Czech Gynaecology and Obstetrics Board Exam key terms

Estimation of fetal age in early pregnancy from the embryo's maximum length, measured by transvaginal ultrasound between roughly 7 and 13 weeks; it is the most accurate single dating parameter and is used to set the estimated date of delivery.

A method of estimating the date of delivery by adding one year, subtracting three months, and adding seven days to the first day of the last menstrual period, assuming a regular 28-day cycle; ultrasound dating supersedes it when the two differ significantly.

Risk calculation for trisomy 21, 18 and 13 performed at 11 to 14 weeks, combining maternal age, nuchal translucency thickness, free beta-hCG and PAPP-A, sometimes with nasal bone or ductus venosus assessment; it yields a risk estimate, not a diagnosis.

The sonographic measurement of the fluid-filled space behind the fetal neck at 11 to 14 weeks; increased thickness raises the risk of aneuploidy, congenital heart defects and other structural anomalies and prompts further investigation.

A maternal blood test that analyses placental DNA fragments to estimate the risk of common autosomal trisomies; it has high sensitivity and specificity but remains a screening test, so a positive result requires confirmatory invasive testing.

Prenatal testing that obtains fetal or placental tissue, mainly chorionic villus sampling in the first trimester and amniocentesis after 15 weeks, to provide a definitive karyotype or molecular result at the cost of a small procedure-related miscarriage risk.

Maternal formation of antibodies against fetal RhD-positive red cells after fetomaternal haemorrhage, which can cause fetal anaemia and hydrops in later pregnancies; it is prevented by anti-D immunoglobulin given antenatally and after potentially sensitising events.

A stain-based blood test that counts fetal red cells in maternal blood to quantify fetomaternal haemorrhage, used to decide whether the standard anti-D dose must be increased after trauma, external cephalic version or delivery.

A pregnancy-specific disorder defined by new hypertension after 20 weeks together with proteinuria or maternal organ dysfunction such as renal, hepatic, neurological or haematological involvement; delivery remains the only definitive treatment.

A severe variant of pre-eclampsia characterised by haemolysis, elevated liver enzymes and low platelets, often presenting with right upper quadrant pain, nausea and malaise; it can progress rapidly and requires urgent delivery and supportive care.

Doppler assessment of uterine artery flow, usually at the second-trimester scan, where persistent high resistance and notching indicate impaired trophoblast invasion and predict a higher risk of pre-eclampsia and fetal growth restriction.

Failure of a fetus to reach its genetically determined growth potential, recognised by estimated fetal weight below the tenth centile with abnormal Doppler or growth trajectory; it differs from a constitutionally small but healthy fetus.

Continuous simultaneous recording of fetal heart rate and uterine contractions, interpreted by baseline rate, variability, accelerations and decelerations; it is a screening tool that identifies hypoxia risk but has limited specificity and requires structured interpretation.

A second-line intrapartum test in which a capillary blood sample from the fetal scalp is analysed for pH or lactate to clarify an abnormal cardiotocogram and reduce unnecessary operative delivery.

Failure to deliver the fetal shoulders after the head has emerged, requiring prompt manoeuvres such as the McRoberts position and suprapubic pressure; it is an obstetric emergency associated with brachial plexus injury and postpartum haemorrhage.

Blood loss of 500 mL or more after vaginal birth or 1000 mL or more after caesarean section, or any loss causing haemodynamic compromise; uterine atony is the commonest cause and is managed by massage, uterotonics and escalation.

An antifibrinolytic given intravenously in postpartum haemorrhage, ideally within three hours of birth, to reduce death from bleeding; it complements, but does not replace, uterotonics and mechanical measures.

Third- and fourth-degree perineal tears involving the anal sphincter complex, with or without anal mucosa; recognised risk factors include nulliparity, instrumental birth and macrosomia, and primary repair by an experienced clinician is required.

Intravenous magnesium used to treat and prevent eclamptic seizures in severe pre-eclampsia; the clinician monitors reflexes, respiratory rate and urine output for signs of toxicity, with calcium gluconate as the antidote.

A procedure in which the fetus is manually turned to a cephalic presentation through the maternal abdomen, usually attempted from 36 to 37 weeks in breech pregnancy under tocolysis and ultrasound guidance.

Magnified examination of the cervix, vagina and vulva after application of acetic acid and iodine, used to localise abnormal transformation zone epithelium and to direct biopsy in women with abnormal cytology.

Pre-invasive squamous or glandular change of the cervix graded by the proportion of epithelium replaced by atypical cells; high-grade lesions are treated because they carry a substantial risk of progression to invasive carcinoma.

Excision of the cervical transformation zone using a thin wire loop under local anaesthesia, providing a specimen for histology and treating high-grade cervical intraepithelial neoplasia; it carries risks of bleeding and later preterm birth.

Identification and removal of the first draining lymph node after injection of a tracer, used to stage early breast cancer and vulvar cancer while avoiding full lymphadenectomy in node-negative patients.

A malignant tumour of the vulva, usually squamous cell carcinoma arising in older women or associated with HPV in younger women; treatment is surgical excision with groin node assessment, and it is often preceded by lichen sclerosus or intraepithelial neoplasia.

Overgrowth of endometrial glands relative to stroma, classified as hyperplasia without atypia or atypical hyperplasia; atypical forms carry a significant risk of progression to endometrial carcinoma and are usually managed by hysterectomy in postmenopausal women.

Obtaining tissue from the uterine cavity by pipelle biopsy, curettage or hysteroscopically directed biopsy to diagnose hyperplasia or carcinoma, particularly in postmenopausal bleeding or abnormal premenopausal bleeding.

Presence of endometrial-like tissue outside the uterine cavity, causing cyclical pain, dyspareunia and subfertility; diagnosis is clinical or laparoscopic, and treatment combines hormonal suppression with surgery in selected cases.

Presence of endometrial glands and stroma within the myometrium, producing a diffusely enlarged tender uterus with heavy painful periods; it is diagnosed mainly by ultrasound or MRI and treated hormonally or by hysterectomy.

A cyst of the ovary lined by endometriotic tissue, typically containing thick chocolate-coloured fluid and showing ground-glass echogenicity on ultrasound; surgical removal is considered for pain or size but may reduce ovarian reserve.

A common endocrine disorder defined by oligo-ovulation, clinical or biochemical hyperandrogenism and polycystic ovarian morphology on ultrasound, after excluding other causes; it is associated with insulin resistance and infertility.

Pharmacological stimulation of follicular development and ovulation using agents such as clomiphene citrate, letrozole or gonadotrophins, with monitoring to achieve singleton pregnancy and limit ovarian hyperstimulation.

An iatrogenic complication of controlled ovarian stimulation marked by ovarian enlargement, capillary leakage, ascites and haemoconcentration, ranging from mild discomfort to thrombosis and renal failure; prevention by tailored dosing and cycle cancellation is central.

A set of pressure-flow measurements of bladder filling and voiding, including cystometry and detrusor pressure assessment, used to characterise detrusor overactivity, poor compliance or obstruction before continence surgery.

Involuntary leakage of urine on effort, coughing or sneezing due to urethral sphincter or support deficiency; initial management is pelvic floor training and weight loss, with surgery reserved for failure of conservative measures.

A mid-urethral synthetic sling placed at the junction of the mid and distal urethra to support it during increases in abdominal pressure; it is effective for stress incontinence but carries risks of voiding dysfunction and mesh complications.

A standardised clinical staging system describing the position of the anterior, posterior and apical vaginal compartments relative to the hymen during maximal Valsalva, allowing reproducible comparison of prolapse severity.

Supervised exercise of the levator ani and associated muscles to improve strength and endurance, first-line treatment for stress incontinence and a useful adjunct in prolapse; benefit depends on correct contraction and adherence.

Creation of pneumoperitoneum and safe access to the abdominal cavity, by closed Veress needle or open Hasson technique, chosen according to patient history and anatomy to minimise injury to bowel and major vessels.

Minimally invasive inspection of the pelvic and abdominal cavity under general anaesthesia, used to assess tubal patency, endometriosis, adhesions and unexplained pelvic pain, with the option of proceeding to operative treatment.

Testing of sexually active young people, usually by nucleic acid amplification on first-void urine or self-taken swab, to detect asymptomatic infection and prevent pelvic inflammatory disease and tubal infertility.

Ascending infection of the upper genital tract, often by Chlamydia trachomatis or Neisseria gonorrhoeae, presenting with pelvic pain and treated empirically with broad-spectrum antibiotics; it can cause adhesions, chronic pain and infertility.

Infertility caused by obstruction or impaired function of the fallopian tubes, usually a consequence of pelvic inflammatory disease, endometriosis or pelvic surgery, assessed by hysterosalpingography or laparoscopy.

The patient's voluntary agreement to a procedure after receiving comprehensible information about its purpose, benefits, risks and alternatives; it is documented in the medical record and, for major interventions, generally obtained in writing.

A permanent method of contraception achieved by occluding or removing the fallopian tubes, usually laparoscopically; in Czech practice it requires the patient's request and informed consent and is regulated by health-care legislation.

Assessment of venous thromboembolism risk before and after gynaecological surgery, with early mobilisation, compression stockings and low-molecular-weight heparin for moderate- and high-risk patients, balanced against bleeding risk.

A multimodal perioperative pathway combining preoperative counselling, avoidance of prolonged fasting, opioid-sparing analgesia, early feeding and early mobilisation to shorten hospital stay and reduce complications after gynaecological operations.