OB terms

Question 1

ABRUPTION

Answer 1

Placental separation from the uterus with bleeding (concealed or vaginal) before fetal birth, with or without maternal/fetal compromise

Question 2

ANTENATAL STEROIDS INITIATED

Answer 2

At least one dose of corticosteroids was administered to accelerate fetal maturation

Question 3

CLINICAL CHORIOAMNIONITIS

Answer 3

Usually includes otherwise unexplained fever (at or above 38 degree C (100.4F)) with one or more of the following: Uterine tenderness and/or irritability Leukocytosis Fetal tachycardia  Maternal tachycardia Malodorous vaginal discharge
Non-laboring, intact membranes with unexplained fever require additional testing. Clinical diagnosis could be supported by laboratory evaluation of amniotic fluid.

Question 4

EARLY POSTPARTUM HEMORRHAGE

Answer 4

Cumulative blood loss of >=1000ml or blood loss accompanied by sign/symptoms of hypovolemia within 24 hours following the birth process (includes intrapartum loss).

Signs/symptoms of hypovolemia may include tachycardia, hypotension, tachypnea, oliguria, pallor, dizziness, or altered mental status. Cumulative blood loss of 500-999ml alone should trigger increased supervision and potential interventions as clinically indicated. A fall in hematocrit of >10% can be supportive data but generally does not make the diagnosis of postpartum hemorrhage alone. Further research is needed on blood loss for late postpartum hemorrhage

Question 5

ESTIMATED DUE DATE

Answer 5

The best Estimated Due Date is determined by: Last menstrual period if confirmed by early ultrasound or no ultrasound performed, or early ultrasound if no known last menstrual period or the ultrasound is not consistent with last menstrual period, or known date of fertilization (eg, assisted reproductive technology) Ultrasound margin of error and “early” to be defined by the College. Pregnancy should not be re-dated by a later ultrasound after a best obstetrical estimate of Estimated Due Date has been established

Question 6

FORCEPS ASSISTANCE

Answer 6

Application of forceps to the fetal head Should specify whether successful or unsuccessful in achieving birth This includes both cesarean and vaginal births

Question 7

GESTATIONAL AGE

Answer 7

Gestational age (written with both weeks and days, eg. 39 weeks and 0 days) is calculated using the best obstetrical EDD based on the following formula: Gestational Age = (280 - (EDD - Reference Date))/ 7 EDD: Estimated Due Date Reference Date: Date on which you are trying to determine gestational age

Question 8

Chronic Hypertension Diagnosed During Current Pregnancy

Answer 8

Hypertension diagnosed before the 20th week of current pregnancy.

Question 9

AUGMENTATION OF LABOR

Answer 9

The stimulation of uterine contractions using pharmacologic methods or artificial rupture of membranes to increase their frequency and/or strength following the onset of spontaneous labor or contractions following spontaneous rupture of membranes. Does not apply if the following is performed: Induction of Labor

Question 10

LABOR

Answer 10

Uterine contractions resulting in cervical change (dilation and/or effacement) Phases: Latent phase – from the onset of labor to the onset of the active phase Active phase – accelerated cervical dilation typically beginning at 6 cm Avoid the term ‘prodromal labor’ Can be spontaneous in onset, spontaneous in onset and subsequently augmented, or induced

Question 11

INDUCTION OF LABOR

Answer 11

The use of pharmacological and/or mechanical methods to initiate labor Examples of methods include but are not limited to: artificial rupture of membranes, balloons, oxytocin, prostaglandin, laminaria, or other cervical ripening agents Still applies even if any of the following are performed: Unsuccessful attempts at initiating labor Initiation of labor following spontaneous ruptured membranes without contractions

Question 12

SPONTANEOUS LABOR AND BIRTH

Answer 12

nitiation of labor without the use of pharmacological and/or mechanical interventions, resulting in a non-operative vaginal birth Does not apply if any of the following are used or performed: Cervical ripening agents, mechanical dilators, or induction of labor Forceps or vacuum assistance Cesarean birth Still applies if any of the following are used or performed: Augmentation of labor Episiotomy Regional anesthesia

Question 13

SPONTANEOUS ONSET OF LABOR

Answer 13

Labor without the use of pharmacological and/or mechanical interventions to initiate labor Does not apply if the following is performed: Artificial rupture of membranes before the onset of labor

Question 14

TIME OF THE ONSET OF LABOR

Answer 14

The time when regular uterine contractions began that resulted in labor with or without the use of pharmacological and/or mechanical interventions

Question 15

MALPRESENTATION

Answer 15

Any presentation other than a vertex presentation Examples: Brow, face, compound, breech, hand, shoulder, etc.

Question 16

MATERNAL WEIGHT GAIN DURING PREGNANCY

Answer 16

he last recorded maternal weight prior to birth minus the last recorded weight immediately prior to pregnancy Weights used for the calculation should be from the best available information

Question 17

NON-CESAREAN UTERINE SURGERY/SURGICAL SCAR

Answer 17

Surgery/injury and healing of the myometrium prior to birth other than from cesarean birth

Question 18

NULLIPAROUS

Answer 18

A woman with a parity of zero

Question 19

NUMBER OF CENTIMETERS DILATED ON ADMISSION

Answer 19

The last documented cervical dilation, in centimeters, when the provider orders admission Cervical dilation may be unknown with: Preterm labor Rupture of membranes Vaginal bleeding Exam refusal by patient (decline)  Cervical assessment may be performed by any clinician

Question 20

PARITY

Answer 20

The number of pregnancies reaching 20 weeks and 0 days of gestation or beyond, regardless of the number of fetuses or outcomes In cases of multiple pregnancies, parity is only increased with birth of the last fetus

Question 21

PERINEAL LACERATIONS

Answer 21

1° - Injury to perineal skin only 2° - Injury to perineum involving perineal muscles but not involving anal sphincter 3° - Injury to perineum involving anal sphincter complex 3a: Less than 50% of External Anal Sphincter thickness torn 3b: More than 50% External Anal Sphincter thickness torn 3c: Both External Anal Sphincter & Internal Anal Sphincter torn 4° - Injury to perineum involving anal sphincter complex (External Anal Sphincter & Internal Anal Sphincter) and anal epithelium

Question 22

PHYSIOLOGIC CHILDBIRTH

Answer 22

Spontaneous labor and birth at term without the use of pharmacologic and/or mechanical interventions for labor stimulation or pain management throughout labor and birth Does not apply if any of the following are used or performed: Opiates/nitrous oxide Augmentation of labor Regional anesthesia analgesia except for the purpose of spontaneous laceration repair Artificial rupture of membranes Episiotomy Still applies if any of the following are used: Uterotonic medications in the 3rd stage of labor Medications that do not stimulate labor or provide pain management (e.g. Antibiotics, medications to control chronic medical conditions)

Question 23

PLACENTA ACCRETA

Answer 23

The clinical condition in which any part of the placenta invades and is inseparable from the uterine wall Accreta may or may not be supported by pathologic findings

Question 24

PLURALITY

Answer 24

The number of fetuses birthed live or dead at any time in a single pregnancy regardless of gestational age, and regardless of if the fetuses were birthed on different dates Does not apply if any of the following occur:  “Reabsorbed” fetus(es) (those that are not birthed separately from the placenta and membranes) A reduction during the first trimester

Question 25

POSITIVE GBS RISK STATUS

Answer 25

Rectal/vaginal culture positive within 5 weeks prior to birth, or urine GBS culture positive* or GBS bacteruria at any point in current pregnancy, or prior infant with invasive GBS disease

Question 26

ARTIFICIAL RUPTURE OF MEMBRANES

Answer 26

An intervention that perforates the amniotic sac. Applies even if the rupture of membranes occurs during or immediately following a procedure or exam not intended to cause artificial rupture of membranes Does not apply if rupture of membranes occurs during cesarean birth

Question 27

DURATION OF RUPTURED MEMBRANES

Answer 27

Duration from rupture of membranes to birth (in hours and minutes)

Question 28

PRE-LABOR RUPTURE OF MEMBRANES

Answer 28

Spontaneous rupture of membranes that occurs before the onset of labor Modified by gestational age categories (eg, preterm, term)

Question 29

SPONTANEOUS RUPTURE OF MEMBRANES

Answer 29

A rupture of the amniotic sac that is not concurrent with or immediately following a digital exam or other transvaginal intervention involving the amniotic membrane Does not apply if the following is performed: Artificial rupture of membranes

Question 30

SHOULDER DYSTOCIA

Answer 30

A birth complication that requires additional maneuvers to relieve impaction of the fetal shoulder

Question 31

SPONTANEOUS VAGINAL BIRTH

Answer 31

Birth of the fetus through the vagina without the application of vacuum or forceps or any other instrument Does not apply if the following occurs: Breech extraction

Question 32

PRETERM

Answer 32

Less than 37 weeks and 0 days Late Preterm is 34 weeks and 0 days through 36 weeks and 6 days

Question 33

TERM

Answer 33

Greater than or equal to 37 weeks and 0 days using best EDD. It is divided into the following categories: Early Term - 37 weeks and 0 days through 38 weeks and 6 days Full Term - 39 weeks and 0 days through 40 weeks and 6 days Late Term - 41 weeks and 0 days through 41 weeks and 6 days Post Term - Greater than or equal to 42 weeks and 0 days

Question 34

VERTEX PRESENTATION

Answer 34

A fetal presentation where the head is presenting first in the pelvic inlet Does not apply if compound or breech presentation or if brow, face, hand, shoulder, etc., present first in the pelvic inlet Should specify whether position is anterior, posterior, or transverse.