Aarskog syndrome ; Aarskog-Scott syndrome (AAS); faciogenital dysplasia.
A condition characterized by slight to moderate short stature, hypertelorism, small nose with anteverted nares, broad philtrum, orthodontic problems, brachydactyly, prominent umbilicus, and shawl scrotum. A spectrum of behavioral disorders may be part of the AAS phenotype. May be at increased risk for mental deficiency. T
See Also: Online Mendelian Inheritance in Man®
Abdomen (The Belly)
The body cavity below the chest that contains the stomach, liver, intestines and other organs.
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Abdominal circumference (AC)
The distance around fetal abdomen. The abdominal circumference is measured by sonogram from outer skin surface to outer skin surface The appropriate transverse plane for measurement of the fetal abdominal circumference (AC) should include the umbilical vein at the level where the umbilical vein enters the liver. The ossification centers of the spine should be aligned.
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Abortion
Termination of pregnancy before the fetus is developed enough to survive.
Related terms:
- Incomplete Abortion: Passage of some but not all fetal or placental tissue from the uterus before 20 weeks'
- Induced Abortion: Intentional medical or surgical termination of pregnancy
- Elective Abortion: Induced abortion performed at the woman's request
- Therapeutic Abortion: Induced abortion performed to preserve the mother's health or life.
- Inevitable Abortion: Opening of the cervix with uterine bleeding before 20 weeks'.
- Missed Abortion: Death of the fetus before 20 weeks' without expulsion of the fetus
- Septic abortion: Abortion accompanied by infection of the uterus.
- Spontaneous Abortion: Naturally occurring abortion before 20 weeks'. Miscarriage
- Threatened Abortion: Uterine bleeding at less than 20 weeks' without opening or other change in the cervix
Abruptio placenta (Placental abruption)
Partial or complete separation of the placenta from the uterus before delivery. It happens in 0.8-1.0% of all pregnancies and has a high recurrence rate. Contractions are usually present. Bleeding is also present in approximately 80% of patients. Factors that have been associated with abruption include maternal hypertension, intrauterine growth restriction (IUGR), non-vertex presentation, polyhydramnios, advanced maternal age, maternal smoking, cocaine use, chorioamnionitis, premature rupture of membranes, and blunt external maternal trauma
āc
Before meals
Acceleration
An acceleration is an abrupt increase in the fetal heart rate above baseline with onset to peak of the acceleration less than 30 seconds and less than 2 minutes in duration.
Adequate accelerations are defined as:
- In a fetus less than
Acromelia
Shortening of the hands or feet
Active Labor
The active phase (active labor) of labor begins when the cervix is opened (dilated) to 6 cm in the presence of uterine contractions. During the active phase uterine contractions become more frequent, the cervix dilates more quickly, and the baby descends into the pelvis.
Acute Cervical Insufficiency
Cervical dilation of at least 2 cm with membranes visible at 16 0/7 to 22 6/7
weeks' gestation as used by Owen J et al.
Owen J, et al. Multicenter randomized trial of cerclage for preterm birth
prevention in high-risk women with shortened midtrimester cervical length. Am J
Obstet Gynecol. 2009 Oct;201(4):375.e1-8.PMID:19788970
Afterbirth
Collective term for the placenta and fetal membranes that are delivered after the infant
Agenesis of the corpus callosum (ACC)
A birth defect in which there is partial or complete absence of the corpus callosum (the bundle of nerve fibers that connects the two hemispheres of the brain).
ACC may occur as an isolated defect, but it is frequently associated with other malformations, chromosomal abnormalities (trisomy 18 an trisomy 8), and genetic syndromes. The outcome of the abnormality depends on the underlying cause and the presence of other structural defects. Isolated ACC (in particular partial ACC) is associated with no or mild neurologic impairment in a large proportion of cases. ACC occurring as part of a syndrome may be associated with severe mental retardation and seizures. ACC does not cause death in the majority of children.
Ultrasound findings include absence of the corpus callosum and cavum septum pellucidum, 'teardrop' configuration of the lateral ventricles, dilatation and upward displacement of the third ventricle (interhemispheric "cyst") , and abnormal branching of the anterior cerebral artery. Magnetic resonance imaging is sometimes useful in confirming the diagnosis.
Additional abnormalities commonly found in association with ACC include Chiari malformations, schizencephaly, encephaloceles, Dandy-Walker malformations, holoprosencephaly, heart defects, and GI or genitourinary malformations.
The risk of recurrence is ~ 1% for sporadic cases, 25% if ACC is associated with an autosomal recessive cause, and 50% of males will be affected if inherited as an X-linked recessive disorder.
Akinesia
Absence or lack of movement
Alloimmunization (Isoimmunization)
Production of an antibody against antigens produced by members of the same species.
Alpha-fetoprotein (AFP)
A protein produced by the fetal liver and yolk sac that can be detected in the mother's blood. Alpha-fetoprotein levels rise gradually throughout most of pregnancy and level off near term. High levels of alpha-fetoprotein are associated with a more advanced pregnancy than expected, multiple pregnancy, fetal death (including a vanished twin), an opening in the spine (spina bifida), an opening in the head (anencephaly), or an opening in the abdominal wall (gastroschisis). Low levels may be associated with Down syndrome, trisomy 18, and some cases of Turner syndrome.
Amniocentesis
A procedure in which a needle is inserted into the uterus and a sample of the fluid surrounding the fetus is drawn out. The procedure may be done to evaluate the fetal chromosomes, to determine fetal lung maturity, or to obtain fluid to culture for possible infections. The procedure may also be performed to remove an excessive amount of amniotic fluid.
Amnioinfusion
Infusion of fluid (usually normal saline or lactated Ringer's solution) into the amniotic cavity.
Amniotic fluid ‘sludge’
The sonographic finding of dense aggregates of particulate matter in the
amniotic fluid close to the internal cervical os. Amniotic Fluid (AF) ‘sludge’
has been associated with microbial invasion of the amniotic cavity (MIAC), and
histologic chorioamnionitis in patients with spontaneous preterm labor and
intact membranes
Amniotic sac
The membrane (amnion) that surrounds the fetus and the amniotic fluid.
Amniotic sheet
A 'shelf' in the amniotic cavity seen during ultrasound examination. Amniotic sheets
represent chorion and amnion that has grown around uterine synechiae (
adhesions) . Incomplete amniotic sheets have a free edge. Complete
amniotic sheets have no free edge, and have been associated with increased risk
for intrauterine death.
Amniotic sheets may be mistaken for amniotic bands. However, amniotic bands more
often appear as multiple thin membranes, and are frequently attached to
the fetus. Circumvallate placenta is another cause of uterine band, sheet, or shelf.
Tan KB, Tan TY, Tan JV, Yan YL, Yeo GS. The amniotic sheet: a truly benign condition?Ultrasound Obstet Gynecol. 2005 Nov;26(6):639-43. PMID: 16254890
Amniotomy (artificial rupture of membranes , AROM)
A procedure performed (often using a plastic device that looks like a crochet needle ) to open the amniotic sac usually for the purpose of inducing or speeding up the progress of labor .
Anemia
Decreased amount of normal hemoglobin in blood. Hemoglobin is the substance in red blood cells that carries oxygen.
Anencephaly
A birth defect resulting in the absence of a major portion of the skull and brain. Anencephaly results when the upper portion of the neural tube fails to close. The condition is not compatible with life, and infants usually die within a few days after delivery. See picture
Anesthesia
Loss of sensation.
Angle of insonation
measure of deviation from "straight on" to a reference plane measured in degrees. For example a Doppler ultrasound beam aligned to the flow of blood in a vessel has a zero degree of insonation to the flow. A Doppler ultrasound beam aligned perpendicular to the flow of blood in the same vessel has a 90 degree angle of insonation to the flow.
Angelman syndrome ("Happy Puppet Syndrome")
A disorder characterized by a large jaw and open-mouthed expression revealing the tongue, severe speech impairment, motor and intellectual retardation, ataxia, poor muscle tone, seizures, frequent laughing, smiling, and excitability. The disorder is usually caused by abnormalities of chromosome 15.
A deletion of chromosome in the 15q11-q13 region accounts for up to 75% of cases and has a less than 1% recurrence risk. Mutations in the UBE3A gene on chromosome 15 accounts for 6 to 20% of cases and has a recurrence risk of less than 1% unless the patient's mother carries the UBE3A mutation on her own paternally inherited chromosome 15. In the latter case there is a 50% recurrence risk. Angelman syndrome is less commonly caused by inheritance of two copies of chromosome 15 from the father and no maternal copy of chromosome 15 (uniparental disomy) , or mutations in the imprinting center of the UBE3A gene.
Aniridia
Absent or partially absent iris accompanied by macular and optic nerve
hypoplasia. Symptoms include poor vision sensitivity to light (photophobia),
and nystagmus. Frequently associated abnormalities include glaucoma
and cataracts. Mutation of the PAX 6 gene or deletion of a regulatory region controlling its expression, appears to be responsible for
aniridia occurring as an isolated ocular defect . The condition is
autosomal dominant.
Aniridia may also occur as part of the Wilms tumor-aniridia-genital anomalies-retardation (WAGR) syndrome, with a deletion of 11p13 involving the PAX6 (aniridia) locus and the adjacent WT1 (Wilms
tumor) locus.
Anomaly
Malformation or abnormality.
Antenatal
Before birth.
Antenatal steroids
Steroids (either betamethasone or dexamethasone) given to help the fetal lungs and other organs mature more rapidly. Antenatal steroids are given when preterm delivery is anticipated between 24 and 34 weeks' gestation with intact membranes, and at 24 to 32 weeks' with ruptured membranes.
Antepartum
Before delivery or birth.
Anterior
In front
Antibody (Immunoglobulin)
Proteins secreted by white blood cells (lymphocytes) that bind to foreign molecules. Antibodies attach to the antigens and destroy the invader directly , or label them for removal by your white blood cells.Antibodies (immunoglobulins) are grouped into five classes or isotypes: IgG, IgA, IgM, IgD, and IgE.
A molecules that stimulates antibody production is called an antigen (antibody generator).
Anticardiolipin antibodies (ACA, aCL Antibody)
An antibody that attaches to cardiolipin , a fatty molecule, found
mostly in the mitochondrial inner membrane where it is synthesized from
phosphatidylglycerol . ACA may be found in several diseases including
antiphospholipid syndrome and systemic lupus erythematosus (SLE). Three classes
of cardiolipin antibodies may be present in the blood: IgG, IgM and/or IgA.
Anti-c antibody (little c antibody)
A protein made by the immune system that binds to a molecule called the c antigen found on the surface of red blood cells. The c antigen is part of the Rhesus blood group system which consists of several antigens (D , E , e , c, C, ). The antibody hastens removal of the c antigen (and the foreign blood cells) from the body.
Anti-c antibody is capable of crossing the placenta and causing anemia in the fetus and hemolytic disease of the newborn. Pregnancies complicated by anti-c antibody are managed as for Rh-D sensitization .
Anti-D antibody (Rh sensitization, Rh disease)
A protein made by the immune system that binds to a molecule called the D antigen found on the surface of red blood cells. The D antigen is part of the Rhesus blood group system which consists of several antigens (D , E , e , c, C, ).
The antibody hastens removal of the D antigen (and the foreign blood cells) from the body.Anti-D antibody is capable of crossing the placenta and causing SEVERE anemia in the fetus and hemolytic disease of the newborn.
Anti-Duffy antibody (anti-Fya antibody)
A protein made by the immune system that binds to a molecule called the Fya antigen found on the surface of red blood cells. The Fya antigen is part of the Duffy blood group system which consists of the antigens Fya and Fyb . The antibody hastens removal of the and Fya antigen (and the foreign blood cells) from the body.
Anti-Fya antibody is capable of crossing the placenta and causing SEVERE anemia in the fetus and hemolytic disease of the newborn. Anti-Fyb has not been reported to cause significant hemolytic disease of the newborn.
Anti-Kell antibody
A protein made by the immune system that binds to a molecule called the Kell antigen found on red blood cells. The Kell antigen is part of the Kell blood group system which consists of several antigens ( Kell or K1 , Kpa, k , Jsa ,Jsb ). The antibody hastens removal of the Kell antigen (and the foreign blood cells) from the body.
Anti-Kell antibody is capable of crossing the placenta and causing SEVERE anemia in the fetus and
hemolytic disease of the newborn.
SEE ALSO: Q & A ..a pregnant patient with
anti-Kell antibodies...
Anti-Kidd antibody (anti-Jka or anti-Jkb)
A protein made by the immune system that binds to a molecule called Kidd antigen found on the surface of red blood cells. The Kidd antigens Jka and Jkb are part of the Kidd blood group system.
Anti-Kidd antibody is capable of crossing the placenta and causing anemia in the fetus and hemolytic disease of the newborn.
Anti-Lewis antibody
A protein made by the immune system that binds to molecules called the Lewis antigens, Le a and Le b. Lewis antigens are not made by the red blood cell, but are antigens present in body fluids and secretions that have been adsorbed onto the surface of the red blood cell. Lewis antigens are found in very low levels on the fetal red cells.
Most Lewis antibodies are of the IgM type and do not cross the placenta. Lewis blood group antibodies are not known to cause hemolytic disease of the newborn.
Anti-S antibody
A protein made by the immune system that bind to a molecule called the S antigen found on the surface of red blood cells. The S antigen is part of the MNS blood group system which consists of several antigens ( M, S,s, N)
Anti-S antibody is capable of crossing the placenta and causing anemia in the fetus and hemolytic disease of the newborn.
Aorta
The large blood vessel that carries blood away from the left ventricle of heart to the rest of the body
Apnea
Temporary cessation of breathing
Arcuate uterus
| Midline
thickening of the wall of the uterus at the uterine fundus (top of the
uterus). The thickened area results from failure to completely dissolve the
uterine septum during development. The arcuate uterus is considered to be a mild form of
bicornuate uterus.
An arcuate uterus does not appear to have an unfavorable effect on
pregnancy. |
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Areola The darker colored area around the nipple of the breast Arnold-Chiari Malformation A group of birth defects of the cerebellum (the part of the brain that
controls balance) and base of the skull characterized by downward displacement of the cerebellum and
related structures below the level of the foramen magnum (the large hole at the
base of the skull).
The three types of Arnold-Chiari malformation are:
Many persons with a Type I malformation have no symptoms. However,
some persons may experience headache that is aggravated by
coughing and straining, weakness or loss of sensation of the upper arms
and hands, slurred speech,
trouble swallowing, dizziness, or trouble balancing.
Arrest of descent
Second-stage arrest may be diagnosed if there has been
"No progress (descent or rotation) for
4 hours or more in nulliparous women with an epidural
3 hours or more in nulliparous women without an epidural
3 hours or more in multiparous women with epidural
2 hours or more in multiparous women without an epidural"
Spong CY, et. al. Preventing the first cesarean delivery: summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop. Obstet Gynecol. 2012 Nov;120(5):1181-93. doi http://10.1097/AOG.0b013e3182704880. PMID: 23090537
Arrest of dilatation
For spontaneous labor:
6 cm or greater dilation with membrane rupture AND
4 hours or more of adequate contractions (e.g., > 200 Montevideo units) OR
6 hours or more if contractions inadequate with no cervical change
For induced labor:
6 cm or greater dilation with membrane rupture or 5 cm or greater without
membrane rupture AND
4 hours or more of adequate contractions (e.g., > 200 Montevideo units) OR
6 hours or more if contractions inadequate with no cervical change [4].
Spong CY, et. al. Preventing the first cesarean delivery: summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop. Obstet Gynecol. 2012 Nov;120(5):1181-93. doi http://10.1097/AOG.0b013e3182704880. PMID: 23090537
Artificial rupture of membranes (AROM)
See amniotomy.
Aspirate
To inhale into liquid or food into the lungs, or to draw
(fluid) by suction
Augmentation of labor
Stimulation the uterus to increase the frequency, duration , or strength of contractions when spontaneous contractions have failed to cause dilation or thinning (effacement) of the cervix leading to the delivery of the infant.
References
American College of Obstetricians and Gynecologists. Antepartum Fetal Surveillance. Practice Bulletin no. 9. Washington, D.C. ACOG, 1999.
Cunningham FG. ed Williams Obstetrics, 22nd ed., New York: McGraw-Hill.2005
Gabbe ed: Obstetrics - Normal and Problem Pregnancies, 4th ed New York, NY, Churchill Livingstone; 2002
Jones, K.L. ed. Smith’s recognizable patterns of human malformation (5th ed.). Philadelphia: W.B. Saunders.1997
Resnik R, ed., Maternal-Fetal Medicine, 5th ed., pp. 859–899. Philadelphia: Saunders.
Stenchever MA, Droegemueller W, eds. Comprehensive Gynecology. 4th ed. St. Louis: Mosby, 2001
Woodward PJ ed. Diagnostic Imaging Obstetrics, 1st ed., Manitoba: Amirsys, 2005
Ogueh O, et al., Obstetric implications of low-lying placentas diagnosed in the
second trimester.
Int J Gynaecol Obstet. 2003 Oct;83(1):11-7. PMID: 14511867