Clinical Data Interpretation and Obstetrics & Gynaecology Management

Vocabulary flashcards covering clinical management and data interpretation key terms in Obstetrics and Gynaecology based on official guidelines.

Early OHSS

Ovarian hyperstimulation syndrome that presents within $7$ days of hCG injection, typically associated with an excessive ovarian response to stimulation.

Late OHSS

Ovarian hyperstimulation syndrome that presents $10$ or more days after hCG injection, usually caused by endogenous hCG from an early pregnancy, and tends to be more prolonged and severe.

Vascular Endothelial Growth Factor (VEGF)

A vasoactive substance increased in OHSS pathophysiology that increases vascular permeability, causing fluid shifts resulting in ascites, pleural effusion, and hemoconcentration.

Complete Hydatidiform Mole

A form of molar pregnancy originating from mono-spermatic or di-spermatic fertilization of an empty ovum, featuring a diploid paternal-only karyotype (commonly $46,XX$), diffuse villous oedema, absent fetal tissue, and negative p57 staining.

Partial Hydatidiform Mole

A molar pregnancy originating from di-spermatic fertilization of a normal ovum, featuring a triploid karyotype (commonly $69,XXY$), focal villous oedema, presence of non-viable fetal tissue, and positive p57 staining.

p57 Immunohistochemistry

A nuclear stain expressed in tissues containing maternal genetic material, used to distinguish partial molar pregnancy (p57 positive) from complete molar pregnancy (p57 negative).

FIGO Scoring System for GTN

A prognostic scoring system for gestational trophoblastic neoplasia where a score of $\le 6$ indicates low risk (treated with single-agent Methotrexate) and a score of $\ge 7$ indicates high risk (treated with combination EMA/CO chemotherapy).

Gestational Diabetes Mellitus (GDM)

Diabetes diagnosed in pregnancy defined on a $75\,\text{g}$ 2-hour OGTT by a fasting plasma glucose $\ge 5.6\,\text{mmol/l}$ or a 2-hour plasma glucose $\ge 7.8\,\text{mmol/l}$.

Variable Rate Intravenous Insulin Infusion (VRIII)

An IV insulin-dextrose infusion protocol indicated during labour, C-section, or steroid therapy for pregnant diabetic women when capillary blood glucose readings are persistently $> 8.0\,\text{mmol/l}$.

Diabetic Ketoacidosis (DKA) in Pregnancy

A life-threatening medical emergency characterised by capillary blood glucose $> 11\,\text{mmol/l}$, venous pH $< 7.3$ or bicarbonate $< 15\,\text{mmol/l}$, and capillary ketones $> 3\,\text{mmol/l}$.

Desferrioxamine

An iron-chelating agent administered subcutaneously ($20\,\text{mg/kg/day}$) after $20$ weeks of gestation in pregnant women with beta-thalassaemia who have severe hepatic or cardiac iron overload.

Levonorgestrel-releasing Intrauterine System (LNG-IUS)

A first-line medical treatment for heavy menstrual bleeding in women with no identified pathology or fibroids $< 3\,\text{cm}$ in diameter that do not distort the uterine cavity.

Endometrial Ablation

A surgical technique to destroy the uterine endometrium, recommended for heavy menstrual bleeding in women who have completed their family and have a uterine size $\le 10$ weeks of gestation.

Primary Postpartum Haemorrhage (PPH)

Excessive blood loss of $500\,\text{ml}$ or more from the genital tract occurring within $24$ hours of delivery.

B-Lynch Brace Suture

A surgical uterine compression technique using Monocryl 1 (Poliglecaprone 1) to control major postpartum haemorrhage caused by uterine atony.

Middle Cerebral Artery Peak Systolic Velocity (MCA PSV)

A non-invasive Doppler measurement used to assess fetal anaemia in maternal alloimmunisation, where values $> 1.5$ Multiples of the Median (MoM) prompt referral for intrauterine transfusion.

Kleihauer-Betke Test

A diagnostic test performed on maternal blood after $20$ weeks of gestation to quantify fetomaternal haemorrhage by differentiating acid-resistant fetal hemoglobin cells from adult ghost red cells.

Premenstrual Syndrome (PMS)

A condition involving distressing physical, behavioural, and psychological symptoms that regularly recur during the luteal phase of the menstrual cycle and significantly regress or disappear by the end of menstruation.

Bladder Pain Syndrome (BPS)

A chronic pelvic pain syndrome lasting at least $6$ months, characterized by pain related to the bladder accompanied by lower urinary tract symptoms, requiring exclusion of UTI and other pelvic pathologies.

Urethral Diverticulum (UD)

A sac-like outpouching from the urethra presenting classically with dysuria, post-micturition dribbling, dyspareunia, and recurrent UTIs, managed surgically by diverticulectomy.

Rotterdam Criteria

Diagnostic criteria for PCOS requiring the presence of at least two of the following: oligo- or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound ($\ge 12$ follicles or volume $> 10\,\text{cm}^3$).

Free Androgen Index (FAI)

The baseline biochemical indicator of hyperandrogenism calculated using the formula $\frac{\text{Total Testosterone}}{\text{SHBG}} \times 100$.

Small for Gestational Age (SGA)

A fetus or newborn with an estimated fetal weight or abdominal circumference below the 10th centile for gestational age on customized growth charts.

Fetal Growth Restriction (FGR)

Pathological SGA characterized by a fetal size or abdominal circumference below the 3rd centile, or below the 10th centile accompanied by abnormal Doppler indices.

Symmetrical vs Asymmetrical SGA

Symmetrical SGA features both small head and small abdomen (worse prognosis), whereas asymmetrical SGA features a normal head circumference ($\ge 50\text{th}$ centile) with a small abdominal circumference ($< 10\text{th}$ centile).

Aortocaval Compression

Compression of the abdominal aorta and inferior vena cava by the gravid uterus starting from $20$ weeks of gestation, requiring a $15\text{--}30$ degree left lateral tilt or manual uterine displacement during maternal resuscitation.

Intraoperative Cell Salvage (IOCS)

A blood recycling procedure recommended during C-section when anticipated blood loss exceeds $20\%$ of blood volume; requires administering a minimum of $1500\,\text{IU}$ Anti-D to RhD-negative women if the fetus is RhD-positive.

Placenta Praevia

Implantation of the placenta in the lower uterine segment, presenting as painless bright red vaginal bleeding; classified as low-lying if within $20\,\text{mm}$ of the internal os or praevia if covering the os.

Placenta Accreta Spectrum (PAS)

Abnormal attachment of the placenta directly to or through the myometrium, diagnosed on 2D greyscale ultrasound by loss of the hypoechoic 'clear zone' and presence of abnormal placental lacunae.

Fetal Fibronectin (fFN)

A glycoprotein located at the maternal-fetal interface detected in cervicovaginal secretions ($> 50\,\text{ng/ml}$) to assess short-term risk of preterm delivery in symptomatic women with intact membranes.