Iraqi Board OB/GYN key terms

Blood loss of 1000 mL or more, or any loss causing haemodynamic instability, within 24 hours of birth. Common causes are uterine atony, genital tract trauma, retained placental tissue and coagulation disorders.

A package of interventions at birth - prophylactic uterotonic, controlled cord traction and uterine massage with assessment of tone - that shortens the third stage and reduces blood loss compared with expectant management.

Failure to deliver the fetal shoulders after the head with routine gentle traction, requiring manoeuvres such as McRoberts position or suprapubic pressure. It is an obstetric emergency associated with brachial plexus injury and postpartum haemorrhage.

A pre-induction pelvic score from 0 to 13 combining cervical dilatation, effacement, consistency, position and fetal head station. Higher scores predict a favourable response to induction, and 8 or more suggests a ripe cervix.

Continuous simultaneous recording of fetal heart rate and uterine contractions. Interpretation uses baseline rate, variability, accelerations and decelerations; a pathological trace suggests fetal hypoxia and prompts intrauterine resuscitation or expedited delivery.

New hypertension after 20 weeks' gestation with proteinuria or other maternal organ dysfunction such as renal, hepatic, neurological or haematological involvement, or uteroplacental dysfunction. Delivery remains the only definitive treatment.

A severe variant of pre-eclampsia defined by haemolysis, elevated liver enzymes and low platelets. It may occur without marked hypertension or proteinuria and threatens maternal and fetal life, requiring urgent stabilisation and delivery.

Glucose intolerance first recognised during pregnancy that does not meet criteria for overt diabetes. It increases the risks of macrosomia, pre-eclampsia and neonatal hypoglycaemia; management is nutrition therapy, glucose monitoring and insulin or metformin when targets are not met.

A fetus that has not achieved its genetically determined growth potential, usually identified by estimated fetal weight below the 10th centile with abnormal Doppler or falling growth trajectory. It increases stillbirth and neonatal morbidity and needs surveillance and timed delivery.

Betamethasone or dexamethasone given to women at risk of preterm birth, usually between 24 and 34 weeks, to accelerate fetal lung maturation, reducing respiratory distress syndrome, intraventricular haemorrhage and neonatal death. Best effect occurs 24 hours to 7 days after dosing.

Given intravenously to treat and prevent eclamptic seizures in pre-eclampsia with severe features. It is more effective than other anticonvulsants; toxicity is monitored by tendon reflexes, respiratory rate and urine output, with calcium gluconate as the antidote.

The International Federation of Gynecology and Obstetrics system that classifies gynaecological cancers by anatomical extent to guide treatment and allow comparison of outcomes. Stages run from I, confined to the organ of origin, to IV, distant spread.

Graded histological change of the cervical transformation zone caused by persistent high-risk human papillomavirus infection. Grade 1 often regresses; grades 2 and 3 are treated by excision or ablation to prevent progression to invasive cancer.

Malignancy arising from the endometrial lining, typically presenting with postmenopausal bleeding. Type I is oestrogen-driven, low grade and linked to obesity; type II is high grade, often serous, occurs in older women and has a poorer prognosis.

A triage score for adnexal masses multiplying serum CA-125 by a menopausal score and an ultrasound score. Values above about 200 indicate high risk of ovarian cancer and warrant referral to a gynaecological oncology centre.

Persistent or malignant trophoblastic disease after molar or normal pregnancy, including invasive mole, choriocarcinoma and placental-site trophoblastic tumour. It is suspected when hCG plateaus or rises and is highly chemosensitive, usually cured with methotrexate or actinomycin D.

A common endocrine disorder diagnosed by the Rotterdam criteria when two of three features are present: oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology on ultrasound, after excluding other causes.

An iatrogenic complication of ovulation induction in which vasoactive mediators cause ovarian enlargement, capillary leak, haemoconcentration and ascites, with severe cases developing thrombosis or acute kidney injury. Risk rises with hCG trigger and many follicles.

Loss of ovarian function before age 40 with amenorrhoea of at least four months and raised follicle-stimulating hormone on two occasions. It causes infertility and oestrogen deficiency, requiring hormone therapy and sometimes oocyte donation.

The basic laboratory test of male fertility, reporting volume, sperm concentration, total count, progressive motility and morphology against WHO reference limits. Abnormal results are confirmed on a repeat sample after an interval because of biological variability.

A standardised examination system measuring six defined points of the vaginal wall relative to the hymen, recorded in centimetres. It assigns stage 0 to IV and allows reproducible comparison before and after surgery.

A synthetic tape placed under the midurethra to support it during stress, and the commonest operation for stress urinary incontinence. It has good cure rates but carries risks of bladder injury, voiding dysfunction and tape erosion.

The urodynamic finding of involuntary urine leakage on increased abdominal pressure such as coughing or Valsalva, in the absence of detrusor contraction, demonstrating urethral sphincter weakness. It confirms the diagnosis before continence surgery.

A symptom syndrome of urgency, usually with frequency and nocturia, with or without urgency incontinence, in the absence of urinary tract infection or other obvious pathology. First-line treatment is bladder training, fluid advice and pelvic floor exercises.

A polymicrobial dysbiosis of the vagina with loss of lactobacilli and overgrowth of Gardnerella and anaerobes, causing thin grey discharge with a fishy odour and raised pH. Diagnosed by Amsel criteria or Nugent score and treated with metronidazole.

Ascending infection of the upper genital tract, usually by Chlamydia trachomatis or Neisseria gonorrhoeae, presenting with pelvic pain, cervical motion tenderness and fever. Prompt broad-spectrum antibiotics reduce tubal damage, ectopic pregnancy and infertility.

Fungal infection of the vagina and vulva, usually by Candida albicans, causing itching, soreness and thick white discharge. Uncomplicated cases respond to topical imidazoles or a single oral fluconazole dose; recurrent disease needs longer suppressive therapy.

Testing asymptomatic women to detect cervical pre-cancer before invasion, using cytology, HPV testing or both, with colposcopy for positive results. HPV testing has higher sensitivity and is increasingly used as the primary test.

Methods used after unprotected intercourse to prevent pregnancy, including the copper intrauterine device, which is most effective and works up to five days, ulipristal acetate and levonorgestrel. They mainly delay ovulation and do not disrupt an established pregnancy.

A daily pill containing an oestrogen and a progestogen that suppresses ovulation and thickens cervical mucus. Efficacy depends on adherence; the main serious risk is venous thromboembolism, and it is avoided in migraine with aura.

A small device placed inside the uterus for long-acting contraception. Copper devices are non-hormonal and last up to ten years; levonorgestrel-releasing devices also reduce menstrual bleeding and are used for adenomyosis and endometrial protection.

A temporary contraceptive method relying on exclusive breastfeeding, amenorrhoea and less than six months since delivery, which together suppress ovulation. It is over 98% effective when all three conditions are strictly met.

Sonographic measurement of the fluid space behind the fetal neck at 11 to 14 weeks. Increased thickness is associated with trisomies 21, 18 and 13, cardiac defects and genetic syndromes, and it forms part of combined first-trimester screening.

Transabdominal aspiration of amniotic fluid, usually after 15 weeks, for fetal karyotype, microarray or molecular testing. It carries a procedure-related miscarriage risk of roughly 0.1 to 0.5%, lower in experienced centres.

A maternal blood test analysing placental cell-free DNA to estimate the risk of trisomies 21, 18 and 13. It is the most sensitive screening test available but is not diagnostic, so positive results need confirmatory invasive testing.

A detailed ultrasound at 18 to 22 weeks examining fetal anatomy, growth, amniotic fluid, placental site and cervical length. It detects many structural anomalies and informs decisions about further testing, surveillance and place of delivery.

A patient's voluntary agreement to an investigation or treatment after receiving and understanding information about its nature, benefits, alternatives and material risks, given by someone with capacity. It should be documented and may be withdrawn at any time.

The number of patients who must receive an intervention for one additional patient to benefit, calculated as the reciprocal of the absolute risk reduction. Smaller values indicate greater clinical benefit from the intervention.

Sensitivity is the proportion of people with disease correctly identified by a test; specificity is the proportion without disease correctly identified as negative. They describe test performance but do not give post-test probability, which also depends on prevalence.

A structured review that formulates a focused question, searches for all relevant studies, appraises their quality and synthesises the results, often with meta-analysis. It reduces bias and increases precision compared with single studies and underpins clinical guidelines.