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78 Cards in this Set
- Front
- Back
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nulliparous
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a woman who has never been pregnant beyond 20w gestation
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primigravid
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a woman pregnant for the first time
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G6 P4
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gravida 6 para 4
pregnant 6 times (including current) and previously delivered four babies of >20w gestation |
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abortion
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a process by which the products of conception are expelled from the uterus via the birth canal before 20w gestation
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labour
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as per abortion, but after 20w
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Caesarian section
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surgical removal of uterine contents by the abdominal route after 20w
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hysterotomy
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as per C-section, but before 20w gestation
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prolonged pregnancy
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pregnancy prolonged 14d or more past 40w
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premature/preterm infant
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infant born before 37w gestation
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premature rupture of membranes (PROM)
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when membranes rupture before onset of labour
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neonatal death
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a live born infant who dies within 28d of birth of at least 20w gestation or if gestation is unk weighing at least 400g
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stillbirth
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an infant born after 20w gestation (or birthwt >400g if gestation unk) who did not breathe after birth or show any other sign of life
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perinatal mortality rate
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stillbirth + neonatal deaths expressed per 1000 births
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infant death
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death of an infant between 29 and 364 days after birth (i.e. after 4w and before 1y of age)
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maternal death
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death of a woman while pregnant (irrespective of gestation) or within 42d of termination of pregnancy irrespective of cause of death
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presenting part
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part of fetus felt on vaginal examination
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lie of the fetus
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relationship of the long axis of fetus to long axis of uterus
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station of the presenting part
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the level of descent of the presenting part relative to pelvic brim or symphysis on abdo palpation or to the ischial spines on vaginal exam
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engagement
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the station at which the maximum diameter of the presenting part is thru the pelvic inlet
if vertex presentation: 1/5 head palpable above symphysis on abdo palpation, vertex reached level of ischial spines on vag exam |
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position of the fetus
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the rotational relationship of a defined area on the presenting part (the "denominator") to the mother's pelvis
In a cephalic presentation, the "denominator" is the occiput. Thus the fetal position is described as OA, OP, L/ROT. In a breech presentation, the "denominator" is the sacrum (SA, SP, ST). |
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asynclitism
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side-to-side tilt of the fetal head
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attitude (of the fetus)
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relation of fetal head and limbs to fetal trunk (usually flexion)
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Braxton Hicks' contractions
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painless uterine contractions in the antenatal period
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breech presentation types
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complete
frank footling |
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complete breech
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hips and knees flexed
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frank breech
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hips flexed, knees extended
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footling breech
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one or both feet presenting
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cephalic presentation types (include diameter and name of diameter)
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vertex (9.5 cm/suboccipito-bregmatic)
deflexed vertex (11.5 cm/occipito-frontal) brow (13.5 cm/vertico-mental) face (9.5 cm/cervico-bregmatic) |
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sinciput
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forehead
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brow
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between root of nose and anterior fontanelle
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bregma
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anterior fontanelle
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vertex
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between fontanelles and parietal eminences
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fontanelle
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jxn of >2 skull bones, covered only by membrane and skin
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pelvic inlet diameter (AP/transverse) and landmarks
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(11.5 cm/13.5 cm)
true conjugate symphysis to sacral prom |
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mid-pelvis (narrow pelvic plane) diameter (AP/transverse) and landmarks
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(11.5 cm/10.5 cm)
symphysis to S3 and bispinous between ischial spines |
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pelvic outlet diameter (AP/transverse) and landmarks
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(11.5 cm/11.5 cm)
symphysis to coccyx or S5 and intertuberous between ischial tuberosities |
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caput succedaneum
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edema from obstructed venous return in fetal scalp caused by pressure of the head against rim of cervix or birth canal
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cervical dystocia
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difficult labour due to an abnormality in cervix, commonly scarring after cervical surgery
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cervical incompetence
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cervix dilates silently during the second trimester with the result that membranes bulge and rupture and the fetus drops out
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colostrum
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yellowish fluid expressed from the breast during pregnancy and before the onset of lactation
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cord presentation
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cord is alongside or below presenting part with membranes intact
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cord prolapse
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as per cord presentation except membranes have ruptured
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epidural analgesia
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injection of analgesic agent outside the dura
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episiotomy
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incision of perineum and vagina that enlarges the introitus
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fourth degree tear
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a perineal laceration involving rectal mucosa and the anal sphincter and lying open to the anal canal
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Hegar's sign of pregnancy
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bimanual palpation of a soft uterine isthmus between the cervix below and the uterine body above
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hydrops fetalis
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gross edema of fetal subcut tissues together w/accumulation of excess fluid in two or more body cavities (eg. ascites, pleural/pericardial effusions)
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incoordinate uterine action
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fundal dominance is lost; intrauterine tension between contractions is increased
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leucorrhea
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white, non-itchy, non-offensive vaginal discharge
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lochia [loh-kee-uh]
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discharge from uterus during puerperium initially red (lochia rubra), then yellow (serosa), and white (alba)
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lower uterine segment
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the thin, expanded lower portion of the uterus which forms in the last trimester
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Naegele's rule
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estimates probable date of confinement:
add a year, take back 3 months, and add 7 days to the first day of LMP (correction required if pt does not have 28d cycle) |
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oligohydramnios (include quantity, causes, and AFI on US)
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insufficient amniotic fluid
(0-200 mL in 3rd trimester) causes include PROM, placental insufficiency, decreased urine production AFI is <5 (sometimes 8 is used) |
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polyhydramnios (incl. quantity and AFI)
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clinical dx of an excessive amt of liquor amnii (usually >2500 mL)
On US, AFI >25 or deepest pocket of fluid is >10 cm |
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oxytocic
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substance that stimulates contractions of the uterine muscle
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hypertension
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SBP >=140 and/or
DBP >=90 or rise of SBP>=25 or DBP>=15 compared to early pregancy on two readings 6h apart |
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pre-eclampsia
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2 of the following:
HTN generalized edema proteinuria not from contamination or UTI the following conditions must apply: 1. HTN after 20w gestation 2. normal bp in first trimester of pregnancy |
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eclampsia
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grand mal convulsions usually superimposed on preceding severe pre-eclampsia (not attributable to cerebral conditions eg. epilepsy, cerebral hemorrhage)
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precipitate labour
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labour of <4h duration
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prolonged labour
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labour of >24h duration
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pueperium
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period during which reproductive organs return to their pre-pregnant condition usually regarded as 6w after delivery
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quickening
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when the pt first becomes aware of fetal mvmts
approx 17w (multigravida) and 19w (primigravida) |
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restitution
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when the fetal head is born, it is free to undo any twisting caused by internal rotation
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retained placenta
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placenta still in-utero 1h after birth of baby
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show
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a discharge of mucus and blood at the onset of labour when cervix dilates and operculum falls out
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stages of labour
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1st: up to full dilation of cervix
2nd: from full dilation until expulsion of fetus 3rd: from expulsion of fetus until expulsion of placenta and membranes |
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version
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turning of the fetus to produce a change in the presenting part
may be spontaneous/therapeutic, cephalic/podalic, internal/external |
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antepartum hemorrhage
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bleeding from birth canal in excess of 5 mL from 20w gestation to birth of baby
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placenta previa
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placental implantation encroaches upon lower uterine segment
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vasa previa
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fetal vessels lying in the membranes in front of the presenting part (due to velamentous insertion of cord, succenturiate lobe, or bipartite placenta)
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accidental hemorrhage
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bleeding from a normally situated placenta after 20w
abruption - assoc'd w/placental separation marginal - not assoc'd w/placental separation |
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incidental hemorrhage
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bleeding from the lower genital tract, incl. cervix, vag, vulva
commonly related to cervical ectropion or polyp |
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postpartum hemorrhage
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primary: blood loss in excess 500 mL from birth canal in first 24h following delivery of fetus
secondary: excessive bleeding in the interval from 24h post-delivery until end of puerperium (volume unspecified) |
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inversion of uterus
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uterus turns inside out
usually due to pulling of the cord with the uterus relaxed and the placenta not separated |
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placenta accreta
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absence of decidua basalis, with chorionic villi attached directly to uterine muscle.
placenta increta - even more deep; in the muscle wall placenta percreta - villi are through the uterine wall, usually into bladder wall |
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uterine atony
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relaxation of uterus
commonest cause of PPH |
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amniocentesis
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aspiration of a sample of amniotic fluid through the mother's abdo
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preterm PROM
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PROM before 37w gestation
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