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					Birth Glossary
Abruptio placenta · Premature detachment of a normally situated placenta after the th 20 week of gestation. It occurs about once in 200 births. Because it often results in severe bleeding, it is serious. If it is not at the end of the pregnancy, the mother rests in bed and is watched carefully. If the pregnancy is close to the end (usually 7 months or more) the baby is often delivered by cesarean section. Although the cause is unknown, maternal hypertension has a strong correlation. American College of Certified Nurse-Midwives American College of Obstetricians & Gynecologists Developed by 55-100% of gynecological surgery patients, it is defined as an attachment of parts normally separated. Adhesions develop as a result of scar tissue and can cause infertility, pelvic pain and abnormalities of bowel function. New, or "de novo" adhesions may form at a site where none existed before but a surgical procedure was performed. Examples include a myomectomy incision or an ovarian incision at the time of ovarian cystectomy. De novo adhesions may also develop away from the site of surgery, such as adhesions developing around the tubes and ovaries at the time of a cesarean section. Adhesions may also reform following surgical repair. Association of Family Practitioners See alphafetoprotein Assocation of Labor Assistants & Childbirth Educators Against Medical Advice; also American Medical Association An antigen present in the human fetus and in certain pathological conditions in the adult. The maternal serum level can be evaluated at 16 to 18 weeks of pregnancy to detect fetal abnormalities. Elevated levels indicate the possibility that neural tube defetcs are present in the fetus; decreased levels may indicate an increased risk of having a baby with Down syndrome. Test results may be abnormal in persons with diabetes, multiple pregnancies, obesity. Transabdominal puncture of the amniotic sac under ultrasound guidance using a needle and syringe in order to remove amniotic fluid. The sample obtained is studied chemically and cytologically to detect genetic and biochemical disorders and maternal-fetal blood incompatibility and, later in the pregnancy, to determine fetal maturity. The procedure can cause abortion or trauma to the fetus. The membrane that covers the fetal side of the placenta. It contains the amniotic fluid. Artifical rupture of membranes; Surgical rupture of the fetal membranes to induce or expedite labor. Anterior means before or in front of. In the case of pregnancy, the placenta is formed at the front of the uterus. It can indicate difficulty in auscultation of heart tones. Pelvis in which the brim is oval in shape, with an increase in the anteroposterior diameter and a corresponding decrease in the transverse diameter; the sacrum is long and narrow and may contain six vertebrae from fusion of the fifth lumbar vertebra wit the sacrum. This increases the inclination of the pelvic brim and is called high assimilation; it tends to hinder engagement of the fetal head. Noted in tall, well-built women. Labor is usually easy. AKA pithecoid pelvis. Tool used to evaluate the newborn's cardiopulmonary status during the first 5 minutes of life. Apgar is rated on heartrate, breathing, muscle tone, reflex irritability, and color, each having

ACNM ACOG Adhesion

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AFP AFP ALACE AMA Alphafetoprotein

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Amniocentesis

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Amnion Amniotomy Anterior placenta

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Anthropoid pelvis

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Apgar score

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AROM Asyncliticism

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Auscultation Beta strep BF BH Bicornate uterus

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Bilirubin Biophysical profile

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BJM Braxton Hicks contractions

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Breech

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Burns-Marshall Maneuver

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a point value of 0 to 2. See amniotomy An oblique presentation of the fetal head in labor. The head tilts sideways so that a parietal bone enters the pelvic brim. Given strong uterine contractions and molding of the fetal head, the head may pass through the brim. Vaginal delivery is then possible. Listening for fetal heart tones with either a stethoscope or fetoscope, or the ear pressed against the bare belly. See Group B Strep Breastfeeding See Braxton Hicks Contractions A heart shaped uterus. Patients with this condition are at risk for preterm labor and delivery, because the uterine cavity does not expand in the same manner to permit enlargement of the term-sized fetus, possibly resulting in preterm contractions. A reddish yellow pigment produced by the breakdown of hemoglobin. Found in bile, blood, urine, and gallstones. A series of tests which, in combination, offer an assessment of fetal/placental wellbeing. The test has a false positive rate (normal test, distressed infant) of 0.5 percent and a false positive rate of 43 percent (abnormal test, normal infant). If the test is abnormal and the baby is felt to be fine by the mother and care providers, another test should be done within 24 hours. Assessment is based on amniotic fluid level, fetal kick count, fetal breathing movements, muscle tone, and a non-stress test. Each item is rated from 0-2 points each. A score of 8 to 10 is normal, and a score ranging between 4 and 6 can improve, especially with improvement of mother's condition (especially an improvement in maternal diet). Intervention is only appropriate if there are oligohydramnios. A score of 0 to 2 will not improve, and is an indication of high mortality rate. British Journal of Medicine John Braxton Hicks was a British gynecologist (1823-1897) who first described these contractions in 1872. Braxton Hicks contractions are intermittent painless uterine contractions that may occur every 10 to 20 minutes. They occur after the third month of pregnancy. These contractions are not true labor pains but are often interpreted as such. They are not present in every pregnancy. AKA Hicks sign. A variation of normal presentation of the baby in the uterus in which the buttocks, or breech, of the baby is presenting first. One baby in four will present breech at some stage in th pregnancy, but by the 34 week most of these babies have turned. Acupuncture, chiropractic and external version are options for turning a breech baby. For vaginal breech delivery, an epidural is not recommended and the Burns-Marshall maneuver or Mauriceau-Smellie-Veit maneuver may be utilized, providing a normal vaginal delivery. AKA frank breech, footling breech, knee breech, or full breech. For breech delivery, the baby is allowed to hang by its own weight for a few moments to facilitate descent and flexion of the head. When the nape of the neck and hairline come into view, showing that the head is ready to be born, the baby is grasped by its ankles and, using slight traction, the trunk is carried up in a wide arc over the mother's abdomen. The perineum should then be depressed with the fingers to expose the mouth of the fetus. It is cleared of mucus to allow the fetus to breathe without inhaling the fluid. As soon as the nose appears at the vulva the nostrils are cleared. The birth of the head then proceeds very slowly indeed. If it were allowed to 'pop out' very quickly the sudden release of pressure could easily give rise to an intracranial hemorrhage. To avoid this danger the obstetrican

C/SEC Caput Caput succedaneum

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CBAC CBE Cephalhematoma Cervix

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Chorion Chorionic villi

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Classical cesarean

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CNM CPD CPM CS; C/S Ctx Dehiscence

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applies Wrigley's or Neville Barnes forceps to the after-coming head. This enables him to control exactly the speed with which the head is born. It is brought down until the baby's mouth and nose are acccessible so that the air passages can be cleared and oxygen can be given as soon as the baby gasps. Cesarean Section; also Cesarean Support, Education and Concern (inactive organization). See caput succedaneum. A pressure-caused, fluid-filled swelling of the fetal scalp as a result of the forces of labor. Usually disappears within 24 to 48 hours. Cesarean Birth After Cesarean Childbirth Educator A subperiosteal hemorrhage of the newborn that is caused by trauma to the fetal skull during birth. The neck of the uterus; the lower part from the internal os outward to the external os. It is rounded and conical, and a portion protrudes into the vagina. It is about 1 in. long and is penetrated by the cervical canal, through which the fetus and menstrual flow escape. It may be torn in childbirth, especially in a primigravida, and deeper tears may occur in manual dilatation and use of forceps; breech presentation may also be a cause. The outermost membrane layer which arises from the trophoblast and helps in forming the placenta. The chorion develops chorionic villi, which are finger-like projections on its surface. The chorionic villi extend downward through the uterine lining into the maternal blood supply to help supply the developing embryo with oxygen and nutrients. A CVS test, or chorionic villi sampling, can detect abnormalities in the baby by the removal of tissues from what will be the placenta th th sometime between the 9 to 11 week of pregnancy. CVS can damage the embryo, cause miscarriage, cervical lacerations, hemorrhage and infection. CVS is contraindicated in cases of vaginal infection, Rh sensitization, multiple gestation, or markedly retroflexed uterus. A cesarean section performed with a vertical incision on the uterus. Surgical records should be reviewed to determine if the uterine scar is vertical in addition to the external scar. Certified Nurse-Midwives Cephalo Pelvic Disproportion Certified Professional Midwife; also Cesarean Prevention Movement (now ICAN) Cesarean Section Contractions Classified as a uterine rupture, dehiscence involves the myometrium but not the pelvic peritoneum which remains intact. Also called uterine window, occult, or silent rupture, it tends to present with less violent and dramatic signs and symptoms, possibly due to the avascular nature of the scar tissue. Dehiscence is sometimes diagnosed after delivery, especially in cases where there are no signs and symptoms before delivery (as is the instance in 35.3 percent of cases). Dehiscence can be prevented by assessing nutritional status and risk factors such as obesity or malnourishment before surgery, and by ensuring proper nutrition. Direct-Entry Midwife Doulas of North America See Ultrasound. An experienced labor companion who provides continuous emotional support and assistance before, during, and after birth. Doulas have been shown to shorten first-time labor, decrease

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DEM DONA Doppler Doula

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DPO Dubowitz score Shoulder Dystocia

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Dystocia EDC EDD Edema Effacement

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Effleurage

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EFM Endometriosis

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Engagement Epidural

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Episiotomy

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EPO External version FBS Fetal lie Fontanel

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cesarean section and the need for pain medication, helps fathers participate with confidence, and leads to more successful breastfeeding. Days post ovulation A means of assigning gestational age by certain physical characteristics and responses of the newborn. After delivery of the head, the infant's anterior shoulder becomes wedged above the symphysis pubis instead of entering the true pelvis; or the posterior shoulder may have passed the sacral promontory and entered the true pelvis, where it may be jammed against the sacrum. Incidence of shoulder dystocia is generally reported as being less than 1 percent; it occurs in from 0.15 percent to 0.6 percent of all deliveries. Risk factors for shoulder dystocia are maternal diabetes, history of macrosomia, maternal obesity, postdates (14 days past EDD), history of CPD, or prolonged second stage. In deliveries with one or more risk factors present, an epidural is contraindicated as the mother should be able to quickly change positions as indicated by the caregiver to unwedge the stuck shoulder. (diss-toe'-shah) Abnormal or difficult labor or childbirth. See also shoulder dystocia. Expected date of confinement Estimated Due Date; Estimated Date of Delivery A local or generalized condition in which the body tissues contain an excessive amount of tissue fluid. The shortening, or thinning, of the cervical canal from its usual length of 2 to 3 cm to the point where the cervical canal is obligerated, leaving only the external os as the circular orifice with thin edges. This shortening results from the lengthening of the muscular fibers around the internal os as they are taken up into the lower uterine segment. A massage technique used in the Lamaze and other psychoprophylactic methods of childbearing. Effleurage means "feather touch," which describes the amount of pressure to be used in doing it. It is usually done by the laboring woman, using both hands and following a definite pattern over primarly her lowever abdomen. Electronic Fetal Monitor The presence of the endometrial tissue outside the uterus. The most common places for implantation are the ovaries, fallopian tubes, bladder and intestines, uterine wall, lining of the pelvis and may be found in the cesarean section scar, and the vaginal wall. The point at which the widest diameter of the infant's presenting part has passed through the pelvic inlet. The two main components of the ordinary epidural are the drugs bupivacaine hydrochloride and fentanyl epinephrine. These drugs are injected in the space around the bag of nerves at the base of the spine (the epidural space) to stop the messages of pain from being sent to the brain, thus eliminating partially or completely the sensation of pain in childbirth. Incision of the perineum at the end of the second stage of labor to avoid spontaneous laceration of the perineum and to facilitate delivery. Evening Primrose Oil Manual turning of the baby from any presentation other than vertex which utilizes the hands on the pregnant abdomen. Fasting Blood Sugar The position of the fetus in utero, AKA presentation. Membrane-covered space where fetal or newborn skull sutures intersect. The anterior fontanel is a diamond-shaped space bordered by the sagittal and coronal sutures. The posterior

FP FTP GBS GD Hypertension Gestational hypertension Glucose Tolerance Test

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fontanel is a triangular space bordered by the sagittal and lambdoidal sutures. Family Practitioner Failure to Progress See Group B Strep Gestational Diabetes A blood pressure reading of 140/90 or higher on at least two occasions, six hours apart. See hypertension. A test used for screening for diabetes in pregnancy which involves a random oral glucose tolerance test after a 50 g. glucose (sugar) load. Giving a woman concentrated refined sugar load before testing is not recommended; she can have a physiological reaction to the glucose overload which can mimic diabetes. A Guide to Effective Care in Pregnancy and Childbirth by Enkin et al and published in 1989 indicated the oral GTT should be abandoned. General Practitioner A woman who has given birth seven or more times. A pregnant woman. Group B Strep is a bacteria (beta-hemolytic streptococci) that is a leading cause of early-onset neonatal infections and lateonset post-partal infections. In women, this is marked by urinary tract infection, chorioamnionitis, postpartum endometritis, bacteremia, and wound infections complicating cesarean section. It can lead to inflammation of the amniotic sac, the uterine lining, or urinary tract in the mother. Occasionally a newborn will have a local infection. About 15 to 30 percent of all women have asymptomatic strep B in their vaginas. As many as 50 to 75 percent of their babies contract strep, but only 2 to 3 per 1000 get sick. Of these, 7 percent are born under 2 pounds. Late onset newborn infections occur in 0.5 to 1 case per 1000 births. There is increased risk for the baby with premature rupture of membranes or cesarean delivery, although the strep bacteria can permeate the intact membranes. See Glucose Tolerance Test Home Birth After Cesarean HELLP syndrome, a unique variant of preeclampsia (toxemia), an acronym meaning H (hemolysis, which is the breaking down of red blood cells), EL (elevated liver enzymes), and LP (low platelet count). During pregnancy, nausea and vomiting severe enough to cause systemic effects such as acidosis, dehydration, and weight loss. Any adverse mental or physical condition induced in a patient through the effects of treatment by a physician or surgeon. International Cesarean Awareness Network The process of causing or producing, as in induction of labor with oxytocic drugs in cases of uterine dysfunction. Intrauterine Growth Retardation Journal of the American Medical Association An exercise for strengthening the pubococcygeal and levator ani muscles. Basically, the patient tightens those muscles that could be used in attempting to prevent defecation or urination. Increse in the strength of the muscles helps to control urinary and fecal incontinence, aids in the childbirth process, and may enhance the pleasure derived from sexual intercourse. Labor & Delivery th th Downy hair covering the fetus from the 20 to 38 week of gestation. Low birthweight

GP Grand multipara Gravida Group B Strep

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GTT HBAC HELLP

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Hyperemesis gravidarum iatrogenic ICAN Induction IUGR JAMA Kegel exercises

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L&D Lanugo LBW

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Leopold’s maneuvers

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LGA LLL LM LMP LOA Lochia alba

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Lochia rubra

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Lochia serosa

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LOP Lotus birth Macrosomia

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MANA McRobert's maneuver

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Meconium

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Methergine

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Monitrice Mucous plug Multipara

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MW NARM NEJM NFP NST Nullipara OB Occiput

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Maneuvers used to evaluate the unborn infant: palpations to determine fetal lie, attitude, presentation and position; estimation of fetal growth; assessment of amniotic fluid volume; evaluation of fetal responsiveness. Large for Gestational Age La Leche League Lay Midwife, also Licensed midwife Last menstrual period Left Occiput Anterior Postpartum discharge lasting from approximately the tenth through the fourteenth postpartum days. It is creamy white with leukocytes and cellular debris. Postpartum discharge lasting from approximately the first through the fourth postpartum days. It is dark red containing blood and placental and decidual debris. Postpartum discharge lasting from approximately the fourth through the tenth postpartum days. It is pinkish, thin, and serosanguineous containing serous exudate, shreds of degenerating decidua, erythrocytes, leukocytes, cervical mucus, and numerous microorganisms. Left Occiput Posterior Birth without the cutting of the cord; the cord falls off while still attached to the placenta 4 to 10 days postpartum. In a newborn, birthweight of 4000 grams (8 pounds 13 ounces) th or more, or above the 90 percentile on the intrauterine growth curve. Midwives Alliance of North America The woman lies on her back and draws her knees up to her chest, thereby lifting her buttocks a little off the bed. This is ordinarily used for shoulder dystocia but can also be used in a breech delivery where the fetal head is trapped behind an incomplete cervix. The exaggerated flexion of the patient's legs results in a straighteneing of the sacrum relative to the lumbar spine. Although this maneuver does not change the dimensions of the true pelvis, rotation of the symphysis superiorly frees the impacted anterior shoulder. AKA exaggerated lithotomy position. The contents of the fetal and/or newborn colon. Comprised of epithelial cells from the intestinal tract, mucus, skin cells, and hair (lanugo) that the fetus had swallowed with the amniotic fluid. Passage of meconium in utero may indicate fetal distress. Methylergonovine maleate; Drug used in the prevention and treatment of postpartum hemorrhage caused by uterine atony or subinvolution. Contraindicated in pregnancy. Should not be administered via I.V. because of the risk of severe hypertension and stroke. Professional labor assistant, or doula, who also has medical knowledge and may perform some minor medical procedures The plug of mucus that fills the opening of the cervix on impregnation. *SYN: bloody show A woman who has borne more than one viable fetus, whether or not the offspring were alive at birth. The number of deliveries may be recorded as para II, para III, and so on. SYN: multigravida Midwife North American Registry of Midwives New England Journal of Medicine Natural Family Planning Non-Stress Test A woman who has never produced a viable offspring. Obstetrician The back part of the skull. On the fetal head, it is used to

OFP Oligohydramnios

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Para

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Pelvic rock

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determine the position of cephalic presentations in relation to the maternal pelvis Optimal Foetal Positioning An abnormally small amount of amniotic fluid that may be symptomatic of a variety of problems, including fetal renal agenesis and intrauterine growth retardation. A woman who has produced a viable infant (weighing at least 500g or of more than 20 weeks' gestation) regardliess of whether the infant is alive at birth. A multiple birth is considered to be a single parous experience. The Pelvic Rock is an exercise that will improve circulation, and help relieve low backaches by strengthening the muscles of your abdomen and lower back. It also benefits the proper alignment of the fetal head in the pelvis. To perform the Pelvic Rock, get on your hands and knees with your arms straight. Tighten your tummy muscles, tuck your hips and buttocks under so that the small of your back is pushed back as far as possible. Hold this position for 5 – 10 seconds. Relax your back flat again (not arched). Repeat 10 – 30 times per day; 5 days per week. The structures occupying the pelvic outlet and constituting the pelvic floor. The external region between the vulva and anus in a female or between the scrotum and anus in a male. It is made up of skin, muscle, and fasciae. The serous membrane reflected over the viscera and lining the abdominal cavity. Synthetic oxytocin used to induce or augment labor by causing potent and selective stimulation of uterine and mammary gland smooth muscles. Risks include brain hemorrhage, seizures or coma, hypertension, arrhythmias, abruptio placenta, uterine rupture, infant brain damage, low Apgar scores at 5 minutes, neonatal jaunce. Contraindicated when cephalopelvic disproportion is present, prematurity, placenta previa. Extreme caution should be used in first or second stage because cervical laceration, uterine rupture, and maternal and fetal death have all been reported. A temporary organ, the placenta anchors the developing embryo and fetus to the uterus and provides a bridge for the exchange of nutrients, oxygen, protective antibodies, and waste products that pass from the baby to the maternal circulation. The placenta produces protein and steroid hormones to sustain the pregnancy. A placenta in which the cotyledons have invaded the uterine musculature, resulting in difficult or impossible separation of the placenta. The location of the placenta over, or very near, the cervical os. May result in hemorrhage and/or fetal death. See abruptio placenta To convert a malpresentation, a hand is inserted into the vagina and uterus and, by manipulation on the abdomen with one hand and by internal manipulation with the other, a foot is grasped and drawn down, so that the presentation is converted to a breech. A bipolar podalic version is performed similarly with only two fingers in the uterus and the other hand on the abdomen. An excess of amniotic fluid in the bag of waters in pregnancy. (Taber, 1519) Pregnancy that goes beyond 42 weeks, or 294 days. Toward the rear end; opposite of anterior. In fetal positioning,

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Perineum

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Peritoneum Pitocin

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Placenta

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Placenta accreta

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Placenta previa Placental abruption Podalic version

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Polyhydramnios Post-dates Posterior

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P-PROM Pre-eclampsia Primigravida Prodromal PROM Relaxin

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ROA ROP Round ligament

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RRL SGA Sim’s position

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Sinciput Sonogram SROM Staphylococcus Station

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Syntocinon TOL TOLAC Toxemia

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means the back of the babies head is facing the back of the mother. Preterm-Premature Rupture of Membranes See Toxemia A woman during her first pregnancy. The initial stage of labor; the interval between the earliest signs of labor and active labor. Premature Rupture of Membranes A polypeptide hormone secreted in the corpus luteum during pregnancy. It is obtained commercially from the ovaries of pregnant sows. In certain rodents, it relaxes the symphysis, inhibits uterine contractions, and softens the cervix. Right Occiput Anterior Right Occiput Posterior The uterus is suspended in the abdomen by the utero-sacral ligaments and the round ligaments. Round ligaments are attached to the pelvic bones from the front-middle area of the uterus. Normal pain from stretching the round ligaments as the uterus grows can be felt as an ache, bruise-type pain, or a sharp spasm. Red Raspberry Leaf Tea Small for Gestational Age Named after James Marion Sims; a semi-prone position with the patient on the left side, right knee and thigh drawn well up, left arm along the patient's back, and chest inclined forward so patient rests upon it. The fore and upper part of the cranium; the upper half of the skull. See ultrasound Spontaneous Rupture of Membranes Term applied loosely to any pathogenic bacteria. The relationship between the leading edge of the presenting part of the baby and an imaginary line drawn between the ischial spines. Synthetic pitocin. See also Pitocin. Trial of Labor Trial of Labor After Cesarean th Coma and convulsive seizures between the 20 week of pregnancy and the end of the first week postpartum. It develops in 1 out of 200 patients with pregnancy-induced hypertension. Controversy exists over whether this is caused by a lack of adequate nutrition which compromised liver function. SYN: Metabolic Toxemia of Late Pregnancy (MTLP) or Eclampsia. Fetal lie that is at right angles to the long axis of the body; crosswise. A condition of occipitoposterior position, the fetal head may attempt a long rotation, but become caught in the transverse diameter of the outlet, between the ischial spines, should they be unduly prominent. This is suspected if there is delay in the second stage of labor and on examination per vaginam the sagittal suture is found in the transverse diamter of the pelvis with a fontanelle at each end, close to the ischial spines. Rotation of the fetal head to an anterior position and delivery by vacuum extraction or forceps is required. Trying to conceive Unassisted Childbirth Transmission of inaudible sound in the frequency range of approximately 20,000 to 10 billion cycles per second. Ultrasound has different velocities in tissues that differ in density and elasticity from others. This property permits the use of

· Transverse Transverse arrest · ·

TTC UC Ultrasound

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UR US Uterine Rupture

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VBAC VBAcC Vertex WBAC

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ultrasound in outlining the shape of various tissues and organs in the body. Heating effects are produced by beams of low intensity, paralytic effects by those of moderate intensity, and lethal effects by those of high intensity. When doppler ultrasonography is used, the shift in frequency produced when an ultrasound wave is echoed from something in motion. The use of the doppler effect permits measuring the velocity of the blood flow in a vessel (such as the heartbeat of a baby). See Uterine Rupture See Ultrasound A complete uterine rupture is a tear through the thickness of the uterine wall at the site of a prior cesarean incision. It is a potentially life threatening condition for both the mother and/or the baby and requires immediate surgical intervention. However, uterine ruptures have also been known to occur in some women who have never had a cesarean. This type of rupture can be caused by weak uterine muscles after several pregnancies, excessive use of labor inducing agents, prior surgical procedure on the uterus, or mid-pelvic use of forceps. Vaginal Birth After Cesarean Vaginal Birth After Classical Cesarean The top of the head. In fetal lie, presenting head down. Water Birth After Cesarean

Sources: Epregnancy.com Handbook of Maternal Newborn Nursing, by Buckley & Kulb Heart & Hands by Elizabeth Davis th Mayes Midwifery, 12 edition by Betty Sweet th Mayes Midwifery, 12 Edition Ministry of Midwifery by Patti Barnes Mosby Medical Encyclopedia Mothering the Mother by Marshall Klaus, John Kennell and Phyllis Klaus Nursing Drug Handbook, by Springhouse Publishers Obstetric Myths vs. Research Realities by Henci Goer th Taber's Cyclopedic Medical Dictionary, 18 Edition Understanding Lab Work in the Childbearing Year by Anne Frye rd Varney's Midwifery, 3 edition VBAC.com Women's Surgery Group.com


				
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