Download obstetrics

OBSTETRICS
Obstetrics
Is the science of dealing with the care of the pregnant women
during all stages of pregnancy and the period following birth.
An obstetrician is a person who specialises in obstetrics. Often doctors specialise in
obstetrics and gynaecology.
Root
Combining form
Meaning
Obstetric
Obstetr/ic
midwife
Pregnancy is the sequence of events including fertilisation, implantation, embryonic
growth and normally, foetal growth that terminates in birth.
Semen
Is a mixture of sperm and secretions of the seminal vesicles and prostate.
Insemination refers to the deposition of semen in the female reproductive tract.
Artificial insemination (AI) refers to the insertion of semen into the uterus via a
cannula instead of coitus. The sperm used in this procedure can be from two
sources;
AI by husband (AIH) – semen from the woman’s husband is used
AI by donor (AID) - semen from a male other than the husband is used.
Root
Combining form
Semin
Semin/i
Sperm
Sperm/o, spermat/o,
sperm/i
Meaning
Liquid secretion or semen of the testicles and
glands associated with the reproductive system
Sperm cells or spermatozoa, ejaculated from the
male during the peak of sexual excitement
Activity 1
Write the meaning of;
1. aspermia __________________________________________________________
2. oligospermia _______________________________________________________
3. spermicide _________________________________________________________
Build words using spermat/o which mean;
4. formation of sperm ___________________________________________________
Sperm counts are performed to estimate the number of sperm, the percentage of
abnormal sperm and their mobility. The actual number of sperm is important in
determining the fertility of the male. A sperm count of less than 60 million sperm per
cm3 of semen results in decreased fertility, even though only one sperm is required
to fertilise an egg.
Fertilisation
The term fertilisation, or conception, is applied to the union of the sperm and the
ovum. Fertilisation normally occurs in the uterine tube when the ovum is about one
third of the way down the tube. The fertilised ovum is called a zygote. The zygote
moves down the fallopian tube and is implanted in the endometrium.
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Occasionally, fertilised eggs can grow outside the uterus. These are known as
ectopic pregnancies. The most common ectopic site is the fallopian tube.
DEVELOPMENT OF FOETUS
Embryo
The first two months are considered the embryonic period. During this period the
developing human is called an embryo. After the second month (8 weeks) it will be
called a foetus. During the embryonic period the embryonic membranes form. These
membranes lie outside the embryo and will protect and nourish the embryo and later
the foetus. As the embryo grows the amnion, a thin protective membrane, surrounds
it and becomes filled with amniotic fluid. Amniotic fluid serves as a shock absorber for
the foetus. The amniotic sac ruptures just before birth and its fluid is known as the
‘bag of waters’.
Root
Combining form
Amni
Amni/o
Chorion Chori/o
Meaning
Foetal membrane which retains the amniotic fluid
surrounding the developing foetus
Part develops into the placenta and part becomes closely
aligned to the amnion
Activity 2
Write the meaning of
1. amniogenesis ______________________________________________________
2. amniocentesis ______________________________________________________
Foetus
The part of the foetus, which lies in the lower part of the uterus, is known as the
presenting part. In a normal birth the vertex of the skull forms the presenting part and
it enters the birth canal first. Malpresentation is where other parts enter first.
Placenta
The placenta develops between the embryo and the endometrium (lining of the
uterus) of the mother. It provides an exchange of nutrients and wastes between the
foetus and the mother and secretes the hormones necessary to maintain pregnancy.
Root
Combining form
Meaning
Foet
Foet/o
An unborn baby
Placent
Placent/o
Flat cake
Adherent placenta – a placenta which is fused to the uterine wall so that separation is
slow and delivery of the placenta is delayed/difficult
Retained placenta – when the placenta is not expelled
Placenta praevia – placenta forms abnormally in the lower part of the uterus over the
internal opening of the cervix.
Activity 3
Build words which mean;
1. Pertaining to poisoning of the foetus _________________________________
2. Measurement of the foetus ________________________________________
3. Inflammation of the placenta _______________________________________
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Umbilical cord
The umbilical cord connects the foetus to the placenta and transports blood and
nutrients.
Gestation
The time the embryo or foetus is carried in the uterus is called gestation. The total
human gestation is about 280 days. Approximately 9 months.
Root
Combining form
Meaning
Gravida
-gravida
Para
-para
Toc
Toc/o, -tocia
Describes a woman in relation to her pregnancies
Number of previous pregnancies, resulting in a live
infant
Birth/labour
Nat
Nat/o
Birth
Antenatal
Refers to the period from conception until birth. Gravida is the term for a pregnant
woman. The pregnancy is broken into three periods each about three months long
and each called a trimester, ie, first trimester, second trimester, third trimester.
Labour and delivery
The term parturition refers to birth; a parturient is a woman in labour. Parturition is
preceded by a sequence of events commonly called labour. ust prior to birth, the
muscles of the uterus contract rhythmically and forcefully. Uterine contractions, called
eutocia, occur in waves. They start at the fundus of the uterus and move downwards.
These waves expel the foetus. If labour is late or slow an injection of syntocinon can
produce forcible contractions.
There are three stages of labour. The first stage, the stage of dilation, is the time
from the onset of labour to the complete dilation of the cervix. During this stage there
are regular contractions of the uterus, a rupturing of the amniotic sac and complete
dilation of the cervix, 10 cm. The second stage of labour, the stage of expulsion, is
the time from complete cervical dilation to delivery. In the third stage, the placental
stage, the placenta (afterbirth) is expelled a few minutes after the delivery of the
foetus.
During labour the foetus is monitored, usually by its heartbeat, to identify any signs of
distress. The foetus lies in a lateral position in the uterus and during labour its head
moves down to engage with the cervix. The portion of the foetus that is touched by
an examining finger through the cervix is called presentation. Usually it is the head
(vertex). If the buttocks or feet are presented it is called a breech and the foetus may
have to be turned in the uterus before delivery can occur otherwise a caesarian
section is performed.
The 6-8 weeks following birth is known as puerperium. It is the period when the
reproductive system involutes (reverts) to its pre-pregnancy state. Puerperal sepsis is
a serious infection of the genital tract occurring within 21 days of abortion or
childbirth.
Postpartum haemorrhage – excessive bleeding from the birth canal
Eclampsia – sudden convulsion due to toxaemia of pregnancy
Stillbirth – where the foetus is born dead
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Congenital – present at the time of birth, eg. congenital heart disease is a structural
heart defect present at the time of birth
Caesarean section – delivery by way of a surgical incision through the abdominal
wall
Forceps – surgical instruments used in difficult labour to help delivery
Activity 4
Write the meaning of;
1. Placentopathy ______________________________________________________
2. Primigravida (gravida 1) _______________________________________________
3. Multigravida
______________________________________________________
4. Primipara (para 1) ___________________________________________________
5. Multipara
______________________________________________________
6. Dystocia
______________________________________________________
7. Tocology
______________________________________________________
8. Neonatal
______________________________________________________
9. Antenatal
______________________________________________________
10. Neonatology
______________________________________________________
Mammary glands
The essential function of the mammary glands is milk secretion or lactation. The
mammary glands are glands that lie over the pectoralis muscles and are attached to
them by a layer of connective tissue. The amount of adipose (fat) tissue determines
the size of the breast. Ducts convey milk from the lobes of the breast to the exterior.
The circular, pigmented arc of skin surrounding the nipple is called the areola.
Root
Combining form
Meaning
Mast
Mast/o
Breast
Mamm
Mamm/o
Breast
Lact
Lact/o, lact/i
Milk
Galact
Galact/o
milk
Activity 5
Build words which mean;
1. Technique of x-raying a breast _________________________________________
2. Surgical repair of breast _______________________________________________
3. Removal of a breast
_______________________________________________
Write the meaning of;
4. Lactiferous
______________________________________________________
5. Prolactin
______________________________________________________
6. Galactorrhoea ______________________________________________________
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Abbreviations:
ARM
Artificial rupture of membranes
CTG
cardiotocograph
DOB
Date of birth
EDC/D
Estimated date of confinement/delivery
EDD
Estimated date of delivery
EP
Ectopic pregnancy
FDIU
Foetal distress in-utero
FECG
Foetal electrocardiograph
FHR
Foetal heart rate
HDN
Haemolytic disease of the newborn
IUD
Intra-uterine death/intra-uterine device
LSCS/LUSCS
Lower section caesarian section
NB
Newborn
PET
Pre-eclamptic toxaemia
PPH
Postpartum haemorrhage
PROM
Premature rupture of membranes
PV
Per vaginum, per vagina
Apgar score
Method of assessing the general state of a baby one and five
minutes after birth. Named after Virginia Apgar. Appearance
(colour), pulse (heart rate), grimace (response to slap), activity
(movement), respiration (breathing).
Two points for each, a score of 8 - 10 indicates a baby in excellent
condition, a score of 7 or less would cause concern.
Caesarean section
delivery of the foetus through an abdominal incision
episi/o
pubic region, vulva
gravida
a pregnant woman
multigravida
woman who has been pregnant at least twice
multipara
a woman who has given birth to two or more children
-natal
pertaining to birth
nulligravida
having never been pregnant
para
to bear; a woman who has produced one or more viable offspring
primigravida
first pregnancy
primipara
first delivery
the period of up to about 6 weeks after childbirth during
which the uterus returns to normal size (involution).
puerperium
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MISCARRIAGE
Expulsion of products of conception before 20 weeks gestation.
Woman who has had 3 consecutive pregnancy losses before 20
weeks gestation with foetuses under 500 grams.
Spontaneous abortion Expulsion of the products of conception occurring naturally
Habitual aborter
Incomplete
Inevitable
Missed
Threatened
Part of the foetus or placenta is retained within the uterus
One which has advanced to a stage where termination of
pregnancy cannot be prevented. Cervix is opened.
Early signs and symptoms of pregnancy disappear and the foetus
dies, but is not expelled for some time.
Abdominal pain and bleeding from the uterus but the foetus is still
alive. Cervix is closed.
Conditions and Terms:
Cervical incompetence
Ectopic pregnancy
Placenta praevia
Pre-eclampsia
Obstetrics
Abnormal weakness of the cervix which can result in
recurrent miscarriages
Pregnancy that develops outside the uterus, usually in
the fallopian tubes
Placenta situated in the lower part of the uterus, near or
over the cervix
Serious condition in which hypertension, oedema and
proteinuria develops in a woman during the second half
of pregnancy
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