ObGyn Definitions
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| Nulliparous | A woman who has never been pregnant beyond 20 weeks gestation
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| Primigravid | A woman pregnant for the first time
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| Gravida | Number of pregnancies including current pregnancy
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| Para/Parity | Number of deliveries beyond 20 weeks gestation (regardless of liveborn or stillborn)
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| G6P4 | Gravida 6 Para 4 means pregnant 6 times (including current pregnancy) and previously delivered of 4 babies of greater than 20 weeks gestational age
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| Grandmulti | Para 5 or more. A woman who has delivered at least 5 babies of greater than 20 weeks gestation
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| Abortion | The process by which the products of conception are expelled from the uterus via the birth canal before the 20th week of gestation
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| Labour | Regular uterine contractions occuring beyond 20 weeks gestation, in association with cervical dilatation and ultimately resulting in delivery
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| Caesarian section | Surgical removal of the uterine contents by the abdominal route after 20 weeks gestation.
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| Hysterotomy | Surgical removal of the uterine contents by the abdominal route before 20 weeks gestation
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| Prolonged pregnancy | Pregnancy prolonged 14 days or more after 40 weeks
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| Preterm or premature labour | The presence of uterine contractions and progressive cervical effacement and dilatation occuring between 23 and 37 weeks gestation
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| Tocolytic drugs | Medications used to suppress premature labour (e.g. Nifedipine, Indomethacin, salbutamol, magnesium sulphate)
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| Premature infant or preterm infant | Infant born before 37 weeks gestation
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| Premature rupture of membranes (PROM) | When the membrane rupture before the onset of labour
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| Preterm PROM | Rupture of membranes before 37 weeks of gestation
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| Neonatal death | A liveborn infant who dies within 28 days of birth, of at least 20 weeks gestation or if gestation is unknown weighing at least 400g
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| Stillbirth | An infant born after the 20th week of gestation (or birthweight >400g, if gestation unknown) who did not breathe after bith or show any other sign of life
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| Perinatal mortality rate | Stillbirths plus neonatal deaths expressed per 1000 births
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| Hyperemesis gravidarum | Excessive vomiting during pregnancy. It usually resolves by the 2nd trimester
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| Infant death | Death of an infant between 29 and 364 days after birth
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| Maternal death | The death of a woman while pregnant (irrespective of the gestation) or within 42 days of the conclusion of pregnancy irrespective of the cause of death or gestation at delivery
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| Presenting part | The part of the fetus felt on vaginal examination
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| Lie of the fetus | Relationship of the long axis of the fetus to the long axis of the uterus
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| Station of the presenting part | The level of descent of the presenting part relative to the pelvic brim or symphysis on abdominal palpation, or to the ischial spines on vaginal examination
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| Engagement | The station at which the maximum diameter of the presenting part is through the pelvic inlet. If vertex presentation: 1/5 head palpable above the symphysis on abdo palpation, vertex reached level of ischial spines on vaginal ex
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| Position of fetus | The rotational relationship of a defined area on the presenting part (the denominator) to the mothers pelvis. If cephalic, denom=occiput. Position is OA,OA, LOT or ROT. In breech denom is sacrum (SA, SP, ST)
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| Asynclitism | Side to side tilt of fetal head
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| Attitude of fetus | Relationship of fetal head and limbs to fetal trunk (usually flexion)
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| Braxton-Hicks contractions | Painless uterine contractions in antenatal period
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| Breech presentation types | Complete: hips and knees flexed
Frank: hips flexed, knees extended
Footling: one or both feet presenting
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| Cephalic presentations | Vertex/9.5cm/suboccipito-bregmatic
Deflexed vertex/11.5/occipito-frontal
Brow/13.5/vertico-mental
Face/9.5/cervico-bregmatic
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| Parts of the fetal head | Sinciput: Forehead
Brow: Between root of nose and anterior fontanelle
Bregma: anterior fontanelle
Vertex: Between fontanelles and parietal eminences
Fontanelle: Junction of >2 skull bones covered only by a membrane and skin
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| Normal pelvis diameters AP/Transverse | Pelvic inlet/11.5/13.5
Mid pelvis/11.5/10.5 - ischial spines
Pelvic outlet 11.5/11.5 ischial tuberosities
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| Caput succedaneum | Oedema from obstructed venous return in the fetal scalp caused by pressure of the head against the rim of the cervix or birth canal
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| Cervical dystocia | Difficult labour due to an abnormality of the cervix - commonly scarring after cervical surgery
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| Cervical incompetence | The cervix dilates silently during the second trimester with the result that the membranes bulge and rupture and the fetus drops out
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| Colostrum | Yellowish fluid expressed from the breasts during pregnancy and before the onset of lactation
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| Cord presentation | The cord is alongside or below the presenting part with the membranes intact
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| Cord prolapse | The cord is alongside or below the presenting part and the membranes have ruptured
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| Epidural analgesia | Injection of analgesic agent outside the dura
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| Episiotomy | An incision of perineum and vagina that enlarges the introitus
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| Hegar's sign of pregnancy | Bimanual palpaion of a soft uterine isthmus between the cervix below and the uterine body above
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| Hydrops Fetalis | Gross oedema of fetal subctuanous tissues together with accumulation of excess fluid in 2 or more body cavities. ie. ascites, pericardial or pleural effusion
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| Incoordinate uterine action | Fundal dominance is lost, intrauterine tension between contractions is increased
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| Leucorrhea | White non-itchy non-offensive vaginal discharge
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| Epidural analgesia | Injection of analgesic agent outside the dura
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| Episiotomy | An incision of perineum and vagina that enlarges the introitus
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| Hegar's sign of pregnancy | Bimanual palpaion of a soft uterine isthmus between the cervix below and the uterine body above
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| Hydrops Fetalis | Gross oedema of fetal subctuanous tissues together with accumulation of excess fluid in 2 or more body cavities. ie. ascites, pericardial or pleural effusion
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| Incoordinate uterine action | Fundal dominance is lost, intrauterine tension between contractions is increased
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| Leucorrhea | White non-itchy non-offensive vaginal discharge
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| Lochia | The discharge from the uterus during the puerperium. Initially red (lochia rubra), then yellow (serosa), then white (alba)
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| Lower uterine segment | The thin expanded lower portion of the uterus which forms in the last trimester of pregnancy
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| Naegele's rule | To estimate the probable date of confinement. Add 9 months and 7 days to the first day of the last menstrual period. Correction is required if the patient does not have 28 day cycles
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| Oligohydramnios | Insufficiency of amniotic fluid (0-200ml in 3rd trimester). Causes include PROM, placental insufficiency, decreased urine production. AF1<5-8
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| Polyhydramnios | The clinical diagnosis of excessive amount of liquor amnii (>2500ml). AFI>25, deepest pocket >10cm
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| Oxytocic | Substance that stimulates contractions of uterine muscle
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| Pregnancy induced HTN | Hypertension >140/90 compared with early pregnancy, measure 2 times 6 hours apart, occuring after 20 weeks of pregnancy that resolves after delivery of fetus, membranes and placenta
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| Pre-eclampsia | HTN >140/90 compared with early pregnancy, measured on 2 readings 6 hrs apart, after 20 weeks pregnancy, resolving after delivery of fetus placenta and membranes AND proteinuria not due to UTI. There may be generalised oedema
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| Eclampsia | Grand mal convulsions, usually superimposed on severe pre-eclampsia. Not attributable to other conditions such as epilepsy or cerebral haemorrhage
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| Precipitate labour | Labour less than 4 hours duration
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| Prolonged labour | Labour longer than 24 hours duration
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| Puerperium | The period during which the reproductive organs return to their pre-pregnany condition - usually regarded as an interval of 6 weeks after delivery
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| Quickening | When the parent first becomes aware of fetal movements. Occurs at approximately 17 multigravida and 19 primigravida
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| Restitution | When the fetal head is born it is free to undo any twisting caused by internal rotation
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| Induction of labour | The process by which labour is artificially commenced
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| Prostin | Prostaglandin E2. Gel used to prime the cervix in preparation for induction
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| Retained placenta | Placenta still in-utero one hour after birth of the baby
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| Show | A discharge of mucus and blood at the onset of labour when the cervix dilates and the operculum (cervical mucus plug) falls out
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| Stages of labour | 1st: up to full dilation of cervix
2nd: to expulsion of fetus
3rd: delivery of placenta and membranes
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| Version | Turning of the fetus to produce a change in the presenting part
May be spontaneous/therapeutic, cephalic/podalic, internal/external
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| External cephalic version | Turning a breech fetus manually to a cephalic position
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| Antepartum haemorrhage | Bleeding from the birth canal, in excess of 5ml, from the 20th week of gestation to the birth of the baby
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| Placenta praevia | Placental implantation encroaches on the lower uterine segment
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| Vasa praevia | Fetal vessels lying in the membranes in front of the presenting part (due to velamentous cord insertion, succenturiate lobe or bipartite placenta)
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| Accidental haemorrhage | Bleeding from a normally situated placenta after 20 weeks.
Abruption: associated with separation.
Marginal: Not associated with placental separation
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| Incidental haemorrhage | Bleeding from the lower genital tract (cervix, vagina, vulva), commonly related to cervical ectropion or polpy
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| Postpartum haemorrhage | Primary: blood loss in excess of 500ml from the birth canal in the first 24 hours following delivery of the fetus
Secondary: Excessive bleeding occuring in the interval from 24 hrs after delivery until the end of puerperium
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| Inversion of the uterus | Uterus turned inside-out. Usually due to pulling on the cord with the uterus relaxed and the placenta not separated
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| Placenta accreta | Absence of decidua basalis, with chorionic villin attached to uterine muscle. Placenta increta: the villi are in the muscle wall. Placenta percreta: the villi are through the muscle wall, usually into the bladder wall
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| Uterine atony | Relaxation of the uterus
- commonest cause of PPH
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| Amniocentesis | Aspiration of a sample of amniotic fluid through the mothers abdomen
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| CTG | Cardiotocography: an electronic method of simultaneously recording fetal heart rate, fetal movements and uterine contractions
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| Decelerations seen on cardiotocography | Early, late, variable, prolonged
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| Haemorrhagic disease of the newborn | A coagulation disturbance in newborns due to vitamin K deficiency, leading to impaired production of coagulation factors by the liver
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| Signs of neonatal respiratory distress | Tachypnoea >60, increased effort, noisy breathing, central cyanosis
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| CVS | Sampling of the placenta performed using a needle under US guidance for the purpose of diagnostic testing (usually for chromosomal abnormalities)
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| Restitution | When the fetal head is born it is free to undo any twisting caused by internal rotation
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| Induction of labour | The process by which labour is artificially commenced
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| Prostin | Prostaglandin E2. Gel used to prime the cervix in preparation for induction
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| Retained placenta | Placenta still in-utero one hour after birth of the baby
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| Show | A discharge of mucus and blood at the onset of labour when the cervix dilates and the operculum (cervical mucus plug) falls out
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| Stages of labour | 1st: up to full dilation of cervix
2nd: to expulsion of fetus
3rd: delivery of placenta and membranes
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| Version | Turning of the fetus to produce a change in the presenting part
May be spontaneous/therapeutic, cephalic/podalic, internal/external
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| External cephalic version | Turning a breech fetus manually to a cephalic position
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| Antepartum haemorrhage | Bleeding from the birth canal, in excess of 5ml, from the 20th week of gestation to the birth of the baby
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| Placenta praevia | Placental implantation encroaches on the lower uterine segment
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| Vasa praevia | Fetal vessels lying in the membranes in front of the presenting part (due to velamentous cord insertion, succenturiate lobe or bipartite placenta)
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| Accidental haemorrhage | Bleeding from a normally situated placenta after 20 weeks.
Abruption: associated with separation.
Marginal: Not associated with placental separation
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| Incidental haemorrhage | Bleeding from the lower genital tract (cervix, vagina, vulva), commonly related to cervical ectropion or polpy
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| Postpartum haemorrhage | Primary: blood loss in excess of 500ml from the birth canal in the first 24 hours following delivery of the fetus
Secondary: Excessive bleeding occuring in the interval from 24 hrs after delivery until the end of puerperium
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| Inversion of the uterus | Uterus turned inside-out. Usually due to pulling on the cord with the uterus relaxed and the placenta not separated
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| Placenta accreta | Absence of decidua basalis, with chorionic villin attached to uterine muscle. Placenta increta: the villi are in the muscle wall. Placenta percreta: the villi are through the muscle wall, usually into the bladder wall
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| Uterine atony | Relaxation of the uterus
- commonest cause of PPH
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| Amniocentesis | Aspiration of a sample of amniotic fluid through the mothers abdomen
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| CTG | Cardiotocography: an electronic method of simultaneously recording fetal heart rate, fetal movements and uterine contractions
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| Decelerations seen on cardiotocography | Early, late, variable, prolonged
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| Haemorrhagic disease of the newborn | A coagulation disturbance in newborns due to vitamin K deficiency, leading to impaired production of coagulation factors by the liver
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| Signs of neonatal respiratory distress | Tachypnoea >60, increased effort, noisy breathing, central cyanosis
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| CVS | Sampling of the placenta performed using a needle under US guidance for the purpose of diagnostic testing (usually for chromosomal abnormalities)
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| Neonatal jaundice | Development of jaundice in the neonatal period
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| Phototherapy | Use of standard fluorescent white light or blue light therapy to conjugate bilirubin to allow for its excretion in the urine in infants with jaundice
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| Exchange transfusion | Procedure used to treat severe pathological jaundice in which blood is removed and replaced with fresh blood. It removes bilirubin as well as antibodies contributing to haemolysis and jaundice
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| Rhesus isoimmunisation | Antibodies cross the placenta resulting in haemolysis of fetal red blood cells. Antibodies include D, kell, Kidd, Duffy, cC etc.
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| Primary amenorrhea | Either the absence of menses by 14 with absense of growth or development of secondary sexual characteristics (e.g. breast development) or absense of menses by age 16 with normal development of secondary sex characteristics
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| Menorrhagia | Prolonged >7d or excessive >80mls/cycle occuring at regular intervals
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| COC | Contains oestrogen and progestagen
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| Progesterone contraception | Contained in OCP, implanon, mirena IUD, depo-provera
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| Hormonal contraception while breastfeeding | Progesterone only: progesterone only minipill, implanon, depo-provera
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| Pituitary macroadenoma | Benign growth in pituitary gland >10mm. May be associated with galactorrhea. Tx includes dopamine agonist therapy (bromocriptine, capergoline)
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| Mullerian agenesis | A congenital malformation characterised by failure of development of Mullerian ducts, resulting in absent uterus and variable vaginal malformations. Common cause of primary amenorrhea.
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| Urge UI | Complaint of involuntary leakage of urine accompanied by or immediately preceded by urgency
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| Stress UI | The complaint of involuntary leakage of urine on effort or exertion, or on sneezing or coughing
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