Terminology Flashcards
1
Q
Define abortion
A
- Termination of pregnancy (spontaneous or intentional) BEFORE 20 weeks GA or less than 500g birthweight
- <24 weeks a baby cannot survive outside the womb
- Between 20-24 weeks is a grey area = stillbirth
- Not to be confused with IUFD – there are different
- reasons for IUFD <20 weeks gestation and >20 weeks gestation
2
Q
What is the amniotic fluid index?
A
- calculated by adding the depth in centimetres of the largest vertical pocket in each of four equal uterine quadrants
- Reference ranges have been established from 16 weeks onward, and in the majority of normal pregnancies the AFI ranges between 8-24cm
- AFI <5cm = oligohydramnios
- AFI >20-24cm = polyhydramnios
- Another method is to measure the largest vertical pocket of amniotic fluid. The normal range is 2- 8cm; <2cm = oligohydramnios, >8cm = hydramnios
3
Q
What is antepartum haemorrhage?
A
- Bleeding from or in to the genital tract after 24 weeks of gestation till the delivery of the fetus
- Causes
- trauma
- placenta previa
- placental abruption
- cervical lesions
- (cancer, polyps – hence need to spec exam always)
4
Q
What is ARM?
A
- Artificial ROM
- Induction of labour by decompressing the uterus
- release of prostaglandins to ripen the cervix
- Cervix is firm prior to labour
- With the release of PGs (regardless of the source), water is absorbed into the collagen fibres to allow softening of the cervix
- ARM can augment labour to release PGs and enhance the process of labour
5
Q
What is GBS?
A
- Group B streptococcus
- One of the most common causes of neonatal sepsis
- Not screened for in all mothers in TTH
- Routine testing offered if they’ve had GBS previously
6
Q
What is gravidity?
A
- Number of times a woman has been pregnant, including current pregnancy
- Nulligravida = a woman who has never been pregnant
- Primigravida = a woman who is pregnant for the first time
7
Q
What is parity?
A
- Number of times a woman has given birth to a live or stillborn baby >20w gestation. A twin delivery counts for 1 birth
- Nullipara (‘nullip’) = a woman who has never carried a pregnancy to >/= 20w before = P0
- Primipara = P1
- Multipara = ≥ P2
- Grand multipara = ≥ P5
- Great grand multipara ≥ P10
8
Q
Define labour
A
- Onset of regular painful uterine contractions associated with cervical dilatation or effacement and descent of the presenting part
-
First stage = from the onset of regular painful uterine contractions until full dilatation of the cervix
- Latent phase = the initial period of time during which contractions become increasingly strong and regular and the cervix effaces and dilates up to 3-4cm = “early labour”
- Active phase = from 3-4cm till full dilatation = “established” or “active” labour
- Second stage = begins when the cervix is fully dilated and is complete with the birth of the baby
- Third stage = from delivery of baby to delivery of placenta and membranes
- Fourth stage = after placenta is delivered – observe mum for first four hours (measure blood loss)
9
Q
What is fetal lie?
A
The lie is the relation of the long axis of the fetus to that of the mother (fetus spine compared to mothers spine):
▪ Longitudinal
▪ Transverse
▪ Oblique (uncommon)
o Oblique lie (45* to mother spine) is unstable and always becomes longitudinal or transverse during the course of labour
10
Q
What is fetal presentation?
A
- The presenting part of the portion of the fetal body that is either foremost within the birth canal or in closest proximity to it
- In longitudinal lies, the presenting part is either the fetal head (cephalic) or breech.
- When the fetus lies with the long axis transversely, the shoulder is the presenting part
- Cephalic = head
- Breech = bum
- Shoulder = shoulder
- Brow // face
11
Q
What are the different types of breech?
A
- frank breech - bum first, legs extended (hips flexed, knees extended)
- incomplete breech - bum first, one leg extended, one leg flexed
- complete breech - bum first, legs flexed (hips flexed, knees flexed)
- footling breech - foot first (one or two) (at least one hip extended)
- if ROM in footling then the cord can prolapse because the cervix is blocked off by the presenting part of the fetus
12
Q
What is fetal attitude?
A
- Relation of all of the fetal parts of each other – best to be flexed
- Flexed or extended
13
Q
What is the fetal position?
A
- Position refers to the relationship of an arbitrarily chosen portion of the fetal presenting part to the right or left side of the maternal birth canal
- Related to the presentation of fetus:
- Vertex = Occipital
- Breech = Sacral
- Face = Mentum (chin) description
14
Q
Define birth
A
- The complete expulsion or extraction from the mother of a fetus, irrespective of whether the umbilical cord has been cut or the placenta is attached
- Fetuses weighing <500g are usually not considered as births, but rather are termed abortuses for purposes of vital statistics
- Parturition = the whole process of baby
15
Q
What is cephalopelvic disproportion?
A
The size of the fetal head is too large relative to the size of the maternal pelvis
- Macrosomia, vitamin D deficiency in mothers, pelvic fracture
Mothers who were large babies themselves are at higher risk of having big babies, mothers with GDM (GDM babies have more fat distribution on shoulders and hips = shoulder dystocia)
