Glossary and abbreviations

 
     
abstinence syndrome Clinical manifestations related to baby withdrawing from maternal substance abuse during pregnancy
anomaly ultrasound scan Ultrasound scan usually performed at 18–20 weeks of gestation to exclude fetal anatomical abnormality and check the placental site
antepartum haemorrhage Bleeding from the genital tract from 24 weeks of gestation and before delivery
Apgar score A system to assess the status of the infant after birth. The Apgar score is based on the following five variables: heart rate, respiratory effort, muscle tone, reflex irritability and colour. Maximum score is 10. It is recorded at 1 minute and 5 minutes after birth.
audit An examination or review that establishes the extent to which a condition, process, or performance conforms to predetermined standards or criteria
BAPM British Association of Perinatal Medicine
birth trauma Mechanical injury that occurs to the baby during the birth process
Black, Asian and Other minority ethnic group Term encompassing Black, Asian, Chinese and other ethnic groups as distinct from White ethnic origin
blood glucose Blood sugar plasma value
brachial plexus injury See Erb's palsy
caesarean section Surgical abdominal delivery of the baby
Case–control study A study that compares exposure in subjects who have a particular outcome with those who do not
CEFM continuous electronic fetal monitoring
congenital anomaly rate Number of offspring with confirmed congenital anomalies as a proportion of total births (live and still)
congenital malformation/abnormality/anomaly A physical malformation (including biochemical) which is present at birth
continuous electronic fetal monitoring The electronic fetal monitoring of the fetal heart rate and of uterine contractions. The fetal heart rate is recorded by means of either an external ultrasonic abdominal transducer or a fetal scalp electrode. Uterine contractions are recorded by means of an abdominal pressure transducer. The recordings are graphically represented on a continuous paper printout
CTG Cardiotocograph (see continuous electronic fetal monitoring)
cyanotic episode In a baby, an episode of bluish discolouration due to excessive concentration of reduced haemoglobin in the blood
DAPHNE Dose Adjustment for Normal Eating
DCCT Diabetes Control and Complications Trial
DCCT-aligned HbA1c HbA1c values that have been measured using a standardised assay and are comparable with data in the Diabetes Control and Complications Trial
DESMOND Diabetes Education and Self-Management for Ongoing and Newly Diagnosed
detailed retinal assessment Examination of the fundi through pupils which have been dilated with eye drops
diabetic retinopathy A complication of diabetes affecting the blood vessels in the retina at the back of the eye, which can affect vision. There may be bleeding from retinal vessels (non-proliferative retinopathy) or the development of new abnormal vessels (proliferative retinopathy)
early neonatal death Death of a live born baby occurring less than 7 completed days from the time of birth
EDD estimated delivery date
elective caesarean section A caesarean section which is timed to suit the woman and health professionals
emergency caesarean section A caesarean section where delivery is expedited due to concerns about maternal and/or fetal wellbeing
Erb's palsy Injury to the nerve roots of the brachial plexus of an arm mainly related to birth trauma and leading to various degree of weakness of the affected arm which may resolve during the first year of life
EUROCAT European Surveillance of Congenital Anomalies
FBS fetal blood sampling
fetal blood sampling A test performed in labour with the purpose of obtaining a capillary blood sample from the baby to check for fetal wellbeing
fetal death Death before complete expulsion or extraction from its mother of a recognisable fetus, irrespective of duration of pregnancy. After separation, the fetus does not show any evidence of life (based on World Health Organization recommended definition)
fetal surveillance The process of performing fetal wellbeing tests (these may include ultrasound scans, fetal and placental Dopplers, biophysical profiles and fetal heart monitoring)
fructosamine A test which measures the amount of glucose-bound serum protein and which reflects how well the diabetes has been controlled over the previous 2–3 weeks. It is used in circumstances where the HbA1c test (see HbA1c) is not reliable due to anaemia or to a haemoglobin variant
gestation The time from conception to birth. The duration of gestation is measured from the first day of the last normal menstrual period
glucagon kit Glucagon has the opposite effect of insulin; that is, it increases the amount of glucose in the blood. The kit contains freeze-dried glucagon as a powder for injection with 1 mg glucagon and a 1-ml syringe of glycerin. The glycerin is mixed with the glucagon powder prior to injection
glucose electrode Blood glucose measurement using electrochemical biosensors
glycaemic control test A test that assesses how well the diabetes has been controlled over a period of time
haematopoiesis The formation and development of blood cells involving both proliferation and differentiation from stem cells. In adult mammals, this usually occurs in bone marrow
HbA1c Gylcated haemoglobin
HbA1c test A test which measures the amount of glucose-bound haemoglobin and reflects how well the diabetes has been controlled over the previous 2–3 months
high-dependency care

Criteria for receipt of high-dependency care are:

  • receiving NCPAP for any part of the day but not fulfilling any of the criteria for intensive care
  • below 1000 g current weight and not fulfilling any of the criteria for intensive care
  • receiving parenteral nutrition
  • having convulsions
  • receiving oxygen therapy and below 1500 g current weight
  • requiring treatment for neonatal abstinence syndrome
  • requiring specified procedures that do not fulfil any criteria for intensive care:
  • care of an intra-arterial catheter or chest drain
    partial exchange transfusion
    tracheostomy care until supervised by a parent
    requiring frequent stimulation for severe apnoea

(British Association of Perinatal Medicine, 2001)

hyperinsulinism Condition related to an increase in insulin hormone secretion (as seen in infants of mothers with diabetes during pregnancy) which: a) leads to hypoglycaemia in the baby; and b) prevents the formation of ketone bodies as alternative fuel for the body (see ketogenesis)
hypertensive disorder of pregnancy High blood pressure with or without proteinuria, which develops for the first time after 20 weeks of pregnancy
hypoglycaemia Low blood plasma sugar level
hypoketonaemic hypoglycaemia Low blood plasma sugar level with no formation of ketone bodies
iatrogenic Due to medical intervention
ICD10 International Classification of Diseases, Revision 10
IMD Index of Multiple Deprivation
in utero loss Death prior to complete expulsion or extraction from its mother of a recognisable fetus, irrespective of duration of pregnancy. After separation, the fetus does not show any evidence of life
induction of labour The process of attempting to start labour (see spontaneous labour). A combination of pharmacological and physical methods may be used
instrumental vaginal delivery Assisted vaginal delivery of the baby using ventouse or forceps
insulin A peptide hormone secreted by the islets of Langerhans in the pancreas that enables the body to metabolise and use glucose. Lack of or insensitivity to insulin results in diabetes
intensive care Criteria for receipt of intensive care are:
  • receiving any respiratory support via a tracheal tube and in the first 24 hours after its withdrawal
  • receiving NCPAP for any part of the day and less than 5 days old
  • below 1000 g current weight and receiving NCPAP for any part of the day and for 24 hours after withdrawal
  • less than 29 weeks of gestational age and less than 48 hours old
  • requiring major emergency surgery, for the preoperative period and postoperatively for 24 hours
  • requiring complex clinical procedures:
    • full exchange transfusion
    • peritoneal dialysis
    • infusion of an inotrope, pulmonary vasodilator or prostaglandin and for 24 hours afterwards
  • any other very unstable baby considered by the nurse-in charge to need one-to-one nursing
  • a baby on the day of death
interquartile range The spread of a set of values between which 25% (25th centile) and 75% (75th centile) of these values lie
intrauterine death/ intrauterine fetal death Intrauterine (fetal) death is death of the fetus within the uterus before delivery
ketogenesis The formation of ketone bodies (substances produced by the body during starvation bringing energy by breaking down fats)
legal abortion In England and Wales, term used to describe the deliberate ending of a pregnancy, under the provisions of the current law (1967/1992 Act of Parliament), with the intention that the fetus will not survive
macrosomia Oversized baby as seen for example as a consequence of the effect of diabetes during pregnancy. Generally defined as having a birth weight above the 90th centile for gestation
maternal death Death of a woman while pregnant or within 42 days of the end of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes
maternal death, coincidental Deaths from unrelated causes which happen to occur in pregnancy or the puerperium
maternal death, direct Death of a woman resulting from obstetric complications of the pregnancy state (pregnancy, labour and puerperium), from interventions, omissions, incorrect treatment or from a chain of events resulting from any of the above
maternal death, indirect Death of a woman resulting from previous existing disease, or disease that developed during pregnancy and which was not due to direct obstetric causes, but which was aggravated by the physiologic effects of pregnancy
maternal death, late Death occurring between 42 days and 1 year after abortion, miscarriage or delivery due to direct or indirect maternal causes. CEMACH also considers cases from unrelated causes that occur within 1 year of pregnancy, i.e. late coincidental
maturity onset diabetes of the young (MODY) A group of autosomal dominant disorders in young people each caused by a single gene defect, associated with decreased insulin production and varying degrees of clinical severity
miscarriage Spontaneous ending of a pregnancy before viability (currently taken as 24 weeks of gestation)
multidisciplinary clinic A clinic with access to care from health professionals in more than one discipline. For diabetes, the disciplines recommended are obstetrics, diabetology, nursing, midwifery and dietetics
multiple pregnancy Pregnancy where there is more than one fetus within the uterine cavity
NCPAP neonatal continuous positive airway pressure
neonatal care Standard categories for hospitals providing neonatal intensive and high dependency care have been defined by the British Association of Perinatal Medicine (BAPM, 2001). See intensive care, high-dependency care, special care, normal care
neonatal death Death of a live born baby before the age of 28 completed days
neonatal death rate The number of neonatal deaths (i.e. occurring within the first 28 days of life) per 1000 live births
neonatal respiratory distress syndrome Caused by surfactant deficiency, usually in premature babies and causes respiratory distress, usually occurring within 4 hours of birth
neural tube defect A major birth defect caused by abnormal development of the neural tube, the structure present during embryonic life which later gives rise to the central nervous system (brain and spinal cord)
normal care (postnatal ward) Care provided for babies who themselves have no medical indication to be in an intensive care unit in hospital (BAPM, 2001) and can therefore stay with their mother on the postnatal ward
NSF National Service Framework
NTD Neural tube defect
obstetric cholestasis A liver disorder of pregnancy characterised by a reduction in the flow of bile from the liver. Associated with increased fetal mortality
offspring Term encompassing live births, in utero losses after 20 completed weeks of gestation and terminations of pregnancy for congenital anomaly
OHA oral hypoglycaemic agents
oral hypoglycaemics/oral hypoglycaemic agents Medicines taken as pills, which are used to help lower blood sugar levels in people with diabetes. There are different types of oral hypoglycaemics; they can be used on their own, in combination with other OHAs or in combination with insulin
parity The number of viable infants that a woman has delivered. Viability is currently accepted from 24 weeks of gestation onwards
perinatal mortality rate The number of stillbirths and early neonatal deaths per 1000 live and stillbirths
placenta praevia Placenta situated wholly or partially within the lower uterine segment
placental insufficiency Impairment of placental blood flow leading to impaired fetal growth and nutrition
polyhydramnios Excess amniotic fluid
PPROM preterm prelabour rupture of the membranes
preconception care service A preconception care service for women with diabetes is a multidisiciplinary service which aims to provide information about diabetes and pregnancy, assess for and treat diabetes complications, review drug medication and work together with the woman to achieve optimal glycaemic control before conception
premature rupture of membranes Spontaneous rupture of the membranes before labour
preterm delivery Delivery before 37+0 weeks of gestation
preterm labour Labour before 37+0 weeks of gestation
prevalence The proportion of individuals in a population having a disease
primigravida A woman who is in her first pregnancy
rhesus isoimmunisation Haemolytic anaemia of the fetus or newborn caused by a rhesus negative mother's anti-rhesus (anti-D) antibodies affecting the red blood cells of her rhesus positive baby
shoulder dystocia Any documented evidence of difficulty with delivering the shoulders after delivery of the baby's head
SIGN Scottish Intercollegiate Guidelines Network
special care Care provided for all babies not receiving intensive or high dependency care but whose carers could not reasonably be expected to look after them in hospital or at home (BAPM, 2001)
spontaneous labour Regular painful contractions leading to progressive cervical effacement and dilatation
spontaneous preterm delivery rate The percentage of babies delivered between 24+0 and 36+6 weeks of gestation, inclusive, due to preterm labour, with the denominator being all babies delivered from 24+0 weeks of gestation onwards
spontaneous vaginal delivery A baby delivering vaginally without instrumental assistance; usually refers to babies born with the head presenting first
stillbirth rate The number of stillbirths per 1000 total births (live births and stillbirths)
stillbirth, legal definition A child that has issued forth from its mother after the 24th week of pregnancy and which did not at any time after being completely expelled from its mother breathe or show any other signs of life (Section 41 of the Births and Deaths Registration Act 1953 as amended by the Stillbirth Definition Act 1992)
Super Output Area Geography for the collection and publication of small area statistics
termination of pregnancy See legal abortion
transitional care Care of term or near-term babies not needing high-dependency or intensive care which can safely be delivered without being separated from their mothers in a so-called transitional care unit or nursery
transitional care unit In this facility, parents can look after their own infants with some supervision from trained neonatal unit staff. Transitional care is interpreted in a wide range of ways. There is undoubtedly a group of babies who are not well enough to be looked after on regular postnatal wards and yet there are strong advantages in their parents carrying out the bulk of their care. Such infants include babies with hypoglycaemia when it is believed there is no underlying serious pathology, babies of 34 and 35 weeks of gestation who are establishing breastfeeding and babies who have mild respiratory disease but do not require oxygen supplementation. Phototherapy may safely be given in transitional care. The transitional care area can also be used by mothers who are gaining confidence immediately prior to discharge home
trimester One of the 3-month periods into which pregnancy is divided. The first trimester is 0–13 weeks of gestation, the second trimester is 14–26 weeks of gestation and the third trimester is 27 weeks of gestation until birth.
unstable lie Unpredictable and frequent changes in the way the fetus lies relative to the long axis of the uterus after 37 weeks of gestation
vaginal breech A baby delivering vaginally with the breech presenting first