Afghanistan Midwifery Exit Exam key terms

The length of time a fetus has been developing, counted in completed weeks from the first day of the woman's last menstrual period. It guides dating, screening schedules, and decisions about fetal maturity and timing of care.

The projected calendar date when a pregnancy reaches 40 weeks of gestation, calculated from the last menstrual period or confirmed by early ultrasound. It is a reference point, not a deadline, and is revised if dating scans disagree.

The distance in centimeters from the top of the pubic symphysis to the top of the uterus, measured with a tape. Between roughly 20 and 36 weeks it usually approximates gestational age and helps detect growth restriction or excess fluid.

Use of high-frequency sound waves to image the pregnant uterus, fetus, and placenta. It confirms viability and dating, detects multiple pregnancy and anomalies, and assesses fetal growth, amniotic fluid, and placental position.

Gravida is the total number of times a woman has been pregnant, including the current pregnancy. Para is the number of births after 20 weeks or of infants weighing at least 500 g, regardless of outcome.

The handheld record in which a pregnant woman's history, examination findings, test results, and care plan are written. It travels with her so any provider, including at referral, can see her full antenatal course.

A schedule of a reduced number of antenatal visits with proven effective content, such as blood pressure, weight, fundal height, fetal heart check, and screening tests. It replaces many ritual visits with fewer, better-targeted contacts.

The first time a pregnant woman feels fetal movements, usually between 18 and 22 weeks in a first pregnancy and somewhat earlier in later pregnancies. Its timing helps confirm fetal well-being and dating.

Listening to the fetal heartbeat with a Pinard stethoscope or handheld Doppler to confirm fetal life and assess rate and rhythm. A normal rate is about 110 to 160 beats per minute.

The early part of the first stage, from the onset of regular painful contractions until the cervix is about 5 cm dilated. Progress is often slow and variable, so prolonged duration alone is not necessarily abnormal.

The period from about 5 cm cervical dilation until full dilation, when contractions become stronger and more regular and the cervix normally dilates faster. Slower-than-expected change here signals possible obstructed or inefficient labor.

A single-sheet graphic record of labor showing cervical dilation, fetal head descent, contractions, fetal heart rate, and maternal vital signs over time. It helps detect slow progress and fetal distress early so referral can be timely.

The position of the lowest part of the fetal head relative to the ischial spines of the maternal pelvis, recorded in centimeters above or below them. Station zero means the head is engaged at the level of the spines.

The passage of the widest part of the fetal head through the pelvic inlet, so that it is fixed at or below the level of the ischial spines. It is a reassuring sign that the pelvis can admit the head.

Periodic listening to the fetal heart rate during labor, typically for a minute after a contraction every 15 to 30 minutes in the active phase. It identifies decelerations or abnormal rates that require further assessment or referral.

A package used to prevent postpartum hemorrhage: a prophylactic uterotonic drug given at birth of the baby, controlled cord traction, and uterine massage with assessment of blood loss. It shortens the third stage and reduces bleeding.

Bleeding of 500 mL or more after a vaginal birth, or 1000 mL or more after a cesarean, or any bleeding that makes the woman unwell. It is the leading cause of maternal death and demands rapid resuscitation and cause-directed treatment.

Failure of the uterus to contract firmly after delivery of the placenta, leaving open vessels at the placental site to bleed. It is the commonest cause of postpartum hemorrhage and is treated with massage and uterotonic drugs.

New high blood pressure after 20 weeks of pregnancy together with proteinuria or other organ involvement such as headache, visual change, or abnormal liver or kidney tests. It can progress to seizures and requires close monitoring and timely delivery.

The occurrence of generalized seizures in a woman with preeclampsia, not explained by another cause. It is an obstetric emergency treated with magnesium sulfate, airway support, and prompt planning for delivery.

A drug given intramuscularly or intravenously to prevent or treat seizures in preeclampsia and eclampsia. Toxicity can cause loss of reflexes and respiratory depression, so monitoring of reflexes, breathing, and urine output is essential.

Labor in which the fetus cannot descend through the birth canal despite strong contractions because of a mechanical barrier, such as a contracted pelvis or malposition. Signs include a Bandl ring, constant pain, and no cervical change, and it risks uterine rupture.

A mismatch in which the fetal head is too large or the maternal pelvis too small or abnormally shaped for vaginal birth. It may be suspected when the head fails to engage or descend during labor and is confirmed by lack of progress.

Implantation of the placenta over or very near the internal cervical os. It causes painless vaginal bleeding in late pregnancy and makes vaginal birth dangerous, so cesarean delivery is usually needed.

Bleeding from the genital tract after 20 to 24 weeks of pregnancy and before birth. The main causes are placenta previa and placental abruption, and initial care includes resuscitation, monitoring, and avoiding vaginal examination outside hospital.

Premature separation of a normally implanted placenta from the uterine wall before birth. It typically causes painful bleeding, a tense uterus, and fetal distress, and can lead to maternal shock out of proportion to visible blood loss.

A widespread, abnormal activation of clotting that consumes platelets and clotting factors and causes both clotting and severe bleeding. In obstetrics it can follow abruption, hemorrhage, or severe infection and requires urgent supportive treatment.

A life-threatening organ dysfunction caused by the body's response to infection, which may arise from the uterus, urinary tract, or a wound. It needs early recognition, antibiotics, fluids, and referral, and can present without high fever.

Infection of the genital tract occurring after birth, with fever, pelvic pain, and abnormal lochia, sometimes progressing to systemic illness. Prompt antibiotics and referral reduce severe complications and death.

Infection and inflammation of the lining of the uterus after delivery, often after prolonged rupture of membranes or cesarean birth. It causes fever, lower abdominal tenderness, and foul-smelling lochia and is treated with broad-spectrum antibiotics.

Infection of the membranes and amniotic fluid, usually with maternal fever, uterine tenderness, and foul or purulent fluid. It threatens both mother and fetus, so antibiotics and planning for delivery are needed promptly.

A stepwise set of actions to help a newborn breathe and circulate after birth, starting with warmth, drying, stimulation, and airway positioning, then bag-mask ventilation if not breathing. Chest compressions and drugs follow only if the heart rate stays very low.

Delivering breaths to a newborn who is not breathing adequately, using a self-inflating bag and mask with a good seal and correct head position. It is the single most important step in newborn resuscitation.

A rapid assessment at 1 and 5 minutes after birth of heart rate, breathing effort, muscle tone, reflex response, and color, each scored 0 to 2. It describes the newborn's condition and response to resuscitation but does not by itself diagnose asphyxia.

Failure of a newborn to establish adequate breathing around the time of birth, leading to low oxygen and possible brain or organ injury. It requires immediate resuscitation and close follow-up for complications such as seizures or feeding difficulty.

A body temperature below 36.5 degrees Celsius, which increases oxygen use and the risk of infection and death. Prevention uses immediate drying, skin-to-skin contact, delayed bathing, and warm, draught-free environments.

Continuous skin-to-skin contact between a newborn and the mother or another caregiver, with frequent breastfeeding and close follow-up. It stabilizes temperature and breathing and reduces death and illness in low-birth-weight infants.

Feeding an infant only breast milk, with no water, other fluids, or foods, from birth until about 6 months of age. It provides complete nutrition and protection from infection and supports the mother's recovery.

A temporary family planning method that relies on full breastfeeding, no return of menstruation, and a baby under 6 months old to prevent pregnancy. Effectiveness falls if any of these conditions is not met.

Insertion of a copper or hormonal intrauterine device within 48 hours after delivery, or later, to provide long-acting contraception. It is safe during breastfeeding and can be inserted before the woman leaves the facility.

Methods used after unprotected intercourse to prevent pregnancy, such as levonorgestrel pills or a copper intrauterine device. Pills work best when taken as early as possible, and the device is the most effective option.

Removal of uterine contents with a hand-held syringe and cannula, used for early incomplete abortion or missed miscarriage. It is quick, effective, and can be done with local anesthesia and pain relief in low-resource settings.

Loss of pregnancy in which some products of conception remain in the uterus, causing bleeding, cramping, and an open cervix. Treatment is uterine evacuation, with antibiotics and referral if infection or heavy bleeding is present.

Care given after a miscarriage or induced abortion, including emergency treatment of bleeding or infection, uterine evacuation when needed, contraception counseling, and emotional support. It is provided regardless of how the pregnancy ended.

Routine infection-control practices applied to every patient, including hand hygiene, gloves, and protective clothing, safe sharps handling, and safe waste disposal. They assume all blood and body fluids may carry infection.

Cleaning hands with soap and water or alcohol-based rub at the correct moments, including before and after patient contact and after body-fluid exposure. It is the single most effective way to prevent infection transmission.

Practices that keep equipment and the working area free of microorganisms during procedures such as delivery, catheterization, or wound care. It includes sterile gloves, sterile drapes, and avoiding contact with non-sterile surfaces.

A uterotonic hormone drug used to start or strengthen labor and to prevent or treat postpartum hemorrhage. It must be given in controlled doses because excess can cause excessive uterine contraction and fetal distress.

A prostaglandin drug that causes uterine contraction and cervical softening, used for postpartum hemorrhage prevention or treatment and for abortion care. It is stable at room temperature, and common side effects are shivering and fever.

An antifibrinolytic drug that reduces breakdown of clots and is given in postpartum hemorrhage to lower the risk of death from bleeding. It works best when given early, ideally within 3 hours of birth.

A person's voluntary agreement to a test or treatment after receiving clear information about its purpose, benefits, risks, and alternatives. It must be given without pressure and can be withdrawn at any time.

The duty to keep a woman's health information private and share it only with those who need it for her care or as the law requires. It builds trust and is a core professional obligation.

Care that preserves a woman's dignity, privacy, and choice and is free of abuse, neglect, and discrimination. It includes allowing a companion of her choice and supporting her during labor and birth.

The planned transfer of a woman or newborn to a higher level of care when needs exceed what the current facility can safely provide. Good referral includes prior communication, stabilization, and a written summary with the reason and treatment given.