Obstetrics Definitions 4

Question 1

Birth of the fetus with the occiput directed posteriorly; anterior rotation of the occiput fails to occur

Answer 1

Persistent occipitoposterior or face to pubes

Question 2

A hereditary enzyme deficiency which can cause mental retardation; a blood test is routinely taken a few days after birth to exclude this condition; incidence I in 10,000 birth

Answer 2

phenylketonuria

Question 3

Use of light energy, (around wavelength 450 nm) to convert the bilirubin molecule in the jaundiced infant’s skin to a form which can be excreted without conjugation in the liver.

Answer 3

phototherapy

Question 4

Eating of a substance usually considered inedible

Answer 4

pica

Question 5

The organ which permit gas and nutrient transport between the fetus and the mother. Forms from the chorion frondosum with a maternal decidual contribution

Answer 5

placenta

Question 6

Placental separation from the uterine decidua prior to birth of the baby.

Answer 6

placenta abruption

Question 7

Deficiency of decidua basalis and/or deeper than normal implantation of the placenta, with chorionic villi attached to uterine muscle. In placenta increta the villi are in the muscle wall; in placenta percreta the villi are through the muscle wall (a variety of uterine rupture)

Answer 7

placenta accreta

Question 8

Placenta with a double fold of amnion forming a ring on the fetal surface some distance in from the edge of the placenta

Answer 8

placenta circumvallata

Question 9

A thinner, larger placenta where there is failure of atrophy of the usual proportion of the chorionic villi

Answer 9

placenta membranacea

Question 10

exists when the placenta is inserted wholly or in part into the lower segment of the uterus

Answer 10

placenta praevia

Question 11

the placenta lies over the internal cervical os

Answer 11

major praevia

Question 12

: the leading edge of the placenta is in the lower uterine segment but not covering
the cervical os, minor or partial praevia exists

Answer 12

minor/partial praevia

Question 13

Accessory lobe of the placenta may be multiple

Answer 13

placenta succenturiata

Question 14

(a) Schultze retroplacental haematoma turns the placenta inside-out and the shiny fetal surface, with umbilical cord attached, presents. (b) Matthews-Duncan. The placenta separates edge first and slides out with the maternal surface (cotyledons) exposed.

Answer 14

placenta separation mechanisms

Question 15

The relationship of a defined area on the presenting part (called the denominator) to the mother’s pelvis

Answer 15

position of the fetus

Question 16

Signs that are infallible; fetal heart sounds, palpable fetal parts or movements, ultrasonography and tests for the presence of chorionic gonadotrophic hormone in the urine or blood.

Answer 16

positive sign of pregnancy

Question 17

Small triangular space in the fetal or infant skull situated at the posterior end of the sagittal suture

Answer 17

posterior fontanelle

Question 18

The fetal occipital bone is directed to the posterior aspect of the maternal pelvis, either to the left (LOP) or to the right (ROP). It occurs in about 15-20% of labours and is commonly associated with
prolonged and difficult labour It causes more trouble in labour than any other obstetric complication

Answer 18

posterior position of occiput

Question 19

. (a) Primary. Blood loss in excess of 500 mL from the birth canal, during the third stage and for 24 hours afterwards, (b) Secondary. Excessive bleeding, occurring in the interval from 24 hours after delivery until the end of the puerperium (volume not specified).

Answer 19

postpartum haemorrhage

Question 20

Baby born after more than 40 completed weeks of gestation.

Answer 20

post-term infant

Question 21

Labour of less than 4 hours duration.

Answer 21

precipitate labour

Question 22

Premature spontaneous rupture of the membranes before 37 weeks gestation without the onset of contractions Preterm infant. Baby born before 37 weeks gestation

Answer 22

preterm prelabour rupture of the membranes

Question 23

That part of the fetus felt on abdominal or vaginal examination.

Answer 23

presenting part

Question 24

The interval after menstruation, and up to ovulation during which growth of the endometrium is stimulated by oestrogen from the developing Graafian follicle.

Answer 24

proliferative phase of menstrual cycle

Question 25

Labour of more than 24 hours' duration.

Answer 25

prolonged labour

Question 26

Pregnancy prolonged 14 days or more past the due date of confinement (full term); the incidence is approximately 4% (table 17.1) and has fallen since induction of labour is often performed at full term + 7 - 10 days.

Answer 26

prolonged pregnancy

Question 27

Naturally occurring substances, in the decidua, semen and many tissues. The PGEI, PGE2 and PGF2 compounds stimulate uterine muscle activity and also cause oxytocin release from the posterior lobe of the pituitary.

Answer 27

prostaglandins

Question 28

A phantom pregnancy, the woman thinks she is pregnant but she is not. A royal illness (Queen Mary). Seen typically in the premenopausal nullipara anxious for a child.

Answer 28

pseudocyesis

Question 29

Bilateral injection of local analgesic in the region of the ischial spines, which renders the vagina and perineum insensitive to pain.

Answer 29

pudendal nerve block

Question 30

developing after birth until 6 weeks postpartum. Sepsis may be defined as infection plus systemic manifestations of infection.Most common site of puerperal sepsis is the genital tract. It could also cause by mastitis, UTI, pneumonia, skin and soft-tissue infection, gastroenteritis, pharyngitis and bacterial meningitis.

Answer 30

puerperal sepsis

Question 31

The period during which the reproductive organs return to their prepregnant condition, usually regarded as an interval of 6 weeks after delivery

Answer 31

puerperium

Question 32

When the woman in first becomes aware of fetal movements, add 5 calendar months (22 weeks) to calculate the due date.

Answer 32

quickening

Question 33

A common complication, of large fibromyomas in pregnancy associated with pain due to ischaemic necrosis.

Answer 33

red degeneration

Question 34

Term used to describe any infant who develops a respiratory rate greater than 60 per minute, has difficulties in breathing as shown by retraction of the sternum and lower costal margin, and an expiratory grunt

Answer 34

respiratory distress

Question 35

A condition which is due to lung immaturity and surfactant deficiency in preterm infants, previously it was known as hyaline membrane disease. May be treated with exogenous surfactant

Answer 35

respiratory distress syndrome (RDS)

Question 36

When the fetal head is born it is free to undo any twisting caused by internal rotation

Answer 36

restitution

Question 37

Placenta still in utero 1 hour after birth of the baby

Answer 37

retained placenta

Question 38

The quality of uterine muscle, whereby permanent shortening occurs after contractions in labour. The uterine fundus thickens and pulls up the dilating cervix like a hood over the presenting part

Answer 38

retraction

Question 39

Occurs in obstructed labour when Bandl's ring rises to about the level of the umbilicus and becomes visible and palpable

Answer 39

retraction ring

Question 40

The uterine fundus lies in the rectovaginal pouch of Douglas instead of anteriorly on the bladder. Occurs in 20% of women.

Answer 40

retroversion of the uterus

Question 41

An antigen attached to red blood cells capable of causing production of antibodies when introduced into the circulation of a person lacking this factor (a Rh negative person).

Answer 41

rhesus factor

Question 42

(a) Internal. The occiput rotates to the anterior position and rarely (1-2%) to the posterior position. (b) External. The head rotates after it is born because the shoulders (bisacromial diameter) are turning into the anteroposterior diameter of the pelvic outlet

Answer 42

rotation of the head

Question 43

Causes pain in mid-pregnancy that may be confused with renal infection or red degeneration of a fibroid. The hypertrophied muscular ligament is in spasm and often is readily palpated lateral to the uterus in the lower abdomen. Appendicitis must be considered when the pain is unilateral and right-sided.

Answer 43

round ligament strain

Question 44

Cold oedema of the newborn.

Answer 44

sclero-oedema

Question 45

Voluntary muscles of the abdominal wall, and diaphragm, which by their contraction increase intra-abdominal pressure in the second stage of labour. Intrauterine pressure rises to 110 mm of mercury with the combined effect of primary uterine action (35-60 mm) and secondary powers (50 mm).

Answer 45

secondary powers in labour

Question 46

The interval between ovulation and the succeeding menstrual period during which oestrogen and progesterone from the corpus luteum stimulate growth of the endometrium and glycogen secretion of the glands.

Answer 46

secretory phase of menstrual cycle

Question 47

Obstruction to the passage of the shoulders through the bony pelvis; the head having been delivered, the neck fails to appear and the baby's chin burrows into the mother's perineum when the occiput is anterior

Answer 47

shoulder dystocia (impacted dystocia)

Question 48

A discharge of mucus and blood at the onset of labour when the cervix dilates and the operculum (cervical mucus plug) falls out

Answer 48

show

Question 49

That part of the fetal head in front of the anterior fontanelle, it is subdivided into the brow and the face

Answer 49

sinciput

Question 50

Infant born with a birth weight less than the 10th centile.

Answer 50

small for gestational age (SGA)

Question 51

fetus has an estimated fetal weight or abdominal circumference of less than the 3rd centile

Answer 51

severe SGA

Question 52

A pathological restriction of the genetic growth potential. Growth restricted fetuses may manifest evidence of fetal compromise (abnormal Doppler studies, reduced liquor volume).

Answer 52

fetal-growth restriction

Question 53

An infant with birth weight less than 2500g at or beyond 37 weeks gestation.

Answer 53

low birth-weight

Question 54

infants are those weighing less than 1500g; they comprise 1 % of all births and provide 50% of perinatal deaths.

Answer 54

very low birth-weight

Question 55

infants weigh less than 1000 g at birth and comprise 0.5% of all births

Answer 55

extremely low birth-weight

Question 56

Overlapping of the cranial bones seen radiographically; is a sign of fetal death if moulding due to labour can be excluded. Fetal death is now confirmed with ultrasonography and/or cardiotocography.

Answer 56

spalding sign

Question 57

Painful uterine contractions, without cervical effacement or dilatation.

Answer 57

spurious or false labour

Question 58

(a) The first stage is that of dilatation of the cervix and is finished when the uterine cavity and vagina are no longer separated by a rim of cervix (full dilatation) (b) The second stage is from full dilatation of the cervix to delivery of the fetus (c) The third stage is completed with the delivery of the placenta and membranes (secundines)

Answer 58

stages of labour

Question 59

The level of the presenting part, within the mother's pelvis. The ischial spines are the reference points on vaginal examination

Answer 59

station

Question 60

Baby delivered without signs of life from 24 weeks gestation or a birthweight ≥500g.

Answer 60

stillbirth

Question 61

Are red or purple in colour during the pregnancy in which they first appear, later become white

Answer 61

striae (stretch marks)

Question 62

A method of inducing labour. Less effective than amniotomy. but also carries the risk of infection.

Answer 62

stripping of the membranes

Question 63

In late pregnancy 10% of women experience faintness when lying supine due to inferior vena caval obstruction causing reduced venous return and a fall in cardiac output,

Answer 63

supine hypotension syndrome

Question 64

Term applied to the membranous junction between the bones of the fetal (and infant) skull; the chief sutures are between the frontal bones (frontal), parietal bones (sagittal), parietal and frontal (coronal). parietal and occipital (lambdoid)

Answer 64

suture

Question 65

Division of the pubic symphysis, to enlarge the diameters of the bony pelvis

Answer 65

symphysiotomy

Question 66

A fetal heart rate above 160 beats per minute and a maternal heart rate above 100 beats per minute; in each case is indicative of distress.

Answer 66

tachycardia

Question 67

A deformed or twisted foot (clubfoot)

Answer 67

talipes

Question 68

From 37 to 42 completed weeks'gestation (259-293 days), neither preterm 42 weeks. The due date of confinement or full term (often mistakenly referred to as 'term') is calculated to be 40 weeks (280 days).

Answer 68

term

Question 69

Medical process of ending a pregnancy as to not result in the birth of a baby.

Answer 69

termination of pregnancy

Question 70

A hereditary disorder of haemoglobin synthesis present in about 6% of women who were born in Greece and 4% of those born in Italy. It is also common in South East Asia. May cause severe pregnancy anaemia.

Answer 70

thalassaemia minor

Question 71

Infection with Candida albicans; usual sites are the mother's vagina and the baby's mouth

Answer 71

thrush

Question 72

Women with one previous caesarean delivery should be reviewed formally by a senior obstetrician early in pregnancy to discuss the management of the pregnancy and the mode of delivery. The views of the woman should be sought, including her plans for future pregnancies.

Answer 72

trial of labour after caesarean section (TOLAC)

Question 73

A period of approximately 3 months

Answer 73

trimester

Question 74

The cells, which line the blastodermic vesicle and surround the embryonic cell mass. Chorionic processes or villi develop with outer syncytial and inner cytotrophoblastic layers

Answer 74

trophoblast or chorion

Question 75

A genetic abnormality, where the individual has 45 chromosomes (XO karyotype) instead of 46 and is sex chromatin negative, despite being female in appearance.

Answer 75

turner syndrome

Question 76

Use of high frequency, short wavelength, sound wave reflections to diagnose pregnancy, assess gestational age fetal and neonatal anatomy diagnose multiple pregnancy malpresentations and hydatidiform mole identify non-viable pregnancies, locate the placental site investigate fetal and neonatal haemodynamics, detect fetal malformations and direct intrauterine manipulation

Answer 76

ultrasonography

Question 77

The connecting lifeline between the fetus and placenta; it contains 2 umbilical arteries and 1 umbilical vein encased in Wharton jelly

Answer 77

umbilical cord

Question 78

a) Primary;Inefficient uterine activity. (b) Secondary; (uterine exhaustion). Occurs usually in the late first, or second stage when uterine action becomes poor or ceases. In the second stage the commonest cause is obstruction due to a tight perineum in a nullipara.

Answer 78

uterine inertia

Question 79

Noise made by maternal blood passing through the uterine vessels.

Answer 79

uterine souffle

Question 80

Generalized tonic contraction, of the uterus usually due to misuse of oxytocic drugs.

Answer 80

uterine tetany

Question 81

Instrumentation to deliver the fetal head by traction on a suction cup placed on the scalp (usually the occipital region)

Answer 81

vacuum extraction

Question 82

Dilatation of veins, of the lower half of the body. Usually occur for the first time or become worse in pregnancy

Answer 82

varicose veins

Question 83

Fetal vessels coursing through the membranes over the internal cervical os and below the fetal presenting part, unprotected by placental tissue or the umbilical cord. This can be secondary to a velamentous cord insertion in a single or bilobed placenta (vasa praevia type 1), or from fetal vessels running between lobes of a placenta with one or more accessory lobes (vasa praevia type 2)

Answer 83

vasa praevia

Question 84

The umbilical cord inserts onto the membranes over which the vessels course to reach the fetal surface of the placenta

Answer 84

velamentous insertion of the cord

Question 85

Produced by sebaceous glands this 'complexion cream' prevents waterlogging and maceration of the fetal skin by the amniotic fluid

Answer 85

vernix caseosa

Question 86

A turning of the fetus in utero whereby the presentation is changed, usually from breech to vertex

Answer 86

version

Question 87

. Top of the skull, the area between the anterior and posterior fontanelles and the parietal eminences

Answer 87

vertex

Question 88

The average weight gain in pregnancy is about 12.5 kg. A weight gain of more than 0.5 kg per week in late pregnancy may precede generalized oedema

Answer 88

weight gain

Question 89

The mucoid connective tissue supporting the umbilical cord vessels

Answer 89

wharton jelly