Key Terms in Obstetrics and Gynecology Flashcards
(77 cards)
1
Q
What is obstetrics?
A
It deals with care of the women’s reproductive tracts and their children during pregnancy, childbirth and post-natal period.
2
Q
Last menstrual period?
A
The first day of the last menstrual period
3
Q
Estimated date of delivery?
A
- This is equal to 40 weeks gestation age.
- The average pregnancy gestation from the first day of last menstrual period.
4
Q
What is Nagele’s rule?
A
- Add 7 days to first date of LMP.
- Subtract 3 months from month of LMP.
- Add one year to year of LMP.
5
Q
Gravida?
A
Number of pregnancies a woman has had including the current pregnancy irrespective of outcomes
6
Q
Types of gravida?
A
- Nulligravida: never been pregnant
- Primigravida: for the first time
- Multigravida: more than once
7
Q
Parity?
A
It is the number of times a woman has delivered after 28 weeks of gestation
8
Q
Types of parity?
A
- Nullipara: never given birth
- Primipara: once
- multipara: more than once
- Grand multipara: greater than or equal to 5 live births and still births.
9
Q
Gestation?
A
It is period of development in the uterus from conception till birth.
10
Q
Trimester?
A
The pregnancy is divide into 3 months
1. First: LMP to 12 weeks
2. Second: 13 weeks to 28 weeks
3. Third: 28 weeks to delivery
11
Q
Preterm birth?
A
It is a delivery between 28 weeks to 37 weeks of gestation.
12
Q
Post term birth?
A
It is the birth after 42 weeks of gestation.
13
Q
Presentation?
A
It refers to which anatomical part of the fetus is leading
- the part closest to the pelvic birth canal
14
Q
Malpresentation?
A
any presentation other than the top of the head first
- vertex presentation
15
Q
Types of presentation?
A
According to the leading part.
1. Cephalic - normal
2. Breech
3. Shoulder
16
Q
Cephalic presentation?
A
The head is the leading part
17
Q
Types of cephalic presentation?
A
- Vertex/crown- top of the head first and it is the most common and is also associated with less complications
- Sinciput: forehead first
- Brow- eyes brows first
- Face
- Chin
18
Q
Breech presentation?
A
- Buttocks or feet first
- Can be complete, footling or frank breech
19
Q
Complete breech position?
A
- The buttocks are pointing downwards with the legs folded at the knees and feet near the buttocks
- both hips and both knees flexed
20
Q
Frank breech position?
A
- both hips flexed and both knees extended and the feet close to the head.
- buttocks are aimed at the birth canal with its legs sticking straight up in front of his or her body and the feet near the head
- most common type of breech presentation
21
Q
Footling breech presentation?
A
one or both of the baby`s feet point downward and will deliver before rest of the body
22
Q
Shoulder presentation?
A
- Can be arm, shoulder or trunk
- classified into four types, based on the location of the scapula (shoulder blade)
- This presentation needs to be delivered by Cesarean section.
23
Q
Types of shoulder presentation?
A
- Left scapula-anterior (LSA)
- Right scapula-anterior (RSA)
- Left scapula-posterior (LSP)
- Right scapula-posterior (RSP)
24
Q
Causes of breech presentation?
A
Not fully understood but seen to be common in:
1. Subsequent pregnancies
2. Pregnancies of multiples
3. Where there is history of premature delivery
4. Too much or too little amniotic fluid
5. Abnormally shaped uterus or one with fibroids
6. Placenta previa (placenta lying low in uterus and partially/completely covering cervix)
25
Position?
- It is the orientation of the fetus in the womb identified by location of presenting part of the fetus relative to the pelvis of the mother.
- The normal is the occipitoanterior.
26
Lie?
- It is the relationship of longitudinal axis of fetus to the longitudinal of the mother pelvis.
- The most common is longitudinal.
27
Attitude?
- It is the relation of fetal parts to each other.
- the normal is flexed.
28
Engagement?
It is when the widest part of the presenting part of the fetus has passed successfully through the pelvic inlet.
- portion of the head above the brim is 2 fingers of less
29
Effacement?
It is thinning of the cervix before or during labor.
30
Partograph?
- Graphic recording of the progress of labor.
- Records the condition of the fetus and the progress of labor.
31
Principles of a partograph?
1. Active phase of labor commences at 4cm cervical dilatation
2. Latent phase of labor last < 8hours
3. During active labor, the rate of cervical dilation should not be slower than 1cm/hr
4. A lag of 4 hours between slowing of labour and the need for intervention is unlikely to compromise the fetus or the mother
5. Vaginal examinations should be performed as frequently as is compatible with safe practice
- once every 4 hours
32
Average time in labour after admission to a health institute?
5-6hours > 2 vaginal exams necessary
33
Descent?
Passage of the presenting part of the foetus into and through the birth canal
34
How to assess descent of a fetal head?
1. 5/5 - head completely above pelvic brim
2. 4/5 - sinciput high, occiput easily felt
3. 3/5 - sinciput easily felt, occiput felt
4. 2/5 - sinciput felt, occiput just felt
5. 1/5 - sinciput felt, occiput not felt
6. 0/5 - none of head palpable
35
Moulding?
It is the extent of overlapping of fetal skull bones.
36
State of moulding?
1. Bones are separated & sutures felt O
2. Bones are just touching each other 1+
3. Bones are overlapping 2+
4. Bones are overlapping severely 3+
37
Caput?
Diffuse swelling of the scalp caused by the pressure of the scalp against dilating cervix during labour
38
Uterine contractions?
- Assessed every 30 minutes in active phase
- Frequency - Number of contractions in a 10-minute period
- Duration characterizes strength
- Mild, moderate, strong
39
Grading the strength of contractions?
1. mild < 20 seconds
2. moderate - 20-40 seconds
3. strong > 40 seconds
NB: Active phase-partograph starts at moderate (>1 lasting 20s)
40
What is liquor?
- Liquor, also known as amniotic fluid, is a clear, slightly yellowish fluid that surrounds the unborn baby during pregnancy
- It is contained in the amniotic sac.
- It is generated from the maternal plasma and is made up of mostly water in the first stages of pregnancy, but in later stages becomes mixed with urine
- It also has nutrients
- Amniotic fluid acts as a cushion for the fetus
- It helps in the development of the lungs.
41
Function of liquor?
- It has nutrients
- Amniotic fluid acts as a cushion for the fetus
- It helps in the development of the lungs.
42
Volume of amniotic fluid?
- At the 34th week its volume may get as high as 800ml but at full term decreases to 600ml.
- Too much liquor is called polyhydramnios.
- Oligohydramnios is when there is too little amniotic fluid
NB:
* This condition is common in late pregnancies and premature rupture of membranes
* These patients usually present with draining liquor
43
When to make a note f membranes and liquor?
- at the time of each vaginal exam
- whenever a change in the liquor is noted
44
Episiotomy?
A surgical incision through the perineum made to enlarge the vagina and assist child birth.
45
Crown to rump length?
Measurement from the top of the baby’s head to the buttocks.
46
Spontaneous vaginal delivery?
A delivery through the vagina.
47
Vacuum assisted delivery?
- It is the method to assist baby delivery using a vacuum device.
- Used in the second stage of labor if it has not progressed adequately.
- It may be used an alternative to forceps delivery and caesarian section.
48
Trial of labor?
It is when a woman who has had a caesarian section want to have a vaginal delivery so she undergoes trial of labor when her contractions starts.
49
Miscarriage/abortion?
- It is the spontaneous or induced termination of pregnancy before fetal viability.
- According to the WHO, it is below 20 weeks
- In Malawi however it is 28 weeks.
50
Types of miscarriages?
1. Spontaneous
- It can be threatened, inevitable, incomplete, complete or missed.
- A septic abortion is any spontaneous abortion complicated further by infections.
2. Recurrent
- Repetitive spontaneous abortions with an underlying factor.
3. Induced
- Surgical or medical termination of a live fetus that has not reached viability.
51
Stillbirth?
It is a baby born dead after 28weeks of gestation.
52
Ectopic pregnancy?
It is the pregnancy outside the uterus.
common in the fallopian tubes
53
Hyperermesis Gravidarum?
It is the persistent severe vomiting leading to weight loss and dehydration as a condition in pregnancy which cannot be attributed to any cause.
54
Hyperemesis gravidarum triad?
1. dehydration
2. electrolyte imbalance
3. >5% of pre-pregnancy weight loss
55
Multiple pregnancy?
- Is a term used to describe a pregnancy with more than one fetus.
- Mostly its twins
56
Antepartum hemorrhage?
It is the bleeding from or in the genital tract occurring from 24 weeks of pregnancy and prior to the birth of the child.
57
Postpartum hemorrhage?
- It is blood loss greater than or equal to 500 ml within 24hours of vaginal delivery
or
- blood loss greater or equal to 1000ml with 24 hours of caesarian section.
- It can also be any amount of blood loss that disturbs maternal hemodynamic status.
58
Gestation hypertension?
- It is a blood pressure greater than 140/90mmHg at more than 20 weeks of gestation
- The hypertension resolves by 12 weeks post-natal.
- There is no proteinuria.
59
Pre-eclampsia?
- It is a condition that pregnant women develop which is marked by high blood pressure in women who have previously not experienced high blood pressure before.
- Usually appears late in pregnancy generally after the 20-week mark although it can occur earlier.
60
Eclampsia?
- A condition in which one or more convulsions occur in a pregnant woman suffering from high blood pressure, often followed by coma and posing a threat to health of mother and baby.
- A disease characterized by tonic-clonic seizures, attributable to no other etiology, that occur during the antenatal, intrapartum or postnatal period
61
TORCH Syndrome?
It refers to the infection of the developing fetus by:
Toxoplasmosis
Other (syphilis, VZV, HIV)
Rubella
Cytomegalovirus
Herpes simplex
62
Amenorrhea?
- It is the absence of menses during a woman’s reproductive years.
63
Types of amenorrhea?
1. Primary: no menses by age of 14 years in the absence of growth and development of secondary sexual characteristics or no menses by age 16 years with normal growth and secondary sexual characteristics.
2. Secondary: menses absent for 3 or 6 months or longer in women with previously established menstruation.
64
Cervical incompetence?
- It is the painless cervical dilation and shortening leading mid trimester pregnancy loss.
- It is often repetitive.
65
3 stages of labour?
stage 1: Neck of the womb(cervix)opens up to 10cm dilated
stage 2: baby moves through down through the vagina and is born
Stage 3: placenta (afterbirth) is delivered
66
Postpartum period?
This is termed as the fourth term of labour and has three distinct but continuous phases
1. acute, first 6-12 hrs postpartum
2. subacute, 2-6 wks postpartum
3. delayed, up to 6 months
67
Gynecology?
It is a branch of medicine that deals with disease and routine physical care of the reproductive system of women.
68
Menstrual cycle?
- Series of changes in the endometrium of the uterus to prepare it for pregnancy
- Average duration is 28 days, ranging from 21 to 35 days
- Divided into 4 phases
69
Phases of the menstrual cycle?
1. phase (average 1-5 days)
- uterus lining sheds blood
2. Follicular phase (from day 1-13th )
- maturation of the egg
3. Ovulation phase (day 14)
- egg release
4. Luteal phase (day 15-28)
- unfertilized egg disintegrates and the endometrium sheds again
70
Menopause?
It is the age a woman stops having her menstrual period.
71
Menarche?
It is the age a woman starts her first menstrual period.
72
Infertility?
It is inability of a sexually active non contraceptive couple to achieve pregnancy in one year.
73
Fistula?
Abnormal connection between to open cavities i.e. anus to vagina.
74
Dysmenorrhea?
- It refers to pain during menstrual period.
- It can be primary or secondary.
75
Adenomyosis?
- Disorder in which endometrial glands are found deep within the myometrium.
- Usually in multiparaous women and its diagnosied in their late 30’s and early 40’s.
- They present with increasingly spasmodic dysmenorrhea and increasing menstrual blood loss.
- On examination there is a bulky and tender uterus.
76
Endometriosis?
Presence of normal endometrial mucosal (glands and stroma) abnormally implanted in locations other than the uterine cavity.
77
Gestation trophoblastic disease?
- abnormal growth of cells that will become the placenta.
E.g.
1. choriocarcinoma: malignant fast growing but respond to treatment fast.
2. Hydatiform mole: benign
