AFP (alpha-fetal protein)
-- A byproduct of fetal waste. Levels that are too high or too low may indicate
a problem with the baby, such as a neural tube disorder (spina bifida or
anecephaly) or Down's Syndrome. The early test (done around 16 weeks using the
mother's blood) is called the triple screen, or AFP-3 test. The false positive
rate on the test is outrageously high at around 80%, making it a very
controversial test for unnecessarily upsetting pregnant women. AFP screening
during amniocentisis, which is the second tier test, is far more accurate. An
abnormal blood test will usually be repeated, with an amnio or Level II sonogram
following.
amniocentesis -- a test where amniotic fluid is
pulled from the sac using a sonogram-guided needle. This fluid is used for AFP
screening and genetic karyotyping, and is recommended for women over 35. While
infection and possible miscarriage from the procedure is a known risk factor,
the incidence is very low. The procedure is best left to perinatologists or high
risk doctors who perform it regularly, and have little or no incidence of
complications due to their experience.
anencephaly -- a
type of neural tube disorder where the baby's brain does not form. This is
caused by a failure of the neural tube to close properly very early in the
baby's development. Anencephalic babies often die prior to birth, but can live a
few hours after being born. Recent studies show that the presence of folic acid
in the mother's blood at the time of conception greatly reduces the number of
neural tube disorders. It does not, however, prevent them entirely. In
Westernized countries, most women get sufficient folic acid in their diet and
the numbers of the disorders have not dropped dramatically despite huge
campaigns.
anti-cardiolipin antibodies -- see
immune causes of miscarriage
anti-phospholipid antibodies -- see
immune causes of miscarriage
bicornuate uterus
-- a uterus shape where the two ducts that form the uterus do not fuse and form
a single open area, but remain two distinct uterine cavities that may be fused
only at the bottom, or even half way. This condition significantly increases the
chance for miscarriage and infertility. Depending on the severity of the shape,
surgery may be an option to correct the uterus or improve the uterus' ability to
carry a pregnancy to term.
blighted ovum -- a condition where the egg
creates a sac and the pregnancy seems to progress normally, but an
ultrasound reveals that the baby never formed. See more under causes
of miscarriage.
cervical incompetence -- a
condition where a woman's cervix, or opening between the uterus and vaginal
tract, is not strong enough to remain closed during pregnancy. During a critical
time period of growth, most often from about 16 to 22 weeks, the cervix may open
and labor will begin prematurely. A cervical stitch can be used to help hold the
cervix closed.
cervical stitch, cerclage -- a stitch placed
around the cervix, or opening between the uterus and vaginal tract,
to keep it closed during pregnancy. This is only needed in cases
where a woman has a diagnosis of cervical incompetence. This
procedure will work for most women, and although early labor may
still occur, it will often be past the viability age for the baby.
chemical pregnancy -- usually a general term
to apply to many early miscarriages where a baby never develops. The
"chemicals" or hormones of the pregnancy were produced,
but a baby did not form. Often the pregnancy itself could not be
diagnosed, as the loss happened too early. See also blighted ovum.
chromosomal anomalies -- any problem in a
person's genetic code, or DNA. Very minor anomalies may not even be
noticeable. More serious ones cause problems such as Down's Syndrome
and other known genetic disorders. The most dramatic ones will cause
the death of the baby, usually during the first trimester, and most
often before the mother knew she was pregnant. The chromosomal
problem may have started with a poor quality egg, poor quality
sperm, during fertilization, or in the early cell divisions.
Clomid
-- also clomiphene, a drug used to stimulate ovulation in women who may not be
ovulating or may have a luteal phase defect
complete abortion -- a miscarriage where all
tissue has been passed out of the uterus
cord accident -- a general term for many
problems with the umbilical cord, including prolapse (see below), a
knot tied in the cord, or any failure of the cord to provide oxygen
and nutrients to the baby
cord prolapse
-- a condition when the umbilical cord falls through the cervix and possibly
even into the vaginal canal, usually during labor or when water breaks. Delivery
or cesarean is usually performed immediately
CVS (chorionic villus sampling) -- a test
where a small bit of the chorion surrounding the baby is sampled
with a tube going up through the cervix. Testing this can reveal
genetic problems with the baby and tell its sex. This test can be
performed much earlier in a pregnancy than amniocentesis, although
the risks are higher for complications, such as infection leading to
miscarriage. These risks are still quite small, but need to be
weighed against the need for the test.
depo provera
-- a synthetic hormone given in larger doses as a form of birth control that
works about three months, or a smaller dose to help stimulate periods in a woman
whose cycle is not ending
ectopic pregnancy --
a pregnancy where the fertilized egg has implanted outside the uterus, usually
in the fallopian tube, or rarely in the abdomen. This pregnancy cannot continue,
as the pregnancy will eventually stop growing and miscarry, or grow until the
tube bursts or causes intense pain in the mother. The first signs of an ectopic
may be a pregnancy test that is positive, then negative a few days later, hCG
levels that fail to double, or persistent spotting. An ultrasound can
usually locate an ectopic by six weeks. See also treatment
for ectopic pregnancy.
edema -- excessive swelling during pregnancy,
which can be a sign of complications, such as preeclampsia
elective abortion -- usually refers to a
D&C surgery performed to end a pregnancy around 7-9 weeks, even
as late as 15 weeks. Sometimes an elective abortion is performed
(depending on where you live) in early pregnancy via a drug called
RU486, which will also end the pregnancy.
endometrial biopsy -- a test for progesterone
where a bit of the lining is taking from the uterus to check if the
lining is "in phase," or at the proper point of
development for that part of the cycle
fetal demise -- death of the baby in
utero,
diagnosed via ultrasound
Fifth Disease -- an
illness commonly acquired by small children resembling the flu with a rash
across their cheeks. Most adults have been to exposed to this disease already
and are immune, but a pregnant woman who has never been exposed to this disease
may pass it on to the fetus, causing (in very rare cases) complications or fetal
death.
habitual aborter -- a woman with several
unexplained spontaneous miscarriages
hCG levels -- the amount of pregnancy hormone
in a woman's body. A level of 5 is considered "pregnant,"
although a home pregnancy test will require a level of 50-80 to be
positive. See page on hCG for more
information.
heparin -- a blood-thinning drug used to
treat women suspected of certain immune causes of miscarriage. The
drug cannot cross the placenta, so does not affect the baby. It
should be discontinued, however, well prior to delivery since it
will hamper the mother's ability to clot from labor or surgery.
hormone testing -- a
general term for dozens of types of testing for progesterone, hCG, estrogen, and
other important hormones for general health or during pregnancy. See page on testing.
human chorionic
gonadotrophin (hCG)--a
hormone only produced during pregnancy. This is the hormone tested by doctor's
blood tests and home pregnancy tests to determine if you are pregnant. See page
on hCG for more information on proper levels.
hydatidiform mole -- see molar pregnancy
hysterogram -- in
most cases, this term is just a shortened version of hysterosalpinogram below
hysterosalpingogram
(HSG) -- a test where dye is pushed into the uterus, and then x-rayed to see
the shape of the uterus, and if there is blockage in the fallopian tubes. This
test cannot be performed when you are pregnant. See also testing.
hysteroscopy -- a test where a tiny scope is
inserted through the cervix so the doctor can view the walls of the
uterus
incompetent cervix -- see cervical
incompetence
incomplete abortion -- a miscarriage where
some pregnancy tissue remains in the uterus even though blood and
tissue has been passed. A D&C procedure is often needed to empty
the uterus, although sometimes a mild contraction stimulating drug
such as Cytotec or a drug called Methotrexate can be used.
karyotype -- genetic testing where tissue or
blood cells are cultured and grown to reveal their chromosomal
structure
luteal phase defect -- a condition in which a woman
does not produce sufficient progesterone to create the proper lining
for a fertilized egg to implant. For more on this problem, see hormone
causes of miscarriage
lupus anticoagulant antibody -- see
immune causes of miscarriage
methotrexate -- a drug used to end an ectopic
pregnancy before surgery is necessary. See treatment
for ectopic.
missed abortion -- a miscarriage where the
pregnancy tissue has not been expelled from the uterus. See also pregnancy
treatment.
molar pregnancy -- a pregnancy
where huge bubble clusters form in the uterus instead of a baby, or occasionally
in addition to an underdeveloped baby. This condition can sometimes be related
to a form of cancer, and the woman will not be allowed to try again for an
extended period, and may need chemotherapy. See more information in the
miscarriage causes section.
mycoplasma -- a bacteria sometimes found in
the vaginal tract that has been linked to miscarriage. This is a
common test following a miscarriage and is easily treatable if
found.
placental abruption
-- a condition where all or part of the placenta has pulled away from the
uterine wall, disrupting the flow of blood and oxygen to the fetus. Small
abruptions can heal, but larger ones can cause fetal distress or death.
Abruptions can be caused by several factors, including blood clotting disorders,
an infection, or poor chromosomal development. Rarely, an abruption is caused by
an accident or severe strain.
polycystic ovarian disease (PCOD) or polycystic
ovarian syndrome (PCOS) -- a diagnosis that covers a range of
hormonal problems that result in the ovaries not ovulating, often
forming tight cysts rather than fertile quality eggs.
premature separation of the placenta -- a
condition where the placenta pulls away from the uterine wall prior
to or during labor. This serious situation can cause fetal distress
and death if not caught and the baby delivered immeidately.
premature rupture of membranes
(PROM) -- any time your water breaks prior to the 37th week, you have PROM.
You will be usually be hospitalized until the baby is delivered, and typically
placed on antibiotics, since infection is a very common complication. PROM can
be unexplained, and may recur, but many babies' deliveries can be held off until
viability age, preferably 32 weeks, but even as early as 24 weeks.
progesterone -- a hormone produced in in
every menstrual cycle after ovulation. This hormone plays a very
important role in pregnancy. See more information in miscarriage
causes.
PROM -- see premature rupture of membranes
provera -- a synthetic progesterone often
given to women to bring on a period after a seven or more week
delay, when she is not pregnant
reproductive endocrinologist
-- a specialist in handling high risk pregnancies and in diagnosing causes
of miscarriage. This type of doctor receives specialized training beyond the
standard ob/gyn.
rH incompatibility
-- a situation where the mother's blood type is rH negative, and the father is
rH positive. This is not a concern during a first pregnancy, but if the mother
is sensitized to rH-positive blood during pregnancy, subsequent pregnancies may
be attacked by her immune system. A shot is given to the rH negative mother at the end of any
pregnancy, regardless of length or outcome, to prevent the production of harmful
antibodies.
spontaneous abortion -- a term for any sudden
miscarriage
sub-chorionic hemorrhage -- an area, usually
near the edge of the placenta or in fluid just outside of the
gestational sac, that is bleeding. This can either bleed out and
show as spotting or bleeding, or can form a bruise that does not
bleed. A sub-chorionic hemorrhage is not uncommon, and does not mean
the pregnancy will end in miscarriage. It most often happens because
during the normal course of the uterus stretching and growing, a bit
of the placenta peeled away and bled. It will almost always heal on
its own. There is a slightly increased risk of miscarriage if the hemorrhage
is large (over 200 ml in volume), as it may mean the placenta
implantation is weak. Bed rest is not always given, as many hemorrhages
are very minor.
threatened abortion -- a pregnancy where
bleeding has occurred, and a miscarriage may be forthcoming
toxoplasmosis
-- a disease found most often in cat feces. It can cause fetal death should the
pregnant woman become exposed for the first time during pregnancy. Most
women are routinely screened for toxoplasmosis in early pregnancy to determine
immunity. Exposure prior to pregnancy makes you immune. Most women with outdoor
cats will already have exposure, but should still avoid handling cat litter.
translocation
-- a chromosomal anamoly where two pieces of genetic material are switched in
position. A translocation will usually show no symptoms in parents, but may
greatly increase their chance of miscarriage, as the chromosomes in the egg and
sperm will not align correctly. A karyotype of the parents can uncover this rare
problem.
triple screen -- see AFP
septate uterus
-- a uterus with a band of tissue coming down the middle. The septum may be very
minor and paper thin, causing no problem to a pregnancy, or may be very thick
and unmovable, adding to your risk of miscarriage and premature labor. An HSG
test is used to diagnose this condition, which is usually treated with surgery
if necessary. (Deanna herself has this condition and has had the HSG and the
surgery.)
viability age -- usually babies must weigh 500
grams, or 1 pound, to survive, although as technology advances, some babies
smaller than this do make it. This point is usually crossed at about the 24th
week. Babies can have severe complications however, any time before 32 weeks,
and a few complications after that mark. This term also refers to the point in
pregnancy when you can no longer seek a legal end to a pregnancy. See politics
for more information.
