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 San Gabriel Valley Perinatal Medical Group
  Specialists in High Risk Pregnancy
  Glossary

Abruptio placenta (Placental abruption)

Partial or complete separation of the placenta from the uterus before delivery. It happens in 0.8-1.0% of all pregnancies and has a high recurrence rate. Contractions are usually present. Bleeding is also present in approximately 80% of patients. Factors that have been associated with abruption include maternal hypertension, intrauterine growth restriction (IUGR), non-vertex presentation, polyhydramnios, advanced maternal age, maternal smoking, cocaine use, chorioamnionitis, premature rupture of membranes, and blunt external maternal trauma


Active Labor

The active phase (active labor) of labor begins when the cervix is opened (dilated) to 6 cm in the presence of uterine contractions. During the active phase uterine contractions become more frequent, the cervix dilates more quickly, and the baby descends into the pelvis.


Alloimmunization (Isoimmunization)

Production of an antibody against antigens produced by members of the same species.


Alpha-fetoprotein (AFP)

A protein produced by the fetal liver and yolk sac that can be detected in the mother's blood. Alpha-fetoprotein levels rise gradually throughout most of pregnancy and level off near term. High levels of alpha-fetoprotein are associated with a more advanced pregnancy than expected, multiple pregnancy, fetal death (including a vanished twin), an opening in the spine (spina bifida), an opening in the head (anencephaly), or an opening in the abdominal wall (gastroschisis). Low levels may be associated with Down syndrome, trisomy 18, and some cases of Turner syndrome.


Amniocentesis

A procedure in which a needle is inserted into the uterus and a sample of the fluid surrounding the fetus is drawn out. The procedure may be done to evaluate the fetal chromosomes, to determine fetal lung maturity, or to obtain fluid to culture for possible infections. The procedure may also be performed to remove an excessive amount of amniotic fluid.


Amniotic fluid

The liquid that surrounds the fetus. Amniotic fluid is nearly all fetal urine with a small amount of fluid contributed by the lungs.


Amniotic Fluid Index (AFI)

An ultrasound procedure used to asses the amount of amniotic fluid. The amniotic fluid index is measured by dividing the uterus into four imaginary quadrants. The deepest, unobstructed, vertical pocket of fluid is measured in each quadrant. The four pocket measurements are then added to calculate the AFI. A normal AFI is between 5 and 25 cm.


Amniotic sac

The membrane (amnion) that surrounds the fetus and the amniotic fluid.


Anemia

Decreased amount of normal hemoglobin in blood. Hemoglobin is the substance in red blood cells that carries oxygen.


Anencephaly

A birth defect resulting in the absence of a major portion of the skull and brain. Anencephaly results when the upper portion of the neural tube fails to close. The condition is not compatible with life, and infants usually die within a few days after delivery.

 


Antenatal

Before birth


Antenatal steroids

Steroids (either betamethasone or dexamethasone) given to help the fetal lungs and other organs mature more rapidly. Antenatal steroids are given when preterm delivery is anticipated between 24 and 34 weeks' gestation with intact membranes, and at 24 to 32 weeks' with ruptured membranes.


Antibody (Immunoglobulin)

Molecules produced by white blood cells (lymphocytes) that attach to foreign molecules. Antibodies (immunoglobulins) are grouped into five classes or isotypes: IgG, IgA, IgM, IgD, and IgE.


Antigen

A molecule that causes your body to produce antibodies against the antigen is called an antigen (antibody generator).


Bag of waters

The membrane (amnion) surrounding the fetus and the amniotic fluid.


Bicornuate Uterus

Two separate single horn uterine bodies sharing one cervix. Bicornuate uterus is associated with increased risk for miscarriage, preterm labor, breech presentation, and fetal growth restriction.


Blighted Ovum

A fertilized egg that has failed to develop.


Bloody show

Passage of blood-tinged mucus from the vagina caused by loss of the cervical mucous plug. Bloody show often precedes the onset of labor.


Bradley Method (husband-coached birth)

A method of natural childbirth developed by Robert A. Bradley, M.D. (1917–98). The Bradley method emphasizes education and relaxation techniques for pain management. The method prepares the baby's father to be the mother's birth coach, and prepares the mother to deliver without pain medication.


Bradycardia

In a fetus a mean heart rate less than 110 beats per minute lasting for at least two minutes. In an adult a sustained heart rate less than 60 beats per minute.


Braxton Hicks Contractions

Sporadic uterine contraction that do not increase in intensity and do not result in childbirth, typically felt after 20 weeks. Named after John Braxton Hicks a British gynecologist who first described these contractions in 1872.


Breech presentation

The baby is in a sitting position with the buttocks, knees, or feet nearest to the cervix.

Breech presentation occurs in 25 percent of pregnancies less than 28 weeks' and 1 to 3 percent of births at term. The three types of breech presentation are frank breech (flexed at hips with extended knees-legs above buttocks), footling breech (one or both hips extended-leg(s) extended below buttocks), and complete breech (flexed hips and knees-no limbs extended).


Catheter

A hollow tube used to inject fluid into, or drain fluid from a space such as the bladder.


Cephalhematoma

A collection of blood caused by rupture of blood vessels between the skull and the periosteum (the membrane surrounding a bone). The blood does not cross the joints of the skull, because it is trapped between the periosteum and bone. Subtle skull fractures may underlie a cephalhematoma. The condition generally resolves over several weeks.


Cephalic presentation

The baby's head is down near the mother's cervix.


Cephalhematoma

A collection of blood caused by rupture of blood vessels between the skull and the periosteum (the membrane surrounding a bone). The blood does not cross the joints of the skull, because it is trapped between the periosteum and bone. Subtle skull fractures may underlie a cephalhematoma. The condition generally resolves over several weeks.


Cerclage

A procedure used to temporarily stitch the cervix closed in pregnant women with a history of premature delivery caused by an incompetent cervix. Cerclage sutures are usually placed at 10 to 15 weeks' gestation


Cerebral Palsy

A group of disorders characterized by inability to move and /or to control movements caused by injury or abnormal development in the immature brain.


Certified nurse midwife (CNM)

A registered nurse with at least 1-2 years of nursing experience who has received additional training in delivering babies and providing prenatal and postpartum care to women. They are certified by the American College of Nurse-Midwives (ACNM).


Cervical incompetence

Cervical insufficiency (sometimes called an incompetent cervix) is the failure of the cervix to maintain a pregnancy when there are no signs or symptoms of labor in the second trimester.


Cervix

Lower narrow part of the uterus that opens into the vagina.


Cesarean section (C-section)

An incision made through the abdomen and uterus for the purpose of delivering one or more fetuses. The incision on the abdomen may be vertical or transverse. The incision made on the uterus may not be in the same direction as the abdominal incision.
 


Chloasma (mask of pregnancy, melasma)

Blotchy areas of darkened skin over the the forehead, cheeks and upper lips associated with pregnancy or with the use of contraceptives. Exposure to ultraviolet (UV) rays from the sun or tanning salons intensifies the pigment changes. The areas of darkened skin usually fade several months after delivery or discontinuation of the contraceptive


Cholestasis of pregnancy (Intrahepatic cholestasis of pregnancy ,ICP)

A condition of pregnancy characterized by intense itching.


Chorioamnionitis

Inflammation of the fetal membranes and amniotic fluid usually associated with a bacterial infection. The bacteria responsible are usually those that are normally present in the vagina. The presence of fever, uterine tenderness, and foul vaginal discharge help to confirm the clinical diagnosis of chorioamniotis.


Chorion

The outermost of the two fetal membranes that gives rise to the placenta.


Chorionic Villus Sampling (CVS)

Removal of cells that line the placenta, the chorionic villi, through the cervix using a catheter or through the abdomen using a needle. The material obtained may be tested for Down syndrome and other disorders. The procedure is usually performed between the 10th and 12th weeks of pregnancy .


Choroid plexus

Structures in the ventricles (spaces) of the brain that produce the cerebrospinal fluid. Each plexus is made up of a network of capillary blood vessels covered by transporting epithelial cells.


Choroid plexus cyst

Pockets of fluid in the choroid plexus believed to be caused by abnormal folding of the epithelium lining of the choroid plexus which traps fluid and debris .


Chromosome

Structures made of of tightly coiled DNA (deoxyribonucleic acid) found in the nucleus of a cell.
Chromosomes are the structures in the cells of your body that are inherited from each of your parents, and hold the instructions for how your body looks and functions. Humans have 23 pairs of chromosomes for a total of 46. The first 22 chromosomes are numbered from largest to smallest in size. The 23rd pair are the sex chromosomes and are named as X or Y .


Circumvallate placenta Copyright © 2014 by Focus Information Technology.

Circumvallate placenta

The membranes insert closer to the center of the placenta instead of extending to the edge of the placenta  creating a folded and thickened placental margin that appears as a 'shelf-like' structure at  the placental edge during ultrasound examination. Circumvallate placenta has been associated with premature labor, stillbirth, hemorrhage and placental abruption

 


Cleft lip and palate (orofacial cleft)

A gap of the lip or lip and palate (roof of the mouth) caused by failure of the lip or the lip and palate to grow together.


Consanguinity

To be related through a recent common ancestor ( a close blood relative ).


Contraction, uterine

Tightening of the muscular wall of the uterus that may feel like menstrual cramps.


Crown-rump length (CRL)

The distance between the top of the head (crown) and buttocks (rump) of the embryo or fetus.


Cystic fibrosis

A condition characterized by  thick mucus build up in the lungs and digestive tract. The mucus in the lungs causes inflammation and infections leading to the formation of scar tissue (fibrosis) and cysts in the lungs. Cystic fibrosis (CF) also affects the pancreas, liver, intestines, sinuses, and sex organs


Cystic hygroma

Single or multiple sac-like structures caused by abnormal development of the lymphatic system (the system responsible for carrying white blood cells that help fight infection and disease). Cystic hygromas occur most often about the neck. More than half of fetuses with cystic hygromas diagnosed in utero have Turner syndrome (one x chromosome).


Cytomegalovirus (CMV) infection

Cytomegalovirus (CMV) is a common virus transmitted by direct person-to-person contact through saliva, breast milk, or urine. About 33% of (33 of every 100) women who become infected with CMV for the first time during pregnancy pass the virus to their fetuses. Severe infections can lead to significant damage to the nervous system and other vital organs of the unborn baby.

Findings on ultrasound that would raise the possibility of a severe CMV infection include very high or very low levels of amniotic fluid , fluid collections in the abdomen (ascites), dense appearing (echogenic) bowel, growth restriction, very small head (microcephaly), dilation of the fluid filled chambers of the brain ventriculomegaly or hydrocephaly), or calcium deposits in the brain or liver.


Deep vein thrombosis, DVT

A blood clot in a blood vessel that carries blood back to the heart (vein). Symptoms include pain, tenderness, and swelling of the affected extremity.


Diabetes

A condition in which a person has an abnormally high amount of sugar (glucose) in their blood. Diabetes occurs when the body does not produce insulin, the substance in the body that lowers blood sugar, or the cells in the body do not respond to insulin .


Diamniotic

Two separate amniotic sacs (bags of water)


Diaphragmatic hernia (congenital diaphragmatic hernia -CDH)

An abnormal opening in the diaphragm (the muscle used for breathing . It divides the chest from the abdomen.) caused by failure to completely form the diaphragm. The defect allows the abdominal organs to move into the chest cavity which may prevent normal development of the lungs. The condition is associated with a 30 to 60% death rate due to underdeveloped lungs and associated abnormalities such as heart defects, malformed or absent kidneys, and hydrocephalus. The presence of the liver in the chest generally increases the likelihood of a poor outcome.


Dichorionic

Two separate placentas.


Dilation and curettage (D and C)

A surgical procedure in which the cervix is gradually opened with instruments called dilators and the surface of the endometrium (lining of the uterus) is scraped away with a curette, a sharp-edged instrument.


Down syndrome (trisomy 21)

A disorder characterized by mental retardation, flat facial profile with protruding tongue, poor muscle tone, excess skin on neck, slanting eye openings (slanted palpebral fissures), abnormal pelvis, and short stature. In addition there may be heart defects (AV canal defect) , gastrointestinal malformations, problems with vision and hearing, and increased susceptibility to leukemia and infections. The syndrome is named after John Langdon Down, the first physician to identify the syndrome.

Down syndrome occurs in one out of 800 live births and is caused by extra material from chromosome 21. In most cases (95%) there are three copies of chromosome 21 instead of two. In 90% of these cases the extra chromosome is inherited from the mother.


Due date (estimated due date-EDD)

The date that spontaneous onset of labor is expected to occur. The due date may be estimated by adding 280 days  to the first day of the last menstrual period (LMP).


Dystocia

Slow or difficult labor caused by inadequate uterine contractions, abnormalities in the maternal pelvis, a large fetus or a combination of these causes.


Doppler ultrasound

A method using ultrasound to detect and measure blood flow.


Echogenic (hyperechogenic) bowel

Intestine that reflects more sound on an ultrasound examination than usual making it appear very white. The finding of echogenic bowel may be a normal variant in some babies. However, the finding of echogenic bowel has been associated with an increased risk for chromosomal abnormality (such as Down syndrome) , cystic fibrosis, viral infection (CMV and parvovirus) , unexplained fetal death, growth restriction, and premature birth.


Echogenic focus

A distinct area that reflects more sound on an ultrasound examination than usual making it appear very white. The term commonly refers to bright spots seen in the ventricles of the heart. Very bright small spots may represent dense papillary muscles or tendons within the heart. Cardiac tumors may also appear as spots within the heart . However, tumors tend to be larger, multiple, and are not as bright as an echogenic focus.


Eclampsia

New-onset convulsions (grand mal seizure) in a woman with preeclampsia. Preeclampsia is a condition characterized by high blood pressure and protein in the urine that develops after the 20th week of pregnancy. The cause of preeclampsia is unknown.


Ectopic pregnancy

A pregnancy growing outside of the uterus.


Edema

Swelling caused by the accumulation of fluid under the skin.


Edwards' syndrome (Trisomy 18)

A rare disorder that happens when the baby has three copies of chromosome 18 instead of the usual 2 copies. Chromosomes are the structures in the cells of your body that are inherited from each of your parents.  Babies with trisomy 18 have severe mental retardation and usually have many birth defects, because of the extra chromosome 18. Only 5% to 10 % of infants survive the first year after delivery. Death is usually caused by inability to maintain normal breathing or heart and lung problems Ultrasound findings that are often seen in babies with trisomy 18 include cleft lip and palate, a small jaw, low set ears, club feet, clenched fists, a single umbilical artery , kidney abnormalities, poor growth, and a high level of amniotic fluid (polyhydramnios) . More than 90% of babies with trisomy 18 will have a heart defect.


Effacement

Thinning or shortening of the cervix



Embryo

A fertilized egg from initial cell division until the eighth week of development.



Encephalocele
 

A defect affecting the skull resulting in the herniation of the meninges and portions of the brain through a bony midline defect in the skull


Epidural

A method of pain relief in which anesthesia is injected into the space around the spinal cord (epidural space)


Episiotomy

An incision made between the vagina and rectum to widen the vaginal opening for delivery.


Erythema infectiosum (Parvovirus infection)

Erythema infectiosum also known as Fifth disease is a common childhood illness caused by a virus called parvovirus B19. About 50% of all adults have been infected sometime during childhood or adolescence.  Women who become infected with parvovirus for the first time during their pregnancy may pass the virus to their unborn child. Parvovirus can cause severe anemia in the fetus which may lead to congestive heart failure. The heart itself may become enlarged. In addition parvovirus infection has uncommonly been associated with enlarged ventricles in the fetal brain and calcium deposits in the spleen.


External cephalic version

To manually turn the fetus from a breech (sitting position) presentation to a cephalic presentation (head down nearest to the cervix) by applying external pressure on the mother's abdomen.


Extremely low birth weight (ELBW)

A birth weight of less than 1000 grams ( 2 pounds 3 ounces)


Factor V

Factor V is one of the substances in your blood that helps your blood to form blood clots. Factor V is broken down by activated protein C (APC) which acts to control the formation of the clots.

Factor V Leiden is a form of factor V that is resistant to APC . People with factor V Leiden have an increased tendency to form blood clots (thrombophilia)


Factor V Leiden Mutation (activated protein C resistance)

A genetic mutation in the factor V gene that makes the activated factor V protein resistant to inactivation by protein C. The increased activity of factor V in the blood leads to a higher risk of forming a blood clot (thrombophilia) . The factor V Leiden mutation has a prevalence of 5–9% in the general population.


Fetal fibronectin (fFN)

Fetal fibronectin (fFN) is a substance that acts like "glue" holding the fetal sac to the uterine lining during pregnancy. It can normally be found in the cervicovaginal secretions of women up to 22 weeks of gestation.  However, the presence of fetal fibronectin in cervicovaginal secretions between 24 and 34 completed weeks of gestation is reported to be associated with preterm delivery.


Fetus

A human conceptus from 70 days' gestational age until delivery


Fetal viability

The capacity for sustained survival outside the uterus as determined by the judgment of the responsible attending physician.  Newborns with malformations incompatible with life such as renal agenesis, anencephaly, trisomy 13 , or trisomy 18 are not considered viable regardless of the gestational age.


Fetal Warfarin Syndrome

A group of birth defects associated with exposure of the developing fetus to warfarin (Coumadin®) an oral anticoagulant used to prevent blood clots. The defects include nasal hypoplasia, stippled epiphyses, limb deformities, mental retardation, and seizures. Hall et al.  placed the critical period for warfarin effects on the fetus as 6 to 9 weeks following conception.


Fibroid (leiomyoma, myoma)
 

A non-cancerous (benign) growth of fibrous tissue and muscle fibers. Fibroids are often found in the uterus, and occur in about 30% of women over the age of 30.


Fontanel ("soft spot")

A membranous gap between the bones of the developing skull.
The newborn normally has six fontanels the anterior, posterior, two mastoid, and two sphenoid fontanels. The most prominent fontanel is the diamond-shaped anterior fontanel which is closed in 96 percent of infants by 24 months of age.


Fragile X Syndrome (Martin-Bell syndrome)

A disorder affecting males and females characterized by mental retardation.. In the U.S. fragile X syndrome affects approximately 1 in 4000 males and 1 in 8000 females and is a common cause of autistic-like behaviors.  Fragile X syndrome is caused by an expansion mutation that prevents the normal expression of the the Fragile X mental retardation 1 (FMR1) gene located on the X chromosome.


Fraternal twins (dizygotic twins)

Two offspring created when two separate eggs are fertilized by separate sperm during the same menstrual cycle. The two products of conception develop as two separate embryos, and each embryo develops its own membranes and placenta.


Fundal height

The distance from the top of the pubic bone to the top of the pregnant uterus (fundus) in centimeters. The measurement is used to approximate fetal age and growth.


Fundus

The uppermost part of the uterus.


Gastroschisis

Gastroschisis is a birth defect in which the baby's intestines (bowels) stick out through a hole to one side of the belly button.

Gastroschisis is thought to arise from disruption of blood flow to the affected abdominal wall. Another explanation is that  the yolk sac does not become part of the the umbilical cord, as it normally does, leaving a hole about 2 to 4 centimeters (0.8 to 1.6 inches) wide that is nearly always to the right side of the belly button.


Gene
 
A section of the molecule DNA (deoxyribonucleic acid) which codes for a particular protein and carries the hereditary information for such characteristics as hair color, eye color, and susceptibility to disease.


Genetic counseling
 
Evaluation of prospective parents' risks of having a child born with a birth defect or genetic disorder, and advise on their options for testing and treatment.


Gestational age

The time elapsed since the first day of the last menstrual period. If pregnancy was achieved using assisted reproductive technology, gestational age is calculated by adding 2 weeks to the conceptional age.


Gestational diabetes (GDM)

Gestational diabetes mellitus (GDM) is diabetes that is found for the first time when a woman is pregnant. The high blood sugar in gestational diabetes appears to be caused by hormones produced by the placenta that prevent the mother's cells from responding to her insulin. It is estimated that gestational diabetes affects about 18% of pregnancies.


Gravida

A pregnant woman.


Group B streptococcus:

Group B streptococcus (GBS) is a bacteria normally found in the vagina and/or rectum of about 1 in 4 of all healthy women. GBS bacteria passed from the mother to the baby can cause some babies to become very sick and even die.


Hemolytic disease of the newborn (HDN)
 
Anemia in a newborn infant caused by the destruction of red blood cells. In severe cases jaundice, pallor, an enlarged spleen, or hydrops may be present
 


Hemophilia

A group of hereditary disorders characterized by prolonged bleeding and sometimes excessive bleeding. There may be bleeding into joints, gastrointestinal tract, and urinary tract. On laboratory the activated partial thromboplastin (PTT) time is prolonged. However, the prothrombin time (PT) and bleeding time are normal.

Hemophilia A and hemophilia B (Christmas disease) account for most cases of hemophilia. Hemophilia A is caused by a lack of the blood clotting protein factor VIII, and hemophilia B is caused by a lack of the blood clotting protein factor IX. Hemophilia A is 7 times more common than hemophilia B. Both diseases are caused by a defective gene located on the X chromosome.


HELLP syndrome

HELLP is an acronym that describes the syndrome of :  H Hemolysis; EL elevated liver enzymes; LP, low platelets.

HELLP syndrome usually presents in the third trimester with right upper quadrant or epigastric pain, nausea, and vomiting. HELLP syndrome is considered to be a variant of preeclampsia.  HELLP syndrome occurs in approximately 0.2 to 0.6 percent of all pregnancies. The cause of HELLP syndrome is unknown.

Strict criteria for the diagnosis of HELLP syndrome:

  • Hemolysis (characteristic peripheral blood smear) and serum lactate dehydrogenase levels >600 U/L
  • Serum aspartate aminotransferase levels >70 U/L
  • Platelet count <100,000/mul.

Hydronephrosis

Enlargement of the renal pelvis (the part of the kidney that collects urine) to greater than 10 mm.  Renal pelvis dilation of 4 to 10 mm in anterioposterior diameter is commonly referred to as fetal pyelectasis. Hydronephrosis is usually caused by a blockage of the flow of urine along the urinary tract.


Hydrocephaly (hydrocephalus, water on the brain)

Enlargement of the spaces within the brain (ventricles ) caused by excessive fluid (cerebrospinal fluid). The excessive fluid may cause enlargement of the infant's head.
The abnormally increased fluid may be the result of increased production of fluid, but more commonly is caused by obstruction of fluid flow between the different spaces in the brain. Hydrocephaly has been associated with aqueductal stenosis, spina bifida, X-linked hydrocephalus, Arnold-Chiari malformation , Dandy-Walker malformation, tumors, subarachnoid hemorrhage, infections (CMV and toxoplasmosis) , and chromosome abnormalities


Hydrops

Hydrops fetalis is a condition in the fetus characterized by an abnormal collection of fluid with at least two of the following:

  • Edema (fluid beneath the skin, more than 5 mm).
  • Ascites (fluid in abdomen)
  • Pleural effusion (fluid in the pleural cavity, the fluid-filled space that surrounds the lungs)
  • Pericardial effusion (fluid in the pericardial sac, covering that surrounds the heart)

Hydrops fetalis is found in about 1 per 2,000 births and is categorized as immune (10 - 20%) or nonimmune (80-90%) hydrops . Immune hydrops is caused by antibodies against the baby's red blood cells. Nonimmune hydrops has many causes including cystic hygroma, infections, chromosomal abnormalities such as Down syndrome, fetal heart defects, fetal anemia, twin to twin transfusion, fetal tumors, and metabolic diseases to name a few.


Identical twins (monozygotic twins)

Two offspring created when a single fertilized egg divides to form two separate embryos during the first 2 weeks after conception. Identical twins account for about 30% of naturally occurring twins in the United States.


Implantation (nidation)

Penetration into the womb by the embryo. Implantation occurs approximately 6 days after conception.


Implantation Bleeding

Bleeding that occurs when the fertilized egg attaches to the uterus (womb) is called implantation bleeding. Implantation bleeding is common and may be mistaken for a menstrual period. The bleeding usually lasts for 1 to 2 days.


Incompetent Cervix

See cervical incompetence


Induction of labor

Stimulation of uterine contractions before the spontaneous onset of labor in order to achieve a vaginal delivery.


Infant

A child under one year of age.


Infertility

Inability to conceive after one full year of regular sexual intercourse without the use of contraception.


Intrauterine fetal death

A fetus with a crown-rump length more than 15 mm long without cardiac activity.
 


In utero

Inside the uterus (womb).


Jaundice

Yellowing of the skin, eyes, and membranes caused by too much bilirubin in the blood. Bilirubin is a yellowish pigment produced from the breakdown of red blood cells. Bilirubin is removed from the body largely by the liver. The mild jaundice that commonly occurs between the 2nd and 5th day of life in newborns is called physiological jaundice and is due to the newborn's immature liver function.


Karyotype

A picture of an individual's chromosomes. The 23 pairs of chromosomes are organized according to size, location of the centromere, and the pattern of bands on each chromosome.
 


Kegel exercises (pelvic floor muscle exercises)

An exercise performed to improve bladder control developed by Dr Arnold Kegel. The exercises are carried out by repeatedly tightening and releasing the pubococcygeal and levator ani muscles pelvic muscles (those muscles used to stop the flow of urine).


Kell blood antibody (Anti-Kell)

A protein made by the body's immune system that attaches to a molecule called the Kell antigen found on some peoples red blood cells. The Kell antigen is part of the Kell blood group system which consists of several antigens ( Kell or K1 , Kpa, k , Jsa ,Jsb ). The antibody hastens removal of the Kell antigen (and the foreign blood cells) from the body.

Anti-Kell antibody is capable of crossing the placenta and causing SEVERE anemia in the fetus and hemolytic disease of the newborn.

 Rh (anti-D, anti-E, anti-c ), Kell (anti--K), Duffy (anti-Fya) antibodies are the most likely to cause hemolytic disease of the fetus and newborn (HDFN) requiring a blood transfusion.


Kernicterus

A condition characterized by athetoid cerebral palsy, hearing loss, vision abnormalities, and dental problems. Kernicterus is caused by very high levels of bilirubin in the newborn.


Labor

Regular contractions of the uterus that cause dilatation and thinning (effacement) of the cervix leading to the delivery of the infant.


Labia

The folds of skin at the opening of the vagina consisting of large outer folds called the labia majora and inner folds called the labia minora.


Laceration ( Tear )

A cut or tear in tissues. Spontaneous lacerations of the perineum (the area between the vagina and anus) may occur as a result of childbirth. Perineal lacerations are classified by degree.


Lactation

The production and excretion of milk by the breast.


Lamaze (Lamaze method)

 A method of childbirth preparation using behavioral techniques to reduce pain and anxiety in labor developed by the obstetrician Ferdinand Lamaze (1891-1957).


Lanugo

The fine hair that covers the fetus.


Leopold's maneuvers

4 specific steps in palpating the uterus through the abdomen in order to determine the lie and presentation of the fetus.


Lie

The longitudinal axis of the fetus in relation to the mother's longitudinal axis (i.e., longitudinal would be parallel to the mother).


L&D (L and D)

Labor and Delivery.


Lightening (dropping, engagement)

The descent of the presenting part of the fetus into the pelvis.


LMP

Last menstrual period. Refers to date of onset of the last menstrual period.


Low-lying placenta

Many sources define a low lying placenta as being present when the lower edge of the placenta is within 1 millimeter to  20 millimeters (mm) of the internal cervical opening.   It has also been proposed that the term low lying placenta be used if the placental edge is located farther than 20 mm but within 35 mm from the internal cervical opening


Magnesium sulfate (Epsom salts)

A naturally occurring mineral used to prevent and treat seizures in preeclampsia - eclampsia.


Mask of pregnancy (melasma)

See chloasma


Mastitis

Inflammation of the breast, usually caused by infection in a woman who is breast-feeding or has recently delivered.  The condition is treated with antibiotics, and the mother may continue to breast feed while being treated.


Meconium

The thick, mucoid, dark green contents of the fetal intestine.


Microcephaly

An abnormally small head (a head circumference of 3 standard deviations below the mean for the gestational age) usually associated with abnormal neurological findings and mental retardation. Microcephaly be caused by a chromosomal abnormality, a gene defect, an infection such as rubella, cytomegalovirus, or toxoplasmosis, exposure to drugs such as alcohol, aminopterin ,or hydantoin, or a maternal condition such as phenylketonuria (PKU).


Micrognathia

An abnormally small jaw (mandible).
Micrognathia may occur as an isolated finding or may be found in association with many syndromes including trisomy 18, Treacher-Collins syndrome, Pierre Robin syndrome, Russell-Silver syndrome , Seckel syndrome, Progeria, and Smith-Lemli-Opitz syndrome


Micromelia

Shortening of all the long bones (humerus, radius, ulna, femur, tibia, and fibula) of the extremities.  Micromelia is a characteristic of many forms of skeletal dysplasias including, thanatophoric dysplasia, homozygous achondroplasia, osteogenesis imperfecta Type II and III, achondrogenesis, diastrophic dysplasia, short rib polydactyly syndrome, Chondroectodermal dysplasia, Campomelic dysplasia, Kniest dysplasia, dyssegmental dysplasia, hypophosphatasia (perinatal lethal).


Midwife

A person who provides pregnancy, birth and postnatal support for normal births.


Milia (milk spots)

Tiny, 1 to 2 mm, white bumps (nodules) found on the face and nose of newborn infants. The bumps usually disappear within a few weeks of delivery without treatment.


Miscarriage (spontaneous abortion, SAB)

A pregnancy loss before 20 weeks' gestation calculated from the date of onset of the last menses.


Molding (moulding)

Abnormal shape of a baby’s head caused by pressure on the head during childbirth


Mongolian spot

A bluish-gray birthmark over the lower back and rump of infants that may be mistaken for bruising. Mongolian spots are most commonly seen in infants of African, Asian, Hispanic, and Native American descent. They are harmless and most will have completely faded by the age five.


Monoamniotic

One amniotic sac (bag of water)


Monochorionic

One placenta


Mucus plug (cervical mucus plug)

An accumulation of thick clear secretions in the cervical canal.


Multigravida

A woman who has been pregnant more than once regardless of whether she carried the pregnancy to term.


Multipara

A woman who has given birth to an infant at least once before. A multiple gestation counts as a single birth.


Myelomeningocele (meningomyelocele , spina bifida cystica)

A birth defect in which the spinal cord and the membranes covering the spinal cord (meninges) protrude through a cleft in the bones of the spine (veretebrae) usually in the lower back or tailbone (lumbosacral) region. Myelomeningocele is a form of spina bifida that typically results in paralysis and loss of sensation below the level of the spinal defect.


Natural childbirth

Labor and childbirth with minimal or no medical intervention including drugs to relieve pain.


Neonatal intensive care unit (NICU, newborn intensive care unit)

An intensive care unit that cares for high risk newborn babies


Neonate

A newborn infant until 28 days of age.


Neonatologist

A physician who has completed specialty training in pediatrics and additional subspecialty training in the care of newborns that are ill or require special medical care


Necrotizing Enterocolitis (NEC)

An inflammatory disease of the bowel (enterocolitis) usually seen in premature infants. Injured bowel may die (necrosis) and allow the intestinal contents to leak into the abdominal cavity causing severe infection which can be fatal.


Neural-tube defect (NTD)

A general term for birth defects caused by incomplete closure of the tube shaped structure (neural tube) that forms the brain and spinal cord.   Failure of the cranial end to close results in lack of a complete brain (anencephaly) . Failure of the caudal end ,near the rump,  to close results in an open spinal cord (spina bifida).

Neural tube defects mat be seen using ultrasound , and usually cause  serum alpha-fetoprotein levels to be elevated  in the mother's blood .


Nevus

A  pigmented area of the skin. For example, a mole or birthmark.


Nonstress Test (NST)

A method for testing fetal well-being. The study is performed by making a graphical recording of the fetal heart rate using an electronic monitor.
 


Obstetrician-Gynecologist

A physician who has completed specialty training in the care of pregnant women, the delivery of babies, and in the treatment of diseases of the female reproductive system.
 


Oligohydramnios

Abnormally low amount of amniotic fluid. Quantitatively an amniotic fluid index (AFI) of 5 or less or the largest vertical pocket of amniotic fluid volume is 2 or less .Causes of oligohydramnios may include ruptured membranes (water bag), urinary tract abnormalities , fetal growth restriction, and postmaturity.


Oxytocin (Pitocin)

A hormone that stimulates the uterus to contract (uterotonic agent) , causes milk let down, and appears to influence pair bonding. Oxytocin is made in the supraoptic nucleus and paraventricular nucleus of the hypothalamus in the brain and is released into the blood from the posterior lobe of the pituitary gland during labor, nipple stimulation, and sex.


Ovarian cyst

A fluid-filled cavity within or on the surface of one of the ovaries. A cyst that is produced as a result of the normal release of an egg from an ovary during the menstrual cycle is called a functional cyst .


Ovary

The female reproductive organs on each side of the uterus in the pelvis that make female hormones and eggs.


Ovulation

Release of an egg (ovum) from its follicle in the ovary .


Omphalocele

A birth defect of the abdominal wall that allows the bowel and /or liver to protrude into the base of the umbilical cord (a type of hernia). Omphalocele occurs in approximately 1 in 4,000 births.  Congenital syndromes that have been associated with omphalocele include trisomy 18, trisomy 13, triploidy, Turner syndrome, Beckwith-Wiedemann syndrome,Pentalolgy of cantrell, and OEIS complex. The outcome for omphalocele is generally good if the chromosomes are normal and there are no other abnormalities


Pap smear (Papanicolaou smear)

A screening method for cervical cancer named after George Papanicolaou (1883-1962),


Para, Parity

The number of completed pregnancies beyond 20 weeks gestation (whether viable or nonviable). The number of fetuses delivered does not determine the parity. For example a woman who has been pregnant once and delivered twins at 38 weeks would be noted as Gravid 1 Para 1.


Patent Ductus Arteriosus (PDA)

Failure of the blood vessel (called the ductus arteriosus) to close after birth. The ductus arteriosus is a normal structure in the fetus that diverts blood from the fetal lungs by connecting the pulmonary artery directly to the ascending aorta.


Pediatrician

A physician who has completed specialty training in the development, care and diseases of children.


Pelvis

The lower part of the abdomen, between the hip bones that contains the uterus, bladder , and part of the large intestine


Percutaneous umbilical blood sampling (PUBS)

A procedure in which a needle is inserted into the uterus and into the umbilical cord of the fetus at the base of the placenta. A sample of fetal blood is then withdrawn.


Perinatal

Around the time of birth. As defined by the World Health Organization (WHO) ICD-10 the perinatal period is begins at " 22 completed weeks (154 days) of gestation (the time when birthweight is normally 500 grams) and ends seven completed days after birth".


Perinatologist

A physician who has completed specialty training in obstetrics and gynecology and additional subspecialty training in high risk pregnancy and disorders of the fetus. Also called a maternal-fetal medicine specialist.


Pfannenstiel's incision (Bikini incision)

A horizontal cut made through the skin just above the joint of the pubic bones.


Placenta (Afterbirth)

A disk-shaped organ that develops during pregnancy. The placenta is attached to the uterus on one side by its large flat surface and to the fetus by the umbilical cord on its other side. The placenta exchanges nutrients, wastes, and gases between the blood of the mother and fetus as well as producing numerous hormones. Normally the placenta is delivered after the birth of the infant.


Placenta Accreta, Increta, Percreta

Abnormal penetration of the placenta beyond the lining of the uterus to varying depths.

  • Placenta accreta. The placenta adheres directly to the myometrium (muscular wall of the uterus)
  • Placenta increta. The placenta grows into the myometrium.
  • Placenta percreta. The placenta grows completely through the myometrium.


    Placental insufficiency

    Failure or inability of the placenta to normally exchange nutrients, wastes, and gases between the blood of the mother and fetus.


    Placenta Previa

    A condition in which the placenta (including the marginal veins) partially or completely covers the opening of the cervix (cervical os).

     


    Placental lakes (placental vascular lacunae, placental caverns, placental venous lakes, placental sonolucencies)

    Placental lakes are enlarged spaces in the placenta filled with maternal blood called also called intervillous vascular spaces.


    Polyhydramnios (too much amniotic fluid)

    An abnormally high amount of amniotic fluid. Quantitatively an amniotic fluid index (AFI) of 24 or more, or the largest vertical pocket of amniotic fluid volume is 8 cm or more . Some causes of polyhydramnios  include  gastrointestinal abnormalities (such as esophageal atresia and  intestinal obstruction), central nervous system abnormalities, chromosomal abnormalities, nonimmune hydrops skeletal dysplasias diabetes twin- to -twin transfusion. Many times no cause is found.


    Postpartum

    Following birth.


    Postpartum blues

    A common (up to 70% of women) self limiting condition occurring within a few days of delivery. Characterized by mood lability, weeping, depression, fatigue, anxiety, confusion, difficulty concentrating, and depersonalization


    Postpartum depression

    A condition (~ 10%) occurring within days to weeks following delivery and lasting more than 2 weeks. Characterized by  vegetative signs of depression, tearfulness, anxiety, loss of interest in normal activities, guilt, inadequacy in coping with the infant duration, thoughts of suicide. Typically requires treatment for up to 6 months with antidepressants.


    Postpartum psychosis

    Uncommon condition occurring within a few days and up to 4 weeks after delivery. Characterized by auditory hallucinations, delusions, euphoria, grandiosity, hyperactivity, and inappropriate affect. There is a high risk of infanticide and a high chance of developing psychosis in the future.  Treatment usually requires hospitalization.


    Preeclampsia
     
    Preeclampsia is a disease of pregnancy that affects the lining of the mother's blood vessels causing high blood pressure, leaking of fluid from the blood vessels, and damage to multiple organs. Preeclampsia is believed to be caused by an abnormal placenta releasing higher than normal amounts of substances that control the growth of blood vessels and the placenta


    Preterm

    Less than 37 completed weeks' (less than 259 days) of gestation


    Quickening

    The first movements of the fetus felt by the woman on average at 19 weeks during the first pregnancy, and as early as 14 weeks during subsequent pregnancies.


    Respiratory distress syndrome (RDS, hyaline membrane disease ,HMD)

    A condition of the lungs where the lungs are too stiff to expand because a substance (surfactant) is not present to prevent the tiny air sacs in the lungs (alveoli) from collapsing and sticking together. Damaged cells collect in the airways and form a glassy (hyaline) membrane over the alveoli. RDS is most likely to occur in premature infants less than 32 weeks' gestational age, and is twice as common in boys.


    Round ligaments

    The round ligaments of the uterus are two flattened bands extending from each side of the uterus that proceed forward through a tunnel in the abdominal wall (the inguinal canal) to the large folds of skin at the opening of the vagina (labium majus).


    Round ligament pain

    Sharp pain in the lower abdomen or groin caused by spasm of the round ligaments of the uterus. The pains usually last a few seconds and are associated with rapid movement or rolling over during sleep.


    Rupture of membranes (ROM, “breaking of the water bag” )

    Breaking or tearing open of the fluid filled amniotic sac . Often described as a "gush of fluid".


    Shoulder dystocia

    An average head-to-body delivery time more than 60 seconds, also  defined as "a delivery that requires additional obstetric maneuvers following failure of gentle downward traction on the fetal head to effect delivery of the shoulders." Shoulder dystocia is usually caused by the anterior shoulder becoming stuck behind the mother's pubic bone.


    Singleton

    A pregnancy with only one fetus in the uterus.


    Small for gestational age (SGA)

    Weight below the 10th percentile for gestational age. Most small for gestational age fetuses are small because of constitutional factors such as female sex or heredity.


    Sonogram (Ultrasound)

    An image or images produced by collecting  sound waves reflected from structures inside the body.


    Spotting

    Light vaginal bleeding.


    Station

    The level of the presenting part in the birth canal in relation to the ischial spines of the pelvis. The spines represent 0 station. The presenting part is described as being from -1 to -5 cm above the spines or +1 to+ 5 cm below the spines. A station of + 5 cm would correspond to the presenting part at the vaginal opening (introitus).


    Stress test (Contraction stress test,CST, oxytocin contraction stress test)

    A method of testing fetal well-being and in particular the function of the placenta under stress. The study is performed by making a graphical recording of the fetal heart rate using an electronic monitor. The tracing is observed for late decelerations.


    Stillbirth

    A fetal death that occurs during pregnancy at 20 weeks' or greater gestation.


    Subchorionic hematoma

    A blood clot beneath the placenta.


    Succenturiate placenta

    One or more accessory placental lobes connected  to the main placenta by blood vessels.  There is an increased risk for postpartum hemorrhage and infection  due to retained placenta with a succenturiate placenta. Sometimes the blood vessels that connect the lobes of the placenta  cross over or near the opening of the cervix leaving the blood vessels vulnerable to rupture. This latter condition is called type II vasa previa


    Surfactant

    A substance produced in the lungs that prevents the tiny air sacs (alveoli) in the lungs from collapsing and sticking together by reducing surface tension.


    Sutures

    Sutures (stitches) : Sterile, threadlike materials made of catgut, silk, or wire used by surgeons to sew tissues together  OR
    Sutures : The fibrous joints between the skull bones .


    Teratogen

    Anything that can cause a birth defect .


    Term pregnancy

    The four definitions of the types of ‘term’ deliveries are:

    Early Term: Between 37 weeks 0 days and 38 weeks 6 days
    Full Term: Between 39 weeks 0 days and 40 weeks 6 days
    Late Term: Between 41 weeks 0 days and 41 weeks 6 days
    Postterm: Between 42 weeks 0 days and beyond


    Tetralogy of Fallot

    A birth defect of the heart consisting of :
    1. Pulmonic stenosis (narrowing of the pulmonary artery).
    2. A ventricular septal defect (VSD). The VSD causes cyanosis (bluish discoloration of the skin due to lack of oxygen) by allowing blood to flow from the right side of the heart to the left side without passing through the lungs.
    3. Malignment of the aorta so that it arises from the VSD or the right ventricle instead of directly from the left ventricle
    4. Right ventricular hypertrophy (thickening of the right heart chamber that pumps blood to the lungs).


    Thalassemia

    A group of inherited blood disorders characterized by moderate to severe anemia. Thalassemias are caused by defects in the genes that control production of globins, the building blocks of hemoglobin (the oxygen carrying molecule in red blood cells).


    Thrombocytopenia

    A lower than normal number (count) of platelets in the blood. Platelets are cell fragments in the blood that help to form blood clots.


    Titer

    The concentration of an antibody in the blood.


    Tocolytic

    A substance that decreases uterine contractions.


    Toxemia

    Old name for preeclampsia


    T-sign

    On ultrasound examination the junction of two amniotic sacs forms a 90 degree angle with the placenta. The T-sign strongly indicates that there is a single placenta (monochorionic).


    Twin peak sign, Lambda sign

    On ultrasound examination the presence of a triangular projection of placental tissue extending between two amniotic sacs. The twin peak sign strongly indicates that there are two separate placentas (dichorionic).


    Umbilical arteries

    Blood vessels originating from the fetal internal iliac arteries that carry all the oxygen depleted blood from the fetus through the umbilical cord to the placenta.


    Umbilical cord

    The flexible tube that connects the fetus at the abdomen with the placenta.


    Uterine contractions

    Recurrent tightening and relaxation of the uterine wall (myometrium).


    Uterine rupture

    A tear through the entire thickness of the uterine wall.


    Uterus (womb)

    The pear-shaped reproductive organ in a woman's pelvis. The lower narrow part of the uterus (the cervix) opens into the vagina.


    Vacuum extraction

    Traction to the infant's head through the use of a suction cup applied to the infant's scalp for the purpose of assisting delivery.



    Vaginal birth

    Delivery of an infant through the birth canal (vagina).


    Vaginal birth after cesarean ( VBAC )

    Delivery of an infant through the birth canal in a woman who has previously given birth by cesarean delivery.


    Varicella-Zoster virus (Chickenpox, shingles)

    A common childhood infection caused by a  virus that causes fever followed by  small  fluid filled blisters . The virus can cause birth defects in the fetus of women infected with the  chickenpox virus  for the first time during their pregnancy.


    Vasa previa

    Unsupported fetal blood vessels running over the cervix  that are vulnerable to bleeding.


    VATER association

    An abbreviation for the combination of defects Vertebral defects, Anal atresia, Tracheoesophageal fistula with Esophageal atresia, and Radial dysplasia.


    Velamentous cord insertion

    Insertion of the fetal blood vessels on the membranes at the periphery instead of directly over the placenta.


    Ventilator

    A device that mechanically assists or controls breathing continuously through a tracheostomy or by endotracheal tube.


    Vertex ( vertex presentation )

    The top of the head just in front of the occipital fontanel. Vertex presentation describes a type of cephalic presentation where the top of the fetal head is felt through the cervix on vaginal examination.


    Very low birth weight (VLBW)

    Birth weight less than 1500 grams (3 pounds 5 ounces).


    VSD ( Ventricular septal defect )

    A hole in the wall that divides the large chambers of the heart (ventricles) that pump blood.


    Womb ( uterus )

    The pear shaped reproductive organ in a woman's pelvis.


    Yolk sac

    A membranous structure outside of the embryo that serves as the early site for the formation of blood.


    X-Linked recessive trait

    A trait transmitted by a gene located on the x chromosome; also called sex-linked


    Zygote ( fertilized egg )

    The cell that results from fusion of a sperm and egg at fertilization. After three divisions the zygote is called a morula.

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