Medical glossary for Birth Emergency Skills Training
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ABCs The first three aspects of a patient to check in an emergency--Airway (taking care with the spine), Breathing, and Circulation (with attention to bleeding). abortifacient A substance or device that causes abortion. abortion The spontaneous or induced termination of pregnancy before fetal viability. Complete--all products of conception are expelled. Incomplete--some products of conception remain in the uterus. Elective--voluntary termination of pregnancy. Inevitable--cannot be stopped. Missed—the embryo dies, and products of conception are retained. Septic--pregnancy loss complicated by infection of the products of conception. Spontaneous--expulsion of products of conception before 20th week of gestation. Therapeutic--medically sanctioned pregnancy termination performed when pregnancy endangers the mother’s health or when the fetus has a known life-limiting or fatal condition. Threatened--bleeding from uterus or cramping that may or may not result in loss of the pregnancy. abrasion Scraping away of tissue, often skin or mucous membrane, usually superficial. ACLS Advanced Cardiac Life Support. active labor First-stage labor, between about 6 and 10 cm dilation. The rate of cervical cervical change increases and contractions usually grow longer, stronger, closer, and more regular. adhesion Union of normally separate parts, as during healing of a wound or infection. Surgery, inflammation, or trauma may create adhesions—scar tissue that binds tissues together abnormally, causing pain and organ dysfunction. acute respiratory distress syndrome (ARDS) Severe, acute lung dysfunction that occurs as a result of illness or injury involving an accumulation of fluid in the alveoli (air sacs) in the lungs. It becomes difficult for oxygen to move into the circulating blood and the person may develop inadequate levels of oxygen in bloodstream (hypoxemia). ARDS may develop if the body is compromised by widespread infection (sepsis) or as a result of pneumonia, trauma, shock, severe burns, toxic inhalations, aspiration of food or chemicals into the lung, multiple blood transfusions, or in response to other conditions. afterpains Cramps caused by the contractions of uterine involution during the first few days after childbirth. ALS Advanced Life Support amenorrhea Absence or cessation of menstruation. Primary—Primary amenorrhea is the absence of menses at age 15 years of age in the presence of normal growth and secondary sexual characteristics. Secondary--Secondary amenorrhea is the cessation of regular menses for three months or the cessation of irregular menses for six months. amniocentesis A prenatal diagnostic procedure in which a small amount of amniotic fluid is withdrawn by a needle inserted through a pregnant woman’s abdominal wall into the uterus, then examined in a laboratory to diagnose various conditions or establish lung maturity. amniotic fluid The clear liquid within the amnion that protects the fetus and allows for movement and lung expansion amniotic fluid embolism A reaction similar to anaphylaxis that occurs in reaction to amniotic fluid that enters the maternal circulatory system. amniotic sac The inner fetal membrane; it encloses the fetus and contains amniotic fluid. amniotomy Deliberate rupture of the amniotic membranes. ampulla (plural ampullae) The dilated ovarian end of a fallopian tube, which joins the funnel-shaped infundibulum. anaphylactic shock An extreme, sometimes fatal allergic reaction that may involve heart failure, circulatory collapse, and airway obstruction. android pelvis Pelvis with a narrow, somewhat heart-shaped passage which may be inadequate for the passage of some infants. antepartum The period of pregnancy before labor or delivery; prenatal. anthropoid pelvis Pelvis with an oval inlet, larger from front to back than from side to side. anus The outlet of the rectum. Apgar score Measurement of a newborn’s condition at 1, 5, and sometimes at 10 minutes, based on Appearance (color); Pulse; Grimace (reflex); Activity (muscle tone), and Respiration apnea Cessation of respiration. appendicitis Inflammation of the vermiform appendix. arrhythmia Irregular heartbeat. Also dysrhythmia. asphyxia Extreme hypoxia with increased carbon dioxide in the blood, which may lead to coma or death. aspiration 1. Inhaling either purposely (as with an asthma inhaler) or by accident, as in meconium aspiration. 2. Withdrawal by means of a needle (as in amniocentesis) or by suction. asthma A disease characterized by bronchospasm. asynclitism Tilting of the fetal head at an oblique angle. atelectasis Alveolar collapse resulting from insufficient ventilation. It can also represent incomplete expansion of the lungs in the neonate. atony, uterine Lack of uterine muscular tone, which may impede the progress of labor or cause postpartum hemorrhage. bacteremia Bacteria in the blood. bag of water An informal term for the amniotic sac. biophysical profile An ultrasound exam to assess fetal wellbeing, which is interpreted alongside the nonstress test (which see). During the biophysical profile, the sonographer evaluates fetal movement, fetal tone, breathing movements, and the amniotic fluid volume. biopsy Removal of a tissue sample for examination. bladder A membranous sac that holds a secretion, e.g., the urinary bladder and the gallbladder. bloody show Blood-tinged mucus from the vagina during pregnancy. Dilation and stretching of the cervix causes capillaries to rupture and mix with mucus. blowby Issuing a stream of oxygen past the face bolus A single dose of drug or quantity of fluid injected or infused into a blood vessel over a short period of time. brachial plexus A network of nerves located in the neck and axilla supplying the chest, shoulder, and arm. bradycardia Slow heart rate (below 60 beats per minute in an adult or 120 in a fetus). Braxton Hicks contractions Brief, usually painless uterine contractions that occur throughout pregnancy, do not dilate the cervix, and can usually be palpated by an examiner during the third trimester. breech presentation Fetal buttocks or lower extremities enter the maternal pelvis first. cannula 1. A tube or sheath encasing a trochar. To establish intravenous access one cannulates a vein. 2. A device that delivers oxygen through a pair of tubes inserted in the patient’s nostrils. carboxyhemoglobin A compound formed when carbon monoxide combines with hemoglobin in the blood. cardiac arrest Absence of effective ventricular contraction. cardinal movements of labor Changes in the position of the fetus as it negotiates the maternal pelvis during the second stage of labor. (Also called mechanisms of labor.) In a vertex birth the sequence is engagement, descent, flexion, internal rotation, extension, external rotation, restitution, and expulsion. catecholamine Any of a group of neurotransmitters and hormones produced in the medulla of the adrenal gland, including epinephrine, norepinephrine, and dopamine. cephalic malpresentations Occurs when part of the fetal head other than the vertex enters the maternal pelvis first, such as the brow or face. cephalohematoma A subperiosteal hemorrhage, or bleeding between the infant’s skull and scalp, caused by the pressures of birth. It is similar to caput succedaneum, but does not cross suture lines. cephalopelvic disproportion A condition in which the size or position of the fetal head with respect to the maternal pelvis prevents progress in labor. See presentation. cerclage A suture that secures the cervix in an attempt to prevent premature delivery. cervical incompetence Tendency of the cervix to open painlessly in the second or third trimester of pregnancy. cervical os The outer or inner opening of the cervix; from the latin for “mouth.” cesarean section (cesarean delivery, cesarean birth, or simply cesarean) Delivery of a baby through an abdominal incision. Perimortem cesarean delivery—surgical delivery performed when the mother is in cardiac arrest. chlamydia The most common sexually transmitted bacterial infection in the United States, produced by Chlamydia trachomatis; a common cause of pelvic inflammatory disease. chloasma The “mask of pregnancy,” irregular brownish patches that may appear on the face during pregnancy and sometimes during the use of oral contraceptives. cholecystitis Inflammation of the gallbladder. chorioamnionitis Infection of the fetal membranes. chorion The outer membrane of the amniotic sac chorionic villi Small, vascular surface projections of the chorion, which tap the uterine lining to provide oxygen, nutrition and waste elimination for the embryo by way of the maternal circulatory system. closed-glottis pushing Pushing the infant down and out while holding the breath. colostrum The thin, yellowish, first milk produced by the breasts during late pregnancy and for a few days after childbirth. colposcopy Examination of the vagina and cervix by means of a colposcope (a device that magnifies and photographs). complete breech A presentation in which the fetus is sitting crosslegged at the mother’s pelvis compound presentation Fetal hand or arm presents alongside the head in a cephalic presentation. conceptus Collective term for the embryo or the fetus, placenta and other structures. congenital Present at birth or during uterine development, as a result of either hereditary or environmental influences. contraction Tightening of the uterine musculature. cord prolapse An emergent situation involving an umbilical cord that lies beside or below the fetal presenting part. corpus luteum A yellowish structure formed in the ovary at the site of a ruptured ovarian follicle; it secretes estrogen and progesterone. costovertebral angle The junction of the bottom ribs and the spine. crackles (rales) Crackling sounds produced in the lungs by air passing over secretions or through constrictions. crib death The sudden, unexplained death of an infant younger than 1 year of age. Crohn’s disease A disease marked by recurring inflammation, usually in the small intestine, less often elsewhere in the gastrointestinal tract. crowning Emergence of widest part of the fetal head from the vagina. In common usage this term can mean a glimpse of any fetal presenting part. cyanosis Blue or purple discoloration indicating poor circulation or oxygenation. Central cyanosis (which involves the trunk) denotes hypoxia. cystitis Inflammation of the urinary bladder, often caused by infection. cytomegalovirus A common herpes virus that may cause congenital anomalies. decelerations Significant decrease in fetal heart rate, as when the umbilical cord is compressed or blood flow is otherwise compromised. deep vein thrombosis A blood clot in a deep vein, often in a leg. deflexed Not flexed, partially or completely extended. In a deflexed fetus, the chin is not on the chest, potentially making birth more difficult by presenting a wider part of the head to the pelvic inlet. descent Passage of the fetal presenting part into and through the maternal pelvis. dextrorotation Rotation to the right. As the pregnant uterus grows into the abdomen, it rotates to the right, displaced by the colon on the left. diabetes Diabetes mellitus—a disorder of carbohydrate metabolism in which insufficient insulin production by the pancreas (or insulin resistance) causes hyperglycemia. Gestational diabetes—glucose intolerance of variable degree with onset or first recognition during the present pregnancy. dilation (dilatation) Opening or enlargement, as of the pupils or the cervix. dilation and curettage A surgical procedure in which the cervix is dilated and the lining of the uterus is scraped with a curette, usually performed to obtain tissue samples, to stop abnormal bleeding, to remove placental fragments after childbirth, or as a method of abortion. disseminated intravascular coagulation (DIC) A life-threatening condition characterized by the formation and dissolution of blood clots throughout the body, which produce simultaneous blockages and hemorrhages. diverticulitis Inflammation of small outpouchings of the colon. dizygotic Derived, like twins or other multiples, from two separately fertilized eggs; fraternal. Doppler In this text, the term refers to Doppler ultrasonography, which uses Doppler shifts in high-frequency sound to observe and measure things in motion, such as flowing blood. dorsal position Lying on the back. ductus arteriosus A fetal blood vessel that connects the pulmonary artery to the ascending aorta, allowing the circulating blood largely to bypass the pulmonary circulation. It normally closes at birth. due date The date on which birth is expected. Also known as the estimated date of delivery (EDD), estimated date of birth (EDB), or the older term, estimated date of confinement (EDC). dyspnea Difficulty breathing. dysrhythmia An abnormal heart rhythm, also arrythmia. dystocia Abnormal or difficult labor. early labor The part of first-stage labor in which contractions become regular and begin to dilate, efface and soften the cervix. Also called prodromal labor. eclampsia Preeclampsia complicated by convulsions or coma. ectopic pregnancy An abnormal pregnancy in which the fertilized egg implants outside the uterus, often in a fallopian tube. edema Swelling of soft tissues caused by accumulation or retention of fluid. effacement Shortening and thinning of the cervix in preparation for birth, expressed in percentages. A cervix that is 100% effaced is paper thin. electrolytes Ionized molecules found throughout the blood, tissues, and cells of the body, which conduct electric current and have many roles, including regulating function of the neuromuscular, endocrine, and excretory systems. embryo In humans, the stage of development from the 2nd to 8th week of gestation, inclusive. endometriosis A condition in which endometrial tissue grows outside the uterus. endometritis Inflammation of the endometrium (which see), usually caused by infection. endometrium The mucous membrane lining the uterus. endotracheal (ET) tube A ttube inserted into the trachea to provide an open airway to administer oxygen, gaseous medication, or anesthetics; remove blockages; or provide a view of the interior walls. endotracheal suctioning Mechanical suction through endotracheal tube. engagement Passage of the widest diameter of the fetal presenting part through the pelvic inlet. epidural anesthesia (epidural block) Injection of a local anesthetic into the epidural space of the spinal column to achieve anesthesia of the pelvis, abdomen, or genitals. episiotomy An incision through the vagina, perineum, and underlying muscles to facilitate delivery. estrogen A hormone produced mostly in the ovaries and involved in the development of female characteristics, in menstruation, in reproduction, and in maintaining the health of bones and the central nervous system. eversion Turning outward. expulsion Pushing out. extension The fetal attitude of deflexion, lifting the chin away from the body. external rotation A cardinal movement of labor that occurs after birth of the head as the shoulders rotate 45°, causing the head to face one of the mother’s legs. extremely low birth weight Less than 1,000 g at birth. face presentation A cephalic presentation in which the fetus enters the maternal pelvis face first. fallopian tubes Narrow tubes connecting the ovaries to the uterus; the site of fertilization. false labor Rhythmic uterine contractions that do not progressively dilate the cervix. ferning The fernlike pattern of dried amniotic fluid, visible under a microscope; it can be used to confirm suspected rupture of membranes. fetal death (fetal demise) Technically, death of the fetus at any stage. Legal and accepted definitions vary by state and agency, but the term usually refers to the in utero death of a fetus beyond 20–22 weeks gestation and over 350-500 g in weight. fetal distress A precarious fetal condition that, if allowed to persist, may lead to perinatal damage or death. The diagnosis is often based on fetal heart rate or ultrasonographic findings. fetal heart tones (FHT) Sounds made by the fetal heart. fetal macrosomia Excessively large fetus, with a birth weight of 4000–4500 g (8 lb 13 oz to 9 lb 15 oz) or greater than the 90th percentile for gestational age. fetoscope An instrument for auscultating fetal heart tones. fetus A developing human from the 9th week of gestation to delivery. fibroids (leiomyomas) Benign tumors of the uterine muscle. flexion The attitude of the fetus that brings the chin to the chest and ideally presents the smallest diameter of the head to the maternal pelvis. Fetal and neonatal limbs are also normally held in an attitude of flexion. folic acid A B vitamin especially important for preventing spina bifida and other neural-tube defects in a fetus. follicle (ovarian follicle) A structure within the ovary that can produce ova and hormones. follicle-stimulating hormone (FSH) In humans, a gonadotropic hormone secreted by the anterior pituitary that stimulates growth of ovarian follicles in women and activates sperm-forming cells in men. footling breech A fetal presentation in which a foot or feet are first to enter the maternal pelvis. foramen ovale An opening between the atria of the fetal heart that ordinarily closes on its own shortly after birth. forceps, obstetrical Two interlocking metal blades that fit around the baby’s head, used by obstetricians in some situations to assist delivery. frank breech A fetal position in which the presenting part is the fetal sacrum, and the lower extremities are extended toward the fetal head. Gaskin’s maneuver A maneuver using the hands-and-knees position to resolve shoulder dystocia. gastric motility Ability of the gastrointestinal tract to move food being digested. gestation The time from conception to birth, approximately 280 days. gestational age The age of an embryo or fetus with respect to the first day of the last menstrual period (LMP). Usual gestation is 40 weeks, but 37–42 weeks is considered term. gestational diabetes glucose intolerance of variable degree with onset or first recognition during the present pregnancy. gonadotropin (also gonadotrophin) A gonad-stimulating hormone. grand multipara A woman who has given birth many times, usually more than 5. gravida 1. A pregnant woman. 2. The number of times a woman has been pregnant, including the present pregnancy. This is the number of pregnancies, not the number of babies or births. Multigravida—a woman who is pregnant for at least the second time or who has been pregnant at least twice. Nulligravida—a woman has never been pregnant. Primigravida—a woman who is pregnant for the first time HELLP syndrome A potentially life-threatening complication of pregnancy characterized by Hemolysis, Elevated Liver enzymes, and Low Platelets. hematoma A swelling filled with blood (often clotted), created by rupture of one or more blood vessels. hemolysis Destruction of red blood cells. hemorrhage Abnormal internal or external bleeding, sometimes sudden and dangerous. hemorrhoids Varicose veins in the anus or rectum. hemostasis Arrest of bleeding or maintenance of blood volume. high-risk pregnancy A pregnancy in which complications or special circumstances may require bedrest or advanced medical techniques or technology. holism Belief in the indivisibility of mind, body, and spirit. A healthcare provider with a holistic attitude is concerned with the whole person and the interrelationships among the emotional, social, spiritual, and physical aspects of disease and health. Homan’s sign Pain in the calf upon dorsiflexion of the foot. hormone A blood-borne substance produced by one body part to influence a function of another. human chorionic gonadotropin (hCG) A hormone secreted in early pregnancy by the fertilized ovum; it stimulates the corpus luteum. hydatidiform mole (hydatid mole, molar pregnancy) A condition in which the embryo either dies early (partial molar pregnancy) or is never formed (complete molar pregnancy), but the chorionic villi proliferate and degenerate into fluid-filled vesicles that distend the uterus. hydramnios Excessive amounts of amniotic fluid. hydronephrosis Backup of urine in the kidney as a result of blocked flow; it can occur in either mother or fetus. hypercoagulable state A condition in which the blood has a higher tendency to clot, even in the absence of bleeding. hyperemesis Severe, persistent nausea and vomiting. Hyperemesis gravidarum is an extreme form of pregnancy-related “morning sickness” that can cause weight loss, ketosis, dehydration, and hypokalemia or other electrolyte imbalance and sometimes requires hospitalization. hyperreflexia Exaggerated reflexes, sometimes a sign of preeclampsia (which see). hypertension High blood pressure, usually considered to be 140/90 or greater. See also gestational/pregnancy-induced hypertension. hypotension Abnormally low blood pressure. Orthostatic hypotension occurs when a person rises after sitting or lying down. hypovolemia A decrease in the volume of circulating blood. hypoxia Deficiency of oxygen in the blood and tissues. hysterectomy Surgical removal of the uterus. implantation The process by which fertilized ovum attaches to the uterine wall, penetrates the endometrium, and taps into the maternal circulatory system. induced labor Labor started or accelerated through intervention, such as an IV drip of the hormone oxytocin (Pitocin). infant mortality Death occurring between birth and 1 year of age. internal rotation A cardinal movement of labor in which, in a vertex delivery, the anterioposterior diameter of the fetal head moves into alignment with the anterioposterior diameter of the maternal pelvis. intrapartum A noun or adjective pertaining to the period of pregnancy from the onset of labor through the expulsion of the placenta. intrauterine growth restriction (or retardation; IUGR) Fetal weight below the 10th percentile with poor growth due to insufficient nutrition and oxygenation in utero. introitus The entrance to the vagina, between the labia minora. intubation Inserting an endotracheal tube to maintain a patent airway or for other reasons. ischemia Temporary deficiency of blood flow to a body part. IUGR Intrauterine growth restriction—abnormally slow fetal growth. jaundice Yellowish coloration of body tissues and fluids by high levels of bilirubin in the bloodstream. knee-chest position A position in which the cheek, elbows, chest, and knees are flat on a surface and the buttocks are elevated labor The process of expelling the fetus and other products of conception from the uterus. First-stage labor—begins with the onset of regular uterine contractions that effect cervical change and ends with full dilation of the cervix (usually about 10 cm). Second-stage labor—involves expulsion of the fetus. Third-stage labor—involves delivery of the placenta. laceration An irregular tear. lactated Ringer’s solution (LR) A sterile solution of calcium chloride, potassium chloride, sodium chloride, and sodium lactate in water used intravenously to expand fluid volume and replace electrolytes. lactation Production and release of milk by the mammary glands. last menstrual period (LMP) The menstrual period immediately before pregnancy. Its first day is the conventional beginning of gestation and the reference for estimates of gestational age (both of which see). left lateral recumbent position A position in which the patient lies on the left side with the right knee and thigh drawn toward the chest. leiomyoma (fibroid) A benign tumor of the uterine smooth muscle. Leopold maneuver(s) Palpation of the maternal abdomen to ascertain the size and orientation of the fetus. lie The relationship of the long axis of the fetus to that of the mother. lochia Liquid discharged from the vagina after childbirth, containing primarily blood, cellular debris, mucus, and fetal substances such as meconium, lanugo, and vernix. lordosis Exaggerated forward curvature of the lumbar spine (considered normal in pregnancy); “swayback.” low birth weight Less than 2,500 g regardless of gestational age. malaise A vague feeling of discomfort or unwellness. malpresentation Abnormal position of the fetus that may make vaginal delivery difficult or impossible. mastitis Inflammation of the connective tissue in the breast, usually caused by bacterial infection. McRobert’s position Lying on the back with knees drawn toward the chest; sometimes useful in resolving shoulder dystocia (which see). meconium The tarry blackish-green substance excreted in a baby’s first bowel movement, which ideally occurs shortly after birth, but may occur in utero. meconium aspiration syndrome Hypoxia and other problems that occur when meconium is inhaled into the tracheobronchial airways. microcephaly Abnormally small head. miscarriage An informal term for spontaneous abortion. molding Temporary alteration of the shape of a baby’s head by pressures that it encounters in the birth canal. Müllerian ducts A pair of embryonic structures that give rise to the reproductive organs in the female, but disappear in the male. multipara A woman who has had two or more deliveries beyond 20 weeks’ gestation. See para. multiple gestation Carrying more than one embryo or fetus at a time. necrotizing fasciitis Severe infection with toxin-producing bacteria that leads to necrosis of subcutaneous tissue and adjacent fascia. Neisseria gonorrhoeae Causative microorganism of gonorrhea, a sexually transmitted disease. neonate An infant less than 4 weeks old. Nitrazine® paper Paper impregnated with phenaphthazine, an indicator dye, used to determine the pH of solutions by its change in color. noncephalic presentation When a fetal part other than the head enters the maternal pelvis first nonstress test (NST) A test that assesses fetal wellbeing by graphing the fetal heart rate while monitoring for uterine contractions. Reassuring features of a fetal heart rate include accelerations when the baby moves, variability or fluctuations above and below the normal baseline rate, and lack of pathological decelerations. normal saline A sterile solution of 0.9% sodium chloride in water, given intravenously to replace fluid volume lost to bleeding or dehydration, used to irrigate wounds, and so on. nuchal Involving the fetal neck. Nuchal cord: an umbilical cord wrapped around the fetal neck. Nuchal hand: a fetal hand positioned at the fetal neck. nullipara A woman who has never delivered beyond 20 weeks’ gestation. See para. occiput posterior (OP) A fetal position in which the occiput of the fetal skull is directed toward the mother’s sacrum. OLDCART A mnemonic for the main points to consider in pain assessment: Onset, Location, Duration, Characteristics, Associated symptoms, Relieving/aggravating factors, and previous Treatment. oligohydramnios An abnormally small amount of amniotic fluid. oliguria Abnormally low urinary output. os Either of the two openings of the cervix. The inner os (os uteri internum) is the opening of the cervical canal into the corpus of the uterus; the outer os (os uteri externum) is the opening of the cervical canal into the vagina. ovarian cysts A pathological, but usually noncancerous cavity in the ovary containing fluid, semisolid material, or gas. oxytocin A hormone secreted by the posterior pituitary gland that stimulates uterine contractions during labor and the release of milk. Pitocin is a synthetic form. pallor Paleness, lack of color. palpate To examine by feeling with the hands. para (Also parity) the number of a woman’s pregnancies that have ended with the birth of a fetus (or fetuses) beyond 20 weeks’ gestation, regardless of whether they were born alive. The term is often used to denote the number of live births. Multipara—a woman who has delivered at least one infant greater than 20 weeks’ gestation. Grand multipara—a woman who has delivered 5 or more babies beyond 20 weeks’ gestation. Nullipara—a woman who has never delivered beyond 20 weeks’ gestation. “passage” The route that a fetus must negotiate during birth; a narrow or obstructed passage may cause long, exhausting labor or render vaginal birth impossible. “passenger” The fetus, especially when considered with respect to his passage during birth. patient-centered practice Considering each patient’s physical and mental condition, medical history, personal preferences, spirituality, family dynamics, and other important things, then providing the most efficacious treatments likely to maximize the quality and quantity of life for that person. pelvic floor The muscles and other tissues forming a “sling” between the coccyx and pubic bone that supports the organs in the pelvis and control urination and defecation. pelvic inflammatory disease (PID) A generic term for infections of the female reproductive tract, including endometritis and peritonitis. It is often caused by the sexually transmitted microorganisms responsible for chlamydia and gonorrhea. pelvis The structure comprising the two innominate (hip) bones, the sacrum, and the coccyx, joined at the symphysis pubis, sacroiliac, and sacrococcygeal joints by cartilage and ligaments. perfusion Circulation of blood through tissues. perinatal Pertaining to the combined fetal and neonatal periods, that is, from the 21st week of gestation through the 4th week after birth. perineum The area between the vaginal opening and the anus. peristalsis Involuntary, wavelike movements in various tubes in the body (e.g., fallopian tubes and the gastrointestinal tract). petechiae Pinpoint hemorrhages, sometimes seen on the face of a newborn who had a tight nuchal cord (which see) or was born rapidly. pituitary gland The “master gland” at the base of the brain, which secretes many hormones, regulates and controls other glands, and influences many body processes, including reproduction. placenta An organ that develops in the uterus during pregnancy to facilitate transfer of oxygen and nutrients from the mother’s bloodstream to the fetus and removal of fetal waste products by the same route. Placenta accreta—a placenta that has grown into the uterine wall. Placenta increta—a placenta that has grown into the uterine muscle. Placenta percreta—a placenta that has grown entirely though the uterine wall. placenta previa (placental presentation) A condition in which the placenta partially encroaches upon or covers the cervical os. Marginal—the edge of the placenta comes to the edge of the cervical os. Partial—the placenta partially obstructs the cervical os. Complete—the placenta completely covers the cervical os. placental abruption (abruption, abruptio placentae) Partial or complete separation of the placenta from the uterine wall. It can cause hemorrhage that threatens the life of both mother and fetus. platypelloid pelvis A pelvis that is wider than it is deep and not well suited to the vaginal delivery of some fetuses. polyhydramnios (hydramnios, hydramnion) Excessive amounts of amniotic fluid. postpartum A noun or adjective pertaining to the period from delivery of the placenta until the woman’s body returns to its essentially pre-pregnant condition, usually about 6 weeks after delivery. “powers” The strength and effectiveness of uterine contractions. precipitous delivery Abrupt, rapid, often forceful, and sometimes uncontrollable descent and expulsion of the fetus. preeclampsia A condition characterized by hypertension, edema, and proteinuria; a precursor of eclampsia (all of which see). gestational/pregnancy-induced hypertension High blood pressure caused by or occurring in pregnancy. Sometimes used as a synonym for preeclampsia (which see), a condition that comprises not only hypertension, but also edema and proteinuria. premature Occurring or born before full term (37 completed weeks of gestation). premature rupture of membranes (PROM) Rupture of the amniotic membranes before the onset of labor. preterm premature rupture of membranes (PPROM)—rupture of the amniotic membrane before 37 completed weeks of gestation. presentation 1. The observable manifestation of a disease or condition, including signs and symptoms. 2. Fetal presentation is determined by the fetal presenting part entering the maternal pelvis, e.g., double footling breech presentation, vertex presentation. Cephalic presentation--the head enters the pelvis first. Vertex presentation—occurs when the top of the head enters the pelvis first. Noncephalic presentation—a fetal part other than the head, such as buttocks or shoulder, enters pelvis first. Compound presentation—occurs when a limb accompanies the main presenting part, such as a hand beside the head. presenting part The fetal part that first enters the pelvis. preterm Occurring or born before the 37th completed week of gestation. preterm labor Labor occurring after 20 weeks’ completed gestation, but before the 37th week. primigravida A woman who is pregnant for the first time. primipara A woman who has had one delivery greater than 20 weeks’ gestation. This term is used informally to indicate a woman giving birth for the first time. progesterone A steroidal hormone secreted by the corpus luteum of the ovary and produced by the placenta during pregnancy. prolapse Falling or slipping out of place. PROM Premature Rupture Of Membranes. prostaglandin A hormonelike substance that may affect metabolism, blood pressure, smooth-muscle activity, or nerve transmission. proteinuria Abnormal amounts of protein in the urine. pulmonary edema Excessive fluid in the lungs. pulmonary embolism A circulatory obstruction in the lungs, often a dislodged clot from the lower extremities or elsewhere. Embolism in general is the leading cause of maternal death in pregnancy. pulmonary hypoplasia Underdeveloped lungs. pyelonephritis Inflammation of the kidney and renal pelvis, usually from infection. rales Crackling sounds produced in the lungs by air passing over secretions or through constrictions. renal calculi Kidney stones. restitution Rotation of the head 45° toward the right or left after emerging from the mother’s body, a cardinal movement of labor. resuscitation Measures taken to restore respiration or heartbeat. retained placenta A condition in which all or part of the placenta resists expulsion. retraction Pulling in of the flesh above and below the sternum, between the ribs, and around the neck when a newborn breathes, a sign of respiratory distress. Rh isoimmunization A condition in which antibodies from an Rh-negative woman destroys the blood of an Rh-positive fetus. The antibodies are usually produced by fetal blood accidentally entering her circulation during a previous pregnancy. This is a potentially life-threatening condition for the fetus. RhoGam A blood product (anti-D immunoglobulin) given to Rh-negative women in pregnancy and postpartum to prevent harm to subsequent Rh-negative babies (Rh isoimmunization). rubella (German measles) An acute infectious disease that may harm the fetus if the mother contracts it during pregnancy. rupture Tearing apart of an organ or tissue. See also rupture of membranes and uterine rupture. rupture of membranes Usually referred to as “breaking the waters,” this is rupture of the amniotic sac and release of amniotic fluid. salpingitis Inflammation of the fallopian tube. semi-Fowler’s position Lying on the back with the trunk forming a roughly 45-degree angle with the floor or ground. shock A clinical syndrome where blood flow is inadequate to perfuse organs and tissues. Shock may be cardiogenic (caused by poor cardiac output), hypovolemic (caused by loss of blood or body fluid), neurogenic (caused by CNS injury), anaphylactic (caused by allergic reaction) or septic (caused by infection). shoulder dystocia A condition in which the anterior fetal shoulder is impacted against the maternal pubic bone after delivery of the head, preventing delivery. shoulder presentation A fetal presentation in which shoulder is the first part to enter the pelvis; not deliverable vaginally. side-lying position (maternal) Lying on either side, usually with the knees slightly bent. SIDS The sudden, unexplained death of an infant younger than 1 year of age. Sims’ position A semi-prone position with patient on left side, right knee and thigh drawn up, chest inclined forward. Skene’s glands A pair of glands within the vaginal vestibule that secrete lubricants during arousal. small for gestational age (SGA) A term describing a fetus who falls below the 10th percentile of expected weights for that gestational age. somatization disorder A condition characterized by physical symptoms that have no apparent physiological cause and are attributable to psychological factors. souffle A “whooshing” in a heart sound. spermatocyte (spermatozoan) A male reproductive cell. spontaneous abortion Expulsion of the products of conception before the 20th week of gestation. station Position of the fetal presenting part with respect to the ischial spines of the maternal pelvis. Station +2 means that the presenting part is 2 cm below the ischial spines. stillbirth The birth of a dead fetus beyond 20–22 weeks gestation. streptococci Common disease-producing bacteria. stress A broad, vague, evolving term generally taken to mean anything that disturbs mental or physical equilibrium. striae gravidarum “Stretch marks”; streaks or lines on the skin of a pregnant woman, usually on the abdomen, hips, breasts, and legs. subinvolution Failure of the uterus to return to its prepregnant size after delivery, often because of retained placental fragments or infection. substance abuse Using chemically active substances frivolously, irresponsibly, or harmfully. The term includes a great variety of maladaptive behaviors, such as misusing prescription drugs, using legal nonprescription drugs such as alcohol to excess, taking illicit psychoactive drugs, using otherwise beneficial substances such as gasoline to alter consciousness, or using harmful substances with no known benefit, such as tobacco. sudden infant death syndrome (crib death) The sudden, unexplained death of an infant younger than 1 year of age. supine hypotension syndrome A drop in blood pressure that occurs when a pregnant woman lies on her back, allowing her uterus and its contents to compress her vena cava against her spine. supine (dorsal) position Lying on the back. surfactant A substance secreted by the alveolar cells of the lung that reduces surface tension of fluids that coat the lung, allowing the lung to remain expanded. suture lines Joints that are (or will eventually become) immovable, such as those between adjacent bones of the skull. symphysis pubis The junction of the two pubic bones, at the midline of the pubic arch. syncope Transient loss of consciousness, usually because of inadequate blood flow to the brain; fainting. syphilis A sexually transmitted bacterial disease (caused by Treponema pallidum) that, if not treated, can cause spontaneous abortion, neurological damage, and eventual death. tachycardia Abnormally rapid heart rate; the threshold is often considered 100 beats per minute in an adult and 160 in a fetus. teratogen Anything (such as ionizing radiation or a toxic substance) that interferes with normal embryonic or fetal development. term Normal end of the pregnancy period, when the fetus is considered mature, between 37 and 42 completed weeks of gestation. therapeutic abortion Medically sanctioned pregnancy termination performed when pregnancy endangers the mother’s health or when the fetus has a known fatal condition. threatened abortion Bleeding from the uterus or cramping that may or may not result in loss of the pregnancy thromboembolism Circulatory blockage by a detached blood clot. thrombophlebitis Inflammation of a vein, usually in a leg, that coincides with formation of a clot. torsion (tubal or ovarian torsion) Twisting of the fallopian tube, leading to compromise of blood flow and ischemia of the ovary and distal tube. toxemia An obsolescent term for preeclampsia (which see). toxic shock syndrome A multisystem disease caused by toxins produced by Staphylococcus aureus or Streptococcus pyogenes (group A strep). toxoplasmosis Infection by a parasite (Toxoplasma gondii, found in raw and rare meat, garden soil, and cat feces) not usually harmful to nonpregnant adults, but potentially damaging and sometimes deadly to the fetus. transition The phase of active labor in which the cervix finishes dilating. transverse presentation (transverse lie) A condition in which the fetus lies at right angles to the mother’s spine, with his head on one side of her abdomen and his rump on the other. trauma 1. A physical injury caused by external force. 2. A profound emotional injury. Treponema pallidum The bacterium that causes syphillis. trichomonas (“tric”) A sexually transmitted disease caused by Trichomonas vaginalis, a protozoan, and characterized by vaginal irritation and discharge. trimester One of the 3-month periods into which a pregnancy is divided for convenience. true labor Regular uterine contractions that produce increasing cervical dilation and descent of the fetus. tubal reanastomosis Reversal of tubal ligation to achieve pregnancy. ulcerative colitis An inflammatory and ulcerative condition of the colon. ultrasound Diagnostic imaging technology that uses high-frequency sound instead of electromagnetic radiation to view internal organs and other things hidden from sight; often used to observe the fetus in utero. umbilical cord (umbilicus) The cord connecting the fetus to the placenta. It contains two arteries and a vein, which carry oxygen and nutrients to the fetus and remove waste products. umbilical cord prolapse An emergent situation involving an umbilical cord that lies beside or below the fetal presenting part. universal precautions Safety guidelines for healthcare workers exposed to bloodborne pathogens involving protection against exposure to the blood and body fluids of all patients (gloves, gowns, goggles, etc.). ureter A tube that carries urine from a kidney to the bladder. urethra The tube that carries urine from the bladder; in women, its opening (urethral meatus) is in the vaginal vestibule below the clitoris. urinary tract infection Infection of kidneys, ureters, or bladder by microorganisms, most often those that ascend the urethra. uterine dysfunction A general term comprising hypertonic and hypotonic contractions (both of which see). uterine fibroids Benign tumors of the uterine muscle. uterine prolapse (uterine inversion) 1. Obstetrics—a condition in which the uterus turns inside out after delivery, causing life-threatening hemorrhage. 2. Gynecology—a condition in which a defective pelvic floor allows all or part of the uterus to protrude into or through the vagina. Most often seen in postmenopausal women of high parity. uterine rupture The tearing apart of uterine muscles, sometimes enough to allow the fetus to be born into the abdominal cavity. uteroplacental insufficiency Insufficient oxygen and nutrient exchange between the uterus and the placenta. uterus The womb; a hollow, muscular, pear-shaped organ in a woman’s pelvic cavity between the sacrum and the symphysis pubis; it holds the embryo and fetus from conception to birth. UTI Abbreviation for urinary tract infection (which see). vagina The sheathlike tube connecting the cervix and the vulva which receives the penis during intercourse and becomes the birth canal for delivery of an infant. vaginal vestibule The area between the labia minora, which contains the introitus (vaginal entrance), the urethral meatus, two Skene’s glands (which secrete lubricants during arousal), and two Bartholin’s glands, also for secreting mucus. vaginitis Inflammation of the vagina as a result of infection or of irritation by chemicals or foreign bodies. vaginosis Inflammation of the vagina and vicinity, usually with itching, burning, and increased volume of vaginal discharge; caused by bacterial infection (Gardnerella vaginalis). varicella (chickenpox) A disease caused by the varicella-zoster herpes virus, common in childhood, potentially serious in adults, and hazardous to the fetus in the first 20 weeks of gestation. VSV also causes shingles (herpes zoster). VBAC Vaginal Birth After Cesarean. vernix caseosa A white, greasy, tenacious substance secreted by fetal sebaceous glands that adheres to the body hair and protects delicate fetal skin in utero. vertex presentation A fetal presentation (which see) in which the top of the head enters the pelvis first. very low birth weight Less than 1,500 g. viable Able to live outside the womb. The threshold of fetal viability is usually considered 500 g or 20 weeks of gestation, though 24 weeks is generally the practical limit. Legal and popular definitions are numerous. virilization Development of male secondary sex characteristics. vital signs Physical signs of functions essential to life—pulse, rate of respiration, blood pressure, and temperature. vulva The external female genitalia. yeast infection Fungal infection of the vagina and vicinity, commonly by Candida albicans; usually characterized by itching, burning, or redness. |
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