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TERMS AND DEFINITIONS

Nulliparous:
A woman who has never been pregnant beyond 20 weeks gestation.

Primigravid:
A woman pregnant for the first time.
G6 P4:
Gravida 6, Para 4 means pregnant 6 times (includes current if pregnant) and previously
delivered of 4 children of greater than 20 weeks gestational age.

Abortion:
The process by which the products of conception are expelled from the uterus via the birth
canal before the 20th week of gestation.

Labour:
As for abortion but after 20 weeks.

Caesarean section:
Surgical removal of the uterine contents by the abdominal route after 20 weeks.

Hysterotomy:
As for Caesar but before 20 weeks.

Prolonged pregnancy:
Pregnancy prolonged 14 days or more past 40 weeks.

Premature infant or Preterm infant:

One born before 37 weeks of gestation.

Premature rupture of the membranes: (PROM)

When the membranes rupture before the end of the first stage of labour.

Preterm PROM:
Rupture of membranes before 37 weeks of gestation.

Neonatal death:
A liveborn infant who dies within 28 days of birth.

Stillbirth:
An infant born after the 20th week of gestation (or >birth weight 400g, if gestation unknown)
who did not breathe after birth or show any other sign of life.

Perinatal mortality rate:

Stillbirths plus neonatal deaths expressed per 1,000 births.

Infant death:
Death of a liveborn infant within the first year of life.

Presenting part:
The part of the fetus felt on vaginal examination.

Lie of the fetus:

Relationship of the long axis of fetus to the long axis of the uterus.

Station of the presenting part:

The level of descent of the presenting part within the birth canal. (Determined by abdominal
palpation and vaginal examination.)

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Engagement:
The station at which the maximum diameter of the presenting part is through the pelvic inlet.
If Vertex presentation, determined by:
1/5 head palpable,
Vertex reached level of ischial spines.

Position of the fetus:

The rotational relationship of a defined area on the presenting part (the denominator) to the
mothers pelvis

Asynclitism:
Side to side tilt of the fetal head.

Attitude of the fetus:

Relation of fetal head and limbs to the fetal trunk (usually flexion)

Braxton Hicks contractions:

Painless uterine contractions in the antenatal period.

Breech presentation types:

Complete breech: hips and knees flexed
Frank breech: hips flexed, knees extended
Footling breech:one or both feet presenting

Cephalic presentations:
Presentation Diameter Name of Diameter
Vertex 9.5cm suboccipito-bregmatic
Deflexed vertex 11.5cm occipito-frontal
Brow 13.5cm vertico-mental
Face 9.5cm cervico-bregmatic

Parts of the fetal head:

Sinciput forehead
Brow between root of nose and anterior fontanelle
Bregma anterior fontanelle
Vertex between fontanelles and parietal eminences
Fontanelle junction of >2 skull bones, covered only by a membrane and skin.

Normal pelvis diameters: (in centimetres)

AP TR
Pelvic inlet 11.5 13.5
true conjugate
symphysis to sacral prom
Mid Pelvis 11.5 10.5
(Narrow symphysis to S3 bispinous
pelvic plane) between ischial spines

Pelvic Outlet 11.5 11.5

symphysis to intertuberous
coccyx or S5 between ischial
tuberosities

Caput succedaneum:
Oedema from obstructed venous return in the fetal scalp caused by pressure of the head
against the rim of the cervix or birth canal.

Cervical dystocia:
Difficult labour due to an abnormality of the cervix commonly scarring after cervical
surgery.

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Cervical incompetence:
The cervix dilates silently during the second trimester with the result that the membranes
bulge and rupture and the fetus drops out.

Colostrum:
Yellowish fluid expressed from the breasts during pregnancy and before the onset of
lactation.

Cord presentation:
The cord is alongside or below the presenting part with the membranes intact.

Cord prolapse:
As for cord presentation except the membranes have ruptured.

Epidural analgesia:
Injection of analgesic agent outside the dura.

Episiotomy:
An incision of perineum and vagina that enlarges the introitus.

Fourth degree tear:

A perineal laceration passing through the anal sphincter and laying open the anal canal.

Hegars sign of pregnancy:

Bimanual palpation of a soft uterine isthmus between the cervix below and the uterine body
above.

Hydrops fetalis:
Gross oedema of fetal subcutaneous tissues together with ascites, pericardial and pleural
effusions.

Incoordinate uterine action:

Fundal dominance is lost, intrauterine tension between contractions is increased.

Leucorrhoea:
Colourless (white), non-itchy, non-offensive vaginal discharge.

Lochia:
The discharge from the uterus during the puerperium. Initially red (lochia rubra), then yellow
(serosa) and finally white (alba).

Lower uterine segment:

The thin expanded lower portion of the uterus which forms in the last trimester or pregnancy.

Naegeles rule:
To estimate the probably date of confinement.
Add 9 months and 7 days to the first day of the last menstrual period.
A correction is required if the patient does not have 28 day cycles.

Oligohydramnios:
An insufficiency of amniotic fluid (0-200ml in the third trimester)
Causes include: PROM, Placental insufficiency, decreased fetal urine production.
On ultrasound, the AFI is <5 (or 8)

Polyhydramnios:
The clinical diagnosis of an excessive amount of liquor amnii (usually >2500ml)
On ultrasound the amniotic fluid index (AFI) is >25, or deepest pocket > 10cm

Oxytocic:
Substances that stimulate contractions of the uterine muscle.

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Hypertension:
SBP 140 and/or DBP 90
Or rise of SBP 25 and/or DBP 15 compared to early pregnancy on two readings six hours
apart.

Pre-eclampsia:
2 of 3 signs of hypertension, generalised oedema and proteinuria not due to contamination of
UTI. For hypertension the following must apply:
1. Hypertension developing after 20 weeks of pregnancy.
2. Normal blood pressure in the first trimester of pregnancy.

Eclampsia:
Grand mal convulsions.
Usually superimposed on preceding severe pre-eclampsia.
(Not attributable to cerebral conditions such as epilepsy or cerebral haemorrhage.)

Precipitate labour:
Labour of less than 4 hours duration.

Prolonged labour:
Labour of more than 24 hours duration.

Puerperium:
The period during which the reproductive organs return to their pre-pregnant condition
usually regarded as an interval of 6 weeks after delivery.

Quickening:
When the patient first becomes aware of fetal movements.
Occurs at approximately 17 weeks in multigravida and 19 weeks in primigravida.

Restitution:
When the fetal head is born it is free to undo any twisting cause of internal rotation.

Retained placenta:
Placenta still in-utero one hour after birth of the baby.

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

Stages of labour:
(a) The first stage is up to full dilation of the cervix.
(b) The second stage from full dilation until expulsion of fetus.
(c) The third stage from expulsion of fetus until expulsion of the placenta and membranes.

Version:
Turning of the fetus to produce a change in the presenting part
may be spontaneous/therapeutic, cephalic/podalic, internal/external.

Antepartum haemorrhage:
Bleeding from the birth canal, in excess of 5ml,
from the 20th week of gestation to the birth of the baby.

Placenta praevia:
Placental implantation encroaches upon the lower uterine segment.

Vasa praevia:
Fetal vessels lying in the membranes in front of the presenting part.
(due to velamentous insertion of cord, succenturiate lobe or bipartite placenta).

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Accidental haemorrhage:
Bleeding from a normally situated placenta after 20 weeks.
Abruption: associated with placental separation.
Marginal: not associated with placental separation.

Incidental haemorrhage:
Bleeding from the lower genital tract (cervix, vagina, vulva)
- commonly related to cervical ectropion or polyp.

Postpartum haemorrhage
Primary: Blood loss in excess of 600ml from the birth canal during the third stage and 24
hours afterwards.
Secondary: Excessive bleeding occurring in the interval from 24 hours after delivery until the
end of puerperium (no volume required in definition).

Inversion of uterus:
Uterus turned inside-out.
- usually due to pulling on the cord with the uterus relaxed and the placenta not separated.

Placenta accreta:
Absence of decidua basalis, with chorionic villi attached to uterine muscle.
Placenta increta: the villi are in the muscle wall. Placenta percreta: the villi are through the
muscle wall, usually into bladder wall.

Uterine atony:
Relaxation of the uterus
- commonest cause of PPH

Amniocentesis:
Aspiration of a sample of amniotic fluid through the mothers abdomen.

Womens Health, Terms and Definitions 2004