Mitchell Community College Holbrook-Huskins Associate Degree Nursing Program NUR 113 Family Health Concepts

OB Vocabulary List
Abruption placenta-the premature separation of the placenta from the uterus Acrocyanosis- is blueness of the extremities (the hands and feet). Acrocyanosis is typically symmetrical. It is marked by a mottled blue or red discoloration of the skin of the fingers and wrists and the toes and ankles and by profuse sweating and coldness of the fingers and toes. Amniocentesis- the surgical insertion of a hollow needle through the abdominal wall and into the uterus of a pregnant female to obtain amniotic fluid especially to examine the fetal chromosomes for an abnormality and for the determination of sex Amnioinfusion- a procedure in which normal saline or lactated Ringer's solution is placed into the uterus after sufficient cervical opening and rupture of membranes. Amnioinfusion can treat problems associated with decreased intra-amniotic volume, including: prophylactic treatment of oligohydramnios, treatment of severe variable decelerations during labor, and to reduce the risk of meconium aspiration during labor in patients with moderate or thick meconium fluid Amnionitis- inflammation of the amnion, a manifestation of an intrauterine infection, often associated with prolonged membrane rupture and long labor. Amniotomy- Surgical rupture of the fetal membranes to induce or expedite labor. PATIENT CARE. Amniotomy results in drainage of the amniotic fluid and thus hastens labor by allowing the head to fit more snugly into the dilating cervix. There is little or no discomfort accompanying the procedure; the patient will require only an explanation of what is to be done, and proper draping and cleansing of the perineum. After amniotomy the expelled fluid is carefully observed for color. A yellow or green color indicates fetal distress. The fetal heart rate is monitored for signs of fetal distress because amniotomy increases the risk of a prolapsed cord Apgar score- an evaluation of a newborn's physical condition, usually performed 1 minute and again 5 minutes after birth, based on a rating of five factors that reflect the infant's ability to adjust to extrauterine life. The system rapidly identifies infants requiring immediate intervention or transfer to a neonatal intensive care unit. method The infant's heart rate, respiratory effort, muscle tone, reflex irritability, and color are scored from a low value of 0 to a normal value of 2. The five scores are combined, and the totals at 1 minute and 5 minutes are noted; for example, Apgar 9/10 is a score of 9 at 1 minute and 10 at 5 minutes.

nursing considerations A low 1-minute score requires immediate intervention, including administration of oxygen, clearing of the nasopharynx, and usually transfer to a neonatal intensive care unit. A baby with a low score that persists at 5 minutes requires expert care, which may include assisted ventilation, umbilical catheterization, cardiac massage, blood gas analysis, correction of acid-base deficit, or medication to reverse the effects of maternal medication. outcome criteria A score of 0 to 3 represents severe distress, a score of 4 to 7 indicates moderate distress, and a score of 7 to 10 indicates an absence of difficulty in adjusting to extrauterine life. The 5-minute total score is normally higher than the 1-minute score. Because a normal, vigorous, healthy newborn almost always has bluish hands and feet at 1 minute, the first score for color will include a 1 rather than a perfect 2; however, at 5 minutes the blueness may have passed, and a score of 2 may be given. A 5-minute overall score of 0 to 1 correlates with a 50% neonatal mortality rate; infants who survive exhibit three times as many neurologic abnormalities at 1 year of age as do children with a 5-minute score of 7 or more.

Apnea- Temporary absence or cessation of breathing. Areola- a narrow zone surrounding a central area, e.g. the darkened area surrounding the nipple of the human mammary gland. Atony- Lack of normal tone or tension; flaccidity Augmentation of labor- involves the stimulation of uterine contractions to produce delivery after the onset of spontaneous labor. Bilirubin- A pigment produced by the liver that is excreted in bile which causes a yellow discoloration of the skin and eyes when it accumulates in those organs. Biophysical Profile (BPP) - a prenatal ultrasound evaluation of fetal well-being, involving a scoring system.[1] It is often done when a non-stress test is non-reactive, or for other obstetrical indications. The biophysical profile (BPP) has 5 components: 4 ultrasound (US) assessments and a nonstress test (NST). The nonstress test (NST) (CTG) evaluates fetal heart rate and response to fetal movement. The five discrete biophysical variables: 1. 2. 3. 4. 5. Fetal movement Fetal tone Fetal breathing Amniotic fluid volume Fetal Heart Rate

Bloody show- A blood-tinged mucus cervical plug that filled the cervical canal during pregnancy which is a classic sign of impending labor; BS also refers to the beginning of menstruation Breech - Breech birth is the delivery of a fetus (unborn baby) hind end first Caput succedaneum- A swelling formed on the presenting part of the head of a fetus during labor, resulting in edema and varying degrees of scalp hemorrhage. Cephalohematoma- a localized effusion of blood beneath the periosteum of the skull of a newborn, due to disruption of the vessels during birth. Cephalhematoma, in contrast to CAPUT SUCCEDANEUM, does not cross cranial suture lines. It is firmer to the touch than an edematous area: it feels like a water-filled balloon. Cephalhematoma usually appears on the second or third day after birth and disappears within weeks or months Cephalopelvic Disproportion (CPD) - The condition in which the baby's head is too large to fit through the mother's pelvis Cervix- A small cylindrical organ about an inch or so long and less than an inch around that makes up the lower part and neck of the uterus. The cervix separates the body and cavity of the uterus from the vagina Incompetent Cervix- a uterine cervix abnormally prone to dilate in the second trimester of pregnancy, resulting in premature expulsion of the fetus. Circumcision- The surgical removal of the foreskin of the penis or prepuce Colostrum- The first milk secreted at the time of parturition, differing from the milk secreted later by containing more lactalbumin and lactoprotein, and also being rich in antibodies that confer passive immunity to the newborn. Also called foremilk Crowning- the phase at the end of labor in which the fetal head is seen at the introitus of the vagina. The labia are stretched in a crown around the head just before birth Dilatation- the act of dilating or stretching Doula- A woman who assists another woman during labor and provides support to her, the infant, and the family after childbirth Down Syndrome- a genetic condition in which a person has 47 chromosomes instead of the usual 46. Dystocia- abnormal labor or childbirth Eclampsia- Coma or convulsions in a patient with preeclampsia, occurring in late pregnancy, during labor, or within 24 hours after parturition

EDC (Estimated Date of Confinement) - The date at which an infant is expected to be born, calculated from the date of the last menstrual period. Also called due date Effacement- he thinning out of the cervix that normally occurs along with dilation shortly before delivery. Engagement- the entrance of the fetal head or presenting part into the superior pelvic strait Engorgement- distension or vascular congestion of body tissues, such as the swelling of breast tissue caused by an increased flow of blood and lymph before true lactation Episiotomy- An episiotomy is a surgical incision made in the area between the vagina and anus (perineum). This is done during the last stages of labor and delivery to expand the opening of the vagina to prevent tearing during the delivery of the baby. Erythema toxicum- A skin condition caused by reaction to a toxic and characterized by a widespread erythematous eruption Fallopian tubes- The narrow ducts leading from a woman's ovaries to the uterus. After an egg is released from the ovary during ovulation, fertilization (the union of sperm and egg) normally occurs in the fallopian tubes. False labor- Signs of false labor include:

Contractions are irregular and unpredictable (for example, in intervals of ten minutes, six minutes, two minutes, eight minutes, etc.) No progression is seen over time Contractions are felt as a generalized abdominal tightening Change in activity or position causes contractions to slow down or stop There is usually no bloody show Membranes will not rupture

Fetal lie- the relationship of the long axis of the fetus to the long axis of the mother Fetal Alcohol Syndrome- Fetal alcohol syndrome (FAS) is a pattern of birth defects, learning, and behavioral problems affecting individuals whose mothers consumed alcohol during pregnancy Fetus- The term used to describe a developing human infant from approximately the third month of pregnancy until delivery. The term embryo is used prior to the third month. Fontanelle- a soft spot, such as one of the membrane-covered spaces remaining at the junction of the sutures in the incompletely ossified skull of the fetus or infant.

Fundus- the part of the uterus above the orifices of the uterine tubes The bottom of or part farthest from the opening of a sac or hollow organ. Gestational Age- The estimated age of a fetus expressed in weeks, calculated from the first day of the last normal menstrual period. Gestational Age Assessment (Dubowitz, Ballard) - A baby's gestational age often can be closely estimated using this examination. The Dubowitz/Ballard Examination evaluates a baby's appearance, skin texture, motor function and reflexes. The physical maturity part of the examination is done in the first two hours of birth. The neuromuscular maturity examination is completed within 24 hours after delivery. Gestational Diabetes- Gestational diabetes is a condition that occurs during pregnancy. Like other forms of diabetes, gestational diabetes involves a defect in the way the body processes and uses sugars (glucose) in the diet Gestational Hypertension- The development of high BP/HTN without other symptoms of preeclampsia or eclampsia after 20 wks. of gestation in a previously normotensive Gravida- a pregnant woman; called g. I (primigravida) during the first pregnancy, g. II (secundigravida) during the second, and so on Homans sign- pain in the calf of the leg upon dorsiflexion of the foot with the leg extended that is diagnostic of thrombosis in the deep veins of the area Hydraminos- The presence of an excessive amount of amniotic fluid. Also called polyhydramnios. Hyperemesis Gravidarum- excessive vomiting during pregnancy. Hyperbilirubinemia- An abnormally high concentration of bilirubin in the blood. Hypoglycemia- low blood sugar IUGR Intrauterine Growth Retardation- occurs when the unborn baby is at or below the 10th weight percentile for his or her age (in weeks). Induction- the act or process of inducing or causing to occur. Intrapartum- Occurring during labor and delivery Intrauterine Pressure Catheter- A device inserted between the uterine wall and the fetus to measure the intensity of contractions in a who has received oxytocin

Jaundice- Normal newborn jaundice is the result of two conditions occurring at the same timea pre-hepatic and a hepatic source of excess bilirubin. First of all, the baby at birth immediately begins converting hemoglobin from a fetal type to an adult type. The fetal type of hemoglobin was able to extract oxygen from the lower levels of oxygen in the mother's blood. At birth the infant can extract oxygen directly from his or her own lungs and does not need the fetal hemoglobin any more. So fetal hemoglobin is removed from the system and replaced with adult hemoglobin. The resulting bilirubin loads the system and places demands on the liver to clear it. But the liver is not quite ready for the task, so there is a period of a week or so when the liver has to catch up. During that time the baby is jaundiced. Newborns are more likely to have problems with jaundice if:

They are premature. They are Asian or Native Americans. They have been bruised during the birth process. They have lost too much weight during the first few days. They are born at high altitude. The mother has diabetes. Labor had to be induced.

Kegal exercise- consists of contracting and relaxing the muscles that form part of the pelvic floor Labia- the folds of skin at the opening of the vagina Labor- the function of the female by which the infant is expelled through the vagina to the outside world: the first stage begins with onset of regular uterine contractions and ends when the os is completely dilated and flush with the vagina; the second extends from the end of the first stage until the expulsion of the infant is completed; the third extends from expulsion of the infant until the placenta and membranes are expelled; the fourth denotes the hour or two after delivery, when uterine tone is established Lactation- yielding of milk by the mammary glands which leads to breastfeeding Lanugo- The fine, soft hair that grows on a fetus and is present on a newborn. Leopolds Maneuver- a common and systematic way to determine the position of a fetus inside the woman's uterus;

Lightening- The sensation of decreased abdominal distention during the latter weeks of pregnancy following the descent of the fetal head into the pelvic inlet. Linea Nigra- a dark line appearing longitudinally on the abdomen of a pregnant woman during the latter 24 weeks of term. It usually extends from the symphysis pubis midline to the umbilicus and sometimes as far as the sternum. Lochia (rubra, serosa, alga) lochia is the discharge following childbirth; there is a progressive sequence: Rubra-very red discharge; mostly blood Serosa-less red, thinner looking, gets a little brown-ish, because there is less blood and less volume Alba-white-ish, more mucous, no blood L/S ratio- The ratio of lecithinphosphatidyl choline to sphingomyelin, a 'bench' parameter used to determine infant lung maturity and predict the infant's ability to survive without developing respiratory distress Mastitis- Inflammation of the breast Meconium- The first waste products to be discharged from the body in a newborn infant, usually greenish in color and consisting of mucus, bile and so forth. Membranes (Rupture of Amniotic) (ROM) - when the sac containing the developing baby (fetus) and the amniotic fluid burst Milia- Milia are tiny white bumps or small cysts on the skin that are almost always seen in newborn babies

Molding- the adjusting of the shape and size of the fetal head to the birth canal during labor. Mongolian spot- a smooth, brown to grayish blue nevus, consisting of an excess of melanocytes, typically found at birth in the sacral region in Asians and dark-skinned races; it usually disappears during childhood. Moro reflex- flexion of an infant's thighs and knees, fanning and then clenching of fingers, with arms first thrown outward and then brought together as though embracing something; produced by a sudden stimulus, such as striking the table on either side of the child, and seen normally in the newborn. Called also embrace reflex Nageles Rule (EDC)- a standard way of calculating the due date for a pregnancy. The rule estimates the expected date of delivery (EDD) by adding one year, subtracting three months, and adding seven days to the first day of a woman's last menstrual period (LMP). The result is approximately 280 days (40 weeks) from the LMP. Non-Stress Test (NST) - is a simple, non-invasive test performed in pregnancies over 28 weeks gestation. The test is named non-stress because no stress is placed on the fetus during the test. The test involves attaching one belt to the mothers abdomen to measure fetal heart rate and another belt to measure contractions. Movement, heart rate and reactivity of heart rate to movement is measured for 20-30 minutes. If the baby does not move, it does not necessarily indicate that there is a problem; the baby could just be asleep. A nurse may use a small buzzer to wake the baby for the remainder of the test. Occiput- The back part of the head or skull. Oligohydramnios- deficiency in the amount of amniotic fluid Oxytocin- a hypothalamic hormone stored in the posterior pituitary, which has uterinecontracting and milk-releasing actions; it may also be prepared synthetically or obtained from the posterior pituitary of domestic animals; used to induce active labor, increase the force of contractions in labor, contract uterine muscle after delivery of the placenta, control postpartum hemorrhage, and stimulate milk ejection Para or Parity- the classification of a woman by the number of live-born children and stillbirths she has delivered at more than 20 weeks of gestation. Commonly parity is noted with the total number of pregnancies and represented by the letter P or the word para. A para 4 (P4) gravida 5 (G5) has had four deliveries after 20 weeks and one abortion or miscarriage before 20 weeks. Currently a more complete system is in use: the total number of term infants (T) is followed by the number of premature infants (P), the number of abortions or miscarriages before 20 weeks' gestation (A), and the number of children living at present (L). This system may be abbreviated as TPAL

Perineum- The area between the opening of the vagina and the anus in a woman, PKU Phenylketonuria- a rare metabolic disorder caused by a deficiency in the production of the hepatic (liver) enzyme phenylalanine hydroxylase (PAH). PKU is the most serious form of a class of diseases referred to as "hyperphenylalaninemia," all of which involve above normal (elevated) levels of phenylalanine in the blood. Phototherapy- or light therapy is the administration of doses of bright light in order to normalize the body's internal clock and/or relieve depression. Placenta- The organ that allows interchange between the fetus and the mother. Blood from the fetus and the mother do not directly mix, but the thin placental membrane allows the fetus to absorb nutrients and oxygen from the mother. Waste products from the fetus can exit through the placenta. Placenta Previa- a condition that occurs during pregnancy when the placenta is abnormally placed, and partially or totally covers the cervix Polyhydramnios- excess of amniotic fluid, usually exceeding 2000 mL Position- the relationship of a given point on the presenting part of the fetus to a designated point of the maternal pelvis. Precipitous Birth- a labor that lasts less than three hours. Preeclampsia- Also called toxemia, preeclampsia is a condition during pregnancy that results in high blood pressure, swelling that doesn't go away and large amounts of protein in the urine. Without treatment, it can progress to a dangerous condition called eclampsia, in which a woman goes into convulsions. Presentation- the part of the fetus lying over the pelvic inlet; the presenting body part of the fetus Puerperium - the time after childbirth, lasting approximately 6 weeks, during which the anatomic and physiologic changes brought about by pregnancy resolve and a woman adjusts to the new or expanded responsibilities of motherhood and nonpregnant life. Quickening- the first feeling by a pregnant woman of movement of her baby in utero, usually occurring between 16 and 20 weeks of gestation Rh Factor- genetically determined antigens present on the surface of erythrocytes; incompatibility for these antigens between mother and offspring is responsible for erythroblastosis fetalis.

Rooting Reflex - a normal response in newborns when the cheek is touched or stroked along the side of the mouth to turn the head toward the stimulated side and begin to suck. The reflex disappears by 3 to 4 months of age but in some infants may persist until 12 months of age. Rotation of Fetus- manual rotation of fetus via the vagina Station- the location of the presenting part of the fetus in the birth canal, designated as 5 to 1 according to the number of centimeters the part is above an imaginary plane passing through the ischial spines, 0 when at the plane, and +1 to +5 according to the number of centimeters the part is below the plane. Striae Gravidarum- Stretch marks resulting from pregnancy. Surfactant- a complex naturally occurring substance made of six lipids (fats) and four proteins that is produced in the lungs Tocolytic Drugs- also called anti-contraction medications or labor represents are medications used to suppress premature labor Tocodynamometer- An instrument for measuring the force of uterine contractions TORCH Infections- (toxoplasmosis, other agents, rubella, cytomegalovirus, herpes simplex) any of a group of infections seen in neonates as a result of the infectious agent having crossed the placental barrier. Toxemia (see Eclampsia) condition encountered in pregnancy characterized by high blood pressure, proteinuria, and edema. May precede the onset of seizures (eclampsia). Also called preeclampsia. Trimester- one of the three periods of approximately 3 months into which pregnancy is divided. The first trimester includes the time from the first day of the last menstrual period to the end of 12 weeks. The second trimester, closer to 4 months in length than 3, extends from the twelfth to the twenty-eighth week of gestation. The third trimester begins at the twenty-eighth week and extends to the time of delivery. Transition- the last phase of the first stage of labor, sometimes indicated by cervical dilation of 8 to 10 cm. Umbilical cord- The flexible cordlike structure connecting a fetus at the navel with the placenta and containing two umbilical arteries and one vein that transport nourishment to the fetus and remove its wastes. Also called funis.

Vernix- the thick white substance composed of sebum and desquamated epithelial cells that provide a protective covering for the skin of the fetus. In the full-term newborn, during the first two or three days of life there is a small amount of vernix caseosa in body creases and the hair. Vertex- the summit or top, especially the top of the head