Pregnancy Glossary

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• ectopic pregnancy - A pregnancy that occurs outside the uterus. The most common extrauterine place for an ectopic to form is in the fallopian tube. Risk factors for ectopic include prior ectopic, prior pelvic infection with gonorrhea, chlamydia, pelvic inflammatory disease, current IUD use, prior ruptured appendix or other major intraabdominal infection or surgery. If not detected and treated in a timely fashion this can be life threatening, as the fallopian tube can rupture and the patient can bleed to death. A ruptured ectopic is a surgical emergency. If diagnosed early, it can be treated with an injectable medication called methotrexate, or it can be treated surgically, often with laparoscopy, and often with salvage of the fallopian tube. Symptoms are bleeding in pregnancy, abdominal pain, and with rupture patients can get shoulder pain (blood in the belly irritates nerve endings under the diaphragm which are the same nerves that supply the shoulder). Blood tests show abnormally rising levels of HCG in the blood, and ultrasound will show no pregnancy in the uterus, and can sometimes show a mass or even a heartbeat in the fallopian tube.

• Epidural - A form of pain relief given in labor that is called regional anesthesia and is a safe and superior method of pain control in labor. A needle is placed by an anesthesiologist in a the epidural space which is in your back in a safe place well below where the spinal cord has ended (you can't get paralyzed from putting a needle in at this level). A thin catheter is then placed in this space, and medicine is delivered throughout the labor, and the catheter can be left in place after delivery for postoperative pain control if the patient had a c-section. It is safe for the baby because it stays in moms spinal canal and doesn't go through her bloodstream to the baby, and it is safe for mom with the most common risks being dropping her blood pressure or getting a spinal headache (1/200) both of which can be easily fixed.

• Episiotomy - A surgical cut that is made at the time of vaginal delivery of a baby to allow a wider passage for the fetal head. It is not done routinely. We try to ease the baby's head out without cutting, or try to allow the head to pass even if it looks like the vaginal tissue may tear a little, but if it looks like there will be bad tearing all over, we will do a controlled cut. A midline episiotomy is straight down (towards but not near the rectum), and a mediolateral episiotomy is done usually to the right of the midline in cases where you need even more room, or where you are concerned you will lacerate into the rectum if you do a midline. Mediolateral episiotomies are more painful, harder to heal, and have higher chances of infection and breakdown. Episiotomies are repaired with dissolvable sutures- you thankfully don't have to have them removed.

• full term - A full term baby is one that is at least 37 weeks gestation. At this gestational age the baby can live safely and well outside the mother.

• gestational age - The number of weeks pregnant someone is, counted from the first day of the last menstrual period (LMP). If a patient has an LMP of 8 weeks ago, their gestational age would be 8 weeks of gestation (but in reality they have only really been pregnant for 6 weeks). It is a worldwide convention to calculate gestational age based on the LMP.