Abortion.
Abruptio placentae
Acidosis.
Acrocyanosis.
Active management of labour. A concept of management to diagnose and correct poor progress of labour.
Its main components are: regular assessment of progress, prompt administration of oxytocin, one-to-one reassurance and support, pain relief and hydration.
Afterpains (after-birth pains). Uterine contractions due to release of oxytocin from the posterior lobe of the pituitary gland, especially during suckling; more intense in multiparas. They promote involution of the uterus.
Amniocentesis.
Amnion.
Aspiration of a sample of amniotic fluid through the mother's abdomen for diagnosis of fetal maturity and/or disease by assay of the constituents of the fluid; when performed in the second trimester for genetic counselling
(usually at 16-18 weeks) the fetal loss rate is 0.5%.
A smooth membrane enclosing the fetus and amniotic fluid; it is loosely fused with the outer chorionic membrane
Amnioscope.
The process by which the products of conception are expelled from the uterus via the birth canal before fetal viability. The definition of the World
Health Organization is of birth before 22 weeks' gestation. The UK definition was changed from 28 completed weeks to 24 weeks in 1992.
(The term miscarriage should be used to lay persons women are often justifiably upset when loss of a wanted pregnancy is called an abortion, implying induced expulsion of the uterine contents).
(accidental haemorrhage). Bleeding from a normally situated placenta causing its complete or partial detachment after the 20th week of gestation. The diagnosis is confirmed by the demonstration of an old retroplacental clot after delivery
The fetus is acidotic when the blood pH is 7.20 or less in labour or at birth, or 7.25 or less if tested at induction of labour or after elective Caesarean section.
Cyanosis of the hands and feet of the baby, common after birth, and due to peripheral vasoconstriction.
Amniotic fluid embolism.
Amniotomy.
Anaemia.
Anencephalus.
A lighted tubular instrument which is introduced through the internal os in late pregnancy and in labour; it enables an inspection of the colour and amount of amniotic fluid through the intact membranes, and also facilitates fetal blood sampling if the membranes are ruptured
Entry of amniotic fluid into the maternal venous circulation. Fetal squamous cells, hair, and vernix become impacted in the pulmonary arterioles, and thromboplastic substances cause intravascular coagulation
Surgical rupture of the membranes to induce or enhance labour
A maternal haemoglobin value below 11.5 g/dl in the first trimester or below 10.5 g/dl in later pregnancy. The World Health Organization recommends that the haemoglobin concentration should not fall below
11.0 g/dl at any time in pregnancy.
Absence of the brain and vault of the skull, the cerebellum and basal

ganglia are sometimes present.
Antepartum haemorrhage. Bleeding from the birth canal in the period from the 20th week of gestation to the birth of the baby.
Apgar score. A numerical scoring system usually applied at 1 and 5 minutes after birth to evaluate the condition of the baby, based on heart rate, respiration, muscle tone, reflexes and colour.
Apnoea of prematurity.
Areola.
Apnoea which occurs in preterm infants due to immaturity of respiratory control mechanisms.
The pigmented zone of skin around the nipple, which contains sebaceous glands. The nipple and areola become further pigmented during pregnancy
Asphyxia neonatorum.
Asymptomatic bacteriuria. Bacteria in a concentration of 105 or more per ml of urine without symptoms. This is present in about 8% of pregnant women, about half of whom will, if untreated, develop signs of urinary tract infection during pregnancy.
Asynclitism.
Term used to describe the condition of an infant who has been subjected to hypoxia and acidosis during delivery and who fails to breathe following birth.
When the sagittal suture of the fetal skull does not lie midway between the maternal sacral promontory and pubic symphysis; there is usually disproportion, and the head is rocking fore and aft to enter the pelvis
Attitude of the fetus.
Bandl ring.
Relationship of fetal head and limbs to the fetal trunk, usually flexion
The groove between upper and lower uterine segments; it is situated at the level of the pubic symphysis at the onset of labour.
Birth plan.
Birth-weight.
The plan is either a list or a statement of preferences prepared by the woman for care during labour, birth and the postnatal period in the hospital.
The first weight of the newborn obtained preferably within 1 hour of birth before significant postnatal weight loss has occurred.
Assessment of suitability of the cervix for induction of labour.
Fetal heart rate below 120 beats per minute.
Bishop score.
Bradycardia.
Brandt-Andrews method of expressing the placenta from the uterus: controlled cord traction is applied with one hand while the contracted uterus is pushed upwards away from the placenta with the other hand on the mother's abdomen
Braxton Hicks contractions. Spontaneous painless uterine contractions originally as a sign of pregnancy.
Occur from the first trimester onward, and probably promote uterine blood flow and transfer of oxygen to the fetus
Breech presentation. (a) Complete: the knees and hips are flexed and buttocks, genitalia, and the

Bregma.
Brow.
Caesarean section.
Caput succedaneum.
Cardiotocography (CTG).
Cephalohaematoma.
Cerebral palsy.
Cervical dystocia.
Chloasma.
Chorion frondosum.
Chorion laeve.
Chorionic villus sampling.
Chromosomes.
Cleft lip.
Colostrum. feet present. (b) Incomplete: (i) frank breech - the legs are extended and buttocks and genitalia present; (ii) footling: one or both feet present; there is a 10% risk of cord prolapse .
The large diamond shaped anterior fontanelle.
That part of the fetal head between the root of the nose and the anterior fontanelle
Surgical removal of the uterine contents by the abdominal route after practical fetal viability (22-24 weeks)
Oedema from obstructed venous return in the fetal scalp caused by pressure of the head against the rim of the cervix or birth canal.
Monitoring of the fetal heart rate using Doppler ultrasound or a direct scalp electrode to make an immediate assessment of fetoplacental wellbeing especially in high-risk pregnancies.
A collection of blood beneath the periosteum of a skull bone, limited to that bone by periosteal attachments
A non-progressive disorder of the brain causing impairment of motor function (spastic rigidity). The prevalence is constant at 2 per 1,000 births in developed countries. More than 90% of cases are unrelated to intrapartum events or birth asphyxia. The risk is greatly increased in infants with birth-weight less than 1,500g.
Difficult labour due to failure of the cervix to dilate, in spite of adequate uterine contractions
The brown, pigmented mask of pregnancy. Usually patchy and simulates suntan it also occurs in some women who are taking oral contraceptives.
The part of the chorion forming the placenta
The part of the chorion forming the extraplacental membrane
Under ultrasound control, 10-12 mg of chorion frondosum is obtained through a fine cannula (via the cervix or more commonly, transabdominally); fetal karyotype is available in 2 days in 99% of cases; the procedure has a fetal loss rate of 1-2%. Can be performed earlier (9-12 weeks) than amniocentesis.
Deeply-staining bodies in the nucleus of the cell which contain the hereditary material (genes); 23 are derived from each parent, making the normal complement of 46.
Failure of the upper lip to fuse in the midline. It may be associated with cleft palate where the bones of the roof of the mouth fail to fuse in the midline
Yellowish fluid expressed from the breasts during late pregnancy and before the onset of true lactation.

Congenital dislocation of the hip. The baby has a relaxed joint capsule and shallow acetabulum, which may allow the head of the femur to become displaced. This requires early diagnosis and treatment.
Constriction ring. A localized spasm of the uterine muscle.
Coombs test.
Cord presentation.
Cord prolapse.
Detects sensitized red blood cells (antibody attached), e.g. in erythroblastosis.
The cord lies below the presenting part with the membranes intact.
Corpus luteum.
As for cord presentation except that the membranes have ruptured, and pressure on the umbilical cord vessels is more likely to occur.
An ovarian cyst formed from the Graafian follicle after ovulation which produces oestrogen and progesterone; essential for implantation of the fertilized ovum in the endometrium.
Cotyledons.
Couvelaire uterus
Crede
Crowning of the head
The lobes of the placenta
(uterine apoplexy). Occurs with severe abruption of the placenta. The uterus is purple due to haemorrhage within its musculature method of placental delivery:the uterus is squeezed to express the attached placenta
Visualisation of the fetal head as birth becomes imminent. The widest diameter of the fetal head has passed the bony pelvic outlet and emerged under the pubic arch.
Curve of carus
Decidua
The 90 degree curve of the birth canal
The exaggerated endometrial reaction to oestrogen and progesterone during pregnancy. The glands become tortuous and cells enlarge
Delay in the second stage of labour > 1hour in para 0 and > 30 minutes in para 1+
Dextrorotation of the uterus The pregnant uterus is normally rotated to the right side
Diameters The distance between certain important bony points in the fetus and the maternal pelvis. The following 10 are of value (i) anteroposterior of the brim (true conjugate) 11.5 cm; (ii) transverse diameter of pelvic brim 13.5 cm; (iii) bispinous or interspinous (transverse diameter of narrow pelvic plane) 10.5 cm; (iv) anteroposterior of outlet 11.5 cm; (v) biparietal
(between the parietal eminences) 9.5 cm; (vi) bitemporal 8.0 cm; (vii) occipitofrontal (from occipital protuberance to above the orbital margins)
11-12 cm; (viii) suboccipitobregmatic (nape of neck to middle of anterior fontanelle) 9.5 cm; (ix) bisacromial (between tips of acromial processes)
12.5 cm; (x) bitrochanteric (between outer aspects of greater trochanters)
9.5 cm .
Diastasis of the rectus abdominis muscles. The separation which occurs when the muscles can stretch no more. The peritoneum bulges between them when the woman coughs.
Postnatal exercises are required

Discharge. Physiological vaginal secretion increases in pregnancy. The vagina has a stratified squamous epithelial lining but no glands; its moisture is provided chiefly by secretion of cervical mucus (and at coitus by vaginal transudation). If there is itching or the discharge is yellow, speculum examination is required to exclude vaginitis.
Doppler measurement of blood flow. A non-invasive method of assessing blood flow based on the change in frequency of reflected sound. The technique has been applied to umbilical and other fetal vessels and the uteroplacental blood supply
(uterine arteries).
Double monster.
Dublin method
A fetus from a single ovum with duplication of head, trunk or limbs
Down syndrome (mongolism) congenital abnormality characterized by the presence of an extra chromosome 21 of placenta delivery. The uterus is used as a piston to push the separated placenta out of the cervix and vagina
Ductus arteriosus. The channel between pulmonary artery and descending arch of the aorta which allows the right ventricular output to be shunted away from the unexpanded fetal lungs.
Ductus venosus.
Dystocia.
Eclampsia.
A fetal vessel that connects the umbilical vein to the inferior vena cava.
Difficult or abnormal labour due to cephalopelvic disproportion or a primary disorder of uterine action.
'To flash forth'. A clinical state characterized by convulsions, not attributable to cerebral conditions such as epilepsy or cerebral haemorrhage, and usually superimposed on preceding severe preeclampsia.
Ectopic pregnancy.
Effacement of cervix.
Embryo.
Endometrium.
Engagement.
Engorgement of breasts.
Epidural analgesia.
Implantation of the fertilized ovum outside the uterine cavity. The commonest site is in the Fallopian tube.
The cervical canal becomes taken up from above down; usually occurs during the early (latent) phase of labour
The name given to the conceptus up to the 10th week of gestation (8th week post conception), after this, the word fetus is used
The mucous membrane lining the uterus, which responds to ovarian hormones during the menstrual cycle.
The fetal head is engaged when its maximum diameters
(suboccipitobregmatic and biparietal when the head is well flexed) have passed the pelvic inlet.
Full, red, hard, sore breasts due to increased blood flow before milk secretion commences.
Injection of analgesic agent outside the dura, which covers the spinal canal.
A sacral (caudal) epidural gives complete analgesia of all pelvic structures

Episiotomy
Ergometrine
Erythema toxicum.
Erythroblastosis
Exchange transfusion.
Face.
Ferning.
Fertilization.
Fetal monitoring.
Fontanelle.
Foramen ovale.
Fourchette.
Funic souffle.
Funnel (android) pelvis.
Gene.
Generalized oedema.
Genotype.
Gestational age.
An incision of the perineum and vagina that enlarges the introitus and lessens the curve of the birth canal.
The active oxytocic drug derived from ergot.
A common maculoerythematous rash, with vesicles that contain eosinophils, which appears on the newborn in the first days after birth. It requires no treatment.
Haemolytic disease of the newborn, due usually to rhesus antibodies.
Hypoxia due to fetal anaemia stimulates production of primitive red cells
(erythroblasts) which are present in excessive numbers in the blood.
The blood of the baby is gradually replaced with donor blood; most commonly used in babies with erythroblastosis, to remove harmful bilirubin pigment, maternal rhesus antibodies and the infant's rhesus positive cells, as well as to treat anaemia
The area of fetal head below the root of the nose and the orbital ridges.
During the proliferative phase of the menstrual cycle cervical mucus forms a palm-leaf pattern when it dries on a slide.
The union of one sperm and the mature ovum; usually occurs in the outer half of the Fallopian tube
The use of methods such as ultrasound and cardiotocography to assess the fetal well-being especially of the high-risk fetus.
Space at the junction of 3 or more skull bones, covered only by a membrane and skin.
An opening in the interatrial septum which allows oxygenated blood from the umbilical vein to flow from the right to the left side of the heart in the fetus.
The fold of skin formed by merging of the labia minora and labia majora posteriorly.
The sound of blood passing through the umbilical cord, synchronous with the fetal heart beat.
A pelvis in which midpelvic and outlet diameters are narrower than those at the pelvic brim.
The functional unit of heredity; large numbers are situated in each of the
46 chromosomes in the cell nucleus.
Excessive accumulation of fluid in the tissues demonstrated by swelling of the legs, hands, and face, is often associated with pre-eclampsia.
The hereditary constitution of genes of an individual.
Time from the first day of the last normal menstrual period to birth.

Grand multipara.
Gravid.
Growth restriction
Haemorrhoids.
Heartburn.
Hegar sign of pregnancy
High forceps.
Hyaline membrane.
Hydatidiform mole.
Para 4 or more, these woman are likely to have powerful and coordinated uterine contractions, hence the risk of uterine rupture if there is cephalopelvic disproportion.
Means pregnant; a primigravida is a woman pregnant for the first time. .
Failure to achieve growth potential, note difference with the term “small for gestational age” which simply means less than the tenth percentile.
Enlarged haemorrhoidal veins of the lower bowel. These are common during pregnancy, particularly in labour when the head distends the perineum
A common symptom in late pregnancy due to regurgitation of acid from the compressed stomach, more usual when the woman lies down.
Bimanual palpation of a soft uterine isthmus between the cervix below and the uterine body above. Used before modern urine tests for pregnancy became available
Forceps application when the head is not engaged, should not be performed because of the risk of trauma to mother and fetus.
A homogeneous eosinophilic membrane lining the alveoli, and respiratory bronchioles; commonly seen in the lungs of infants who die from respiratory distress syndrome
A condition in which there is partial or complete conversion of the chorionic villi into grape-like vesicles . The villi are avascular and there is trophoblastic proliferation. The condition may result in malignant trophoblastic disease (invasive mole or choriocarcinoma .
Hydrocephalus.
Hydrops fetalis.
Hyperbilirubinaemia.
Hyperemesis gravidarum. Vomiting during pregnancy sufficient to warrant admission of the woman to hospital.
Hypertension.
An excessive amount of bilirubin in the blood, most commonly due to haemolysis. .
A blood pressure (of 140/90 or above) Chronic hypertension is diagnosed when hypertension is known to be present before or during early pregnancy.
Hypofibrinogenaemia.
Accumulation of excessive amounts of cerebrospinal fluid within the ventricles of the brain
Gross oedema of fetal subcutaneous tissues together with ascites, pericardial and pleural effusion; usually due to erythroblastosis
Hypospadias.
The commonest cause of blood coagulation failure in obstetrics. The blood fibrinogen level falls below the normal of 4-6 g/L. Usually secondary to severe placental abruption, severe pre-eclampsia, prolonged retention of a dead fetus, or amniotic fluid embolism.
A malformation of the male penis where the urethra opens on it’s under

Hysterotomy. surface or on the perineum
Removal of fetus by incision of the uterus via the abdominal route before the 20th week of gestation; after this time the operation is termed a
Caesarean section.
Implantation. Penetration of the endometrium by the early fertilized ovum (blastocyst) which becomes completely surrounded by decidua occurs 6-8 days after ovulation.
Incarceration of the gravid uterus. The uterus is retroverted and with enlargement becomes imprisoned in the pelvis, impacting beneath the sacral promontory leading to urethral obstruction and acute urinary retention.
Incidental antepartum haemorrhage. Bleeding after the 20th week of gestation due to local causes
(cervicitis, carcinoma of cervix, vaginitis); diagnosis is made by speculum examination.
Incompetent cervix. The cervix dilates silently during the second trimester with the result that the membranes bulge and rupture and the fetus drops out. A curable cause of recurrent miscarriage and prematurity.
Incoordinate uterine action. Fundal dominance is lost, intrauterine tension between contractions is increased, the uterus is tender on palpation, and the woman complains of backache.
Infant mortality.
Introitus.
Inversion of the uterus.
Death in the first year of life of infants born alive (includes neonatal deaths). The rate is 5-10 per 1,000 births in developed countries.
Entrance to the vagina
Kernicterus.
Uterus turned inside-out, usually due to pulling on the cord when the uterus is relaxed.
Yellow staining of the baby's brain due to high blood levels of billirubin causing severe neurological damage (billirubin encephalopathy) or death.
Labour.
Lactiferous sinus.
Leucorrhoea.
Lie of the fetus.
The process by which the products of conception are expelled from the uterus via the birth canal after the 20th week of gestation.
A dilatation of the mammary duct just before it enters the nipple.
Colourless (white) non-itchy, non-offensive vaginal discharge.
Lightening.
Linea nigra.
Relationship of the long axis of fetus to the long axis of the uterus. Usually longitudinal but can be transverse or oblique
Usually occurs after 36 weeks and is commoner in nulliparos; the presenting part enters the pelvis and thus reduces the pressure on the diaphragm; the mother notices that it is easier to breathe. Lightening is not synonymous with engagement; often 3-4 cm of head remain palpable abdominally.
Brown or black line of pigmentation in the midline of the abdominal wall

Living ligatures.
Lochia.
Lovset manoeuvre. during pregnancy.
The interlacing spirally-arranged muscle fibres of the middle muscle layer in the uterine wall; contraction of these fibres closes the blood vessels and prevents postpartum haemorrhage.
The discharge from the uterus during the puerperium; it is initially red
(lochia rubra), then yellow (serosa), and finally white (alba).
Rotation and traction of the fetal trunk during breech birth to facilitate delivery of the arms and shoulders.
Low birth-weight.
Lower uterine segment.
Manual removal of the placenta. Removal of the placenta by means of a hand inside the uterus; it is performed when other methods fail.
Manual rotation of the occiput. Performed prior to forceps application, as an alternative to forceps rotation when the mechanism of anterior rotation of the head has failed.
Maternal death. Death occurring during pregnancy, childbirth, or in the 42 days of the puerperium, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management
The maternal mortality rate ranges from 1-4 per 10,000 births in developed countries.
Meconium.
Menarche.
Meningomyelocele.
The first greenish-black stool of the newborn, composed of cellular debris, bile, lanugo, and vernix caseosa.
Onset of menstruation.
Mid-forceps
Protrusion of the meninges and spinal cord through a defect (spina bifida) in the vertebral arches of the spine
The head is engaged and the lowermost part of the head has reached or passed the ischial spines, but rotation to the anterior position may not have occurred
Milia.
Birth weight less than 2,500 g. Includes premature infants and growth retarded infants of maturity beyond 37 weeks. Very low birth-weight infants are those weighing less than 1,500 g; they comprise 1 % of all births and provide 50% of perinatal deaths. Extremely low birth-weight infants weigh less than 1,000 g at birth and comprise 0.5% of all births.
The thin expanded lower portion of the uterus which forms from the isthmus in the last trimester of pregnancy; it provides the usual method of approach to the baby in the operation of Caesarean section
Montgomery follicles.
Morula.
Tiny white papules on the nose due to retention of secretions in sebaceous glands, which disappear in the first weeks after birth
Hypertrophied sebaceous glands, which appear as lumps scattered throughout the areola surrounding the nipple
The mulberry-like mass of cells formed by repeated divisions of the fertilized ovum

Moulding.
Mullerian duct. An embryonic tubular structure, which forms the female genital tract
(Fallopian tubes, uterus, vagina).
A woman who is pregnant for the second or subsequent time. Multigravida.
Naegele rule.
Neonate.
Neonatal death.
To estimate the probable date of confinement, add 9 months and 7 days to the first day of the last menstrual period. A correction is required if the woman does not have 28-day cycles.
Narrow pelvic plane or plane of least pelvic dimensions. From the lower border of the symphysis pubis, to the ischial spines laterally and to the lower border of the fourth sacral vertebra posteriorly. This is below the mid pelvic plane which runs from the middle of the symphysis, above the ischial spines, to the junction of the second and third sacral vertebrae
Infant from birth to 28 days of age.
A liveborn infant weighing at least 500g at delivery (or, when birth-weight is unavailable, of at least 22 weeks' gestation) who dies within 28 days of birth . This is the WHO definition and should be used for statistical purposes even when the legal definition is different as it is in many countries.
Newborn screening.
Alteration in shape and diameters of the fetal head during labour. The fontanelles and sutures permit the force of contractions to compress the head against the bony pelvis and adapt its shape and size to that of the birth canal.
Normal labour.
Most countries screen for phenylketonuria, hypothyroidism, cystic fibrosis and galactosaemia on blood collected on blotting paper from a heel prick on the 4-5th day of life.
A labour in which the fetus presents by the vertex, the occiput rotates anteriorly, and the result is the birth of a living, mature fetus with no complications, the duration of labour ranging from 4-24 hours.
Obstructed labour.
Occiput.
Oligohydramnios.
Onset of labour.
Operculum.
Ovulation.
There is no descent of the presenting part in the presence of good contractions. Usually there is extensive caput and moulding, a malposition or malpresentation, and a retraction ring, the fetus is often large and the pelvis small or abnormal in shape.
The back of the fetal head behind the posterior fontanelle
An insufficiency of liquor amnii not uncommon and usually associated with fetal growth retardation ('intrauterine malnutrition' or 'placental insufficiency')
Regular uterine contractions, leading to dilatation and effacement of the cervix.
The plug of mucus that occludes the cervical canal during pregnancy
Extrusion of the ripened ovum from the Graafian follicle in the ovary to the peritoneal cavity (and then into the tube)

Oxytocic.
Parous.
Partograph (cervicograph) is a graphic representation of cervical dilatation and descent of the presenting part; used to indicate departure from normal and the need for active management of labour, especially in nulliparas
Pawlik grip. Suprapubic palpation with the outstretched hand to identify the presenting part of the fetus, its position, flexion and its station within the mother's pelvis
Pelvic brim or inlet.
Hastens birth of fetus and/or placenta by stimulating contractions of the uterine muscle; by definition may accelerate first, second or third stages of labour.
The woman has delivered a viable (20 weeks or more) child. A nullipara is a woman who has never reached 20 weeks in a previous pregnancy, although she may have been pregnant more than once (multigravida).
Pelvic outlet.
Pelvimetry.
Pendulous abdomen.
The plane (flat surface) of division, between the true and false pelvis. The plane passes from the upper border of the symphysis pubis, along the pubic crest to the iliopectineal eminence then to the sacroiliac joint, along the wings of the sacrum to the centre of the sacral promontory. The shape is transversely oval with the promontory causing a projection posteriorly.
A diamond-shaped opening, which runs from beneath the symphysis pubis along the ischiopubic ramus to the ischial tuberosity (on which we sit) along the sacrotuberous ligament to the fifth piece of the sacrum (the coccyx being mobile folds back in labour).
Measurement of the size of the pelvis, either clinically or by radiography.
Perinatal mortality.
Perineal body.
Perineal massage.
Characteristic of the obese with poor muscle tone and diastasis of the rectus muscles and in multiple pregnancy. The uterus bulges forward and malpresentations are common.
Stillbirths plus early neonatal deaths (first seven days of life) expressed per
1,000 total births. The rate is 8-12 per 1,000 births in developed countries.
A triangular-shaped wedge of tissue based on the perineum separating the lower one third of the posterior vaginal wall from the anal canal
Technique of gradually widening the vaginal opening during the third trimester in preparation for delivery of the baby; the birth is usually easier and episiotomy may not be necessary.
Period of gestation.
Persistent occipitoposterior or face to pubes. Birth of the fetus with the occiput directed posteriorly; anterior rotation of the occiput fails to occur
Phenylketonuria.
The number of completed weeks, from the first day of the last menstrual period to the date in question.
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 births.
Phototherapy. Use of light energy, (around wavelength 450 nm) to convert the bilirubin

Pica.
Placenta.
Placenta accreta.
Placenta circumvallata.
Placenta membranacea. molecule in the jaundiced infant's skin to a form which can be excreted without conjugation in the liver.
Eating of a substance usually considered inedible.
The organ which permit gas and nutrient transport between the fetus and the mother. Forms from the chorion frondosum with a maternal decidual contribution.
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)
Placenta with a double fold of amnion forming a ring on the fetal surface some distance in from the edge of the placenta
A thinner, larger placenta where there is failure of atrophy of the usual proportion of the chorionic villi
Placenta praevia.
Position of the fetus.
Placental implantation entirely or in part in the lower uterine segment.
Bleeding is likely to occur when uterine contractions dilate the cervix, therey applying shearing forces to the placental attachment in the lower uterine segment, or when separation is provoked by unwise digital vaginal examination.
Accessory lobe of the placenta may be multiple. Placenta succenturiata.
Placental separation mechanisms: (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.
Polyhydramnios. The clinical diagnosis of an excessive amount of liquor amnii (more than
1,500 ml at term)
The relationship of a defined area on the presenting part (called the denominator) to the mother's pelvis
Positive signs of pregnancy. 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.
Posterior fontanelle. Small triangular space in the fetal or infant skull situated at the posterior end of the sagittal suture
Posterior position of the occiput. 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
Postpartum haemorrhage. (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,

Post-term infant. occurring in the interval from 24 hours after delivery until the end of the puerperium (volume not specified).
One born after more than 42 completed weeks of gestation. The incidence is approximately 4%
Labour of less than 4 hours duration. Precipitate labour.
Pre-eclampsia.
Pregnancy hypertension.
Pregnancy hypertension (see below) with the addition of significant proteinuria (greater than 300 mg/24 hours in the absence of a urinary tract infection, chronic renal disease or contamination of the urine)
A blood pressure of 140/90 or above occurring for the first time during pregnancy; may be associated with proteinuria in which case the criteria for a diagnosis of pre-eclampsia are present.
Premature rupture of the membranes. Spontaneous rupture of the membranes before the onset of contractions; usually the membranes rupture at the end of the first stage of labour (this flushes the vagina with a sterile fluid before the fetus is born).
Preterm infant.
Presenting part.
One born before 37 completed weeks' gestation. The incidence of prematurity is 6% and it accounts for 60% of all neonatal deaths
That part of the fetus felt on abdominal or vaginal examination.
Proliferative phase of menstrual cycle. The interval after menstruation, and up to ovulation during which growth of the endometrium is stimulated by oestrogen from the developing Graafian follicle.
Prolonged labour.
Prolonged pregnancy.
Labour of more than 24 hours' duration.
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.
Prostaglandins.
Pseudocyesis.
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.
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.
Psycho prophylaxis.
Pudendal nerve block.
Puerperal infection.
Puerperal morbidity.
A psychological preparation for childbirth, which is aimed at distracting attention away from pain during labour and birth
Bilateral injection of local analgesic in the region of the ischial spines, which renders the vagina and perineum insensitive to pain.
An infection of the genital tract arising as a complication of childbirth.
All deaths due to infection and all women in whom the temperature reaches 38'C, on any 2 of the first 14 days after delivery.

Puerperium.
Quickening.
Red degeneration.
Respiratory distress.
The period during which the reproductive organs return to their prepregnant condition, usually regarded as an interval of 6 weeks after delivery
When the woman in first becomes aware of fetal movements, add 5 calendar months (22 weeks) to calculate the due date.
A common complication, of large fibromyomas in pregnancy associated with pain due to ischaemic necrosis.
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.
Respiratory distress syndrome (RDS). 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.
Restitution.
Retained placenta.
Retraction.
When the fetal head is born it is free to undo any twisting caused by internal rotation
Placenta still in utero 1 hour after birth of the baby
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
Retraction ring.
Retroversion of the uterus. The uterine fundus lies in the rectovaginal pouch of Douglas instead of anteriorly on the bladder. Occurs in 20% of women.
Rhesus factor.
Occurs in obstructed labour when Bandl's ring rises to about the level of the umbilicus and becomes visible and palpable
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).
Rotation of the head.
Round ligament strain.
(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
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.
Cold oedema of the newborn. Sclero-oedema.
Secondary powers in labour. 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).
Secretory phase of menstrual cycle. 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.
Shoulder dystocia (impacted shoulders). 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
Show.
Sinciput.
A discharge of mucus and blood at the onset of labour when the cervix dilates and the operculum (cervical mucus plug) falls out
That part of the fetal head in front of the anterior fontanelle, it is subdivided into the brow and the face
Small for gestational age. Weight below the tenth percentile, for gestational age. The term is synonymous with 'small for dates'. The assignment of a birth-weight percentile requires use of data appropriate for the population.
Adjustments for gender, race and birth order may be made for paediatric considerations. Small for gestational age infants will include both constitutionally small infants and infants, which show evidence of growth retardation (placental insufficiency)
Spalding sign.
Spurious or false labour.
Stages of labour.
Station.
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.
Painful uterine contractions, without cervical effacement or dilatation.
(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 (b) The
second stage is that of expulsion of the fetus (c) The third stage is that of expulsion of the placenta and membranes (secundines)
The level of the presenting part, within the mother's pelvis. The ischial spines are the reference points on vaginal examination
Stillbirth. An infant born weighing at least 500g, at delivery, (or when birth-weight is unavailable, of at least 22 weeks' gestation), who did not breathe after birth or show any other sign of life. This is the WHO definition, which is different from that used in some countries, for example the UK definition relies on a gestation of at least 24 weeks.
Striae (stretch marks). Are red or purple in colour during the pregnancy in which they first appear, later become white
Stripping of the membranes, A method of inducing labour. Less effective than amniotomy. but also carries the risk of infection.
Supine hypotensive syndrome. In late pregnancy 10% of women experience faintness when lying supine due to inferior vena caval obstruction causing reduced venous return and a

Surfactant
Suture.
Symphysiotomy.
Tachycardia.
Talipes.
Term.
Thalassaemia minor.
Third degree tear.
Threatened abortion.
Thrush.
Trial of labour.
Trimester.
Trophoblast or chorion.
Turner syndrome.
Ultrasonography fall in cardiac output,
In the respiratory distress syndrome, pulmonary surfactant is deficient; exogenous surfactant (both bovine and synthetic are available) may be used in treatment.
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)
Division of the pubic symphysis, to enlarge the diameters of the bony pelvis.
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.
A deformed or twisted foot (clubfoot)
From 37 to 42 completed weeks'gestation (259-293 days), neither preterm
<37 weeks nor postterm (prolonged pregnancy >42 weeks. The due date of confinement or full term (often mistakenly referred to as 'term') is calculated to be 40 weeks (280 days).
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.
A perineal laceration passing through the anal sphincter, and laying open the anal canal.
Any bleeding from the birth canal before 20 weeks' gestation, with or without uterine pains, signifies a threat to abort
Infection with Candida albicans; usual sites are the mother's vagina and the baby's mouth
Continuous careful assessment of the progress of labour usually in a nullipara with clinical evidence of cephalopelvic disproportion insufficient to indicate elective Caesarean delivery
A period of approximately 3 months
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
A genetic abnormality, where the individual has 45 chromosomes (XO karyotype) instead of 46 and is sex chromatin negative, despite being female in appearance.
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

Umbilical cord.
Uterine inertia.
Uterine souffle.
Uterine tetany.
Vacuum extraction.
Varicose veins.
Vasa praevia. identify non-viable pregnancies, locate the placental site investigate fetal and neonatal haemodynamics, detect fetal malformations and direct intrauterine manipulation
The connecting lifeline between the fetus and placenta; it contains 2 umbilical arteries and 1 umbilical vein encased in Wharton jelly
(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.
Noise made by maternal blood passing through the uterine vessels.
Generalized tonic contraction, of the uterus usually due to misuse of oxytocic drugs.
Operation to deliver the fetal head by traction on a suction cup placed on the scalp (usually the occipital region)
Dilatation of veins, of the lower half of the body. Usually occur for the first time or become worse in pregnancy
Fetal vessels lying in the membranes, in front of the presenting part. There must be an associated velamentous insertion of cord, succenturiate lobe. or bipartite (2-lobed) placenta
Velamentous insertion of the cord. The umbilical cord inserts onto the membranes over which the vessels course to reach the fetal surface of the placenta
Vernix caseosa. Produced by sebaceous glands this 'complexion cream' prevents waterlogging and maceration of the fetal skin by the amniotic fluid
Version.
Vertex.
A turning of the fetus in utero whereby the presentation is changed, usually from breech to vertex
Top of the skull, the area between the anterior and posterior fontanelles and the parietal eminences
Weight gain.
Wharton jelly.
Adenomyosis,
Climacteric,
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
The mucoid connective tissue supporting the umbilical cord vessels ingrowth of endometrium into the myometrium, and glandular and stromal tissue are to be found amongst uterine muscle fibres. The lesion is surrounded by muscle but, as it is thought to arise by direct growth of the endometrium, it is likely that a connection exists to the endometrium.
derived from the Greek klimakter ( the rung of the ladder) and is applied to the 5-15 years before the menopause, when the endocrine and other changes begin, and to the 5-15 years after the menopause

Cystocele,
Detrusor Instability,
a herniation into the anterior vaginal wall. defined as the presence of spontaneous or provoked detrusor contractions during the filling phase when the patient is attempting to inhibit micturition.
Dysfunctional Uterine Bleeding (DUB), Abnormal bleeding from the uterus in the absence of organic disease of the genital tract.
Endometriosis, It is a condition in which tissue similar to normal endometrium in structure and function is found in sites outside the uterine cavity. It is most commonly found in the pelvis, on the ovary, the peritoneum, the fallopian tubes and broad ligaments, or it may be seen in other remote sites.
Enterocele, a herniation of peritoneum covered by vaginal epithelium.
Genuine Stress Incontinence, defined as the involuntary loss of urine when the intravesical pressure exceeds the maximum urethral closure pressure in the absence of detrusor activity.
Haematocolpos, Collection of menstural blood due to an imperforate membrane that may exist at the lower end of the vagina, which is loosely referred to as the imperforate hymen, although the hymen can usually be distinguished separately.
Hirsutism,
Infertility,
Menorrhagia,
Menopause, excessive growth of hair in an abnormal position of the body or a degree of hair growth that worries the patient.
The WHO has defined infertility as failure to conceive over 12 months of exposure.
Excessive regular cyclical bleeding. derived from the Greek men (month) and pauo (to stop) and is applied to the permanent cessation of menstruation due to loss of ovarian activity.
.
Osteoporosis, implies an abnormal state with an increased risk of fractures, and has therefore been defined as ‘a reduction in bone mass per unit volume such that the fractures may occur on minimal of trivial trauma’.
Premenstrual Syndrome (PMS), a disorder of non-specific somatic, psychological or behavioural symptoms recurring in the premenstrual phase of the menstrual cycle. The symptoms should be of sufficient severity to produce social, family or occupational disruption. Symptoms must have occurred in at least four of the six previous menstrual cycles. In primary the symptoms resolve completely by the end of menstruation while in secondary PMS the symptoms remain but improve following menstruation.
Primary amenorrhoea,
Prolapse, refers to a patient of any age who has never menstruated. derived from the Latin procidere which means to fall. Thus a prolapse occurs when there is a defect in the pelvic floor sufficient to allow one or

Procidentia,
Rectocele,
Rokitansky syndrome, more of the pelvic viscera to fall through. Prolapse is classified according to which organ has heniated into the vagina. complete utrovaginal prolapse. a herniation into the posterior vaginal wall.
Congenital absence of the uterus and vagina.
Secondary amenorrhoea, refers to cessation of the periods after menstruation has been established.
Stein-Leventhal Syndrome (polycystic ovaries), a syndrome characterised by obesity, hirsutism, infertilty , oligomenorrhoea and bilaterally enlarged polycystic ovaries.
Urinary Incontinence, defined as an involuntary loss of urine which is a social or hygienic problem, and is objectively demonstrable. Conversely continence is the ability to hold urine within the bladder at all times except during micturition.
Urodynamics, describes several investigations which are employed to determine bladder function.