Medical Terms

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 see 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 pregnancy.

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 immediately.

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  causes of miscarriage

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 (RE) — 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.

Sub-chorionic hemorrhage can be very scary — big clots and lots of red bleeding. But it starts and stops. It can be fairly painful too. You will want to see a doctor right away to assess your risk and decide if you need to stay off your feet.

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.