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Abruption Placentae

Seperation of a normally implanted placenta before the fetus is born occurs in cases of
bleeding and formation of a hematoma on the maternal side of the placenta. As the
clot expands further separation occurs.

Accelerations
An abrupt, temporary increase in the FHR that peaks at least 15 bpm above the
baseline and lasts at least 15 seconds. They often occur with fetal movement. They are
usually a reassuring sign, reflecting a responsive nonacidotic fetus that is > 32 weeks
of gestation.

Alpha-Fetoprotein
The predominant protein in fetal plasma and is synthesized by the embryonic yolk sac,
developing fetal liver, and gastrointestinal tract. AFP diffuses diffuses from fetal
plasma into fetal urine and is excreted into the amniotic fluid.

Amenorrhea
Abnormal absence of menstruation.

Amniocentesis
Transabdominal puncture of the amniotic sac to obtain a sample of amniotic fluid that
contains fetal cells and biochemical substances for lab examination.

Amniotic Fluid
A clear, slightly yellowish liquid that surrounds the unborn baby (fetus) during
pregnancy. It is contained in the amniotic sac.The amount of amniotic fluid is greatest

at about 34 weeks (gestation) into the pregnancy, when it averages 800 mL.
Approximately 600 mL of amniotic fluid surrounds the baby at full term (40 weeks
gestation)The amniotic fluid constantly moves (circulates) as the baby swallows and
"inhales" the fluid, and then releases it.
The amniotic fluid helps:
-The developing baby to move in the womb, which allows for proper bone growth
-The lungs to develop properly
-Keep a relatively constant temperature around the baby, protecting from heat loss
-Protect the baby from outside injury by cushioning sudden blows or movements

Anemia
A condition marked by a deficiency of red blood cells or of hemoglobin in the blood,
resulting in pallor and weariness.

Ballottement
A palpatory technique for feeling a floating object in the body (especially for
determining the position of a fetus by feeling the rebound of the fetus after a quick
digital tap on the wall of the uterus)

Basic Ultrasonography/ USG


The standard scan includes a general survey of the fetus, placenta, and amniotic fluid
volume.

Biophysical Profile / BPP


Evaluates the fetal status with 5 variables: FHR, breathing movements, gross body
movements, muscle tone, and amniotic fluid volume.

Calcium
A mineral found mainly in the hard part of bones, where it is stored. Calcium is added
to bone by cells called osteoblasts and removed from bone by cells called osteoclasts.
Calcium is essential for healthy bones and is also important for muscle contraction,
heart action, and normal blood clotting. Food sources of calcium include dairy foods;
some leafy green vegetables, such as broccoli and collards; canned salmon; clams;
oysters; calcium-fortified foods; and soy foods, such as tofu.

Chadwick's Sign
A bluish discoloration of the cervix, vagina, and labia resulting from increased blood
flow. It is considered an indication of pregnancy, and can be observed as early as 6-8
weeks after conception, and its presence is an early sign of pregnancy.

Chorionic Villi
Villi that sprout from the chorion in order to give a maximum area of contact with the
maternal blood.

Chronic Hypertension
Hypertension preceded the pregnancy or when a women is hypertensive before 20
weeks of gestation. Seen most often in older women, in those who are obese, and in
those with diabetes. More common in African American. Late childbearing and rising
obesity rates at to the risk.

Complete Abortion
Occurs when all the products of conception are expelled from the uterus. After passage
of all products of conception, uterine contractions and bleeding subside, and the
cervix closes. The S/S of pregnancy are no longer present, and the pregnancy test
becomes negative as hormone levels fall.

Comprehensive USG
The specialized scan is done if abnormalities are found during the Basic USG or w/ lab
or other test results.

Contraction Stress Test / CST


Observes the FHR response to contractions. Checks to see if the unborn baby (fetus)
will stay healthy during the reduced oxygen levels that normally occur during
contractions when you are in labor. This test includes external fetal heart monitoring
camera. The test is done when you are 34 or more weeks pregnant. May be done is the
NST findings are nonreactive.

Couvade Syndrome
Also called sympathetic pregnancy, is a proposed condition in which a partner
experiences some of the same symptoms and behavior of an expectant mother. These
most often include minor weight gain, altered hormone levels, morning nausea, and
disturbed sleep patterns.

Decelerations
Classified into 3 types based on the shape and relationship to uterine contractions.
1. Early Decelerations
2. Late Decelerations
3. Variable Decelerations

Deep Tendon Reflex/ DTR


An assessment for Preeclampsia. If clonus is present it should be reported to the
physician.

DIC - Disseminated Intravascular Coagulation

A major complication of a missed abortion. S/S- elevation in temperature, vaginal


discharge with a foul odor, and abdominal pain indicate uterine infection. Also called
Consumptive Coagulation. An anticoagulation problem that may occur with several
complications of pregnancy such as abrupt placentae or hypertension. While
anticoagulation is occurring, inappropriate coagulation also is occurring in the
microcirculation. Tiny clots form in tiny blood vessels blocking blood flow to organs
and causing ischemia.

Dizygotic Twinning
Two ova that are fertilized by different sperm. They may have the same or different
gender and may not have similar physical traits. They have separate placentas. Can be
an inherited trait.

Early Decelerations
-A gradual decrease of FHR from baseline caused by:Fetal head compression briefly
increases ICP causing the vagus nerve to slow the HR. The fetus is not compromised
and needs no interventions. They occur during contractions as the fetal head is
pressed against the woman's pelvis or cervix. Will mirror the contraction

Eclampsia
A potentially preventable extension of severe preeclampsia marked by one or more
generalized seizures, at times occurring before the woman goes to the hospital.

Ectopic Pregnancy
An implantation of a fertilized ovum in an area outside the uterine cavity. 98% occur
in the fallopian tube. Causes maternal death from hemorrhage. Tubal damage caused
by an ectopic pregnancy reduces the woman's chances of subsequent pregnancies.

EDD/EDC

Expected Date of Delivery/ Estimated Date of Confinement


-The date that spontaneous onset of labor is expected to occur

Effleurage
Massage of the abdomen or another part during labor contractions.

Elective Abortion
Voluntary termination of a pregnancy for other than medical reasons. The procedure
may be recommended when the mother's mental or physical state would be
endangered by the continuation of the pregnancy or when the fetus has a condition
incompatible with life. It may also be performed as a result of rape, incest, or at the
mother's request.

Fertilization Age
Prenatal age of the developing baby, calculated from the date of conception.

Fetal Alcohol Syndrome


A group of physical, behavioral, and mental abnormalities that are the most severe
effects of fetal alcohol exposure

Fetal Heart Rate/ FHR


The number of heartbeats in the fetus that occur in a given unit of time. The FHR
varies in cycles of fetal rest and activity and is affected by many factors, including
maternal fever, uterine contractions, maternal-fetal hypotension, and many drugs.
The normal FHR is between 110 beats/min and 160 beats/min. In labor the FHR is
monitored with a fetoscope, an electronic fetal monitor for detecting abnormal
alterations in the heart rate, especially recurrent decelerations that continue past the
end of uterine contractions.


Folic Acid
Type of B vitamin that's key for cell growth, metabolism, and for pregnant women.

Follicular Phase
The first half of the human menstrual cycle, lasting from cessation of menstrual flow
to the surge of luteinizing and follicle-stimulating hormones at the start of the
ovulatory phase of ovarian follicle growth that lasts from the 1st -14th day of the
Ovarian Cycle of egg maturation.

Fundal height
or McDonald's rule, is a measure of the size of the uterus used to assess fetal growth
and development during pregnancy. It is measured from the top of the mother's uterus
to the top of the mother's pubic bone in centimeters.

Gestational Age
Describes how far along a pregnancy is. Prenatal age of the developing baby(measured
in weeks) calculated from the first day of the woman's last menstrual period;
approximately 2 weeks longer than the fertilization age.

Gestational Hypertension
BP elevation after 20 weeks of pregnancy that is not accompanied by proteinuria. Will
return to normal w/in 6 weeks of postpartum. May progress to preclampsia. It
gestational hypertension persists after birth, chronic hypertension is diagnosed. SBP >
140, or DBP > 90

Gonadotropin-Releasing Hormone
Secretions of the anterior pituitary gland that stimulate the gonads, specifically
follicle-stimulating hormone and luteinizing hormone. Chorionic gonadotropin is
secreted by the placenta during pregnancy.

Goodell's Sign
Softening of the cervix; a sign of pregnancy

Gravida
The number of the pregnancy that a woman is in; "in her third pregnancy a woman is
said to be gravida three"

Heger's Sign
Softening of the lower uterine segment; indicative of pregnancy.

HELLP Syndrome / Hemolysis, Elevated Liver Enzymes, and Low Platelets


A group of symptoms that occur in pregnant women who have:
H -- hemolysis (the breakdown of red blood cells)
EL -- elevated liver enzymes
LP -- low platelet count
Many women have high blood pressure and are diagnosed with preeclampsia before
they develop HELLP syndrome. In some cases, HELLP symptoms are the first
warning of preeclampsia and the condition can be misdiagnosed.

Hydatidiform Mole / Gestational Trophoblastic Disease

Occurs when trophoblasts develop abnormally. A rare mass or growth that forms
inside the womb (uterus) at the beginning of a pregnancy. It is a type gestational
trophoblastic disease (GTD). A cancerous form of GTD is called choriocarcinoma.
Results from over-production of the tissue that is supposed to develop into the
placenta. The placenta feeds the fetus during pregnancy. With a molar pregnancy, the
tissues develop into an abnormal growth, called a mass.

Hyperemesis Gravidarum / HEG


Persistent, uncontrollable vomiting that begins in the first weeks of pregnancy and
may continue through out pregnancy. HEG can have serious consequences.

Hypovolemic Shock
An emergency condition in which severe blood and fluid loss make the heart unable to
pump enough blood to the body. This type of shock can cause many organs to stop
working.

Incomplete Abortion
Type of Spontaneous Abortion. Occurs when some but not all of the products of
conception are expelled from the uterus. S/S- uterine bleeding and severe abdominal
cramping.Termination of pregnancy in which the products of conception are not
entirely expelled or removed. It often causes hemorrhage that may require surgical
evacuation by curettage, oxytocics, and blood replacement. Infection is also a frequent
complication of incomplete abortion.

Indirect Coomb's Test


A test of a Rh negative mothers blood that determines if they are sensitized(have
developed antibodies) as a result of previous exposure to RH positive blood. Done at
the initial prenatal visit and repeated at 28 weeks gestation if negative.

Inevitable abortion
An abortion that cannot be stopped when membranes rupture and the cervix dilates.

Informed Consent
Consent by a patient to a surgical or medical procedure or participation in a clinical
study after achieving an understanding of the relevant medical facts and the risks
involved.

Iron
An essential mineral. Iron is necessary for the transport of oxygen (via hemoglobin in
red blood cells) and for oxidation by cells (via cytochrome). Deficiency of iron is a
common cause of anemia. Food sources of iron include meat, poultry, eggs, vegetables
and cereals (especially those fortified with iron).

Kick Counts
Daily evaluations of movements by the fetus assessed by the mother. Variations are
affected by maternal activity, obesity, and medications.

Late Decelerations
- A pattern of late or delayed decelerations caused by deficient exchange of oxygen and
waste products in the placenta. This non reassuring pattern suggests that the fetus has
reduced reserve to tolerate the recurrent reductions in oxygen supply that occur with
contractions. May be acute as with maternal hypotension or chronic as in maternal
hypertension and diabetes.They are similar to early decelerations in the degree of
slowing but are shifted to the right in relation to the contractions. They often begin
after the peak of the contraction. They have a consistent appearance.

Leopold's Maneuvers

A common and systematic way to determine the position of a fetus inside the woman's
uterus

Limited USG
USG that addresses a specific question such as fetal presentation, placental location,
fetal cardiac activity presence, volume of amniotic fluid, guide delivery of the second
twin in a vaginal birth, assist w/ amniocentesis, and to identify problems if the mother
uses drugs, alcohol, or tobacco.

L/S(Lecithin/Sphingomyelin) Ratio
A test for estimating fetal lung maturity. A L/S ratio of 2:1 may not indicate lung
maturity in some conditions such as maternal diabetes

Luteal Phase
The third phase of the human menstrual cycle, beginning with ovulation and ending,
in the absence of fertilization, with the menstrual phase.

Magnesium Toxicity
In rare cases, symptoms of magnesium toxicity (nausea, muscle weakness, loss of
reflexes) occur during magnesium sulfate treatment for eclampsia. The medicine
calcium gluconate is given to treat the problem.

Marginal Placenta Previa


Low Lying- The placenta is implanted in the lower uterus, the its lower border is more
than 3 cm from the internal cervical os.

Menses
The monthly flow of blood fluid and cellular debris from the uterus.

Menstrual Phase
The fourth phase of the human menstrual cycle, following the luteal phase in the
absence of fertilization. The corpus luteum regresses and is shed through
menstruation and growth begins for the ovarian follicle, leading to the next follicular
phase.

Missed Abortion
Occurs when the fetus dies during the first half of pregnancy but is retained in the
uterus. When the fetus dies, the early S/S of pregnancy disappear. The uterus stops
growing and decreases in size, reflecting the absorption of amniotic fluid and
maceration of the fetus. Vaginal bleeding of a red or brownish color may or may not
occur.

Monozygotic Twinning
Pertaining to or developed from a single fertilized ovum, or zygote, such as occurs in
identical twins. They have identical genetics and are the same gender. Not hereditary.

Multiparity
More than one offspring

Nagele's Rule
Rule for calculating an expected delivery date; subtract three months from the first
day of the last menstrual period and add seven days to that date


Nonstress Test / NST
Fetal surveillance test observing the FHR response to fetal movement. An increase in
the FHR occurs when the fetus moves, indicating adequate oxygenation, a healthy
neural pathway from the fetal CNS to the fetal heart and the ability of the fetal heart to
respond to stimuli. If FHR does not accelerate w/ movement then fetal hypoxemia and
acidosis are a concern.

Nulligravida
A woman who has never conceived a child.

Oogenesis
The formation of the female gamete or ova.

Ovulatory Phase
The second phase of the human menstrual cycle, encompassing the surges of
luteinizing and follicle-stimulating hormones, and ovulation; it is followed by the
luteal phase.

Papanicolaou Smear
Cervical smear: a sample of secretions and superficial cells of the uterine cervix and
uterus; examined with a microscope to detect any abnormal cells

Para

Woman who has given birth after pregnancy of at least 20 weeks of gestation; The
number of pregnancies

Partial Placenta Previa


The lower border of the placenta is w/in 3 cm of the internal cervical os but does not
completely cover the os.

Phosphatidylglycerol
A component of surfactant. The presence of PG supports the likelihood that the fetal
lungs are mature.

Pica
Pica is a pattern of eating non-food materials, such as dirt or paper.

Placenta
Fetal structure that provides nourishment and removes waste from the developing
baby and secretes hormones necessary for the continuation of pregnancy.

Placenta Previa
An implantation of the placenta in the lower uterus. As a result, the placenta is closer
to the internal cervical os than to the presenting part of the fetus. Three Classes: Total,
Partial, and Marginal.

Preeclampsia

A condition in which hypertension develops during the last half of pregnancy in a


woman who previously had normal BP. Renal involvement may cause proteinuria. The
only know cure is birth of the fetus.

Primigravida
A woman who is pregnant for the first time.

Proliferative Phase
The phase of the menstrual cycle after menstruation. Under the influence of folliclestimulating hormone from the pituitary, the ovary produces increasing amounts of
estrogen, causing the lining of the uterus to become dense and richly vascular. The
phase is terminated by rupture of a mature follicle and subsequent ovulation.

Puberty
Period of sexual maturation accompanied by the development of secondary sexual
characteristics.

Quickening
The first motion of a fetus in the uterus felt by the mother usually somewhat before
the middle of the period of gestation

Rh Incompatibility
Occurs when the mother is Rh negative and the fetus is Rh positive. The father of the
fetus must be Rh positive. The problem only affects the fetus.

Rupture of Membranes
Term used during pregnancy to describe a rupture of the amniotic sac. Normally, it
occurs spontaneously at full term either during or at the beginning of labor. Rupture
of the membranes is known colloquially as "breaking the water. ...

Secretory Phase
The phase of the menstrual cycle after the release of an ovum from a mature ovarian
follicle. The corpus luteum, stimulated by luteinizing hormone (LH), develops from
the ruptured follicle. It secretes progesterone, which stimulates the development of
the glands and arteries of the endometrium, causing it to become thick and spongy. In
a negative-feedback response to the increased level of progesterone in the blood, the
secretion of LH from the pituitary decreases. In the absence of an embryo and its
secretion of chorionic gonadotropin, the secretory phase ends. The corpus luteum
involutes, progesterone levels fall, and menstruation occurs

Spontaneous Abortion
The termination of pregnancy without action taken by the woman or another person.

Supine Hypotension Syndrome


A fall in blood pressure that occurs when a pregnant woman is lying on her back. It is
caused by impaired venous return that results from pressure of the gravid uterus on
the vena cava. Also called vena caval syndrome.

Teratogens
Any substance, agent, or process that interferes with normal prenatal development,
causing the formation of one or more developmental abnormalities of the fetus.

Therapeutic Communication

The face-to-face process of interacting that focuses on advancing the physical and
emotional well-being of a patient. Nurses use therapeutic communication techniques
to provide support and information to patients.

Threatened Abortion
A type of Spontaneous Abortion. Vaginal bleeding in the first three months of
pregnancy, bleeding and symptoms that could suggest an increased risk of miscarriage

Total Placenta Previa


The placenta completely covers internal cervical os.

Trisomy
The presence of an additional (third) chromosome of one type in an otherwise diploid
cell (2n + 1

Umbilical Cord
The flexible cordlike structure connecting a fetus at the abdomen with the placenta
and containing two umbilical arteries and one vein that transport nourishment to the
fetus and remove its wastes.

Variable Decelerations
Do not have a uniform appearance. Their shape, duration and degree of fall below
baseline rate vary. Will rise and fall abruptly with the onset and relief of cord
compression. May also be non periodic, occurring at times unrelated to contraptions.
The decrease in FHR is at least 15 bpm and lasts at least 15 seconds but less than 2
minutes.


VBAC
Vaginal birth after caesarean refers to the practice of birthing a baby vaginally after a
previous baby has been delivered through caesarean section.