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
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.
Production of an antibody against antigens produced by members of the same
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.
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.
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.
The membrane (amnion) that surrounds the fetus and the amniotic fluid.
Decreased amount of normal hemoglobin in blood. Hemoglobin is the substance in
red blood cells that carries oxygen.
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.
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.
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.
A molecule that causes your body to produce antibodies against the antigen is called an antigen (antibody
Bag of waters
The membrane (amnion) surrounding the fetus and the amniotic fluid.
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.
A fertilized egg that has failed to develop.
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.
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
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.
The baby is in a sitting position with the buttocks, knees, or feet nearest to
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).
A hollow tube used to inject fluid into, or drain fluid from a space such as
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.
The baby's head is down near the mother's cervix.
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.
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
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
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.
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.
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
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 .
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
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 .
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.
To be related through a recent common ancestor ( a close blood relative ).
Tightening of the muscular wall of the uterus that may feel like menstrual
Crown-rump length (CRL)
The distance between the top of the head (crown) and buttocks (rump) of the
embryo or fetus.
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
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.
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 .
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.
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).
Slow or difficult labor caused by inadequate uterine contractions,
abnormalities in the maternal pelvis, a large fetus or a combination of these
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.
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.
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.
A pregnancy growing outside of the uterus.
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
Thinning or shortening of the cervix
A fertilized egg from initial cell division until the eighth week of
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
A method of pain relief in which anesthesia is injected into the space around
the spinal cord (epidural space)
An incision made between the vagina and rectum to widen the vaginal opening
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 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
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
A human conceptus from 70 days' gestational age until delivery
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
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
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
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.
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
The uppermost part of the uterus.
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.
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.
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
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.
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
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 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.
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
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
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 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.
Penetration into the womb by the embryo. Implantation occurs approximately 6
days after conception.
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.
See cervical incompetence
Induction of labor
Stimulation of uterine contractions before the spontaneous onset of labor in
order to achieve a vaginal delivery.
A child under one year of age.
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
Inside the uterus (womb).
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
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.
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.
Regular contractions of the uterus that cause dilatation and thinning
(effacement) of the cervix leading to the delivery of the infant.
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.
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
The fine hair that covers the fetus.
4 specific steps in palpating the uterus through the abdomen in order to
determine the lie and presentation of the fetus.
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.
Last menstrual period. Refers to date of onset of the last menstrual period.
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)
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.
The thick, mucoid, dark green contents of the fetal intestine.
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).
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
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).
A person who provides pregnancy, birth and postnatal support for normal
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
Miscarriage (spontaneous abortion, SAB)
A pregnancy loss before 20 weeks' gestation calculated from the date of onset
of the last menses.
Abnormal shape of a baby’s head caused by pressure on the head during
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.
One amniotic sac (bag of water)
Mucus plug (cervical mucus plug)
An accumulation of thick clear secretions in the cervical canal.
A woman who has been pregnant more than once regardless of whether she carried
the pregnancy to term.
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.
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
A newborn infant until 28 days of age.
A physician who has completed specialty training in pediatrics and additional
subspecialty training in the care of newborns that are ill or require special
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
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 .
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.
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
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
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.
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 .
The female reproductive organs on each side of the uterus in the pelvis that
make female hormones and eggs.
Release of an egg (ovum) from its follicle in the ovary .
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
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
A physician who has completed specialty training in the development, care and
diseases of children.
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.
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".
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
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
Placenta Accreta, Increta, PercretaPlacenta accreta. The placenta adheres directly to the myometrium (muscular
wall of the uterus)
Abnormal penetration of the placenta beyond the lining of the uterus to
Placenta increta. The placenta grows into the myometrium.
Placenta percreta. The placenta grows completely through the myometrium.
Failure or inability of the placenta to normally exchange nutrients, wastes,
and gases between the blood of the mother and fetus.
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.
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
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.
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 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
Less than 37 completed weeks' (less than 259 days) of gestation
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
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.
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
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".
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.
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.
An image or images produced by collecting sound waves reflected from
structures inside the body.
Light vaginal bleeding.
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
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.
A fetal death that occurs during pregnancy at 20 weeks' or greater gestation.
A blood clot beneath the 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
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 (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 .
Anything that can cause a birth defect .
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
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).
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).
A lower than normal number (count) of platelets in the blood. Platelets are
cell fragments in the blood that help to form blood clots.
The concentration of an antibody in the blood.
A substance that decreases uterine contractions.
Old name for preeclampsia
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
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).
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
The flexible tube that connects the fetus at the abdomen with the placenta.
Recurrent tightening and relaxation of the uterine wall (myometrium).
A tear through the entire thickness of the uterine wall.
The pear-shaped reproductive organ in a woman's pelvis. The lower narrow part
of the uterus (the cervix) opens into the vagina.
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.
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.
Unsupported fetal blood vessels running over the cervix that are
vulnerable to bleeding.
An abbreviation for the combination of defects Vertebral defects, Anal
atresia, Tracheoesophageal fistula with Esophageal atresia, and Radial
Velamentous cord insertion
Insertion of the fetal blood vessels on the membranes at the periphery instead
of directly over the placenta.
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.
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
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.