Cambodia Midwifery Exit Exam key terms

The planned number and timing of antenatal visits across pregnancy. The WHO 2016 model recommends eight contacts starting before 12 weeks, then at 20, 26, 30, 34, 36, 38 and 40 weeks, replacing the older four-visit focused ANC model.

Working out how many weeks a pregnancy has lasted, counted from the first day of the last menstrual period or corrected by early ultrasound. Accurate dating guides screening timing, growth assessment and decisions about preterm labour and post-term pregnancy.

The distance in centimetres from the pubic symphysis to the top of the uterus, measured with a tape from about 24 weeks. It should roughly match gestational age in weeks; lagging or excessive growth prompts assessment for fetal growth restriction or multiple pregnancy.

Symptoms that mean a woman must seek care immediately: vaginal bleeding, severe headache with blurred vision, swelling of face and hands, fever, draining of fluid, reduced fetal movement, and severe abdominal pain. Teaching these at every contact is a core midwifery task.

New hypertension after 20 weeks of pregnancy together with proteinuria or signs of organ damage such as headache, visual disturbance, or abnormal liver and kidney tests. It can progress rapidly to eclampsia and needs urgent referral and magnesium sulfate where indicated.

The occurrence of generalised seizures in a woman with pre-eclampsia, without another cause. It is an obstetric emergency requiring airway protection, magnesium sulfate, blood pressure control and urgent referral, often with delivery as the definitive treatment.

The drug of choice for preventing and treating seizures in pre-eclampsia and eclampsia. Given as a loading dose then maintenance doses, with monitoring of respiratory rate, urine output and tendon reflexes to detect toxicity, which is reversed with calcium gluconate.

Blood loss of 500 mL or more after vaginal birth, or 1000 mL or more after caesarean, or any loss causing haemodynamic instability. Uterine atony is the commonest cause, managed by uterine massage, oxytocic drugs, tranexamic acid and referral.

Failure of the uterus to contract firmly after delivery of the placenta, so that bleeding vessels at the placental site stay open. It is the leading cause of postpartum haemorrhage and is treated with massage, oxytocin, and other uterotonics.

A package used to prevent postpartum haemorrhage: a prophylactic uterotonic drug given soon after birth, controlled cord traction for placental delivery, and uterine massage or tone assessment. It shortens the third stage and reduces blood loss.

A graphic record of labour progress plotting cervical dilatation, fetal head descent, contractions and maternal and fetal observations against time. It helps detect slow progress and obstructed labour early so referral is not delayed.

The opening of the cervix measured in centimetres during labour, from 0 (closed) to 10 (fully dilated). Progress is assessed by vaginal examination and plotted on a partograph; in active first stage it is expected to advance about 1 cm per hour.

The three phases of birth: first stage from onset of regular contractions to full dilatation, second stage from full dilatation to birth of the baby, and third stage from birth to expulsion of the placenta. Each stage has distinct care priorities.

Labour in which the fetus cannot descend through the birth canal despite strong contractions, often because of cephalopelvic disproportion or malposition. Signs include a bandl ring, constant pain and no cervical progress; it risks uterine rupture and fistula and needs urgent referral.

A mismatch between the size or shape of the fetal head and the maternal pelvis that prevents normal vaginal birth. It may be suspected when the head does not engage or descend in labour and is a common reason for caesarean section or referral.

Any fetal lie or presenting part other than the normal vertex head, such as breech, transverse lie, shoulder or face presentation. It increases the risk of cord prolapse and obstructed labour and often requires referral for skilled or surgical delivery.

Descent of the umbilical cord through the cervix ahead of the presenting part after membranes rupture. It compresses the cord and cuts fetal blood supply, so the midwife should relieve pressure, keep the woman off the cord, and arrange immediate delivery.

Failure of the shoulders to deliver after the head has emerged, needing specific manoeuvres such as changing maternal position or applying suprapubic pressure. Delay risks fetal hypoxia and brachial plexus injury, so it is managed as an emergency.

A stepwise response for a newborn who is not breathing well at birth: dry and stimulate, clear the airway if needed, and give positive pressure ventilation with a bag and mask, adding chest compressions and drugs if the heart rate stays very low.

A quick assessment at 1 and 5 minutes after birth scoring heart rate, breathing, muscle tone, reflex response and colour from 0 to 2 each. It describes the newborn's condition and response to resuscitation, not a predictor of long-term outcome.

Keeping a newborn warm to prevent hypothermia, which worsens breathing and infection outcomes. Measures include immediate drying, skin-to-skin contact with the mother, delayed bathing, a hat, and wrapping, with kangaroo mother care for small or low birth weight babies.

Continuous skin-to-skin contact between a mother or caregiver and a small newborn, with exclusive breastfeeding and early discharge support. It reduces hypothermia, infection and mortality in low birth weight infants and is recommended where incubators are limited.

Feeding an infant only breast milk, with no other food or drink except medicines and vitamins, for the first six months. It supports immunity and growth; the midwife helps with early initiation within one hour and correct attachment and positioning.

Monitoring of the mother and newborn in the first 24 hours after birth, when most maternal deaths occur. It includes checking bleeding, uterine tone, blood pressure, pulse, temperature, urination and newborn feeding, breathing and warmth at frequent intervals.

Infection of the genital tract or uterus after birth, with fever, foul-smelling discharge, abdominal pain and feeling unwell. Prompt recognition, antibiotics and referral are essential because it is a major cause of maternal death.

The six weeks after birth during which the uterus returns to its non-pregnant size and the body recovers. Care includes monitoring involution, lochia, wound healing, mental health, nutrition and contraception counselling.

A temporary family planning method effective only when three conditions are all met: the baby is fully or nearly fully breastfed, the mother has no periods, and the baby is under six months old. It requires correct counselling and a backup method when conditions change.

The range of family planning options offered by a service, including short-acting methods, long-acting reversible contraceptives, permanent methods and emergency contraception. A good mix allows informed free choice and meets different needs across the reproductive life cycle.

Methods used after unprotected intercourse to prevent pregnancy, such as levonorgestrel or ulipristal pills, or a copper intrauterine device. Pills work best the sooner they are taken; counselling should include information on ongoing contraception.

Abortion services provided with correct technique, infection prevention and respect for the woman's rights, at the earliest appropriate gestation and by a lawful provider. Care includes counselling, pain management, post-abortion contraception and follow-up.

Services for a woman after spontaneous or induced abortion, including treatment of complications such as bleeding or infection, uterine evacuation where needed, emotional support, and contraception counselling. It is provided regardless of the legality of the abortion.

A package of services to stop HIV passing from mother to child: antenatal HIV testing, lifelong or appropriate antiretroviral therapy, safe delivery practices, and infant prophylaxis and feeding guidance. It also links the mother to ongoing HIV care.

Confidential testing offered with informed consent, pre-test information and post-test counselling, including partner testing and linkage to treatment. In antenatal care it identifies women who need PMTCT and is repeated in late pregnancy in high-prevalence settings.

Treating sexually transmitted infections based on a recognised group of symptoms and signs rather than laboratory results, using a national flow chart. It allows same-day treatment where testing is unavailable and includes partner notification and condom counselling.

Standard practices that reduce the spread of infection in health facilities: hand hygiene, gloves and protective clothing, safe sharps handling, correct cleaning and sterilisation of equipment, and safe waste disposal. These apply to every patient at every contact.

Cleaning hands with soap and water or alcohol-based rub at the five key moments of patient care, including before touching a patient and after body fluid exposure. It is the single most effective measure for preventing health-care-associated infection.

A person's voluntary agreement to a test, treatment or procedure after receiving understandable information about benefits, risks and alternatives. It is a legal and ethical requirement in midwifery care and can be withdrawn at any time.

The duty to keep a person's health information private and share it only with those who need it for care, or with consent or as the law requires. Breach can harm trust and is a professional and legal failing.

Care that treats every woman with dignity, privacy and respect, free from abuse, discrimination and neglect, and that supports her informed choices and companionship during birth. It is a right and improves use of services and outcomes.

The range of tasks and decisions a midwife is legally and professionally competent to perform, set by national law, regulation and education. Working outside it without supervision or referral is unsafe and may be unlawful.

The organised process of moving a woman or newborn to a higher level of care, including agreed criteria, communication, transport and feedback. Early, well-documented referral prevents delays that contribute to maternal and newborn deaths.

A framework explaining why women die in childbirth: delay in deciding to seek care, delay in reaching a facility, and delay in receiving adequate care at the facility. It guides community education, transport planning and quality improvement.

Planned communication with individuals and groups to improve knowledge and healthy practices, such as birth preparedness, danger sign recognition and breastfeeding. Effective sessions use local language, active methods and involve families and community leaders.

A planning approach in which a pregnant woman, her family and community prepare for normal birth and for emergencies: saving money, identifying a birth attendant and facility, arranging transport and a blood donor, and knowing danger signs.