
areola
Term used to describe the condition of an infant who has been subjected to hypoxia and acidosis during delivery and who fails to breathe following birth.
asphyxia neonatorum
Defined as at least 10 5 colony-forming units of urinary tract pathogens per ml of urine without symptoms.
Asymptomatic bacteriuria
Asymptomatic bacteriuria occurs in 2% to 10% of pregnancies and, if not treated, up to 30% of mothers will develop acute pyelonephritis. Asymptomatic bacteriuria has been associated with low birthweight and preterm delivery.
When the sagittal suture of the fetal skull does not lie midway between the maternal sacral promontory and pubic symphysis; there is usually disproportion, and the head is rocking fore and aft to enter the pelvis
Asynclitism
Relationship of fetal head and limbs to the fetal trunk, usually flexion
Attitude of the fetus
The groove between upper and lower uterine segments; it is situated at the level of the pubic symphysis at the onset of labour.
Bandl ring
The plan is either a list or a statement of preferences prepared by the woman for care during labour, birth and the postnatal period in the hospital.
Birth plan
The first weight of the newborn obtained preferably within 1 hour of birth before significant postnatal weight loss has occurred.
Birth weight
Assessment of suitability of the cervix for induction of labour
Bishop score
Fetal heart rate below 110 beats per minute.
Bradycardia
method of expressing the placenta from the uterus: controlled cord traction is applied with one hand while the contracted uterus is pushed upwards away from the placenta with the other hand on the mother’s abdomen
Brandt-Andrews
Spontaneous uterine contractions originally as a sign of pregnancy. Occur from the first trimester onward, and probably promote uterine blood flow and transfer of oxygen to the fetus
Braxton Hicks contraction
(a) Complete: the knees and hips are flexed and buttocks, genitalia, and the feet present. (b) Incomplete: (i) frank breech - the legs are extended and buttocks and genitalia present; (ii) footling: one or both feet present; there is a 10% risk of cord prolapse .
Breech presentation
The large diamond shaped anterior fontanelle.
Bregma
That part of the fetal head between the root of the nose and the anterior fontanelle
Brow
The surgical process of delivering the baby through an abdominal incision
Caesarean section
Oedema from obstructed venous return in the fetal scalp caused by pressure of the head against the rim of the cervix or birth canal.
Caput succedaneum
Monitoring of the fetal heart rate using Doppler ultrasound or a direct scalp electrode to make an immediate assessment of fetoplacental well-being especially in high-risk pregnancies. There are four main features including baseline rate, baseline variability, accelerations, decelerations, frequency and strength of contractions.
Cardiotocography (CTG)
A collection of blood beneath the periosteum of a skull bone, limited to that bone by periosteal attachments
Cephalohematoma
A non-progressive disorder of the brain causing impairment of motor function (spastic rigidity). The risk is greatly increased in infants with birth-weight less than 1,500 g.
Cerebral palsy
Difficult labour due to failure of the cervix to dilate, in spite of adequate uterine contractions
Cervical dystocia
Premature effacement and dilatation of the cervix. The cervix dilates silently during the second trimester resulting in bulging/rupture amniotic membrane, second trimester miscarriage or premature delivery. However, it is a frequently imprecise term applied to women with previous mid-trimester loss or preterm birth. Cervical cerclage may provide some structural support and maintaining the cervical length and the endocervical mucus plug as a mechanical barrier to ascending infection.
Cervical incompetence
A transvaginal purse-string suture placed on the cervix.
Cervical cerclage
Insertion of a cerclage offered to women with three or more previous preterm births and/or second trimester losses. This is usually performed electively at 12-14 weeks gestation
History- indicated cerclage
Insertion of a cerclage offered to women with a history of spontaneous second trimester loss and/or preterm birth, with ultrasound evidence of cervical shortening (≤ 25mm).
Ultrasound- indicated cerclage
Insertion of a cerclage as a salvage measure in the case of premature cervical dilatation with exposed amniotic membranes in the vagina.
Rescue cerclage
The brown, pigmented mask of pregnancy. Usually patchy and simulates suntan it also occurs in some women who are taking oral contraceptives.
Chloasma
The part of the chorion forming the placenta
Chorion frondosum
The part of the chorion forming the extraplacental membrane
chorion laeve
Under ultrasound control, 10-12 mg of chorion frondosum is obtained through a fine cannula (via the cervix or more commonly, transabdominally); fetal karyotype is available in 2 days in 99% of cases; the procedure has a fetal loss rate of 1-2%. Can be performed earlier (9-12 weeks) than amniocentesis.
chorionic villus sampling
Deeply-staining bodies in the nucleus of the cell which contain the hereditary material (genes); 23 are derived from each parent, making the normal complement of 46.
chromosomes
Failure of the upper lip to fuse in the midline. It may be associated with cleft palate where the bones of the roof of the mouth fail to fuse in the midline
cleft lip
Yellowish fluid expressed from the breasts during late pregnancy and before the onset of true lactation.
colostrum
The baby has a relaxed joint capsule and shallow acetabulum, which may allow the head of the femur to become displaced. This requires early diagnosis and treatment.
congenital dislocation of the hip
A localized spasm of the uterine muscle.
constriction ring
Traction on the umbilical cord, combined with counter-pressure upwards on the uterine body by a hand placed immediately above the symphysis pubis.
controlled cord traction
CCT is used in conjunction with uterotonic drugs that speed up the placental separation process in active management of third stage of labour.
Detects sensitized red blood cells (antibody attached), e.g. in erythroblastosis.
Coombs test
The cord lies below the presenting part with the membranes intact
cord presentation
As for cord presentation except that the membranes have ruptured, and pressure on the umbilical cord vessels is more likely to occur.
cord prolapse
An ovarian cyst formed from the Graafian follicle after ovulation which produces oestrogen and progesterone; essential for implantation of the fertilized ovum in the endometrium.
corpus luteum
The lobes of the placenta
cotyledons
Occurs with severe abruption of the placenta. The uterus is purple due to haemorrhage within its musculature
couvelaire uterus (uterine apoplexy)
Visualisation of the fetal head as birth becomes imminent. The widest diameter of the fetal head has passed the bony pelvic outlet and emerged under the pubic arch.
crowning of the head
The 90 degree curve of the birth canal
curve of carus
The exaggerated endometrial reaction to oestrogen and progesterone during pregnancy. The glands become tortuous and cells enlarge
Decidua
> 1hour in para 0 and > 30 minutes in para 1+
Delay in the second stage of labour
. The pregnant uterus is normally rotated to the right side
Dextrorotation of the uterus
The distance between certain important bony points in the fetus and the maternal pelvis. The following 10 are of value (i) anteroposterior of the brim (true conjugate) 11.5 cm; (ii) transverse diameter of pelvic brim 13.5 cm; (iii) bispinous or interspinous (transverse diameter of narrow pelvic plane) 10.5 cm; (iv) anteroposterior of outlet 11.5 cm; (v) biparietal (between the parietal eminences) 9.5 cm; (vi) bitemporal 8.0 cm; (vii) occipitofrontal (from occipital protuberance to above the orbital margins) 11-12 cm; (viii) suboccipitobregmatic (nape of neck to middle of anterior fontanelle) 9.5 cm; (ix) bisacromial (between tips of acromial processes) 12.5 cm; (x) bitrochanteric (between outer aspects of greater trochanters) 9.5 cm .
Diameters
The separation which occurs when the muscles can stretch no more. The peritoneum bulges between them when the woman coughs. Postnatal exercises are required
Diastatis of the rectus abdominis muscles
Physiological vaginal secretion increases in pregnancy. The vagina has a stratified squamous epithelial lining but no glands; its moisture is provided chiefly by secretion of cervical mucus (and at coitus by vaginal transudation).
Discharge
If there is itching or the discharge is yellow, speculum examination is required to exclude vaginitis.
A non-invasive method of assessing blood flow based on the change in frequency of reflected sound. The technique has been applied to umbilical and other fetal vessels and the uteroplacental blood supply (uterine arteries)
Doppler management of blood flow
congenital abnormality characterized by the presence of Trisomy 21
Down syndrome (mongolism)
The channel between pulmonary artery and descending arch of the aorta which allows the right ventricular output to be shunted away from the unexpanded fetal lungs
Ductus arteriosus
A fetal vessel that connects the umbilical vein to the inferior vena cava.
Ductus venosus
Difficult or abnormal labour due to cephalopelvic disproportion or a primary disorder of uterine action.
Dystocia
‘To flash forth’. A clinical state characterized by convulsions, not attributable to cerebral conditions such as epilepsy or cerebral haemorrhage, and usually superimposed on preceding severe pre-eclampsia.
eclampsia
Implantation of pregnancy (fertilized ovum) outside the uterine cavity. The commonest site is in the Fallopian tube.
ectopic pregnancy
Effacement occurs when the entire length of the cervical canal has been taken up into the lower segment of the uterus; usually occurs during the early (latent) phase of labour
Effacement of cervix
The name given to the conceptus up to the 10th week of gestation (8th week post conception), after this, the word fetus is used
Embryo
The mucous membrane lining the uterus, which responds to ovarian hormones during the menstrual cycle.
Endometrium
The fetal head is engaged when its maximum diameters (suboccipitobregmatic and biparietal when the head is well flexed) have passed the pelvic inlet
Engagement
Full, red, hard, sore breasts due to increased blood flow before milk secretion commences.
Engorgement of breasts
Injection of analgesic agent outside the dura, which covers the spinal canal. A sacral (caudal) epidural gives complete analgesia of all pelvic structures
epidural analgesia
A surgical procedure in which the perineum is cut with a scissors, with the intention of widening the soft tissue diameter of the introitus in order to prevent a severe perineal tear or accelerate delivery.
episiotomy
The active oxytocic drug derived from ergot used to promote uterine contraction (uterotonic agent).
ergometrine
A common maculoerythematous rash with vesicles containing eosinophils, which appears on the newborn in the first days after birth. It resolves spontaneously within 2-3 weeks and requires no treatment.
erythema toxicum
Haemolytic disease of the newborn, usually due to Rhesus antibodies. Hypoxia due to fetal anaemia stimulates production of primitive red cells which are present in excessive numbers in the blood.
erythroblastosis
The blood of the baby is gradually replaced with donor blood; most commonly used in babies with erythroblastosis, to remove harmful bilirubin pigment, maternal rhesus antibodies and the infant’s Rhesus positive cells, as well as to treat anaemia
exchange transfusion
