This list of terms is not exhaustive, but are commonly used in expert witness reports, letters of claim, letters of response, and medical notes. Not included are conditions of pregnancy which are unlikely to relate to negligence and birth injury. I have not included words relating to injury to the mother, as its outside the scope of this list.
Medical Terms – Pregnancy
When you are reviewing your medical notes, or trying to make sense of expert witness reports, there are a lot of medical words you may not be familiar with.
Therefore, I have put together a summary of some of the words you may see, with a brief explanation of their meaning.
This section deals with pregnancy, with separate sections covering labour and the period after delivery.
These sections only cover terms which are likely to be relevant to birth injury and clinical negligence cases. They are not intended to be an extensive guide to pregnancy or obstetrics, as including everything would make the list far too long.
If you have questions about terms used in any reports you receive, the person to ask is the solicitor dealing with your case. They can explain the terminology in the context of your own child’s medical records and the expert evidence.
Anomaly Scan
An Ultrasound Scan used to detect or rule out abnormalities during pregnancy, usually following abnormal test results or because of other factors.
Antepartum Haemorrhage
Any bleeding relating to the pregnancy from 24 weeks until birth. It can be due to something serious like placental abruption, or be relatively minor. The wellbeing of the mother and baby should always be checked out.
Anterior Placenta/Posterior Placenta
The placenta is growing on the front of the uterine wall (anterior) or on the back (posterior)
Breech position
Baby is feet or bottom down which can present problems at birth.
Brow presentation/facial presentation
Types of malpresentation where the baby’s head is not in the usual flexed, vertex position. In brow presentation the forehead presents first; in facial presentation the face presents first. Vaginal delivery may be difficult or impossible depending on the position and circumstances.
Braxton Hicks Contractions
Minor contractions that are not regular or severe and not associated with other signs of labour. They are simply the uterus readying itself for labour.
Chorionic Villus Sampling CVS
A test carried out between 11-14 weeks to detect abnormalities in the baby’s chromosomes. Often offered following a high reading for one of the fetal abnormalities seen on USS along with other reasons.
Cardiotocography (CTG) or electronic fetal monitoring (EFM)
Electronic monitoring during pregnancy and labour. Two pads are strapped to the abdomen and they record the baby’s heart rate, the mother’s heart rate and the contractions. Misinterpretation of CTG is one of the commonest reasons for birth injury
Cholestasis of pregnancy
This is a liver condition which needs careful treatment and monitoring.
Chorioamnionitis
An infection of the placental tissues, membranes and/or amniotic fluid. There are various indicators of infection which should be picked up early and treated. It is an added risk with pre term rupture of membranes.
Due date
From 37 to 42 weeks is considered a normal term time, although after 40 weeks, the risks can increase in some mothers, particularly if there are other issues such as diabetes.
Doppler Scanner
A hand held method of measuring the baby’s heart rate. Dopplers can sometimes give a false reading where maternal and fetal heart rates can be confused. Sometimes they appear to ‘double up’ and midwives are aware of this so should check with care they are detecting the fetal heart rate.
External Cephalic Version (ECV)
Attempt to turn a breech baby towards the end of the pregnancy
Fetus/foetus
The baby, usually referred to like this when it is very small.
Fundus Height
The height of the uterus measured manually by the midwife as a rough estimate of the baby’s growth
Group Strep B Infection GBS
This is a bacteria that often lives harmlessly in men and women in the genital area. However, in rare cases, when the baby is born via the birth canal, they can become infected with GBS and develop sepsis or meningitis. They can become seriously ill. GBS infection in a newborn can develop rapidly, and prevention involves risk assessment, recognition of maternal risk factors and appropriate intrapartum antibiotics where indicated. The symptoms should be picked up by a competent midwife and treated with antibiotics. A mother known to carry GBS can be given antibiotics during labour. Currently this is not routinely tested for.
Prenatal
Period before birth. Period during pregnancy
Pre-Eclampsia
Condition in the second half of pregnancy causing high blood pressure, usually protein in the urine, and often fluid retention (e.g. swollen hands and ankles)
Eclampsia
Eclampsia is the development of seizures and the baby and mother are both severely compromised. If left untreated, pre-eclampsia may lead to eclampsia, but it may also develop alone.
Transverse lie position
Baby is lying from side to side in the uterus. Again, this is a malpresentation
Placenta Praevia
The placenta is over the cervix and, unless it moves away as the baby grows, can cause extreme haemorrhage during labour or pregnancy
Premature Labour
The mother goes into labour early. Generally speaking the earlier the baby is the worse the chances of survival, but other factors could influence the outcome.
Gestational diabetes
High blood and urine sugar levels during pregnancy in a previously non diabetic woman. Monitoring and treatment of the diabetes with medication or insulin is important as is plotting the baby’s weight, as diabetes can cause the baby to grow larger.
Hydramnios
An excessive amount of amniotic fluid around the baby. This should be monitored as it can affect the mother and baby.
Intrauterine growth restriction (IUGR), also known as fetal growth restriction
Babies with IUGR are small for dates and should have this picked up during routine USS. They should be monitored and, if the IUGR is severe may need early delivery.
Multiple Pregnancy
Two or more babies (twins, triplets etc.). These should always be managed by a consultant, as they are considered high risk.
Oligohydramnios (low amniotic fluid)
Mothers with reduced amniotic fluid should be monitored more carefully.
Placental abruption
A premature separation of the placenta from the uterine wall before the baby is delivered. It can be mild with minimal effects, to catastrophic, with severe haemorrhage and infant mortality. Warning signs are constant abdominal pain with or without bleeding, and an abnormal fetal heart rate.
Premature rupture of membranes (PROM)
Rupture of the membranes is often the precursor to labour. PROM means rupture of the membranes before labour at term, while PPROM means preterm prelabour rupture of membranes. Sometimes a baby can remain in the womb despite reduced amniotic fluid, but there is an increased risk of infection, so careful management and monitoring are important.
Reduced Fetal Movements
Movements of the baby noted by the mother. Any change/reduction in the baby’s usual pattern of movements should prompt assessment.
Ultrasound scan USS
A non invasive scan using sound waves to monitor the pregnancy. They are used to date and to detect any abnormalities. They are used to monitor the size and growth of the baby
Source: NHS, NICE, RCOG
