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DEFINITION OF TERMS IN OBSTETRICS AND GYNECOLOGY

 

OBSTETRICS

Labor: is the process whereby the whole content of the uterus is expelled from the birth canal after the age of viability and characterized by rhythmic, painful, uterine contraction leading to progressive cervical dilatation and effacement, descent of presenting part and eventual delivery of the fetus and placenta.

Normal labor: is a retrospective diagnosis of the spontaneous onset of uterine contractionat at term with singleton fetus in vertex presentation with minimal or no intervention leading to the delivery of a viable baby to a healthy mother.

Mechanism of labor: is the series of adaptational changes in attitude and position the fetus undergoes as it passes through the birth canal during labor.

Active management of labor: is a strategic approach to the management of labor that is already established in the active phase with the aim of preventing prolonged labor by ensuring cervical dilatation of at least 1 cm/hour.

Presentation: is the part of the fetus occupying the lower uterine segment or overlying the maternal pelvic brim.

Presenting part: is the lowermost part of the fetus felt on vaginal examination or the part of the presentation felt on vaginal examination.

Engagement: occurs when the widest diameter of the presenting part has passed through the pelvic inlet.

Station: is the relationship of the fetal presenting part to the maternal ischial spine.

Position: is the relationship of a reference point on the fetal presenting part (denominator) to a fixed point on the maternal pelvis.

Vertex: is the rhomboid shaped space between the anterior and posterior fontanelles and two parietal eminences.

Caput: is edema of the fetal scalp as a result of impairments of venous return due to constriction of the cervix.

Denominator: is part of the presentation which denotes the position.

Descent: is the proportion of the fetal head palpable above the pelvic brim or nunber of fifths of the presentation palpable per abdomen.

Lie: is the relationship between the longitudinal axis of the fetus and the maternal spine

Attitude: is the relationship of different part of the fetus to one another in terms of flexion and extension.

Synclitism: is the relationship of the sagittal suture to the plane of the pelvic inlet and to the sacrum posteriorly and the symphysis anteriorly when the fetal head is in transverse position.

Moulding: is the relative movement of fetal skull bone across suture lines to aid vaginal delivery by effectively reducing the fetal skull diameter.

Restitution: is the rotation of the fetal head through 1/8h of a circle so as to align itself in the oblique direction with the shoulders during vaginal delivery.

Cephalopelvic disproportion: is a previously unrecognized anatomical misfit between the fetal head and the maternal pelvis associated with slow or actual arrest of labor despite efficient uterine contraction, severe moulding and caput formation.

Obstructed labor: is an absolute condition in which there is failure of labor to progress despite adequate uterine contraction due to mechanical factors, and delivery could not be achieved without an intervention.

Crowning: is said to occur when the largest diameter of the fetal head has passed through the pelvic outlet and does not recede in between contraction.

Induction of labor: is the artificial initiation of uterine contraction in a pregnant woman with intact membranes after the age of viability with the aim of achieving vaginal delivery.

Stimulation of labor: is the artificial initiation of uterine contraction after the fetal membranes have ruptured.

Augmentation of labor: is the artificial stimulation of labor that has begun spontaneously.

Prolonged latent phase: a retrospective diagnosis of a latent phase that has not transformed into an active phase after 8 hours (up to a maximum of 24 hours).

False labour: is a retrospective diagnosis of latent phase features with no cervical changes after 24 hours.

Contractile false labor: is one with at least one contraction in 10 minutes.

Precipitate labor: is a labor process whose duration is < 3 hours. Or a cervical
dilatation of 2-5 cm/hour in primipara and > 10 cm/hour in multipara.

Gravidity: is the number of previous pregnancies regardless of the outcome.

Parity: is the number of pregnancies carried beyond the age of viability (28 weeks in Nigeria) regardless of the outcome.

Quickening: is the first maternal perceived fetal movement; primigravida: 18-20 weeks; multigravida: 16-18 weeks.

Post-partum hemorrhage: is a blood loss of 500ml or more following delivery or any volume of blood loss that leads to hemodynamic instability.

Pre-eclampsia: is an idiopathic progressive multi-systemic disorder characterized by
elevated blood pressure of > 140/90 mmHg on at least two occasions 6 hours apart, and significant proteinuria arising de novo after 20th week of gestation in a previously normotensive, non-proteinuric woman and resolving completely within 6 weeks after delivery.

Eclampsia: is the onset of generalized tonic-clonic convulsion in a pregnant woman with signs and symptoms of pre-eclampsia or pregnancy-induced hypertension during pregnancy, labor or within 7-10 days after delivery, with no medical, organic or neurological cause of the convulsion.

Premature rupture of membranes: is the spontaneous rupture of fetal membranes before the onset of labor.

Placenta previa: is the implantation of placenta partially or wholly in the lower uterine segment.

Placental abruption: is uterine bleeding following partial or complete premature
separation of a normally situated placenta after the age of viability.

Caesarean setion: is the delivery of fetus and other products of conception through an abdominal and a uterine incision after the age of viability.

Intermittent preventive therapy (IPT): is the administration of therapeutic dose of anti-malarial drug to an asymptomatic pregnant woman after quickening at predetermined interval in order to prevent placental parasitization and development of malaria in pregnancy.

Anemia in pregnancy: is hemoglobin concentration < 11 g/dL and hematocrit < 33%
(0.33) in a pregnant woman.

Cervical incompetence: is the inability of the uterine cervix to sustain pregnancy to term due to a functional or structural defect.

Urinary tract infection (UTI): is the multiplication of organisms in the urinary tract,
such that a colony count of 10 organisms is isolated per mL of clean-catch urine specimen with or without urinary symptoms.

Shoulder dystocia: is the need for additional obstetric maneuvers to release the shoulder after gentle downward traction has failed.

Episiotomy: is a deliberate surgical incision made on the perineum to widen the diameter of vulva outlet to assist child birth.

Hyperemesis gravidarum: is an intractable vomiting in a pregnant woman leading to
fluid and electrolyte disturbances and nutritional deficiency.

Maternal mortality: is the death of a woman while pregnant or within 42 days of termination of a pregnancy irrespective of the site and duration of the pregnancy from factors related to or aggravated by the pregnancy and its management and not from incidental or accidental causes.

Partograph: is the graphical representation of the events in features in the mother and fetus, and all therapeutics undertaken during labor, plotted against time.

Unwanted Pregnancy: is one that constitute social and psychological stress to the mother and or her partner (or the existing child).

Unplanned pregnancy: is one which occurs when the woman is unaware of her fertile period and sexual intercourse is not timed.

Unstable lie: occurs when there is repeated change in fetal lie and presentation at least on two occasions on consecutive visits after 36 weeks observed by the same physician.

Intrauterine growth restriction: is failure of a fetus to attain its genetic growth potential. Or when the estimated fetal weight is less than 10th percentile for the gestational age, race, and sex.

GYNECOLOGY


Abortion: is the expulsion or extraction of the product of conception in whole or in part via the birth canal before the age of viability.

Unsafe abortion: is the termination of an unwanted pregnancy either by person lacking the necessary skills or in an environment lacking the minimal medical standards or both.

Infertility: is the inability of a couple to achieve pregnancy after 12 months of regular, adequate, unprotected sexual intercourse.

Menopause: is the permanent cessation of menstruation.

Hirsutism: is the development of male body hair pattern in a female, due to hormonal dysfunction.

Sheehan's syndrome: is a partial or complete pituitary insufficiency due to postpartum necrosis of the anterior pituitary gland in women with severe blood loss and hypotension during delivery.

Asherman's syndrome: is persistent amenorrhea and secondary infertility due to
intrauterine adhesions and synechiae as a result of irreversible damage to the basal layer of the endometrium.

Gestational trophoblastic disease: is a spectrum of tumor and tumor-like conditions
characterized by abnormal proliferation of placental tissue.

Family planning: is a way of thinking and living that is adopted voluntarily upon the basis of knowledge, attitudes, and responsible decisions by individuals and couples in order to promote health and welfare of the family group and thus contribute effectively to the social development of the country.

Conclusion


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