正文
Obstetrics
Part I. Vocabulary
afterbirth胎盤: The placenta, the amnion羊膜, the chorion絨毛膜, some amniotic fluid, blood, and blood clots expelled from the uterus after childbirth.
Alpha-fetoproteinα-胎兒球蛋白，甲胎蛋白: A protein found in the amniotic fluid. Measurements of the level of AFP in the amniotic sac are used for early diagnosis of fetal defects, such as spina bifida脊柱裂 (defective closure of the vertebrae of the spinal column) and anencephaly (congenital absence of the brain and spinal cord).
amenorrhea/ah-men-or-REE-ah/閉經: absence of menstrual flow
amnion/AM-nee-on/羊膜: the inner of the two membrane layers that surround and contain the fetus and the amniotic fluid during pregnancy.
amniotic fluid/am-nee-OT-ik/: A liquid produced by and contained within the fetal membranes during pregnancy. This fluid protects the fetus from trauma and temperature variations, helps to maintain fetal oxygen supply, and allows for freedom of movement by the fetus during pregnancy.
amniotic sac羊膜囊: The double layered sac that contains the fetus and the amniotic fluid during pregnancy.
areola/ah-REE-oh-lah/乳暈: The darker pigmented, circular area surrounding the nipple of each breast; also known as the "areola mammae" or the "areola papillaris".
ballottement/bal-ot-MON/觸診子宮檢胎法: A technique of using the examiner's finger to tap against the uterus, through the vagina, to cause the fetus to "bounce" within the amniotic fluid and feeling it rebound quickly.
Braxton-Hick's contractions: irregular, ineffective, contractions of the uterus that occur throughout pregnancy.
cerclage /sE:'klAdV/sair-KLOGH/ 環紮法（術）: Suturing the cervix to keep it from dilating prematurely during the pregnancy. This procedure is sometimes referred to as a "purse string procedure". The sutures are removed near the end of the pregnancy.
cervix: the part of the uterus that protrudes into the cavity of the vagina; the neck of the uterus.
cesarean section/see-SAYR-ee-an/剖宮產術: A surgical procedure in which the abdomen and uterus are incised and a baby is delivered transabdominally.
Chadwick's sign: The bluish-violet淡藍紫色的 hue if the cervix and vagina after approximately the sixth week of pregnancy.
chloasma /kloh-AZ-mah/ 黃褐斑: Patches of tan or brown pigmentation associated with pregnancy, occurring mostly on the forehead, cheeks, and nose; also called the "mask of pregnancy".
chorion/KOH-ree-on/羊毛膜: The outer of the two membrane layers that surround and contain the fetus and the amniotic fluid during pregnancy.
coitus/KOH-ih-tus/: sexual intercourse; copulation
colostrums/koh-LOSS-trim/初乳: The thin, yellowish fluid secreted by the breasts during pregnancy and the first few days after birth, before lactation begins.
conception: The union of a male sperm and a female ovum; also termed fertilization.
copulation: sexual intercourse; coitus
corpus luteum黃體: A mass of yellowish tissue that forms within the ruptured ovarian follicle after ovulation. It functions as a temporary endocrine gland for the purpose of secreting estrogen and large amounts of progesterone, which will sustain pregnancy, should it occur, until the placenta forms. If pregnancy does not occur, the corpus luteum will degenerate approximately 3 days before the beginning of menstruation.
culdocentesis /kull-doh-sen-TEE-sis/ 後穹隆穿刺術: Needle aspiration, through the vagina, into the cul-de-sac(盲腸) area for the purpose of removing fluid from the area for examination or diagnosis. Aspiration of unclotted blood from the cul-de-sac area may indicate bleeding from a ruptured fallopian tube; the aspiration of clear fluid from the area would rule out a ruptured fallopian tube.
dilatation (of cervix)宮口擴張: The enlargement of the diameter of the cervix during labor. The calculation of the amount of dilatation is measured in centimeters. When the cervix has dilated to 10 cm, it is said to be completely dilated.
Doppler: A technique used in ultrasound imaging to monitor the behavior of a moving structure, such as flowing blood or a beating heart. Fetal heart monitors operate on the Doppler sound wave principles to determine the fetal heart rate.
eclampsia /eh-KLSMP-see-ah/ 子癇，驚厥: The most severe form of hypertension during pregnancy, evidenced by seizures (convulsions).
edema: swelling, with water retention.
effacement/eh-FACE-ment/: Thinning of the cervix, which allows it to enlarge the diameter of its opening in preparation for childbirth; this occurs during the normal processes of labor.
ejaculation: The sudden emission of semen from the male urethra, usually occurring during sexual intercourse or masturbation手淫.
embryo: The product of conception from the second through the eighth week of pregnancy.
endometrium/en-doh-MEE-tree-um/子宮內膜: the inner lining of the uterus
episiotomy/ei-peez-ee-OT-oh-mee/外陰切開術: a surgical procedure in which an incision is made into the woman's perineum會陰 to enlarge the vaginal opening for delivery of the baby. This incision is usually made shortly before the baby's birth (second stage of labor) to prevent tearing of the perineum.
estrogen: one of the female hormones that promotes the development of the female secondary sex characteristics.
fallopian/fah-LOH-pee-an/ tubes輸卵管: a pair of tubes opening at one end into the uterus and at the other end into the peritoneal cavity over the ovary.
fertilization: the union of a male sperm and a female ovum; also termed conception.
fetoscope/FEET-oh-scope/胎兒鏡: a special stethoscope for hearing the fetal heartbeat through the mother's abdomen.
fetus: the developing baby from approximately the eighth week after conception until birth.
fimbriae/FIM-bree-ah/輸卵管傘: the fringelike end of the fallopian tube.
fundus: superior aspect of the uterus
gamete/GAM-eet/: a mature sperm or ovum
gastroesophageal/gas-troh-eh-soff-ah-JEE-al/ reflux胃食管反流: a return, or reflux, of gastric juices into the esophagus, resulting in a burning sensation.
gestation/jess-TAY-shun/妊娠: the term of pregnancy, which equals approximately 280 days from the onset of the last menstrual period; the period of intrauterine development of the fetus from conception through birth; also termed the gestational period.
gestational hypertension: a complication of pregnancy in which the expectant mother develops high blood pressure after 20 weeks' gestation, with no signs of proteinuria or edema.
glycogen/GLYE-koh-jen/糖原: the form of sugar that is stored in body cells, primarily the liver
gonads性腺: a gamete-producing gland, such as an ovary or a testis.
Goodell's sign: the softening of the uterine cervix, a probable sign of pregnancy
graafian follicles/GRAF-ee-an FALL-ih-kls/Graff小體: a mature, fully developed ovarian cyst containing the ripe ovum.
gravida/GRAH-vi-dah/孕婦: a woman who is pregnant. She may be identified as gravida I if this is her first pregnancy, gravida II for a second pregnancy, and so on.
Hegar's sign: softening of the lower segment of the uterus; a probable sign of pregnancy
hyperpigmentation: an increase in the pigmentation of the skin
hypertension: high blood pressure; a common, often asymptomatic disorder, in which the blood persistently exceeds 140/90 mm Hg.
hypovolemic shock低血容量性休克: a state of extreme physical collapse and exhaustion due to massive blood loss.
labor: the time and the processes that occur during the process of giving birth, from the beginning of cervical dilatation to the delivery of the placenta.
lactation泌乳: the production and secretion of milk from the female breasts as nourishment for the infant. Lactation can be referred to as a process or as a period of time during which the female is breastfeeding.
lactiferous/lak-TIF-er-us/ ducts輸乳管: channels or narrow tubular structures that carry milk from the lobes of each breast to the nipple.
laparoscope/LAP-ar-oss-kohp/腹腔鏡: visualization of the abdominal cavity with an instrument called a laparoscope腹腔鏡 through an incision into the abdominal wall.
leukorrhea/loo-koh-REE-ah/白帶: a white discharge from the vagina
lightening胎兒下降感: the settling of the fetal head into the pelvis, occurring a few weeks prior to the onset of labor.
linea nigra黑線: a darkened vertical midline appearing on the abdomen of a pregnant woman, extending from the fundus to the symphysis pubis.
lithotomy position截石位: a position in which the patient lies on her back, buttocks even with the end of the table, with her knees bent back toward her abdomen and the heel of each foot resting in an elevated foot rest at the end of the examination table.
lordosis脊柱前凸: a forward curvature of the spine, noticeable if the person is observed from the side.
lunar month太陰月: 4 weeks or 28 days; approximately the amount of time it takes the moon to revolve around the earth.
mammary glands: the female breasts
mask of pregnancy: patches of tan or brown pigmentation associated with pregnancy, occurring mostly on the forehead, cheeks, and nose; also known as chloasma黃褐斑.
multigravida /mull-tih-GRAV-ih-dah/經孕婦: a woman who has been pregnant more than once.
multipara/mull-TIP-ah-rah/經產婦: a woman who has given birth two or more times after 20 weeks' gestation.
Nagele's rule/NAY-geh-leez/: a formula that is used to calculate the date of birth: subtract 3 months from the first day of the last normal menstrual period and add 7 days to that date to arrive at the estimated date of birth.
neonatology/nee-oh-nay-TALL-oh-jee/新生兒科學: the branch of medicine that specializes in the treatment and care of the diseases and disorders of the newborn through the first four weeks of life.
nullipara/null-IP-ah-rah/未產婦: a woman who has never completed a pregnancy beyond 20 weeks' gestation.
obstetrician: a physician who specializes in the care of women during pregnancy, the delivery of the baby, and the first six weeks following the delivery, known as the immediate postpartum period.
obstetrics: the field of medicine that deals with pregnancy, the delivery of the baby, and the first six weeks after delivery.
ovary: one of a pair of female gonads responsible for producing mature ova (eggs) and releasing them at monthly intervals (ovulation); also responsible for producing the female hormones, estrogen and progesterone.
ovulation排卵: the release of the mature ovum from the ovary; occurs approximately 14 days prior to the beginning of menses.
ovum: the female reproductive cell; female sex cell or egg.
para: a woman who has produced and infant regardless of whether the infant was alive or stillborn. This term applies to any pregnancies carried to more than 20 weeks gestation. The term may be written para II, para III, and so on, to indicate the number of pregnancies lasting more than 20 weeks' gestation, regardless of the number of offspring produced by the pregnancy. A woman who has had only one pregnancy resulting in multiple births is still a para I.
parturition分娩: the act of giving birth
perineum/pair-ih-NEE-um/會陰: the area between the vaginal orifice and the anus, composed of muscular and fibrous tissue and serves as support for the pelvic structures.
placenta/plah-SEN-tah/胎盤: a highly vascular, disc-shaped organ that forms in the pregnant uterine wall for exchange of gases and nutrients between the mother and the fetus. The maternal side of the placenta attaches to the uterine wall, whereas the fetal side of the placenta gives rise to the umbilical cord, which connects directly to the baby. After the delivery of the baby, when the placenta is no longer needed, it separates from the uterine wall and passes to the outside of the body through the vagina, at which time it is called the "afterbirth".
pre-eclampsia/pre-eh-KLAMP-see-ah/先兆子癇，子癇前期: a state during pregnancy in which the expectant mother develops high blood pressure, accompanies by proteinuria or edema, after 20 weeks' gestation.
pregnancy: the period of intrauterine development of the fetus from conception through birth. The average pregnancy lasts approximately 40 weeks; also known as the gestational period.
prenatal: pertaining to the period of time, during pregnancy, that is before the birth of the baby.
primigravida/prigh-mih-GRAY-ih-dah/初孕婦: a woman who is pregnant for the first time
primipara/prai-Meep-ah-rah/初產婦: a woman who has given birth for the first time, after a pregnancy of at least 20 weeks gestation.
progesterone孕酮，黃體酮: one of the female hormones secreted by the corpus luteum and the placenta. It is primarily responsible for the changes that occur in the endometrium in anticipation of a fertilized ovum, and for development of the maternal placenta after implantation of a fertilized ovum.
proteinuria: the presence of protein (albumin) in the urine; also called albuminuria. This can be a sign of pregnancy induced hypertension (PIH).
puberty: the period of life at which the ability to reproduce begins; that is, in the female, it is the period when the female reproductive organs become fully developed.
pyrosis胃灼熱，心口灼熱: heartburn; that is, indigestion消化不良
quickening胎動（初）感: the first feeling of movement of the fetus felt by the expectant mother; usually occurs around 18 to 20 weeks' gestation.
salpingectomy/sal-pin-JEK-toh-mee/輸卵管切除術: surgical removal of a fallopian tube
sexual intercourse: the sexual union of two people of the opposite sex in which the penis is introduced into the vagina; also known as copulation; also known as coitus.
signs: objective findings as perceived by an examiner, such as the measurement of a fever on the thermometer, the observation of a rash on the skin, or the observation of a bluish-violet color of the cervix, etc.
sperm: a mature male germ cell; spermatozoon
striae gravidarum/STRAI-ay grav-ih-DAR-um/妊娠紋: stretch marks that occur during pregnancy due to the great amount of stretching that occurs. They appear as slightly depressed, pinkish-purple steaks in the areas of greatest stretch, which are the abdomen, the breasts, and the thighs.
tachycardia心動過速: rapid heartbeat, consistently over 100 beats per minute.
testes: the paired male gonads that produce sperm
transvaginal ultrasonography: an ultrasound image that is produced inserting a transvaginal probe into the vagina. The probe is encased in a disposable cover and is coated with a gel for easy insertion. The gel also promotes conductivity. This procedure allows clear visualization of the uterus, gestational sac, and embryo in the early stages of pregnancy. It also allows the examiner to visualize deeper pelvic structure, such as the ovaries and fallopian tubes.
trimester: one of the three periods of approximately 3 months into which pregnancy is divided. the first trimester consists of weeks 1 to 12; the second trimester consists of weeks 13 to 27 and the third trimester consists of weeks 28 to 40.
ultrasonography: a noninvasive procedure that involves the use of reflected sound waves to detect the presence of the embryo or fetus.
umbilical cord臍帶: a flexible structure connecting the umbilicus ( navel) of the fetus with the placenta in the pregnant uterus. It serves as passage for the umbilical arteries and vein.
uterus: the hollow, pear-shaped organ of the female reproductive system that house the fertilized, implanted ovum as it develops throughout pregnancy; also the source of the monthly menstrual flow from the nonpregnant uterus.
vagina陰道: the muscular tube that connects the uterus with the vulva. It is approximately 3 inches in length, and rest between the bladder (anteriorly) and the rectum (posteriorly).
varicose veins靜脈曲張: twisted, swollen veins that occur as a result of the blood pooling in the legs.
waddling gait鴨步態: a manner of walking in which the feet are wide apart and the walk resembles that of a duck.
Part II: Word elements
word element meaning example
amni/o amnion amniocentesis羊膜腔穿刺術
ante- before anteflexion前屈
culd/o cul-de-sac culdocentesis後穹隆穿刺術
-cyesis pregnancy pseudocyesis假孕
episi/o vulva episiotomy外陰切開術
fet/o fetus fetoscope胎兒鏡
-gravida pregnancy primigravida初孕婦
lact/o milk lactation泌乳
multi- many multigravida經孕婦
nat/o birth prenatal 產前的
nulli- none nullipara 未產婦
-para to give birth multipara 經產婦
primi- first primigravida初孕婦
obstetr/o midwife obstetrics
pelv/i pelvis pelvimetry骨盆測量法
perine/o perineum perineal 會陰的
salping/o fallopian tube salpingectomy輸卵管切除術
-tocia labor dystocia 難產
vagin/o vagina transvaginal
Part III. Discomfort of Pregnancy
Throughout the pregnancy, the expectant mother will experience various discomforts. It is important that she realize that these will be temporary discomforts and should subside after delivery. It is also important that the health care professional be aware of the difference between discomforts of pregnancy and signs of possible complications of pregnancy. The knowledgeable health care professional will have the responsibility of educating the patient regarding measures for relief of these temporary discomforts. The following list includes, but is not limited to, the more common discomforts of pregnancy.
backache: Backache is common during the second and third trimester of pregnancy and is due to the body's adaptation to the stresses placed upon the back as the pregnancy progresses.
Recommended treatment includes encouraging the best posture possible, wearing comfortable shoes, getting adequate rest, and bending from the knees ----not the waist.
edema: Edema, or swelling, of the lower extremities is not uncommon in pregnancy, particularly as the pregnancy progresses.
Recommended treatment includes elevating the feet and legs when sitting, lying down when resting, drinking plenty of water, and avoiding foods high in sodium. If the edema is present in the hands and face also, it should be reported immediately to the physician because this could be an indication of complications of pregnancy.
fatigue: Fatigue usually occurs during the first trimester of pregnancy, disappears during the second trimester, and returns toward the end of the pregnancy. This is due to the body's adjustment to the stresses of pregnancy.
heartburn: Heartburn is also known as pyrosis (pyr/o=fever, fire + osis=condition). This discomfort occurs mainly in the last few weeks of pregnancy due to the pressure exerted on the esophagus by the enlarged pregnant uterus. This pressure may also cause a return, or reflux, of gastric juices into the esophagus, resulting in a burning sensation ------ a condition known as gastroesophageal reflux.
hemorrhoids痔: hemorrhoids are swollen veins of the rectum and anus that develop as a result of the increasing pressure on the area due to the progressing pregnancy. They usually disappear after delivery, but can cause quite a bit of discomfort in the pregnant female. Recommended treatment includes drinking plenty of fluids to avoid constipation, which causes hemorrhoids to become more severe, soaking in warm water baths, and applying topical anesthetic ointments.
nausea: Nausea usually occurs during the first trimester of pregnancy and is known as "morning sickness". It may occur during the morning only in some individuals, in the afternoon only in some individuals, or may occur throughout the day. Recommended treatment includes eating dry toast or crackers, eating small frequent meals, eating something before taking prenatal vitamins, or drinking fluids between meals instead of with meals.
varicose veins: Varicose veins are twisted, swollen veins that occur as a result of the blood pooling in the legs, due to the added weight (from the pregnancy) to the lower extremities of the body. Recommended treatment includes the use of support hosiery, encouraging the pregnant woman to avoid crossing her legs, regular exercise of walking to increase the blood flow to the legs, and elevation of the feet and legs when sitting.
Part IV. Complication of Pregnancy
abortion: termination of a pregnancy before the fetus has reached a viable age; that is, an age at which the fetus could live outside of the uterine environment.
Spontaneous abortion: A spontaneous abortion is one that occurs on its own, as a result of abnormalities of the maternal environment or abnormalities of the embryo or fetus. Most spontaneous abortions occur within the first three months of pregnancy. Symptoms include vaginal bleeding, rhythmic uterine cramping, continual backache, and a feeling of pressure in the pelvic area. Tissue may or may not be passed through the vagina, depending on the type of abortion. A spontaneous abortion may be a complete abortion in which all products of conception are expelled; an incomplete abortion in which some, but not all products of conception are expelled; a threatened abortion in which the symptoms of an impending abortion are present, but ultrasound indicates that a live fetus is present.
abruptio/Ab'rQpFiEu/ placenta: The premature separation of a normally implanted placenta from the uterine wall, after the pregnancy has passed 20 weeks gestation or during labor ( the birthing process). Abruptio placenta is a dangerous and potentially life-threatening condition for both the mother and the fetus due to the potential for hemorrhage.
When bleeding occurs on the maternal side of the placenta, a clot (hematoma) forms in the area; this can lead to the premature separation of the placenta in the area. The severity of the complications from abruptio placenta depends on the amount of bleeding and the size of the clot that forms. The degree of separation may range from partial to complete, with bleeding being concealed or apparent.
Abruptio placenta does not usually occur alone, but may accompany other complications of pregnancy. Some of the conditions that may increase the risk of abruptio placenta are hypertension, sue of cocaine by the expectant mother, trauma to the abdomen while pregnant (as in injury or abuse), and the presence of a short umbilical cord (creating tension on the placenta during the birth process).
One of the classic symptoms of abruptio placenta is uterine tenderness with a board-like firmness to the abdomen. Additional symptoms include vaginal bleeding accompanied by abdominal or low back pain, or frequent cramplike contractions of the uterus (uterine irritability). If the bleeding is concealed, the patient may display other signs indicative of this, such as tachycardia, hypotension, and restlessness.
Treatment for abruptio placenta usually involves immediate delivery of the fetus by cesarean section if there are signs of fetal distress or if the expectant mother displays sign of hemorrhaging.
ectopic pregnancy: Abnormal implantation of a fertilized ovum outside of the uterine cavity; also called a tubal pregnancy.
Approximately 90 percent of all ectopic pregnancies occur in the fallopian tubes; other sites for ectopic implantation are the ovaries and the abdomen. Rarely are abdominal pregnancies carried to full term.
Possible causes of ectopic pregnancy include scarring of the fallopian tubes due to infections, inflammation, or as a result of surgery, adhesions due to endometriosis, congenital defects causing deformity of the tubes, pregnancy occurring while an IUD (intrauterine device) is in place, and maternal age over 35 years.
Tubal pregnancies usually rupture between 6 and 12 weeks' gestation. Some women do not even realize that they are pregnant, because the more common signs of pregnancy may not be present during the early stage of gestation. Symptoms include vaginal spotting (usually dark) and sharp abdominal pain (usually described as colicky or cramping).
Diagnosis of an ectopic pregnancy is often confirmed with a positive pregnancy test, ruling out other conditions, and transvaginal ultrasonography, which will reveal the absence of a gestational sac within the uterus. The physician may perform a culdocentesis to rule out a ruptured ectopic pregnancy. The aspiration of unclotted blood from the dul-de-sac area may indicate bleeding from a ruptured fallopian tube. The aspiration of clear fluid from the area would rule out a ruptured fallopian tube.
If ultrasound and culdocentesis are inconclusive and symptoms indicate the possibility of an ectopic pregnancy, laparoscopy may be necessary to confirm the diagnosis of an ectopic pregnancy.
For an unruptured ectopic pregnancy (tubal pregnancy), treatment includes surgery to remove the products of conception from the area. A ruptured ectopic pregnancy is much more serious, with the potential being present for hemorrhage and hypovolemic shock (diminished blood volume). The affected tube is surgically removed (salpingectomy) and the bleeding is brought under control by tying (ligating) the bleeding vessels.
gestational diabetes: A disorder in which women who are not diabetic before pregnancy develop diabetes during the pregnancy; that is, they develop an inability to metabolize carbohydrates (glucose intolerance), with resultant hyperglycemia.
This disorder develops during the latter part of pregnancy, with symptoms usually disappearing at the end of the pregnancy. Women who have gestational diabetes have a higher possibility of developing it with subsequent pregnancies; they are also at higher risk of developing diabetes later in life.
Factors that increase the risk of developing gestational diabetes include, but are not limited to, the following: obesity; maternal age over 30 years of age; history or birthing large babies (usually over 10 pounds); family history of diabetes; previous, unexplained, stillborn birth; previous birth with congenital anomalies (defects).
Symptoms vary from classic symptoms of diabetes, such as excessive thirst, hunger, and frequent urination, to being asymptomatic. Because a high number of pregnant women have gestational diabetes without obvious symptoms, all pregnant women are routinely screened for diabetes with a blood test; this usually occurs between weeks 24 and 28 of the pregnancy.
hydatidiform mole/high-dah-TID-ih-form/葡萄胎: An abnormal condition that begins as a pregnancy and deviates from normal development very early; the diseased ovum deteriorates (not producing a fetus), and the chorionic villi of the placenta (small vessels protruding from the outer layer) change to a mass of cysts resembling a bunch of grapes.
The growth of this mass progresses much more rapidly than uterine growth with a normal pregnancy. A hydatidiform mole is known as a molar pregnancy; also called a hydatid mole.
Symptoms include, but are not limited to, extreme nausea, uterine bleeding, anemia, an unusually large uterus for the duration of pregnancy (at three months the uterus may be the size expected at 5 or 6 months), absence of fetal heart sounds, edema, and hypertension.
Diagnosis is confirmed through the use of ultrasonography (no fetal skeleton will be visible), and laboratory findings ( the HCG level will be extremely high).
Treatment options include evacuation of the uterus, followed by a dilation and curettage when the uterine wall has regained its firmness (a few days later) or a hysterectomy, in which the uterus is removed. The age of the woman and the condition of the uterus will be factors determining the need for a hysterectomy. The tissue from the mass will be tested for presence of malignant cell.
Follow-up treatment involves close medical supervision for about 1 year following a molar pregnancy. This will include careful monitoring of the HCG levels (until they return to normal), and avoidance of another pregnancy for at least a year after all tests are negative. If no malignancy is detected and the HCG levels decrease, the prognosis is favorable.
hyperemesis gravidarum/high-per-EM-eh-sis grav-ih-DAR-um/妊娠劇吐: An abnormal condition of pregnancy characterized by severe vomiting that results in maternal dehydration, and weight loss.
The nausea and vomiting associated with hyperemesis gravidarum persists beyond the first three months of pregnancy and persists throughout the day to the point that eventually nothing can be retained by mouth.
The exact cause of this condition is unknown, but the incidence seems to be greater in younger mothers, first-time mothers, and those with increased body weight. Psychological factors have been considered as being instrumental in the development of hyperemesis graviarum (such as stress over the pregnancy, ambivalent feelings, toward the pregnancy, and conflicting feelings over becoming a mother). There are physical factors as well such as hyperthyroidism, elevated levels of estrogen, a multiple pregnancy, and the presence of a hydatidiform mole.
Treatment includes control of the vomiting, replacement of lost fluids and electrolytes, and emotional support for the woman. In most women, hyperemesis gravidarum is self-limiting and health is restored.
incompetent cervix: A condition in which the cervical os (opening) dilates before the fetus reaches term, without labor or uterine contractions; usually occurring during the second trimester of pregnancy and resulting in a spontaneous abortion of the fetus.
Treatment for an incompetent cervix involves suturing the cervix to keep it from opening during the pregnancy; this is known as cerclage. If the woman is going to have a vaginal delivery, the sutures are removed near the end of the pregnancy. If she is to have a cesarean section delivery, the sutures may be left in place.
placenta previa前置胎盤/plah-SEN-tah PRE-vee-ah/: A condition of pregnancy in which the placenta is implanted in the lower part of the uterus, and precedes the fetus during the birthing process. The cause (etiology) is unknown.
The degree of previa may range from marginal previa, where the placenta barely comes to the edge of the cervical os to partial previa, where the placenta partially covers the cervical os to total previa, where the placenta completely covers the cervical os.
The classic symptom of placenta previa is painless bleeding during the third trimester of pregnancy. The bleeding is usually abrupt and bright red, and very frightening to the expectant mother.
Diagnosis of placenta previa is confirmed by ultrasonography; sometimes it is detected before symptoms occur, through routine use of ultrasonography.
Treatment ranges from conservative measures of bed rest to immediate delivery by cesarean section, depending on the condition of the expectant mother and the condition of the fetus; that is, maturity of fetus and whether or not fetal distress is detected.
pregnancy-induced hypertension: Pregnancy-induced hypertension is the development of hypertension (high blood pressure) during pregnancy, in women who had normal blood pressure readings (normotensive) prior to pregnancy.
For ease in understanding, pregnancy-induced hypertension (PIH) is divided into three categories based on degree of severity:
1. Gestational hypertension is the development of hypertension after 20 weeks' gestation with no signs of edema or proteinuria. A blood pressure reading of 140/90 mmHg or greater on more than one occasion, or a blood pressure reading of 30 mmHg systolic or 15 mmHg diastolic over the patient's normal baseline readings are indicative of gestational hypertension. The hypertension usually subsides after pregnancy.
2. Pre-eclampsia is the development of hypertension with proteinuria or edema, after 20 weeks' gestation. The factor that distinguishes pre-eclampsia from gestational hypertension is the presence of proteinuria. The patient may also exhibit edema of the hands and face.
Edema of the feet and legs is common during pregnancy; however, edema that occurs above the waist may be indicative of pregnancy-induced hypertension. One of the first signs of edema may be a sudden rapid weight gain of more than 4 pounds in one week. This may be followed by visible signs of edema, such as puffiness or swelling of the face and hands; the woman may remove the rings from her fingers as they seem increasingly tighter on the fingers.
If the condition worsens, the pre-eclamptic patient may experience blurred vision or see spots in front of her eyes, and complain of severe headaches. These symptoms are strong indicators of impending eclampsia and medical treatment will be necessary.
3. Eclampsia子癇 is the most severe form of hypertension during pregnancy and is evidenced by the presence of seizures. An eclamptic seizure may jeopardize the life of the expectant mother and her fetus.
Delivery of the baby is the cure for pregnancy-induced hypertension. If it is determined that the fetus is mature enough for delivery, the pregnancy is ended by inducing labor or by performing a cesarean section. If the fetus is not mature enough for delivery, medical treatment will involve hospitalization of the expectant mother, bed rest, administration of medications to prevent convulsions until the baby can be delivered.
Rh incompatibility: An incompatibility between an Rh negative mother's blood with her Rh positive baby's blood, causing the mother's body to develop antibodies that will destroy the Rh positive blood.
Rh incompatibility can occur if the father of the baby is Rh positive and the mother of the baby is Rh negative; it does not occur when the expectant mother is Rh positive.
An Rh negative mother will give birth to either an Rh negative baby or an Rh positive baby. If her baby is Rh negative, the two are compatible. If her baby is Rh positive, the potential for incompatibility in subsequent births is present. During the birth process, if there is a mixing of Rh negative maternal and Rh positive fetal blood (as the placenta separates from the uterine wall), the mother's blood will recognize this as foreign to her body and will respond by producing antibodies to destroy the Rh positive blood.
The first Rh positive baby born to an Rh negative mother will not be affected by an Rh incompatibility; however, the antibodies that develop in response to the first pregnancy will be present during subsequent pregnancies. If a subsequent pregnancy produces an Rh positive fetus, the antibody production will increase. These antibodies are small enough to cross the placental barrier into the fetal circulation and destroy the red blood cells of the fetus, which have been recognized as "foreign" to the mother's body.
Treatment for preventionof Rh incompatibility is to administer an injection of Rh immune globulin (RhoGAM) to the Rh negative, pregnant woman during the 28th week of pregnancy. If she gives birth to an Rh positive baby, she will be administered another injection of RhoGAM within 72 hours after the birth. The administration of this Rh immune globulin will prevent the formation of the antibodies in the Rh negative mother's blood.
It is important that an Rh negative woman realizes that if her first pregnancy ends in abortion, it is still counted as a pregnancy and she should receive the injection of RhoGAM after the abortion to prevent the formation of antibodies that will affect future pregnancies, should the fetus be Rh positive.
Part V. Signs and Symptoms of Labor
The following is an elementary discussion of the signs and symptoms of impending labor and comparison of true labor and false labor.
bloody show: a vaginal discharge that is a mixture of thick mucus and pink or dark brown blood. It may begin a few weeks prior to the onset of labor and occurs as a result of the softening, dilation, and effacement (thinning) of the cervix in preparation for childbirth. The bloody show will continue and will increase during labor as the cervix continues to dilate and efface..
Braxton Hicks contractions: mild, irregular contractions that occur throughout pregnancy. As full term approaches, these contractions intensify and are sometimes mistaken for true labor.
increased vaginal discharge: This occurs when the baby settles into the pelvis prior to the onset of labor. The pressure of the baby's head in the area creates congestion of the vaginal mucosa, which results in an increase in clear, nonirritating vaginal secretions.
The expectant mother will notice that she can breathe easier because the descent of the baby relieves some of the pressure from her diaphragm. When lightening occurs, most expectant mothers will refer to it by saying that the baby has "dropped". Lightening is more obvious in women who are having their first baby.
rupture of the amniotic sac: The amniotic sac may occur prior to the onset of labor, may occur during labor, or may not occur without assistance. Expectant mothers are usually advised to report to the hospital or birthing center for evaluation if the membranes rupture prior to the onset of labor. This is important because the amniotic sac serves as a barrier between the baby and the unsterile outside environment, and when it is broken, the chance for infection is increased. Women often refer to the rupture of the amniotic sac by saying "water broke," because there may be a sudden gush of amniotic fluid as the membranes rupture.
sudden burst of energy: This occurs in some women shortly before the onset of labor. These women may suddenly have the energy to do major housecleaning duties ---- things they have not had the energy to do previously. They should be cautioned to save their energy during this time, so they will not be fatigued when labor actually begins.
Table 1: COMPARISON OF FALSE LABOR AND TRUE LABOR
FALSE LABOR TRUE LABOR
1. contraction irregular not too frequent shorter duration not too intense regular more frequent longer duration more intense
2. discomfort felt in abdomen felt in groin area felt in lower back radiates to lower abdomen feels like menstrual cramps
3. walking may relieve or decrease contractions may strengthen contraction
4. effacement/dilation dilation and effacement of cervix does not change cervix progressively effaces and dilates
Part VI. Diagnostic Techniques
amniocentesis: a surgical puncture of the amniotic sac for the purpose of removing amniotic fluid.
A needle is passed through the abdomen and uterus into the amniotic sac. Fluid is
removed for laboratory analysis to detect fetal abnormalities, maternal-fetal
blood incompatibilities, and to determine fetal maturity. If necessary, an
amniocentesis is usually performed between the 16th and 20th week of gestation.
cesarean section: a surgical procedure in which the abdomen and uterus are incised and a baby is
delivered transabdominally.
It is performed when abnormal fetal or maternal conditions exist that are judged
likely to make a vaginal delivery hazardous.
contraction stress test宮縮應急試驗: a stress test used to evaluate the ability of the fetus to tolerate the stress of labor and delivery (CST); also known as oxytocin challenge test. The purpose of the oxytocin challenge test is to simulate labor for a measurable period of time to determine whether or not the infant will tolerate labor well. During labor, uterine contractions decrease the oxygen supply to the fetus; if there is a significant decrease in the oxygen supply, it may cause a decrease in the fetal heart rate.
The maternal uterine activity and the fetal heart rate are monitored closely
during this stress test. If it appears that the contractions of the uterus will
endanger the fetus as labor progresses, an emergency cesarean section may
be indicated.
fetal monitoring (electronic)胎兒監護: The use of an electronic device to monitor the fetal heart rate and the maternal uterine contractions; this procedure can be done with external or internal devices. This monitoring is valuable during labor to assess the quality of the uterine contractions and the effects of lab or on the fetus.
nipple stimulation test: a noninvasive technique that produces basically the same results as the
contraction stress test by having the pregnant woman stimulate the nipples
of her breasts by rubbing them between her fingers.
This causes the natural release of oxytocin that causes contractions of the
uterus. The nipple stimulation test is less stressing to the uterus.
pelvic utrasound: a noninvasive procedure that uses high-frequency sound waves to examine
the abdomen and pelvis. The sound waves pass through the abdominal wall
from the transducer, which is moved back and forth across the abdomen.
When the sound waves bounce off of the internal organs in the
abdominopelvic region, these waves are converted to electrical impulses
eventually recorded on an oscilloscope screen. A photograph of the images is
then taken for further study.
Pelvic ultrasound can be used to locate a pelvic mass, an ectopic pregnancy, or
an intrauterine device, to inspect and assess the uterus, ovaries, and fallopian
tubes. Clearer ultrasonic pictures of the pelvic organs can be obtained by using
transvaginal ultrasonography. This procedure produces the same type of
picture as abdominal ultrasound, but involves the use of a vagina probe
inserted into the vagina while the patient is in lithotomy position. The probes
are encased in a sterile sheath and placed in the transducer before it is inserted
into the vagina. The sound waves function in the same way as those for the
abdominopelvic ultrasound, but the transvaginal ultrasonic image is much
clearer.
pelvimetry: The process of measuring the female pelvis, manually or by x-ray, to determine its
adequacy for childbearing.
Clinical pelvimetry is an estimate of the size of the birth canal by vaginal palpation
of bony landmarks in the pelvis and a mathematical estimate of the distance
between them. This is performed during the early part of the pregnancy and is r
ecorded as "adequate", "borderline", or "inadequate".
X-ray pevimetry is an actual x-ray of the pelvis to determine the dimensions of the
bony pelvis of a pregnant woman; it is performed when there is doubt that the head
of the fetus can safely pass through the pelvis during the labor process.
Measurements are actually made on the x-ray, and the true dimensions of the birth
canal and the head of the fetus can be calculated to determine if the proportions are
suitable.
pregnancy testing: tests performed on maternal urine and/or blood to determine the presence of
the hormone, HCG (human chorionic gonadotropin); HCG is detected shortly after
the first missed menstrual period.
Tests performed on blood are highly reliable and results are usually available in
approximately one hour. Tests performed on urine are fairly accurate when done
correctly, and are very popular in the form of home testing kits; results are
available within minutes. Women using home testing kits should test the first
voided urine specimen of the day, since the level of HCG is highest at that time.
Part VII. Common Abbreviations
ABBREVIATION MEANING
AFP alpha-fetoprotein
C-section cesarean section
CS cesarean section
CST contraction stress test
EDB expected date of birth
EDC expected (estimated) date of confinement
EDD expected date of delivery
EFM electronic fetal monitoring
FHR fetal heart rate
FHS, FHT fetal heart sound; fetal heart tone
FSH follicle-stimulating hormone
G gravida (pregnant)
GPA gravida, para, abortion
HCG human chorionic gonadotropin
L & D labor and delivery
LMP last menstrual period
Multip multipara
NSD normal spontaneous delivery
NST non stress test
OB obstetrics
Primip primipara
SVD spontaneous vaginal delivery
TPAL term, pre-term, abortions, living
UC uterine contractions
Part I. Vocabulary
afterbirth胎盤: The placenta, the amnion羊膜, the chorion絨毛膜, some amniotic fluid, blood, and blood clots expelled from the uterus after childbirth.
Alpha-fetoproteinα-胎兒球蛋白，甲胎蛋白: A protein found in the amniotic fluid. Measurements of the level of AFP in the amniotic sac are used for early diagnosis of fetal defects, such as spina bifida脊柱裂 (defective closure of the vertebrae of the spinal column) and anencephaly (congenital absence of the brain and spinal cord).
amenorrhea/ah-men-or-REE-ah/閉經: absence of menstrual flow
amnion/AM-nee-on/羊膜: the inner of the two membrane layers that surround and contain the fetus and the amniotic fluid during pregnancy.
amniotic fluid/am-nee-OT-ik/: A liquid produced by and contained within the fetal membranes during pregnancy. This fluid protects the fetus from trauma and temperature variations, helps to maintain fetal oxygen supply, and allows for freedom of movement by the fetus during pregnancy.
amniotic sac羊膜囊: The double layered sac that contains the fetus and the amniotic fluid during pregnancy.
areola/ah-REE-oh-lah/乳暈: The darker pigmented, circular area surrounding the nipple of each breast; also known as the "areola mammae" or the "areola papillaris".
ballottement/bal-ot-MON/觸診子宮檢胎法: A technique of using the examiner's finger to tap against the uterus, through the vagina, to cause the fetus to "bounce" within the amniotic fluid and feeling it rebound quickly.
Braxton-Hick's contractions: irregular, ineffective, contractions of the uterus that occur throughout pregnancy.
cerclage /sE:'klAdV/sair-KLOGH/ 環紮法（術）: Suturing the cervix to keep it from dilating prematurely during the pregnancy. This procedure is sometimes referred to as a "purse string procedure". The sutures are removed near the end of the pregnancy.
cervix: the part of the uterus that protrudes into the cavity of the vagina; the neck of the uterus.
cesarean section/see-SAYR-ee-an/剖宮產術: A surgical procedure in which the abdomen and uterus are incised and a baby is delivered transabdominally.
Chadwick's sign: The bluish-violet淡藍紫色的 hue if the cervix and vagina after approximately the sixth week of pregnancy.
chloasma /kloh-AZ-mah/ 黃褐斑: Patches of tan or brown pigmentation associated with pregnancy, occurring mostly on the forehead, cheeks, and nose; also called the "mask of pregnancy".
chorion/KOH-ree-on/羊毛膜: The outer of the two membrane layers that surround and contain the fetus and the amniotic fluid during pregnancy.
coitus/KOH-ih-tus/: sexual intercourse; copulation
colostrums/koh-LOSS-trim/初乳: The thin, yellowish fluid secreted by the breasts during pregnancy and the first few days after birth, before lactation begins.
conception: The union of a male sperm and a female ovum; also termed fertilization.
copulation: sexual intercourse; coitus
corpus luteum黃體: A mass of yellowish tissue that forms within the ruptured ovarian follicle after ovulation. It functions as a temporary endocrine gland for the purpose of secreting estrogen and large amounts of progesterone, which will sustain pregnancy, should it occur, until the placenta forms. If pregnancy does not occur, the corpus luteum will degenerate approximately 3 days before the beginning of menstruation.
culdocentesis /kull-doh-sen-TEE-sis/ 後穹隆穿刺術: Needle aspiration, through the vagina, into the cul-de-sac(盲腸) area for the purpose of removing fluid from the area for examination or diagnosis. Aspiration of unclotted blood from the cul-de-sac area may indicate bleeding from a ruptured fallopian tube; the aspiration of clear fluid from the area would rule out a ruptured fallopian tube.
dilatation (of cervix)宮口擴張: The enlargement of the diameter of the cervix during labor. The calculation of the amount of dilatation is measured in centimeters. When the cervix has dilated to 10 cm, it is said to be completely dilated.
Doppler: A technique used in ultrasound imaging to monitor the behavior of a moving structure, such as flowing blood or a beating heart. Fetal heart monitors operate on the Doppler sound wave principles to determine the fetal heart rate.
eclampsia /eh-KLSMP-see-ah/ 子癇，驚厥: The most severe form of hypertension during pregnancy, evidenced by seizures (convulsions).
edema: swelling, with water retention.
effacement/eh-FACE-ment/: Thinning of the cervix, which allows it to enlarge the diameter of its opening in preparation for childbirth; this occurs during the normal processes of labor.
ejaculation: The sudden emission of semen from the male urethra, usually occurring during sexual intercourse or masturbation手淫.
embryo: The product of conception from the second through the eighth week of pregnancy.
endometrium/en-doh-MEE-tree-um/子宮內膜: the inner lining of the uterus
episiotomy/ei-peez-ee-OT-oh-mee/外陰切開術: a surgical procedure in which an incision is made into the woman's perineum會陰 to enlarge the vaginal opening for delivery of the baby. This incision is usually made shortly before the baby's birth (second stage of labor) to prevent tearing of the perineum.
estrogen: one of the female hormones that promotes the development of the female secondary sex characteristics.
fallopian/fah-LOH-pee-an/ tubes輸卵管: a pair of tubes opening at one end into the uterus and at the other end into the peritoneal cavity over the ovary.
fertilization: the union of a male sperm and a female ovum; also termed conception.
fetoscope/FEET-oh-scope/胎兒鏡: a special stethoscope for hearing the fetal heartbeat through the mother's abdomen.
fetus: the developing baby from approximately the eighth week after conception until birth.
fimbriae/FIM-bree-ah/輸卵管傘: the fringelike end of the fallopian tube.
fundus: superior aspect of the uterus
gamete/GAM-eet/: a mature sperm or ovum
gastroesophageal/gas-troh-eh-soff-ah-JEE-al/ reflux胃食管反流: a return, or reflux, of gastric juices into the esophagus, resulting in a burning sensation.
gestation/jess-TAY-shun/妊娠: the term of pregnancy, which equals approximately 280 days from the onset of the last menstrual period; the period of intrauterine development of the fetus from conception through birth; also termed the gestational period.
gestational hypertension: a complication of pregnancy in which the expectant mother develops high blood pressure after 20 weeks' gestation, with no signs of proteinuria or edema.
glycogen/GLYE-koh-jen/糖原: the form of sugar that is stored in body cells, primarily the liver
gonads性腺: a gamete-producing gland, such as an ovary or a testis.
Goodell's sign: the softening of the uterine cervix, a probable sign of pregnancy
graafian follicles/GRAF-ee-an FALL-ih-kls/Graff小體: a mature, fully developed ovarian cyst containing the ripe ovum.
gravida/GRAH-vi-dah/孕婦: a woman who is pregnant. She may be identified as gravida I if this is her first pregnancy, gravida II for a second pregnancy, and so on.
Hegar's sign: softening of the lower segment of the uterus; a probable sign of pregnancy
hyperpigmentation: an increase in the pigmentation of the skin
hypertension: high blood pressure; a common, often asymptomatic disorder, in which the blood persistently exceeds 140/90 mm Hg.
hypovolemic shock低血容量性休克: a state of extreme physical collapse and exhaustion due to massive blood loss.
labor: the time and the processes that occur during the process of giving birth, from the beginning of cervical dilatation to the delivery of the placenta.
lactation泌乳: the production and secretion of milk from the female breasts as nourishment for the infant. Lactation can be referred to as a process or as a period of time during which the female is breastfeeding.
lactiferous/lak-TIF-er-us/ ducts輸乳管: channels or narrow tubular structures that carry milk from the lobes of each breast to the nipple.
laparoscope/LAP-ar-oss-kohp/腹腔鏡: visualization of the abdominal cavity with an instrument called a laparoscope腹腔鏡 through an incision into the abdominal wall.
leukorrhea/loo-koh-REE-ah/白帶: a white discharge from the vagina
lightening胎兒下降感: the settling of the fetal head into the pelvis, occurring a few weeks prior to the onset of labor.
linea nigra黑線: a darkened vertical midline appearing on the abdomen of a pregnant woman, extending from the fundus to the symphysis pubis.
lithotomy position截石位: a position in which the patient lies on her back, buttocks even with the end of the table, with her knees bent back toward her abdomen and the heel of each foot resting in an elevated foot rest at the end of the examination table.
lordosis脊柱前凸: a forward curvature of the spine, noticeable if the person is observed from the side.
lunar month太陰月: 4 weeks or 28 days; approximately the amount of time it takes the moon to revolve around the earth.
mammary glands: the female breasts
mask of pregnancy: patches of tan or brown pigmentation associated with pregnancy, occurring mostly on the forehead, cheeks, and nose; also known as chloasma黃褐斑.
multigravida /mull-tih-GRAV-ih-dah/經孕婦: a woman who has been pregnant more than once.
multipara/mull-TIP-ah-rah/經產婦: a woman who has given birth two or more times after 20 weeks' gestation.
Nagele's rule/NAY-geh-leez/: a formula that is used to calculate the date of birth: subtract 3 months from the first day of the last normal menstrual period and add 7 days to that date to arrive at the estimated date of birth.
neonatology/nee-oh-nay-TALL-oh-jee/新生兒科學: the branch of medicine that specializes in the treatment and care of the diseases and disorders of the newborn through the first four weeks of life.
nullipara/null-IP-ah-rah/未產婦: a woman who has never completed a pregnancy beyond 20 weeks' gestation.
obstetrician: a physician who specializes in the care of women during pregnancy, the delivery of the baby, and the first six weeks following the delivery, known as the immediate postpartum period.
obstetrics: the field of medicine that deals with pregnancy, the delivery of the baby, and the first six weeks after delivery.
ovary: one of a pair of female gonads responsible for producing mature ova (eggs) and releasing them at monthly intervals (ovulation); also responsible for producing the female hormones, estrogen and progesterone.
ovulation排卵: the release of the mature ovum from the ovary; occurs approximately 14 days prior to the beginning of menses.
ovum: the female reproductive cell; female sex cell or egg.
para: a woman who has produced and infant regardless of whether the infant was alive or stillborn. This term applies to any pregnancies carried to more than 20 weeks gestation. The term may be written para II, para III, and so on, to indicate the number of pregnancies lasting more than 20 weeks' gestation, regardless of the number of offspring produced by the pregnancy. A woman who has had only one pregnancy resulting in multiple births is still a para I.
parturition分娩: the act of giving birth
perineum/pair-ih-NEE-um/會陰: the area between the vaginal orifice and the anus, composed of muscular and fibrous tissue and serves as support for the pelvic structures.
placenta/plah-SEN-tah/胎盤: a highly vascular, disc-shaped organ that forms in the pregnant uterine wall for exchange of gases and nutrients between the mother and the fetus. The maternal side of the placenta attaches to the uterine wall, whereas the fetal side of the placenta gives rise to the umbilical cord, which connects directly to the baby. After the delivery of the baby, when the placenta is no longer needed, it separates from the uterine wall and passes to the outside of the body through the vagina, at which time it is called the "afterbirth".
pre-eclampsia/pre-eh-KLAMP-see-ah/先兆子癇，子癇前期: a state during pregnancy in which the expectant mother develops high blood pressure, accompanies by proteinuria or edema, after 20 weeks' gestation.
pregnancy: the period of intrauterine development of the fetus from conception through birth. The average pregnancy lasts approximately 40 weeks; also known as the gestational period.
prenatal: pertaining to the period of time, during pregnancy, that is before the birth of the baby.
primigravida/prigh-mih-GRAY-ih-dah/初孕婦: a woman who is pregnant for the first time
primipara/prai-Meep-ah-rah/初產婦: a woman who has given birth for the first time, after a pregnancy of at least 20 weeks gestation.
progesterone孕酮，黃體酮: one of the female hormones secreted by the corpus luteum and the placenta. It is primarily responsible for the changes that occur in the endometrium in anticipation of a fertilized ovum, and for development of the maternal placenta after implantation of a fertilized ovum.
proteinuria: the presence of protein (albumin) in the urine; also called albuminuria. This can be a sign of pregnancy induced hypertension (PIH).
puberty: the period of life at which the ability to reproduce begins; that is, in the female, it is the period when the female reproductive organs become fully developed.
pyrosis胃灼熱，心口灼熱: heartburn; that is, indigestion消化不良
quickening胎動（初）感: the first feeling of movement of the fetus felt by the expectant mother; usually occurs around 18 to 20 weeks' gestation.
salpingectomy/sal-pin-JEK-toh-mee/輸卵管切除術: surgical removal of a fallopian tube
sexual intercourse: the sexual union of two people of the opposite sex in which the penis is introduced into the vagina; also known as copulation; also known as coitus.
signs: objective findings as perceived by an examiner, such as the measurement of a fever on the thermometer, the observation of a rash on the skin, or the observation of a bluish-violet color of the cervix, etc.
sperm: a mature male germ cell; spermatozoon
striae gravidarum/STRAI-ay grav-ih-DAR-um/妊娠紋: stretch marks that occur during pregnancy due to the great amount of stretching that occurs. They appear as slightly depressed, pinkish-purple steaks in the areas of greatest stretch, which are the abdomen, the breasts, and the thighs.
tachycardia心動過速: rapid heartbeat, consistently over 100 beats per minute.
testes: the paired male gonads that produce sperm
transvaginal ultrasonography: an ultrasound image that is produced inserting a transvaginal probe into the vagina. The probe is encased in a disposable cover and is coated with a gel for easy insertion. The gel also promotes conductivity. This procedure allows clear visualization of the uterus, gestational sac, and embryo in the early stages of pregnancy. It also allows the examiner to visualize deeper pelvic structure, such as the ovaries and fallopian tubes.
trimester: one of the three periods of approximately 3 months into which pregnancy is divided. the first trimester consists of weeks 1 to 12; the second trimester consists of weeks 13 to 27 and the third trimester consists of weeks 28 to 40.
ultrasonography: a noninvasive procedure that involves the use of reflected sound waves to detect the presence of the embryo or fetus.
umbilical cord臍帶: a flexible structure connecting the umbilicus ( navel) of the fetus with the placenta in the pregnant uterus. It serves as passage for the umbilical arteries and vein.
uterus: the hollow, pear-shaped organ of the female reproductive system that house the fertilized, implanted ovum as it develops throughout pregnancy; also the source of the monthly menstrual flow from the nonpregnant uterus.
vagina陰道: the muscular tube that connects the uterus with the vulva. It is approximately 3 inches in length, and rest between the bladder (anteriorly) and the rectum (posteriorly).
varicose veins靜脈曲張: twisted, swollen veins that occur as a result of the blood pooling in the legs.
waddling gait鴨步態: a manner of walking in which the feet are wide apart and the walk resembles that of a duck.
Part II: Word elements
word element meaning example
amni/o amnion amniocentesis羊膜腔穿刺術
ante- before anteflexion前屈
culd/o cul-de-sac culdocentesis後穹隆穿刺術
-cyesis pregnancy pseudocyesis假孕
episi/o vulva episiotomy外陰切開術
fet/o fetus fetoscope胎兒鏡
-gravida pregnancy primigravida初孕婦
lact/o milk lactation泌乳
multi- many multigravida經孕婦
nat/o birth prenatal 產前的
nulli- none nullipara 未產婦
-para to give birth multipara 經產婦
primi- first primigravida初孕婦
obstetr/o midwife obstetrics
pelv/i pelvis pelvimetry骨盆測量法
perine/o perineum perineal 會陰的
salping/o fallopian tube salpingectomy輸卵管切除術
-tocia labor dystocia 難產
vagin/o vagina transvaginal
Part III. Discomfort of Pregnancy
Throughout the pregnancy, the expectant mother will experience various discomforts. It is important that she realize that these will be temporary discomforts and should subside after delivery. It is also important that the health care professional be aware of the difference between discomforts of pregnancy and signs of possible complications of pregnancy. The knowledgeable health care professional will have the responsibility of educating the patient regarding measures for relief of these temporary discomforts. The following list includes, but is not limited to, the more common discomforts of pregnancy.
backache: Backache is common during the second and third trimester of pregnancy and is due to the body's adaptation to the stresses placed upon the back as the pregnancy progresses.
Recommended treatment includes encouraging the best posture possible, wearing comfortable shoes, getting adequate rest, and bending from the knees ----not the waist.
edema: Edema, or swelling, of the lower extremities is not uncommon in pregnancy, particularly as the pregnancy progresses.
Recommended treatment includes elevating the feet and legs when sitting, lying down when resting, drinking plenty of water, and avoiding foods high in sodium. If the edema is present in the hands and face also, it should be reported immediately to the physician because this could be an indication of complications of pregnancy.
fatigue: Fatigue usually occurs during the first trimester of pregnancy, disappears during the second trimester, and returns toward the end of the pregnancy. This is due to the body's adjustment to the stresses of pregnancy.
heartburn: Heartburn is also known as pyrosis (pyr/o=fever, fire + osis=condition). This discomfort occurs mainly in the last few weeks of pregnancy due to the pressure exerted on the esophagus by the enlarged pregnant uterus. This pressure may also cause a return, or reflux, of gastric juices into the esophagus, resulting in a burning sensation ------ a condition known as gastroesophageal reflux.
hemorrhoids痔: hemorrhoids are swollen veins of the rectum and anus that develop as a result of the increasing pressure on the area due to the progressing pregnancy. They usually disappear after delivery, but can cause quite a bit of discomfort in the pregnant female. Recommended treatment includes drinking plenty of fluids to avoid constipation, which causes hemorrhoids to become more severe, soaking in warm water baths, and applying topical anesthetic ointments.
nausea: Nausea usually occurs during the first trimester of pregnancy and is known as "morning sickness". It may occur during the morning only in some individuals, in the afternoon only in some individuals, or may occur throughout the day. Recommended treatment includes eating dry toast or crackers, eating small frequent meals, eating something before taking prenatal vitamins, or drinking fluids between meals instead of with meals.
varicose veins: Varicose veins are twisted, swollen veins that occur as a result of the blood pooling in the legs, due to the added weight (from the pregnancy) to the lower extremities of the body. Recommended treatment includes the use of support hosiery, encouraging the pregnant woman to avoid crossing her legs, regular exercise of walking to increase the blood flow to the legs, and elevation of the feet and legs when sitting.
Part IV. Complication of Pregnancy
abortion: termination of a pregnancy before the fetus has reached a viable age; that is, an age at which the fetus could live outside of the uterine environment.
Spontaneous abortion: A spontaneous abortion is one that occurs on its own, as a result of abnormalities of the maternal environment or abnormalities of the embryo or fetus. Most spontaneous abortions occur within the first three months of pregnancy. Symptoms include vaginal bleeding, rhythmic uterine cramping, continual backache, and a feeling of pressure in the pelvic area. Tissue may or may not be passed through the vagina, depending on the type of abortion. A spontaneous abortion may be a complete abortion in which all products of conception are expelled; an incomplete abortion in which some, but not all products of conception are expelled; a threatened abortion in which the symptoms of an impending abortion are present, but ultrasound indicates that a live fetus is present.
abruptio/Ab'rQpFiEu/ placenta: The premature separation of a normally implanted placenta from the uterine wall, after the pregnancy has passed 20 weeks gestation or during labor ( the birthing process). Abruptio placenta is a dangerous and potentially life-threatening condition for both the mother and the fetus due to the potential for hemorrhage.
When bleeding occurs on the maternal side of the placenta, a clot (hematoma) forms in the area; this can lead to the premature separation of the placenta in the area. The severity of the complications from abruptio placenta depends on the amount of bleeding and the size of the clot that forms. The degree of separation may range from partial to complete, with bleeding being concealed or apparent.
Abruptio placenta does not usually occur alone, but may accompany other complications of pregnancy. Some of the conditions that may increase the risk of abruptio placenta are hypertension, sue of cocaine by the expectant mother, trauma to the abdomen while pregnant (as in injury or abuse), and the presence of a short umbilical cord (creating tension on the placenta during the birth process).
One of the classic symptoms of abruptio placenta is uterine tenderness with a board-like firmness to the abdomen. Additional symptoms include vaginal bleeding accompanied by abdominal or low back pain, or frequent cramplike contractions of the uterus (uterine irritability). If the bleeding is concealed, the patient may display other signs indicative of this, such as tachycardia, hypotension, and restlessness.
Treatment for abruptio placenta usually involves immediate delivery of the fetus by cesarean section if there are signs of fetal distress or if the expectant mother displays sign of hemorrhaging.
ectopic pregnancy: Abnormal implantation of a fertilized ovum outside of the uterine cavity; also called a tubal pregnancy.
Approximately 90 percent of all ectopic pregnancies occur in the fallopian tubes; other sites for ectopic implantation are the ovaries and the abdomen. Rarely are abdominal pregnancies carried to full term.
Possible causes of ectopic pregnancy include scarring of the fallopian tubes due to infections, inflammation, or as a result of surgery, adhesions due to endometriosis, congenital defects causing deformity of the tubes, pregnancy occurring while an IUD (intrauterine device) is in place, and maternal age over 35 years.
Tubal pregnancies usually rupture between 6 and 12 weeks' gestation. Some women do not even realize that they are pregnant, because the more common signs of pregnancy may not be present during the early stage of gestation. Symptoms include vaginal spotting (usually dark) and sharp abdominal pain (usually described as colicky or cramping).
Diagnosis of an ectopic pregnancy is often confirmed with a positive pregnancy test, ruling out other conditions, and transvaginal ultrasonography, which will reveal the absence of a gestational sac within the uterus. The physician may perform a culdocentesis to rule out a ruptured ectopic pregnancy. The aspiration of unclotted blood from the dul-de-sac area may indicate bleeding from a ruptured fallopian tube. The aspiration of clear fluid from the area would rule out a ruptured fallopian tube.
If ultrasound and culdocentesis are inconclusive and symptoms indicate the possibility of an ectopic pregnancy, laparoscopy may be necessary to confirm the diagnosis of an ectopic pregnancy.
For an unruptured ectopic pregnancy (tubal pregnancy), treatment includes surgery to remove the products of conception from the area. A ruptured ectopic pregnancy is much more serious, with the potential being present for hemorrhage and hypovolemic shock (diminished blood volume). The affected tube is surgically removed (salpingectomy) and the bleeding is brought under control by tying (ligating) the bleeding vessels.
gestational diabetes: A disorder in which women who are not diabetic before pregnancy develop diabetes during the pregnancy; that is, they develop an inability to metabolize carbohydrates (glucose intolerance), with resultant hyperglycemia.
This disorder develops during the latter part of pregnancy, with symptoms usually disappearing at the end of the pregnancy. Women who have gestational diabetes have a higher possibility of developing it with subsequent pregnancies; they are also at higher risk of developing diabetes later in life.
Factors that increase the risk of developing gestational diabetes include, but are not limited to, the following: obesity; maternal age over 30 years of age; history or birthing large babies (usually over 10 pounds); family history of diabetes; previous, unexplained, stillborn birth; previous birth with congenital anomalies (defects).
Symptoms vary from classic symptoms of diabetes, such as excessive thirst, hunger, and frequent urination, to being asymptomatic. Because a high number of pregnant women have gestational diabetes without obvious symptoms, all pregnant women are routinely screened for diabetes with a blood test; this usually occurs between weeks 24 and 28 of the pregnancy.
hydatidiform mole/high-dah-TID-ih-form/葡萄胎: An abnormal condition that begins as a pregnancy and deviates from normal development very early; the diseased ovum deteriorates (not producing a fetus), and the chorionic villi of the placenta (small vessels protruding from the outer layer) change to a mass of cysts resembling a bunch of grapes.
The growth of this mass progresses much more rapidly than uterine growth with a normal pregnancy. A hydatidiform mole is known as a molar pregnancy; also called a hydatid mole.
Symptoms include, but are not limited to, extreme nausea, uterine bleeding, anemia, an unusually large uterus for the duration of pregnancy (at three months the uterus may be the size expected at 5 or 6 months), absence of fetal heart sounds, edema, and hypertension.
Diagnosis is confirmed through the use of ultrasonography (no fetal skeleton will be visible), and laboratory findings ( the HCG level will be extremely high).
Treatment options include evacuation of the uterus, followed by a dilation and curettage when the uterine wall has regained its firmness (a few days later) or a hysterectomy, in which the uterus is removed. The age of the woman and the condition of the uterus will be factors determining the need for a hysterectomy. The tissue from the mass will be tested for presence of malignant cell.
Follow-up treatment involves close medical supervision for about 1 year following a molar pregnancy. This will include careful monitoring of the HCG levels (until they return to normal), and avoidance of another pregnancy for at least a year after all tests are negative. If no malignancy is detected and the HCG levels decrease, the prognosis is favorable.
hyperemesis gravidarum/high-per-EM-eh-sis grav-ih-DAR-um/妊娠劇吐: An abnormal condition of pregnancy characterized by severe vomiting that results in maternal dehydration, and weight loss.
The nausea and vomiting associated with hyperemesis gravidarum persists beyond the first three months of pregnancy and persists throughout the day to the point that eventually nothing can be retained by mouth.
The exact cause of this condition is unknown, but the incidence seems to be greater in younger mothers, first-time mothers, and those with increased body weight. Psychological factors have been considered as being instrumental in the development of hyperemesis graviarum (such as stress over the pregnancy, ambivalent feelings, toward the pregnancy, and conflicting feelings over becoming a mother). There are physical factors as well such as hyperthyroidism, elevated levels of estrogen, a multiple pregnancy, and the presence of a hydatidiform mole.
Treatment includes control of the vomiting, replacement of lost fluids and electrolytes, and emotional support for the woman. In most women, hyperemesis gravidarum is self-limiting and health is restored.
incompetent cervix: A condition in which the cervical os (opening) dilates before the fetus reaches term, without labor or uterine contractions; usually occurring during the second trimester of pregnancy and resulting in a spontaneous abortion of the fetus.
Treatment for an incompetent cervix involves suturing the cervix to keep it from opening during the pregnancy; this is known as cerclage. If the woman is going to have a vaginal delivery, the sutures are removed near the end of the pregnancy. If she is to have a cesarean section delivery, the sutures may be left in place.
placenta previa前置胎盤/plah-SEN-tah PRE-vee-ah/: A condition of pregnancy in which the placenta is implanted in the lower part of the uterus, and precedes the fetus during the birthing process. The cause (etiology) is unknown.
The degree of previa may range from marginal previa, where the placenta barely comes to the edge of the cervical os to partial previa, where the placenta partially covers the cervical os to total previa, where the placenta completely covers the cervical os.
The classic symptom of placenta previa is painless bleeding during the third trimester of pregnancy. The bleeding is usually abrupt and bright red, and very frightening to the expectant mother.
Diagnosis of placenta previa is confirmed by ultrasonography; sometimes it is detected before symptoms occur, through routine use of ultrasonography.
Treatment ranges from conservative measures of bed rest to immediate delivery by cesarean section, depending on the condition of the expectant mother and the condition of the fetus; that is, maturity of fetus and whether or not fetal distress is detected.
pregnancy-induced hypertension: Pregnancy-induced hypertension is the development of hypertension (high blood pressure) during pregnancy, in women who had normal blood pressure readings (normotensive) prior to pregnancy.
For ease in understanding, pregnancy-induced hypertension (PIH) is divided into three categories based on degree of severity:
1. Gestational hypertension is the development of hypertension after 20 weeks' gestation with no signs of edema or proteinuria. A blood pressure reading of 140/90 mmHg or greater on more than one occasion, or a blood pressure reading of 30 mmHg systolic or 15 mmHg diastolic over the patient's normal baseline readings are indicative of gestational hypertension. The hypertension usually subsides after pregnancy.
2. Pre-eclampsia is the development of hypertension with proteinuria or edema, after 20 weeks' gestation. The factor that distinguishes pre-eclampsia from gestational hypertension is the presence of proteinuria. The patient may also exhibit edema of the hands and face.
Edema of the feet and legs is common during pregnancy; however, edema that occurs above the waist may be indicative of pregnancy-induced hypertension. One of the first signs of edema may be a sudden rapid weight gain of more than 4 pounds in one week. This may be followed by visible signs of edema, such as puffiness or swelling of the face and hands; the woman may remove the rings from her fingers as they seem increasingly tighter on the fingers.
If the condition worsens, the pre-eclamptic patient may experience blurred vision or see spots in front of her eyes, and complain of severe headaches. These symptoms are strong indicators of impending eclampsia and medical treatment will be necessary.
3. Eclampsia子癇 is the most severe form of hypertension during pregnancy and is evidenced by the presence of seizures. An eclamptic seizure may jeopardize the life of the expectant mother and her fetus.
Delivery of the baby is the cure for pregnancy-induced hypertension. If it is determined that the fetus is mature enough for delivery, the pregnancy is ended by inducing labor or by performing a cesarean section. If the fetus is not mature enough for delivery, medical treatment will involve hospitalization of the expectant mother, bed rest, administration of medications to prevent convulsions until the baby can be delivered.
Rh incompatibility: An incompatibility between an Rh negative mother's blood with her Rh positive baby's blood, causing the mother's body to develop antibodies that will destroy the Rh positive blood.
Rh incompatibility can occur if the father of the baby is Rh positive and the mother of the baby is Rh negative; it does not occur when the expectant mother is Rh positive.
An Rh negative mother will give birth to either an Rh negative baby or an Rh positive baby. If her baby is Rh negative, the two are compatible. If her baby is Rh positive, the potential for incompatibility in subsequent births is present. During the birth process, if there is a mixing of Rh negative maternal and Rh positive fetal blood (as the placenta separates from the uterine wall), the mother's blood will recognize this as foreign to her body and will respond by producing antibodies to destroy the Rh positive blood.
The first Rh positive baby born to an Rh negative mother will not be affected by an Rh incompatibility; however, the antibodies that develop in response to the first pregnancy will be present during subsequent pregnancies. If a subsequent pregnancy produces an Rh positive fetus, the antibody production will increase. These antibodies are small enough to cross the placental barrier into the fetal circulation and destroy the red blood cells of the fetus, which have been recognized as "foreign" to the mother's body.
Treatment for preventionof Rh incompatibility is to administer an injection of Rh immune globulin (RhoGAM) to the Rh negative, pregnant woman during the 28th week of pregnancy. If she gives birth to an Rh positive baby, she will be administered another injection of RhoGAM within 72 hours after the birth. The administration of this Rh immune globulin will prevent the formation of the antibodies in the Rh negative mother's blood.
It is important that an Rh negative woman realizes that if her first pregnancy ends in abortion, it is still counted as a pregnancy and she should receive the injection of RhoGAM after the abortion to prevent the formation of antibodies that will affect future pregnancies, should the fetus be Rh positive.
Part V. Signs and Symptoms of Labor
The following is an elementary discussion of the signs and symptoms of impending labor and comparison of true labor and false labor.
bloody show: a vaginal discharge that is a mixture of thick mucus and pink or dark brown blood. It may begin a few weeks prior to the onset of labor and occurs as a result of the softening, dilation, and effacement (thinning) of the cervix in preparation for childbirth. The bloody show will continue and will increase during labor as the cervix continues to dilate and efface..
Braxton Hicks contractions: mild, irregular contractions that occur throughout pregnancy. As full term approaches, these contractions intensify and are sometimes mistaken for true labor.
increased vaginal discharge: This occurs when the baby settles into the pelvis prior to the onset of labor. The pressure of the baby's head in the area creates congestion of the vaginal mucosa, which results in an increase in clear, nonirritating vaginal secretions.
The expectant mother will notice that she can breathe easier because the descent of the baby relieves some of the pressure from her diaphragm. When lightening occurs, most expectant mothers will refer to it by saying that the baby has "dropped". Lightening is more obvious in women who are having their first baby.
rupture of the amniotic sac: The amniotic sac may occur prior to the onset of labor, may occur during labor, or may not occur without assistance. Expectant mothers are usually advised to report to the hospital or birthing center for evaluation if the membranes rupture prior to the onset of labor. This is important because the amniotic sac serves as a barrier between the baby and the unsterile outside environment, and when it is broken, the chance for infection is increased. Women often refer to the rupture of the amniotic sac by saying "water broke," because there may be a sudden gush of amniotic fluid as the membranes rupture.
sudden burst of energy: This occurs in some women shortly before the onset of labor. These women may suddenly have the energy to do major housecleaning duties ---- things they have not had the energy to do previously. They should be cautioned to save their energy during this time, so they will not be fatigued when labor actually begins.
Table 1: COMPARISON OF FALSE LABOR AND TRUE LABOR
FALSE LABOR TRUE LABOR
1. contraction irregular not too frequent shorter duration not too intense regular more frequent longer duration more intense
2. discomfort felt in abdomen felt in groin area felt in lower back radiates to lower abdomen feels like menstrual cramps
3. walking may relieve or decrease contractions may strengthen contraction
4. effacement/dilation dilation and effacement of cervix does not change cervix progressively effaces and dilates
Part VI. Diagnostic Techniques
amniocentesis: a surgical puncture of the amniotic sac for the purpose of removing amniotic fluid.
A needle is passed through the abdomen and uterus into the amniotic sac. Fluid is
removed for laboratory analysis to detect fetal abnormalities, maternal-fetal
blood incompatibilities, and to determine fetal maturity. If necessary, an
amniocentesis is usually performed between the 16th and 20th week of gestation.
cesarean section: a surgical procedure in which the abdomen and uterus are incised and a baby is
delivered transabdominally.
It is performed when abnormal fetal or maternal conditions exist that are judged
likely to make a vaginal delivery hazardous.
contraction stress test宮縮應急試驗: a stress test used to evaluate the ability of the fetus to tolerate the stress of labor and delivery (CST); also known as oxytocin challenge test. The purpose of the oxytocin challenge test is to simulate labor for a measurable period of time to determine whether or not the infant will tolerate labor well. During labor, uterine contractions decrease the oxygen supply to the fetus; if there is a significant decrease in the oxygen supply, it may cause a decrease in the fetal heart rate.
The maternal uterine activity and the fetal heart rate are monitored closely
during this stress test. If it appears that the contractions of the uterus will
endanger the fetus as labor progresses, an emergency cesarean section may
be indicated.
fetal monitoring (electronic)胎兒監護: The use of an electronic device to monitor the fetal heart rate and the maternal uterine contractions; this procedure can be done with external or internal devices. This monitoring is valuable during labor to assess the quality of the uterine contractions and the effects of lab or on the fetus.
nipple stimulation test: a noninvasive technique that produces basically the same results as the
contraction stress test by having the pregnant woman stimulate the nipples
of her breasts by rubbing them between her fingers.
This causes the natural release of oxytocin that causes contractions of the
uterus. The nipple stimulation test is less stressing to the uterus.
pelvic utrasound: a noninvasive procedure that uses high-frequency sound waves to examine
the abdomen and pelvis. The sound waves pass through the abdominal wall
from the transducer, which is moved back and forth across the abdomen.
When the sound waves bounce off of the internal organs in the
abdominopelvic region, these waves are converted to electrical impulses
eventually recorded on an oscilloscope screen. A photograph of the images is
then taken for further study.
Pelvic ultrasound can be used to locate a pelvic mass, an ectopic pregnancy, or
an intrauterine device, to inspect and assess the uterus, ovaries, and fallopian
tubes. Clearer ultrasonic pictures of the pelvic organs can be obtained by using
transvaginal ultrasonography. This procedure produces the same type of
picture as abdominal ultrasound, but involves the use of a vagina probe
inserted into the vagina while the patient is in lithotomy position. The probes
are encased in a sterile sheath and placed in the transducer before it is inserted
into the vagina. The sound waves function in the same way as those for the
abdominopelvic ultrasound, but the transvaginal ultrasonic image is much
clearer.
pelvimetry: The process of measuring the female pelvis, manually or by x-ray, to determine its
adequacy for childbearing.
Clinical pelvimetry is an estimate of the size of the birth canal by vaginal palpation
of bony landmarks in the pelvis and a mathematical estimate of the distance
between them. This is performed during the early part of the pregnancy and is r
ecorded as "adequate", "borderline", or "inadequate".
X-ray pevimetry is an actual x-ray of the pelvis to determine the dimensions of the
bony pelvis of a pregnant woman; it is performed when there is doubt that the head
of the fetus can safely pass through the pelvis during the labor process.
Measurements are actually made on the x-ray, and the true dimensions of the birth
canal and the head of the fetus can be calculated to determine if the proportions are
suitable.
pregnancy testing: tests performed on maternal urine and/or blood to determine the presence of
the hormone, HCG (human chorionic gonadotropin); HCG is detected shortly after
the first missed menstrual period.
Tests performed on blood are highly reliable and results are usually available in
approximately one hour. Tests performed on urine are fairly accurate when done
correctly, and are very popular in the form of home testing kits; results are
available within minutes. Women using home testing kits should test the first
voided urine specimen of the day, since the level of HCG is highest at that time.
Part VII. Common Abbreviations
ABBREVIATION MEANING
AFP alpha-fetoprotein
C-section cesarean section
CS cesarean section
CST contraction stress test
EDB expected date of birth
EDC expected (estimated) date of confinement
EDD expected date of delivery
EFM electronic fetal monitoring
FHR fetal heart rate
FHS, FHT fetal heart sound; fetal heart tone
FSH follicle-stimulating hormone
G gravida (pregnant)
GPA gravida, para, abortion
HCG human chorionic gonadotropin
L & D labor and delivery
LMP last menstrual period
Multip multipara
NSD normal spontaneous delivery
NST non stress test
OB obstetrics
Primip primipara
SVD spontaneous vaginal delivery
TPAL term, pre-term, abortions, living
UC uterine contractions
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