Maternal-Newborn Nursing: Assessment, High-Risk Conditions, and Labor Comfort

Comprehensive vocabulary flashcards covering obstetrical assessments, antepartum genetic screening, labor induction, hypertensive disorders of pregnancy, gestational diabetes, and pharmacological and non-pharmacological pain management during labor.

Infertility

The inability of a couple to conceive after 1 year of regular unprotected intercourse if the woman is under 35 years of age, or after 6 months if the woman is over 35 years of age.

Endometriosis

An inflammatory condition in which endometrial tissue normally lining the uterine cavity grows in abnormal ectopic locations, leading to pelvic pain, dysmenorrhea, dyspareunia, tissue scarring, and infertility.

Intrauterine Insemination (IUI)

An assisted reproductive technology procedure where prepared sperm is placed directly into the uterus around the time of ovulation.

In Vitro Fertilization (IVF)

A medical assisted reproductive procedure in which mature eggs are retrieved and fertilized with sperm in a laboratory before embryo transfer.

Fetal Kick Counts

A non-invasive daily maternal assessment of fetal well-being initiated around 28 weeks gestation, where fewer than 10 fetal movements within a 2-hour window requires further clinical evaluation.

Non-Stress Test (NST)

An antepartum electronic fetal monitoring assessment performed after 28 weeks gestation; defined as reactive when at least 2 fetal heart rate accelerations (meeting $15\,\text{bpm} \times 15\,\text{sec}$ at >32 weeks) occur within a 20- to 40-minute window.

Biophysical Profile (BPP)

A real-time ultrasound and electronic monitoring assessment lasting 30 minutes to 2 hours that evaluates 5 categories of fetal well-being: breathing movements, gross body movement, muscle tone, amniotic fluid volume, and non-stress test reactivity.

Contraction Stress Test (CST)

An invasive antepartum assessment of fetal heart rate response to contractions stimulated by oxytocin or nipple stimulation after 34 weeks gestation; evaluated across 3 contractions within a 10-minute window.

Cell-Free DNA (cfDNA) Screening

A maternal plasma screening test conducted at 10 to 12 weeks gestation that analyzes circulating fetal DNA fragments for chromosomal conditions; not recommended for multifetal pregnancies.

Fetal Nuchal Translucency (NT)

An ultrasound measurement of fluid collection at the nape of the fetal neck performed between 10 and 14 weeks gestation, where a fluid measurement greater than $3\,\text{mm}$ is considered abnormal.

Quad Screen

A maternal blood screening panel performed between 16 and 18 weeks gestation measuring alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), inhibin A, and unconjugated estriol to evaluate risk for neural tube defects and Down syndrome.

Chorionic Villus Sampling (CVS)

An invasive diagnostic procedure performed at 10 to 13 weeks gestation via a transvaginal or transabdominal approach under ultrasound guidance to aspirate placental tissue for fetal genetic analysis.

Amniocentesis

An invasive diagnostic procedure performed at 14 to 18 weeks gestation for genetic testing, or in the third trimester to analyze amniotic fluid for fetal surfactant and the lecithin-to-sphingomyelin (L/S) ratio to assess lung maturity.

Bishop Score

A 13-point pre-induction scoring system evaluating cervical dilation, effacement, station, cervical consistency, and cervical position, where a score of 8 or higher indicates readiness for successful vaginal induction.

Misoprostol (Cytotec)

A prostaglandin $E_1$ analogue administered orally or vaginally to ripen the cervix and stimulate contractions; strictly contraindicated in patients with a prior cesarean birth (VBAC) due to uterine rupture risk.

Dinoprostone (Cervidil)

A 10 mg prostaglandin $E_2$ controlled-release vaginal insert placed in the posterior fornix for cervical ripening, removed at 12 hours or upon onset of active labor, with oxytocin initiation delayed at least 30 minutes post-removal.

Amniotomy (AROM)

Artificial rupture of the amniotic membranes using an amnihook to stimulate or augment labor, requiring continuous fetal heart rate monitoring and maternal temperature checks every 2 hours post-procedure.

Oxytocin (Pitocin)

A high-alert pituitary hormone medication verified by two nurses that stimulates uterine contractions for induction or augmentation of labor, carrying risks of uterine tachysystole, placental abruption, and uterine rupture.

Chronic Hypertension in Pregnancy

Blood pressure elevation with systolic $\ge 140\,\text{mm\,Hg}$ and/or diastolic $\ge 90\,\text{mm\,Hg}$ diagnosed before 20 weeks of gestation or persisting beyond 12 weeks postpartum.

Gestational Hypertension

New-onset hypertension ($\text{SBP} \ge 140\,\text{mm\,Hg}$ and/or $\text{DBP} \ge 90\,\text{mm\,Hg}$) occurring after 20 weeks of gestation without proteinuria or severe features, which normalizes within 12 weeks postpartum.

Preeclampsia

A multisystem progressive disorder characterized by endothelial cell damage, hypertension ($\ge 140/90\,\text{mm\,Hg}$ on two occasions 4 hours apart after 20 weeks gestation), and proteinuria ($\ge 300\,\text{mg}/24\,\text{hr}$ or protein:creatinine ratio $\ge 0.3$) or specific end-organ dysfunctions.

Eclampsia

The development of new-onset grand mal seizure activity or coma in a patient with preeclampsia who has no preexisting neurological or seizure disorder.

HELLP Syndrome

A severe laboratory variant of preeclampsia presenting with Hemolysis (microangiopathic hemolytic anemia), Elevated Liver enzymes (AST, ALT), and Low Platelets ($< 100{,}000/\mu\text{L}$), often presenting with flu-like symptoms and right upper quadrant pain.

Magnesium Sulfate

A central nervous system depressant administered as a 4 to 6 gram IV loading dose followed by 1 to 4 grams/hour for seizure prophylaxis in preeclampsia; monitored for toxicity indicated by absent deep tendon reflexes, respiratory rate $\le 12\,\text{breaths/min}$, and decreased urine output.

Calcium Gluconate

The specific intravenous antidote administered immediately when magnesium sulfate toxicity is diagnosed or suspected.

Oral Glucose Tolerance Test (OGTT)

A diagnostic screening protocol for gestational diabetes mellitus consisting of a 1-hour 50 g non-fasting screen at 24 to 28 weeks, followed if positive ($\ge 130\text{--}140\,\text{mg/dL}$) by a diagnostic 3-hour 100 g fasting test requiring 2 abnormal values.

Visceral Pain (Labor)

Predominant pain of the first stage of labor arising from cervical stretching, uterine ischemia, and distention of the lower uterine segment, felt primarily over the lower abdomen, back, and hips.

Somatic Pain (Labor)

Intense, sharp, burning, and localized pain experienced during the second stage of labor caused by stretching and distension of pelvic floor tissues, the vagina, and the perineum during fetal descent.

Gate-Control Theory of Pain

A neurobiological concept stating that pain impulses traveling to the brain can be blocked or blunted at spinal gate pathways by sending competing non-painful sensory sensations along large nerve fibers.

Effleurage

A cutaneous stimulation technique involving light, gentle, rhythmic stroking of the abdominal wall in synchronization with breathing during labor contractions to promote relaxation and distract from pain.

Sacral Counterpressure

Continuous, firm pressure applied with the heel of the hand, fist, or tennis ball against the maternal sacrum to relieve back pain caused by an occiput posterior (OP) fetal position.

Nalbuphine (Nubain)

An opioid agonist-antagonist analgesic (5 to 10 mg IV or IM) that provides labor pain relief with a ceiling effect on respiratory depression, but is contraindicated in opioid-dependent women due to precipitating acute withdrawal.

Naloxone (Narcan)

An opioid antagonist administered to promptly reverse opioid-induced central nervous system and respiratory depression in either the laboring mother or newborn.

Pudendal Nerve Block

A transvaginal injection of local anesthetic into the pudendal nerve 10 to 20 minutes prior to delivery that provides somatic anesthesia to the lower vagina, vulva, and perineum for second-stage operative delivery or episiotomy repair.

Epidural Anesthesia

Regional analgesia and anesthesia achieved by threading a catheter between the L4 and L5 vertebrae into the epidural space, requiring pre-procedure hydration with a 500 mL IV fluid bolus to prevent maternal hypotension.

Spinal Anesthesia

Regional anesthesia for scheduled or non-emergent cesarean delivery involving injection of local anesthetic and intrathecal opioids through the dura into the subarachnoid space (CSF) at the 3rd, 4th, or 5th lumbar interspace, providing 1 to 3 hours of dense motor and sensory blockade.

Cricoid Pressure (Sellick Maneuver)

Downward pressure applied directly onto the cricoid cartilage during rapid-sequence endotracheal intubation under general anesthesia to occlude the esophagus and prevent pulmonary aspiration of gastric contents.

Local Perineal Infiltration Anesthesia

Direct injection of 1% lidocaine into the perineal tissues to provide localized numbness immediately prior to cutting an episiotomy or repairing perineal lacerations.