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ACNM: American College of Nurse Midwives Is the professional association that represents certified nurse-midwives and certified midwives in the US. Promotes the health of women & babies through development & support of the profession of midwifery

ACOG: American Congress of Obstetricians & Gynecologists A professional association of medical doctors specializing in obstetrics & gynecology in the US.

AWHONN: Association of Womens Health, Obstetrics, & Neonatal Nurses Nonprofit membership organization whose purpose is to promote the health of women and newborns

PID: Pelvic Inflammatory Disease An infection of the fallopian tubes that may or may not be accompanied by a pelvic abscess; may cause infertility s/t tubal damage.

IUD: Intrauterine Device (ATI p.11) Chemically active T-shaped device that is inserted through a womans cervix & placed in the uterus by the primary care provider. Releases a chemical substance that damages sperm in the transit to the uterine tubes & prevents fertilization. Hormonal contraception.

FSH: Follicle Stimulating Hormone Hormone produced by the anterior pituitary during first half of the menstrual cycle, stimulating development of the graafian follicle.

PMDD: Premenstrual Dysphoric disorder A more serious form of PMS categorized as depressive disorder. Symptoms are relieved by menstruation & occur in most menstrual cycles.

PMS: Premenstrual Syndrome Refers to a symptom complex characterized by behavioral & physical changes that occur during the luteal phase of the menstrual cycle, anywhere from several days to 2 wks before the onset of menstrual flow. Symptoms relieved once flow has started. Cause unknown

BV: Bacterial Vaginosis

Most prevalent form of vaginal infection in the US & worldwide. Etiology of BV is r/t a change in the normal vaginal flora. (Lower genital tract infection) A bacterial infection of the vagina (Gardnerella vaginalis or Hemophilus vaginalis) characterized by a foul-smelling (fishy odor), grayish discharge that exhibits a characteristic fishy odor when 10% potassium hydroxide (KOH) is added. Microscopic examination of a vaginal wet prep reveals presence of clue cells (vaginal epithelial cells coated with gram-negative organisms). Metronidazole is used in the tx of bacterial vaginosis.

HPV: Human Papilloma Virus One of the family of more than 100 viruses that are responsible for causing warts. Several types of HPV are confined primarily to moist skin of the genitals, producing genital warts, & have been identified as a cause of cancer of the cervix & other cancers of anogenital region. HPVs that cause wartlike growths on genitals are sexually transmitted. A vaccine is available that protects against infection by most common types of HPVs that are associated w/ cancer & genital warts. Vaccine not given during pregnancy.

VDRL: Venereal Disease Research Laboratories A blood test for syphilis that detects an antibody that is present in the bloodstream when a patient has syphilis. Test is similar to the newer rapid plasma reagin (RPR) test. Syphilis screening is a routine part of prenatal care during pregnancy. A false positive VDRL can be encountered in pregnancy.

RPR: Rapid Plasma Reagin A screening blood test for syphilis. Looks for antibodies that are present in the blood of people who have the disease. Similar to VDRL.

RPL: Recurrent Pregnancy Loss 3 or more consecutive pregnancy losses before 24 wks gestation. Formerly called habitual abortion

STI/STD: Sexually Transmitted Infection/ Sexually Transmitted Disease STI: Refers to infections ordinarily transmitted by direct sexual contact w/ an infected individual. Also called sexually transmitted disease.

GnRH: Gonadotropin- Releasing Hormone

A hormone secreted by the hypothalamus that stimulates the anterior pituitary to secrete FSH & LH. Onset of puberty

LH: Luteinizing Hormone Anterior pituitary hormone responsible for stimulating ovulation and for the development of corpus luteum.

GH: Growth Hormone Abnormally high or low levels can disrupt onset of normal puberty

PG: Phosphatidylglycerol (p525) A phospholipid present in fetal surfactant after about 35 wks gestation. Present before 35 wks gestation in instances of diabetes complicated by PROM, vascular disease, or severe preeclampsia. Presence of PG is associated w/ very low risk of RDS, & absence of PG is associated w/ development of RDS This test performed by sampling the amniotic fluid indicates lung maturity. Phosphatidyl glycerol usually becomes detectable in amniotic fluid at about 35 or 36 weeks gestation. The presence of phosphatidyl glycerol in the amniotic fluid generally indicates there is minimal risk for neonatal respiratory distress (nclex rn review).

hCG: Human Chorionic Gonadotrophin Hormone produced by the chorionic villi & found in the urine of pregnant women. Also called prolan. Verifies possible pregnancy. Serum and urine tests provide an accurate assessment for presence of (hCG).hCG production can start as early as the day of implantation Secreted in early pregnancy by trophoblast. Hormone stimulates progesterone & estrogen production by corpus luteum to maintain pregnancy until placenta is developed sufficiently to assume that function. If corpus luteum stops functioning before the 11th wk of pregnancy, spontaneous abortion occurs.

VBAC: Vaginal Birth After Cesarean Practice of permitting a trial of labor & possible vaginal birth for women following a previous cesarean birth for nonrecurring causes such as: fetal distress or placenta previa (placenta is improperly implanted in the lower uterine segment).

TPAL: Term births, Preterm births, Abortions/ miscarriages, Living children

TPAL- system used to describe obstetrical history T- term births (38 wks or more) P- preterm births (from viability up to 37 wks) A- abortions (prior to viability) L- living children Example: Client is currently pregnant. Has been pregnant two other times, delivered once at term, has a child that is 2 yrs old, & has had one miscarriage at 8 wks. G3T1P0A1L1 G 3- client has been pregnant twice & is currently pregnant T 1- client delivered one newborn at term P 0- client has had no preterm deliveries A 1- client has had one miscarriage L 1- client has one living child

G/P: Gravida/ para (p318) Gravida: Any pregnancy, regardless of duration, including present pregnancy. Para: Birth after 20 wks gestation, regardless of whether the infant is born or dead.

LMP: Last Menstrual Period Used to estimate date of birth (EDB). First day of womans LMP is needed to calculate EDB.

EDC: Estimated Date of Confinement Due date. Term avoided and birth date term was then referred to estimated date of delivery (EDD). Due date term was then switched to estimated date of birth (EDB), because of the stress that babies are not delivered like a package but rather they are born or birthed by the mother.

EFW: Estimated Fetal Weight Important aspect of fetus assessment in the 3rd trimester. Possible findings: IUGR (inadequate fetal growth) & macrosomia (excessive fetal growth).

EFM: Electronic Fetal Monitoring Method of placing a fetal monitor on the fetus in order to obtain a continuous tracing of the FHR, which allows many characteristics of the FHR to be observed & evaluated

Can also be done using an ultrasound (US) transducer external monitoring, or internal monitoring (w/ a fetal scalp electrode- membranes must be ruptured) .

EDD: Estimated Date of Delivery Due date. Now referred to as estimated date of birth (EDB). Determine estimated date of delivery based on the LMP. A vaginal ultrasound may be done to establish the estimated date of delivery.

CMV: Cytomegalovirus Belongs to the herpes simplex virus group & causes both congenital & acquired disorders. Most common viral cause of infection in human fetus. Able to be transmitted by asymptomatic women across the placenta to the fetus or by the cervical route during birth.

GDM: Gestational Diabetic Mellitus An impaired tolerance to glucose w/ the first onset or recognition during pregnancy. Ideal blood glucose level during pregnancy should fall between 70-110 mg/dL (ATI p100).

LGA: Large for Gestational Age Excessive growth of a fetus in relation to the gestational time period.

SGA: Small for Gestational Age Inadequate weight/ growth for gestational age; birth weight below 10th percentile.

AROM: Artificial Rupture of Membranes An amniotomy is the artificial rupture of the amniotic membranes (AROM) by the primary care provider using Amnihook or other sharp instrument (ATI p 189). At least 2 cm of cervical dilation must be present. May be performed as a method of induction of labor (to stimulate the beginning of labor) or to augment labor.

SROM: Spontaneous Rupture of Membranes Breaking of water or membranes marked by expulsion of amniotic fluid from vagina Occurs at the height of an intense contraction w/ a gush of fluid out of the vagina (p540)

PROM: Premature Rupture of Membranes The spontaneous rupture of the amniotic membranes 1 hr or more prior to the onset of true labor. For most women, PROM signifies the onset of true labor if gestational duration is at term (ATI 120).

PPROM: Preterm Premature Rupture of Membranes The premature spontaneous rupture of membranes after 20 wks of gestation & prior to 37 wks of gestation.

HELLP: Hemolysis, elevated liver enzymes, low platelets A cluster of changes: hemolysis, elevated liver enzymes, & low platelet count; sometimes associated w/ severe preeclampsia. Although it may occur in women w/ normal or minimally elevated BP & no proteinuria.

PIH: Pregnancy Induced Hypertension Vasospasm contributing to poor tissue perfusion is the underlying mechanism for the signs and symptoms of pregnancy hypertensive disorders Symptoms of PIH, including HTN, edema, & proteinuria, that occur prior to 20 wks of gestation (PIH usually does not occur until after 20 wks of gestation)

DIC: Disseminated Intravascular Coagulation A coagulopathy in which clotting & anticlotting mechanisms occur at the same time (ATI p260). Postpartum. Nursing interventions for DIC focus on assessing for & correcting underlying cause (removal of dead fetus or placental abruption, treatment of infection, preeclampsia, or eclampsia) (ATI p262).

RhoGAM: RhO(D) immune globulin RhO(D) immune globulin (RhoGAM) suppresses the immune response of clients who are Rh-negative to Rh-positive RBCs from the fetus (ATI p69). Administered IM around 28 wks of gestation for clients who are Rh-negative (ATI p34). Standard practice after an amniocentesis for all women who are Rh-negative to protect against Rh isoimmunization (ATI p58).

ABO:

ABO incompability (mother is blood type O & the baby is blood type A or B).

GBS: Group B Streptococcus A bacterial infection that can be passed to a neonate during labor & delivery. Risk factors: Positive culture w/ pregnancy, prolonged ROM & preterm delivery.

Organism is not a sexually-transmitted disorder, & causes no problems for any woman who carries it or any man who might have intercourse with her. It is only a potential problem for a woman who is a carrier who is going to have a baby. If a woman is a carrier of this organism, she could potentially pass it on to her child during delivery.

UDS: Urine Drug Screening AFI: Amniotic Fluid Index Method of reporting fluid volume. Assessment based on rationale that decreased uteroplacental perfusion may lead to diminished fetal renal blood flow, decreased urination, &, ultimately, oligohydramnios (decrased amniotic fluid volume). (p.514) AFI calculated by dividing maternal abdomen into 4 quadrants w/ umbilicus as reference point. Deepest vertical pocket of fluid in each quadrant is then measured, & then these 4 measurements are summed to calculate the AFI.

NST: Nonstress Test Assessment method by which rxn (or response) of FHR to fetal movement is evaluated. This test is done frequently during the 3rd trimester to determine fetal response to cyclical periods of rest & activity. A fetal monitor is applied for approximately 90 min. During this time, pt is instructed to press the response button each time the baby moves. Normal fetal response is an increase in FHR of 15 bpm. This finding indicates the likelihood of a positive fetal outcome (nclex review).

FHR: Fetal Heart Rate Number of times the fetal heart beats per minute (110-160 bpm)

UCs: Uterine Contractions Interrupts flow of blood to the placenta & reduces amount of oxygen immediately available to the fetus. (p564) Tightening and shortening of the uterine muscles. During labor, contractions accomplish two things: cause cervix to thin and dilate (open); & help the baby to descend into the birth canal. Palpation is the technique of assessing a UC by touch.

CST: Contraction Stress Test Method of assessing rxn of fetus to stress of uterine contractions. Test may be utilized when contractions are occurring spontaneously or when contractions are artificially induced by oxytocin challenge test (OCT) or breast self-stimulation test (BSST).

Though not performed routinely, a CST is used in high-risk pts to determine fetal response to contractions. The length of time for a CST is generally 90120 min. Contractions are stimulated by beginning an infusion of oxytocin (Pitocin). Ten units of oxytocin (Pitocin) are diluted in 1000 mL of IV fluid, begun at 3 milliunits per minute, and increased every 15 minutes until three contractions in 10 minutes are observed. If fetal bradycardia (fetal heart tone [FHT] is less than 110 bpm) or tachycardia (FHT is greater than 160 bpm) is observed or if the blood pressure of the mother rises above normal, the test is considered abnormal. An abnormal reading can indicate that labor might not be advisable. After the exam, the oxytocin (Pitocin) is discontinued (nclex review).

VAS: Vibroacoustic Stimulation Application of device delivering 90 dB of sound & vibration for 1-3 sec to the mothers abdomen to stimulate movement in fetus, thereby accelerating the FHR. (Also called FAST for fetal acoustic stimulation test or VST for vibroacoustic stimulation test.) Used if there are no fetal movements (fetus sleeping). VAS (sound source, usually laryngeal stimulator) may be activated for 3 sec on maternal abdomen over fetal head to awaken a sleeping fetus.

BSST: Breast Self-Stimulation Test Woman is instructed to stimulate nipples w/ fingers, palms, or a warm, moist face cloth for 2 min or until contraction begins. (p513) Consists of a woman lightly brushing her palm across her nipple for 2 or 3 min, which causes the pituitary gland to release endogenous oxytocin (induces contractions), and then stopping the nipple stimulation when a contraction begins (ATI p55). Stimulates contractions (which decrease placental blood flow) & analyze FHR in conjunction w/ contractions to determine how the fetus will tolerate the stress of labor.

BPP: Biophysical Profile Ultrasound determination of fetal well being Assessment of 5 variables in fetus that help to evaluate fetal risk: breathing movement, body movement, tone, amniotic fluid volume, & FHR reactivity. Uses a real-time ultrasound to visualize physical & physiological characteristics of the fetus & observes for fetal biophysical responses to stimuli (ATI p52).

AFP: Alpha Fetoprotein Measured from the amniotic fluid between 16-18 wks of gestation & may be used to assess for neural tube defects in fetus or chromosomal disorders. May be evaluated to follow up a high level of AFP in maternal serum.- amniocentesis

High levels of AFP are associated with neural tube defects. Low levels of AFP are associated with chromosomal disorders (down syndrome). (ATI p56)

IUGR: Intrauterine Growth Restriction Growth rate does not meet expected norms. Fetal undergrowth d/t any etiology, such as intrauterine infection, deficient nutrient supply, or congenital malformation. A term used to describe fetuses falling below the 10th percentile in ultrasonic estimation of weight at a given gestational age.

MSAFP: Maternal Serum Alpha-Fetoprotein Screening occurs between 15-22 wks of gestation. Used to rule out Down syndrome (low level) & neural tube defects (high level). (ATI p34) Used to detect neural tube defects. (ATI) Screening test performed between 16-22 gestational wks that utilizes multiple markers (triple screen) of (AFP), human chorionic growth hormone (hCG), & urine estriol (uE3) to screen pregnancies for neural tube defects, Down Syndrome, & trisomy 18.

fFN: Fetal Fibronectin A protein in the amniotic fluid that appears between 24-34 wks of gestation. This protein can be found in vaginal secretions when fetal membrane integrity is lost (ATI p117). A strong predictor of preterm birth associated w/ preterm spontaneous rupture of membranes. This test is used in pts w/ preterm labor to determine the likelihood that the pt can continue the pregnancy for at least 2 more weeks. The presence of Fetal Fibronectin (fFN) in cervico-vaginal secretions indicates that the fetus is at risk for preterm delivery (nclex review).

ROM: Rupture of Membranes Rupture may be PROM (premature), SROM (spontaneous), or AROM (artificial). Some clinicians may use the abbreviation RBOW (rupture of bag of waters). Possible gush of fluid (ROM) Spontaneous rupture of membranes can initiate labor or can occur anytime during labor, most commonly during the transition phase. (ATI p128)

IUPC: Intrauterine Pressure Catheter A solid or fluid-filled transducer placed inside the clients uterine cavity to monitor frequency, duration, & intensity of contractions (ATI p166).

Catheter that can be placed through the cervix into uterus to measure uterine pressure during labor. Some types of catheters may be inserted for the purpose of infusing warmed saline to add additional intrauterine fluid when oligohydramnios is present.

FSE: Fetal Scalp Electrode Application of a fetal scalp electrode will help in assessment of fetal well-being. Prior to the insertion of an internal fetal monitor and an intrauterine pressure catheter, the membranes must first have ruptured. (ATI)

LTV: Long Term Variability STV: Short Term Variability CPD: Cephalopelvic Disproportion Abnormal fetal presentations & positions occur in CPD as the fetus moves to accommodate passage through maternal pelvis. (p719).

L/S ratio: Lecithin to sphingomyelin ratio Used to determine lung maturity. Ratio of lecithin to sphingomyelin should be 2:1 if the lungs are mature.

PKU: Phenylkentonuria Common metabolic disease caused by an inborn error in the metabolism of the amino acid phenylalanine. Inability to metabolize amino acid phenylalanine; can result in mental retardation if untreated; this will not be evident at birth, but will be identified with neonatal screening (ATI p380).

RDS: Respiratory Distress Syndrome Respiratory disease of the newborn characterized by interference w/ ventilation at the alveolar level, thought to be caused by presence of fibrinoid deposits lining alveolar ducts. Formerly called hyaline membrane disease. Occurs as a result of surfactant deficiency (regardless of a newborns birth weight) in the lungs & is characterized by poor gas exchange and ventilatory failure. (ATI)

NICU: Neonatal Intensive Care Unit

Most newborns who are preterm are cared for in a neonatal intensive care unit (NICU). Meticulous care & observation in NICU is necessary until the newborn can receive oral feedings, maintain body temperature, & weighs approximately 2 kg (4.4 lb)

ECMO: Extracorporeal Membrane Oxygenator A life support system that circulates the blood through an oxygenating system. ECMO is like a heart-lung machine that takes over the work of the heart and lungs during open heart surgery. Used on newborns w/ resp. failure who are not responding to conventional ventilator therapy

BPD: Bronchopulmonary Dysplacia Causes lungs to become stiff & noncompliant, requiring an infant to receive mechanical ventilation & oxygen, & it is sometimes difficult to remove infant from ventilation & oxygen after initial placement (ATI P361).

Decel: Decelerations

CVS: Chorionic Villus Sampling. Procedure in which a specimen of the chorionic villi is obtained from the edge of the developing placenta at about 8 wks gestation. The sample can be used for chromosomal, enzyme, & DNA test. A collection of tissue from fetal side of placenta is obtained. This test is usually performed late in 1st trimester between weeks 10-12 & can be used to determine fetal genetic abnormalities & chromosomal defects, but not neural tube defects. (nclex rn review)

OCT/PIT: Oxytocin Challenge Test/ Pitocin Contractions that are artificially induced by oxytocin challenge test (OCT) are used to assess rxn of the fetus to the stress of uterine contractions. Pitocin: augments/induces labor Also used to expulse products of conception in late, incomplete, inevitable, or missed abortions (ATI)

TAB: Therapeutic Abortion Medically induced termination of pregnancy when a malformed fetus is suspected or when the womans health is in jeopardy.

TORCH: TOxoplasmosis, Rubella, Cytomegalovirus, Herpesvirus hominis type 2 An acronym used to describe a group of infections that represent potentially severe problems during pregnancy. TO, toxoplasmosis; R, rubella; C, cytomegalovirus; H, herpesvirus.

SIDS: Sudden Infant Death Syndrome Sudden death of an infant; primary cause of infant death beyond neonatal period in the US.

D&C: Dilation & Curettage Performed by the primary care provider to remove retained placental fragments if indicated (ATI p267) Done to dilate & scrape the uterine walls to remove uterine contents for inevitable & incomplete abortions if oxytocics are ineffective in expelling the placental fragments.

IDM: Infant of a Diabetic Mother At-risk infant born to a woman previously diagnosed as diabetic or who develops symptoms of diabetes during pregnancy.

DTR: Deep Tendon Reflexes