Whenever possible the below terms and definitions come from Wicipedia.org, an on-line dictionary and encyclopedia source available to the public.  These terms are posted for informational purposes only.  Always check with your care provider if you have any questions or concerns about a diagnosis, treatment, procedure or terminology use to discuss them to you.

 

Active Labor - begins when the cervix has dilated to 4 or 5 cm and lasts until it reaches about 8cm.  Active labor is marked by clear contractions lasting for at least a full minute and with a frequency of every 3-5 minutes.  Women usually consider these contractions painful. 

 

Amnio infusion - An Intra-Uterine Pressure Catheter or (IUPC) can be used to infuse sterile fluid into the uterus. This can be helpful if an infant has had a bowel movement inside the womb before birth, which is known as meconium staining. This process, called amnio-infusion, can be used to dilute the amniotic fluid and consequently decrease the likelihood that the baby will suffer complications from inhaling thick, meconium-stained fluid at birth.  Sometimes there is evidence of compression of the umbilical cord during labor, leading to slowing of the fetal heart rate. Amnio-infusion may help cushion the cord and diminish the stress on the baby.

 

Amniotomy - An artificial rupture of membranes (ARM), also known as an amniotomy, may be performed by a midwife or obstetrician. This is usually performed using an amnio-hook and is intended to induce or accelerate labor.

 

Apgar - The Apgar score was devised in 1952 by Virginia Apgar as a simple and repeatable method to quickly and summarily assess the health of newborn children immediately after childbirth.  The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two and summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. The five criteria were used as a mnemonic learning aid.

 

Augmentation - The use of Pitocin to speed up labor or restart an arrested labor. 

 

Caesarean Section - or c-section, is a form of childbirth in which a surgical incision is made through a mother's abdomen and uterus to deliver one or more babies. It is usually performed when a vaginal delivery would put the baby or mothers life at risk, although in the last decade it has been performed upon request.

 

Cephalopelvic disproportion (CPD) -  the baby's head is too large to fit through the pelvic outlet, or the mother's outlet is not opening enough to admit the baby's head. Frequently used as a reason for cesarean section, some say that the movement of the mother, particularly squatting can help alleviate this problem in some women.

 

Demerol - is a fast-acting opioid analgesic drug. In the United States, it is more commonly known as meperidine or by its brand name Demerol.  Given intravenously (IV) or intramuscular (IM) to relieve pain.

 

Dilation -is the dilation (opening) of the cervix during childbirth. In the early stages of pregnancy, the cervix may already have opened up to 1-3 cm (or more in rarer circumstances), but during labor, repeated uterine contrations lead to further widening of the cervix to about 6 centimeters. From that point, pressure from the presenting part (head in vertex births or bottom in breech births), along with uterine contractions, will dilate the cervix to 10 centimeters, which is "complete." Cervical dilation is accompanied by effacement, which is the thinning of the cervix.

 

Dystocia - is an abnormal or difficult childbirth or labor. Dystocia may arise due to in-coordinate uterine activity, abnormal fetal lie or presentation, or absolute or relative cephalopelvic disproportion. Oxytocin is commonly used to treat in-coordinate uterine activity. However, pregnancies complicated by dystocia often end with assisted deliveries including forceps, ventouse or, commonly, caesarean section. Shoulder dystocia is a specific case of dystocia whereby the anterior shoulder of the infant cannot pass below the pubic symphysis, or requires significant manipulation to pass below, the pubic symphysis.

 

Early Labor - is the beginning of true labor.  Many women cannot tell if this is true labor or not and often wait for more clear signs that their labor has indeed begun.  Please note -- this is the longest phase of dilation and can take anywhere from four to twenty hours.  It is marked by contractions that resemble slight menstrual cramps and are typically very mild.  They are not in a steady pattern and can be anywhere from 8 to 20 minutes apart lasting 30 to 45 seconds.  This phase of labor is also called the latent phase of the first stage and start the cervix dilating.  It lasts until the cervix has dilated to 4 or 5cm.

 

Effacement - is the shortening, or thinning, of the cervix before or during early labor. Prior to effacement, the cervix is like a long bottleneck, usually about four centimeters in length. Throughout pregnancy, the cervix is tightly closed and protected by a plug of mucus. When the cervix effaces, the mucus plug is loosened and passes out of the vagina. The mucus may be tinged with blood and the passage of the mucus plug is called bloody show (or simply "show").

 

Electronic Fetal Monitoring -The cardiotocograph, more commonly known as an electronic fetal monitor or external fetal monitor (EFM) or non-stress test (NST), is used to monitor a pregnant woman, typically in the third trimester. A cardiotocograph measures simultaneously both the fetal heart rate and the uterine contractions, if any, using two separate disc-shaped transducers laid against the woman's abdomen. An ultrasound transducer measures the fetal heartbeat. A pressure-sensitive transducer, called a tocodynamometer (toco), measures the strength and frequency of uterine contractions.  Use of this machine during the third trimester to monitor fetal well-being is called a non-stress test (NST). A positive result is indicated by a reactive non-stress test. This means that the fetal heart rate increased (acceleration) by at least 15 bpm for at least 15 seconds at least twice during a 20 minute interval.  Use of this machine during labor is called a stress test. When introduced, this practice was expected to reduce the incidence of fetal demise in labor and make for a reduction in cerebral palsy (CP). Its use became almost universal for hospital births in the U.S. In recent years there has been some controversy as to the utility of the cardiotocograph in low-risk pregnancies, and the related belief that over-reliance on the test has led to increased misdiagnosis of fetal distress and hence increased (and possibly unnecessary) cesarean deliveries.

 

Epidural -  term epidural is often short for epidural anesthesia, a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space of the spine. The injection can cause both a loss of sensation (anasthesia) and a loss of pain (analgesia), by blocking the transmission of pain signals through nerves in or near the spinal cord. The epidural space (sometimes called the extradural space or peridural space) is a part of the human spine inside the spinal canal separated from the spinal cord and its surrounding cerebrospinal fluid by the dura mater.   ***   It is important that expectant mothers receive accurate information about the benefits and risks of the procedure, as well as about their other pain-relief options, in order that they may make an informed decision. This is often difficult for the anaesthetist when the women is in active labour, hence the need for accurate antenatal education where possible.   ***

 

Episiotomy - is a surgical incision through the perineum made to enlarge the vagina and assist childbirth. The incision can be midline or at an angle from the posterior end of the vulva, is performed under local anaesthetic and is sutured closed after delivery. It is one of the most common medical procedures performed on women, and although its routine use in childbirth has steadily declined in recent decades, it is still widely practiced in Latin America.

 

Fentanyl - is an opioid analgesic, first synthesized by Janssen Pharmaceutica (Belgium) in the late 1950s, with an analgesic potency of about 80 times that of morphine.

 

Fetal Position - The presentation or presenting part that indicates that portion of the fetus that overlies the pelvic inlet.  EX.  (LOP/ROP) left/right occiput posterior, (LOT/ROT) left/right occiput transverse, (LOA/ROA) left/right occiput anterior.  This can be further classified by fetal lie, attitude and presentation, (cephalic or head first, breech or buttocks or foot first, shoulder, or compound).  Posterior presentations often result in back labor. 

 

Fetal Scalp Electrode - (FSE) An electrode that is placed in the scalp of the baby while in utero to accurately measure heart tones.  An Amniotomy must be performed first, if membranes have not already ruptured.  This is also commonly referred to internal monitoring and requires the laboring mother to remain in bed for the duration of her labor.   

 

Forceps delivery - Forceps are a hand-held instrument used for grasping and holding objects, similar in concept to tongs, tweezers, or pincers.  They are sometimes used in surgery or medical procedures, a common use for them being during childbirth. Although their use was common until the later part of the twentieth century, the use of forceps for delivery is falling out of favor in the birth community.  The cervix must be fully dilated and the bladder emptied, perhaps with the use of a catheter. Since mid-forceps and high forceps are rarely performed in this era, the station of the head must be at least +2. The woman is placed in the lithotomy position and a mild anaesthetic is administered (unless an epidural has been given). It is very important that adequate pain control is achieved. After ascertaining the precise position of the fetal head (by accurately feeling the posterior fontanelle), the two sections of the forceps are individually inserted and then locked into position around the baby's head. The fetal head is then rotated to occiput anterior position if it is not already in this position. An episiotomy is performed and then the baby is delivered.

 

Fundal Pressure - commonly used to assist the decent of the baby at the second stage of labor.  The practitioner applies strong pressure to the top of the uterus to help move the baby down the birth canal. 

 

Induction - Induced labour tends to be more intense and painful for the woman, often leading to the increased use of analgesics and other pain-relieving pharmaceuticals (Vernon, 2005). This cascade of intervention has been shown to lead to an increased likelihood of caesarean section delivery for the baby. (Roberts 2000). Inductions should only be undertaken for significant medical reasons, but some feel that doctors show increasing propensity toward induction simply for personal convenience or to relieve load on hospital facilities. "[Induction] enables doctors to practice daylight obstetrics," says Dr. Marsden Wagner, a neonatologist who served for 15 years as a director of women's and children's health in industrialized countries for the World Health Organization. "It means that as a doctor, I can come in at 9 a.m., give you the pill, and by 6 p.m. I've delivered a baby and am home having dinner."

Common causes for induction include:

1. The baby is believed to be getting too big.
2. Postdate pregnancy, i.e. if the pregnancy has gone past the 42 week mark.
3. Intrauterine fetal growth retardation (IUGR).
4. There are health risks to the woman in continuing the pregnancy (e.g. she has pre-eclampsia).
5. Premature rupture of the membranes (PROM); this is when the membranes rupture, but labour does not start within a specific amount of time.
6. Premature termination of the pregnancy (abortion).
7. Scheduling concerns.

 

Intubate - sometimes used when meconium is present to view and suction the esophagus and lungs. 

 

Intra-Uterine Pressure Catheter - (IUPC) During labor, a thin, flexible tube with a small, pressure-sensing device on the tip can be placed into the uterus next to the baby. This intrauterine-pressure catheter (IUPC), which is usually used in combination with internal or external fetal heart-rate monitoring, measures the actual pressure within the uterus and indicates the frequency and intensity of contractions. This information helps the healthcare team assess the strength of the contractions and how the contractions are affecting the baby.  In order to place the IUPC, the bag of waters must already be broken and the cervix already dilated slightly so that the catheter can be passed through it. The procedure is typically no more uncomfortable than having a normal internal exam. *** Internal Contraction Monitoring

by Lisa Rodriguez, R.N. and Marjorie Greenfield, M.D. reviewed by Marjorie Greenfield, M.D.***

 

Ischial Spines - are bony prominences on each side of the maternal pelvic sidewalls used to determine the station of the fetus head in relationship to her pelvis.

 

Meconium - is the first stool of an infant, composed of materials ingested during the time the infant spends in the uterus: intestinal epithelial cells, lanugo, mucus, amniotic fluid, bile, and water. Meconium is sterile, unlike later feces, is viscous and sticky like tar, and has no odor.  Meconium is normally stored in the infant's intestines until after birth, but sometimes it is expelled into the amniotic fluid prior to birth or during labor and delivery.

 

Pitocin - is a synthetic form of  Oxytocin.  It is a mammalian hormone that also acts as a neurotransmitter in the brain. In women, it is released mainly after distension of the cervix and vagina during labor, and after stimulation of the nipples, facilitating birth and breastfeeding, respectively. It is often used to start or augment labor and can cause very painful contractions. 

 

Precipitous labors - a name given to labor and deliveries typically lasting less than five hours from start to finish.  These labors are intense and can cause maternal and fetal distress due to the speed in which things happen.

 

Prodromal Labor - nicknamed 'false labor'.  Marked by a long early phase, where contractions are sporadic and may pause for long periods of time.  Does not have much effect on the cervix.

 

Prolapsed Cord - is an obstetric emergency during pregnancy or labour that endangers the life of the baby. It is when the umbilical cord presents itself outside of the uterus while the fetus is still inside. It can happen when the water breaks - with the gush of water the cord comes along. Usually, thereafter the fetus will engage and squash the cord, cutting off oxygen supplies and leading to brain damamge or stillbirth. Before that happens, the baby must be quickly delivered by caesarean section. In the meantime, the woman should adopt the knee-elbow position, and an attendant reach into the vagina and push the presenting part (usually the head) back in so that it does not suffocate the cord. It is useless to try to push the cord back.

 

Ring or Rim of Fire - a term used to describe the last stage in pushing where the perineum is stretching and burning as the pressure of the fetus' head is coming down through the birth canal.  A doctor or midwife may assist with perineal support to avoid the need for an epesiotomy and reduce the chance of maternal tearing. 

 

Stadol - Butorphanol (INN) is a morphian-type synthetic opioid analgesic marketed in the U.S. under the trade name Stadol. It is most closely structurally related to dextromethorphan.  The most common indication for butorphanol is management of migraine using the intranasal spray formulation. It may also be used parenterally for management of moderate-to-severe pain, as a supplement for balanced general anesthesia, and management of pain during labor.This drug can be given (IV) or (IM). 

 

Station - a measurement to determine the decent of the fetus' head into the maternal pelvis.  Minus three is floating above Ischel Spine; zero station the head is engaged and pressing down on the pelvis  plus three fetus' head is crowning at perineum. 

 

Transition - commonly referred to as 'Hard Labor'. This phase of labor is marked by contractions that will accelerate in frequency and strengthen. In the "transition phase" from 8 cm-10 cm of dilation, the contractions often come every two minutes and are typically lasting 70-90 seconds. Transition is often regarded as the most challenging and intense for the mother. It is also the shortest phase.  Women often become nauseous, experience uncontrollable shaking and sometimes a premature urge to push.  It is important to breath through these contractions until your doctor or midwife tell you to push.  Bearing down before the cervix is completely dilated and effaced may cause your cervix to swell and "donut.

 

Vacuum Extraction - is the use of a vacuum extractor during childbirth. Vacuum extraction is sometimes used when there is no progression during the second stage of labor. VE is an alternative to forceps extraction and caesarean section. The use of vacuum extraction can have negative effects on both the mother and the child.