Basic Obstetrical

And Gynaecological
Terminology
By: Naushaba Waheed
Rimsha Sami
Reesha Shafique
 Obstetrics
Obstetrics deals with the care of women's reproductive tracts
and their children during pregnancy, childbirth and the
postnatal period.

A doctor performing such practice is called Obstetrician.

LMP : Last Menstrual Period.

It is date of last time the patient had menstrual

bleed.
EDC or EDD : The Due Date.

EDC stands for the old-fashioned "estimated date of confinement."

EDD is the more
modern "Estimated Day of Delivery." The average pregnancy
“gestation” is 40 weeks
or 280 days from the first day of the last menstrual period
(LMP).
For a 28 day cycle, EDD is calculated by taking the LMP and
adding 9 months and 7
days to it.
Gravida:

It is the number of times the mother has been pregnant, regardless of whether these
pregnancies were carried to term.

A current pregnancy, if any, is included in this count.

A nulligravida or gravida 0 is a woman who has never been pregnant.

A primigravida or gravida 1 is a woman who is pregnant for the first time or has been
pregnant one time.

A multigravida or more specifically a gravida 2 , gravida 3,

and so on, is a woman who has been pregnant more than one time.
 Parity

It is the number of times the woman has delivered after the

age of viability.

It is the number of live births at any gestation or stillbirth

after 24 weeks.

In terms of parity twins count as 2.

EXAMPLE:

A woman comes to the

obstetrician 16 weeks pregnant.
How do you calculate her G and P?

G=1
P= 0
Example:

 A woman comes into the office. She brings her only two
children, ages 6 and 14, with her. Both were born at 40
weeks. She has a positive hCG pregnancy test.

 G=3
 P= 2
Example:

 A 37 year old female comes in the clinic with a 4 months

history of missed periods.A Quatitative hCG reveals
levels indicative of a pregnancy. Upon Questioning she
reveals she has 3 living children. The oldest was
delivered at 39 weeks, one at 36 weeks and youngest at
38 weeks.

 G=4
 P=3
Example:

 A woman who has had 6 miscarriages with only 1

live baby born at 32 weeks and is pregnant again.

 G=8
 P=1+6
 Gestation

 Gestation is the carrying of an embryo or fetus inside a female

viviparous animal. Mammals during pregnancy can have one
or more gestations at the same time (multiple gestations).

 The time interval of a gestation is called the gestation period.

 In human obstetrics, gestational age refers to the embryonic or

fetal age plus two weeks. This is approximately the duration
since the woman's last menstrual period (LMP) began.
 Trimester

 The pregnancy is divided into 3 trimesters.

• The first one is from LMP up until 12 or 13 weeks.

• The second trimester is from 12-13 weeks until 28 weeks.
• The third trimester is from 28 weeks until delivery.
 Preterm Birth

It is the birth of a baby between 24 and 37 weeks of

gestational age.

Premature infants are at greater risk for short and long

term complications, including disabilities and
impediments in growth and mental development.
 Post term Birth

Post maturity is when a baby has not yet been born after 42 weeks
of gestation.

Symptoms of post maturity. The most commons symptoms are dry

skin, overgrown nails, creases on the baby's palms and soles of
their feet, minimal fat, a lot of hair on their head, and either a
brown, green, or yellow discoloration of their skin. Some post
mature babies will show no or little sign of post maturity.
Presentation

It refers to which anatomical part of the fetus is leading, that is, is closest to the
pelvic inlet of the birth canal just before the birth. According to the leading part,
this is identified as a cephalic, breech, or shoulder presentation.

Normal presentation is cephalic.

Malpresentation

A malpresentation is any other presentation than a vertex presentation

(with the top of the head first). It could be breech or shoulder presentation.
Position

It is the relationship of specific fetal denominator to maternal denominator.

It includes occipito anterior, occipito posterior, occipito transverse.

Normal position is occipito anterior.

Malposition

It is the abnormal position of the fetus in uterus. Could be occipito

posterior or occipito transverse.
 Lie
It is the relationship of longitudinal axis of fetus to longitudinal
axis of mother’s pelvis.

It can be longitudinal, transverse or oblique.

Most common is longitudinal.

 Attitude

 It is the relationship of different parts of fetus to each other.

 Normal is flexed attitude.

 Engagement

 Engagement is said to have taken place when the widest part of

presenting part of fetus has passed successfully through the
pelvic inlet.

 The number of fifths of the fetal head palpable abdominally s

often used to describe whether engagement has taken place. If
more than two fifths of fetal head is palpable abdominally, the
head is not yet engaged.
 Moulding

 It is the process which effectively reduces the diameter of fetal

skull and encourages progress of delivery through maternal
pelvis without harming the fetal brain.

 It is achieved due to following characteristics of fetal skull:

• Ununited sutures which help the bones to move together and

overlap during delivery.
• compressible nature of bones
• Anterior and posterior fontanelles
 Effacement

 It is the process by which the cervix shortens in length as it

becomes included in the lower segment of uterus.

 The cervical os cannot usually begin to dilate until effacement

is complete.
 Episiotomy

 It is a surgically planned incision on the

perineum during second stage of labor.

 It is also called perineotomy.

Crown-to-Rump Length:
Measurement from the top of the baby's head to the
buttocks of the baby.

Chadwick's sign:
Dark-blue or purple discoloration of the mucosa of the
vagina and cervix during pregnancy.
Happens due to hormonal changes of pregnancy.
.

SVD

Spontaneous Vaginal Delivery - same as NSVD.

Caesarean section (delivery):

Delivery of a baby through an abdominal incision rather than through the vagina.

Primary Cesarean Section

First time a mother has delivered by Cesarean.

Secondary Cesarean Section

Mother has already had a previous Cesarean delivery, and this is a repeat Cesarean birth.
VBAC : Vaginal Birth After Cesarean.
The mother has had a previous Cesarean delivery but has now delivered vaginally.
There is a small amount of risk (less than 1%) that the old surgical scar on the
uterus will rupture when a VBAC is attempted, so mothers who wish to attempt a
VBAC must understand the risks and sign an "informed consent" that shows they
are aware of the risks/benefits.

TOL : Trial of Labor.

If a woman has had a previous Cesarean birth and wants to have a VBAC, she is
said to be undergoing a "trial of labor" when her contractions start.

VAD : Vacuum Assisted Delivery.

The doctor applies a suction cup to the baby's head and gently draws it out, when
the mother is too tired to push effectively any more but the baby is very low in
the pelvis.
 Miscarriage

 Miscarriage is the spontaneous or induced end of a pregnancy

before 24 weeks of gestation.
 Cause includes chromosomal anomalies and maternal uterus
anomalies.
 Probable signs include:
• Low back pain or abdominal pain that is dull, sharp, or
cramping
• Tissue or clot-like material that passes from the vagina
• Vaginal bleeding, with or without abdominal cramps
 Stillbirth

 It is the birth of a baby after the age of viability when it has no

vital functions at birth, if no heart rate, no umbilical cord
pulsation, etc.
 Ectopic Pregnancy
 An ectopic pregnancy, or eccyesis, is a complication of
pregnancy in which the embryo implants outside the uterine
cavity.
 Most ectopic pregnancies occur in the Fallopian tube, so-called
tubal pregnancies), but implantation can also occur in the
cervix, ovaries, and abdomen.
 Symptoms include pain in lower abdomen, during micturition,
bowel movement, vaginal bleeding.
 There are four types:
 Tubal Pregnancy: occurring in fallopian tube
 Non-tubal Ectopic Pregnancy: occurring in ovary, cervix or
are intra-abdominal.
 Heterotopic Pregnancy: There may be two fertilized eggs,
one outside the uterus and the other inside.
 Persistent Ectopic Pregnancy: continuation of trophoplastic
growth after a surgical intervention to remove an ectopic
pregnancy.
 Hyperemesis

Hyperemesis gravidarum (HG) is a severe form of morning

sickness,with "unrelenting, excessive pregnancy-related nausea
and/or vomiting that prevents adequate intake of food and fluids.

It may be due to adverse hormonal effects or raised levels of Human

Chorionic
Gonadotropin (HCG).

Pruritis Gravidarum:
It is the itching during pregnancy.

Postnatal Blues:

Mild depression after delivery.

 Ante partum Hemorrhage

 Also called prepartum hemorrhage, it is the

bleeding from the vagina during pregnancy
from the 24th week gestational age to term.

 It should be considered a medical emergency

and medical attention should be sought
immediately.
 Postpartum Hemorrhage

 It is the loss of greater than 500 ml of blood following

vaginal delivery, or 1000 ml of blood following
cesarean section.
Gynaecological terms
 Menstrual cycle

 It is the regular natural change that occurs in the

female reproductive system that makes pregnancy
possible.
 Normal menstrual cycle is of 28-30 days long.
 Menstruation

 Menstruation (day 1) is the shedding of the 'dead'

endometrium and ceases as the endometrium
regenerates (which happens normally by day 5-6 of the
menstrual cycle)
 Menarche

 The start of menstrual period

 Normally it occurs between 12-15 years
 Heavy Menstrual
Bleeding(HMB)
Excessive menstrual blood loss. It is the most common type
of menstrual bleeding disorder.
Intermenstrual bleeding (imb)

 It is Bleeding between the periods,.

 Often seen with endometrial and cervical polyps mad
endometriosis.
Postcoital bleeding (pcb)

 It is the bleeding after sexual intercourse.

 It is often associated with cervical abnormalities
Post menopause bleeding
(pmb)
 It is the bleeding that occurs more than 1 year after the
cessation of periods.
 It can be a red flag symptom for gynecological cancer.
 Benign causes include unscheduled bleeding on
hormonal replacement therapy or vaginal atrophy.
Amenorrhea

Absence of bleeding for more than 6 months in women of

reproductive age.
It has 2 types:
1. Primary Amenorrhea
In primary amenorrhea, menstrual periods have never
begun (by age 16).
2.Secondary Amenorrhea
Secondary amenorrhea is defined as the absence of
menstrual periods for three consecutive cycles or a time
period of more than six months in a woman who was
previously menstruating.
Oligomenorrhea

Infrequent menstrual bleeding with intervals of more than

35 days, with only 4-9 periods per year.

Causes may be hypothelemic, pituitary, ovarian or

endometrial.
Dysmenorrhea

Painful menstrual bleeding.

It is divided into 2 types:
1.Primary Dysmenorrhea
Painful periods since onset of menarche and is unlikely to
be associated with pathology.
2.Secondary Dysmenorrhea
Painful periods that have developed over time & usually
have a secondary cause.
Polymenorrhagia

Frequent bleeding with shorting of menstrual cycle for

more than 3 cycles.
Menopause

 It is defined as the woman's final menstrual period and

the accepted confirmation of this is made
retrospectively after 1 year of amenorrhea.
 The cause of Menopause is cessation of regular ovarian
function.
Subfertility

Subfertility- describes any form of reduced fertility with

prolonged time of unwanted non-conception.
Primary subfertility- refers to women who have not
conceived after at least one year without using birth
control methods
Secondary subfertility-refers to women who have been able
to conceive before but now are unable to do so.
Polycystic Ovary
syndrome(PCOS)
PCOS is a syndrome of ovarian dysfunction along with
cardinal features of hyperandrogenism and polycystic ovary
morphology.
Hysterectomy

It is a surgical removal of uterus. In the total hysterectomy

the cervix along with uterus is removed which is called
hysterectomy with bilateral salpingo-oophorectomy. In
radical hysterectomy complete removal of uterus is done
with removal of cervix, upper vagina and parametrium
while partial hysterectomy is the surgical removal of uterus
alone.
Fibroid

Fibroid is a benign tumor of uterine smooth muscle termed

a 'leiomyoma'. The gross appearance is of a well
demarcated firm, whorled tumor.
Uterine fibroids
PELVIC INFLAMMATORY
DISEASE
Pelvic inflammatory disease is characterized by
inflammation and infection arising from the endocervix
leading to endometriosis, salpingitis, oophoritis, pelvic
peritonitis and subsequently formation of tubo-ovarian and
pelvic abscesses.
D&E (Dilatation of Cervix &
Evacuation of Uterus)

It is a surgical procedure performed after a miscarriage or

an abortion, in which the uterus along with all its contents
is scrapped and is washed.
Incontinence

 Involuntary loss of urine that is a social or hygienic

problem.
 Urge incontinence: involuntary leakage accompanied by
or immediately proceeds by emergency.
 Stress incontinence: involuntary leakage on effort,
ecertion, sneezing or coughing.
 Most common causes include USI( Urodynamic Stress
Incontinency and Detrusor overactivity.
Dyspareunia

 Painful coital intercourse which can ne either

superficial or deep.
 Can be due to benign conditions of the vulva and
vagina, psychosexual disorders or female genital
mutilation.
UV Prolapse (Uterovaginal
Prolapse)

UV Prolapse (Uterovaginal Prolapse):

Prolapse:
Protrusion of an organ or structure beyond its normal
confines.

UV Prolapse:
It is the type of prolapse in with uterus descend with the
inversion of vaginal apex.
Uterovaginal Prolapse
Any Questions?
THANK YOU!