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D




dactyl finger or toe.


danazol anterior pituitary suppressant drug.


Data Protection Act 1998 Act defining UK law on data processing giving people control over use of information about themselves. Organisations holding personal data, e.g. patient records, are legally obliged to maintain privacy, not disclose information without consent of those involved, facilitate access of individuals to own records.


database information collected, stored, reviewed, updated; used for evaluation and audit or as research resource.


day nursery See nursery.


D-dimer test blood test to detect crosslinked fibrin degradation fragment, d-dimer, indicator of coagulopathy.


deafness complete or partial loss of hearing. Congenital d. deafness present at birth, often due to antenatal infection, especially rubella.


death cessation of all physical and chemical processes in all organs or cellular components. Brain d. in UK, clinical brainstem death diagnosis is governed by guidelines ratified by Medical Royal Colleges. Cot d. sudden infant death syndrome (SIDS). D. certificate statement issued by registrar for deaths after receipt of preliminary certificate completed and signed by attending doctor, indicating date and probable cause of death; burial/cremation cannot take place until this is issued. D. grant payment made by Social Security from Social Fund, payable to low-income families, recoverable from estate of deceased. D. rate number of deaths per stated number of persons (100 or 10 000 or 100 000) in certain region in certain time period.


deceleration decreased speed; e.g. fetal heart rate. Early d. begins at, or after, onset of contraction, returns to baseline rate by end of contraction; not normally representing fetal difficulty. Late d. transitory decrease in heart rate due to uteroplacental insufficiency, compromised fetal blood flow that does not deliver amount of oxygen needed to withstand labour stress Prolonged d. fetal heart decrease of ≥15 beats per minute measured from most recent baseline rate; lasts ≥2 minutes but ≤10 minutes Variable d. Abrupt decrease in FHR of ≥15 beats per minute measured from most recent baseline rate; lasts ≥15 second, ≤2 minutes.


decidua pregnant endometrium in which fertilised ovum embeds; thicker, more vascular than non- pregnant endometrium. D. basalis part on which ovum rests, covering maternal placental surface. D. capsularis part covering ovum as it projects into uterine cavity. D. vera true uterine lining, not in contact with ovum for first trimester.


decidual cast expulsion of decidua intact, in shape of uterine cavity, following death of ovum in ectopic pregnancy.


decompensation inability of heart to maintain adequate circulation, marked by dyspnoea, venous engorgement, cyanosis, oedema.


deep transverse arrest fetal head obstruction during second-stage labour, resulting from first-stage occipitoposterior position; fetus attempts to turn anteriorly (long rotation), head becomes caught between ischial spines of pelvic outlet, especially if prominent. forceps delivery is required to release obstructed head. Baby may have excessive moulding leading to possible intracranial damage.


deep vein thrombosis (DVT) blood clot in vessel, possibly life-threatening if completely occluding vessel, e.g. coronary arteries causing heart attack, cerebral vessels causing cerebrovascular accident. Thrombosis may move from original site, causing problems elsewhere, e.g. pulmonary embolism. Newly birthed mothers are at risk of deep vein thrombosis due to clotting factor changes occurring at term to prevent excess haemorrhage. Signs include red, tender, hot area on calf.


defaecation evacuation of bowels.


defibrillation termination of atrial or ventricular fibrillation, usually by electric shock.


deficiency lack of. D. disease disease caused by dietary or metabolic deficiency.


deflexion fetal attitude in which head is not flexed, or only partially flexed, e.g. occipitoposterior position.


degeneration structural change, lowering vitality of tissue in which it takes place. Red d. See necrobiosis.


dehiscence bursting open or rupture, e.g. abdominal wound rupture after surgery; rupture of Graafian follicle at ovulation.


dehydration excessive loss of body fluid, or failure to take sufficient fluid to balance loss, often with ketoacidosis; occurs in severe vomiting, prolonged labour, excessive haemorrhage. Signs include dry inelastic skin, dry tongue, sunken eyes, ketotic breath odour, oliguria, ketonuria, electrolyte imbalance, abnormal blood reactions. Maternal dehydration with ketoacidosis can be life-threatening to fetus; intravenous dextrose is administered, with saline if urinary chlorides are severely diminished. D. fever neonatal condition resulting from insufficient fluid intake; severe dehydration from diarrhoea, depressed fontanelle, poor skin turgor, weight loss; corrected orally if mild or intravenously if severe.


delay in labour unusual prolongation of labour; most common in first stage – partogram shows cervical dilatation is slower than expected; prolonged delay, usually over 2 hours, may require augmentation of labour. Second-stage delay – technically, more than 30–120 minutes in nullipara and 10–60 minutes in multipara but, in practice, if fetal and maternal conditions remain satisfactory and gradual progressive descent of presenting part is made, no action is taken. Physiological third stage of over 2 hours, or actively managed third stage over 30 minutes; delay in separation and/or expulsion of placenta may require manual removal of placenta and membranes.


deletion in genetics, loss of genetic material from chromosome.


delirium mental disturbance marked by hallucinations, delusions, restlessness, incoherence.


delivery natural expulsion or extraction of baby, placenta and membranes at birth. Abdominal d. caesarean section. Instrumental d. facilitated by use of instruments, particularly forceps or vacuum cup. Spontaneous d. delivery occurring without mechanical aid. Vaginal d. complete delivery via birth canal, cephalic or breech presentation.


demand feeding feeding when baby appears hungry, not according to fixed timetable; ‘on demand’ feeding, baby-led feeding.


demography statistical science dealing with populations, including health, disease, births and mortality.


denaturation test Singer’s test; blood test to distinguish fetal from maternal blood.


denidation degeneration and expulsion of uterine lining during menstruation.


Denis Browne splint special boot designed to correct talipes.


denominator point on presenting part of fetus used to indicate its position in relation to particular part of mother’s pelvis, e.g. occiput in vertex presentation, sacrum in breech presentation, mentum (chin) in face presentation.


dental care dental care is free during pregnancy and up to 1 year after delivery.


dental caries decay of teeth.


dentition teething. Primary d. eruption of temporary (milk) teeth, usually 6 or 7 months of age, continuing until end of second year; eight incisors, four canines, four premolars, four molars. Secondary d. appearance of 32 permanent teeth (eight incisors, four canines, eight premolars, 12 molars), commencing at 6 or 7 years, complete by 12–15 years, except for posterior molars (‘wisdom teeth’), which may appear in early adulthood.


deoxygenate deprived of oxygen. D. blood blood that has lost oxygen in tissues, returning to lungs for fresh supply.


deoxyribonucleic acid (DNA) nucleic acid of complex molecular structure occurring in cell nuclei as basic structure of GENES; present in all living cells.


Department of Health (DH) the body responsible for administering NHS.


Department for Work and Pensions largest UK government body, with two sections: Jobcentre Plus, deals with Jobseeker’s Allowance, Incapacity benefit, Income Support, Employment and Support Allowance, Bereavement Benefits, Maternity Allowance, Industrial Injuries Benefits, Social Fund, and Pension, Disability and Carers Service.


Depo-Provera See medroxyprogesterone acetate.


depression 1. lowering of spirits; mood change, sadness, melancholy. Endogenous d. occurs in bipolar disorder, associated with slowing of thought and action, feelings of guilt. Reactive d. occurs in response to event. Either type may occur in puerperium, usually within 2 weeks of delivery, developing gradually. Treatment: support, psychotherapy and/or antidepressants in mild cases; hospital admission, antidepressants, electroconvulsive therapy if severe. 2. dip, felt on palpation.


dermoid cyst tumour consisting of fibrous wall lined with stratified epithelium, containing pulpy material containing epithelial elements, e.g. hair.


descen downward movement, e.g. of fetus during labour, through brim, cavity and outlet of pelvis; assessed by abdominal examination, may be measured in fifths. See diagram.


desquamation shedding of superficial epithelial cells from any part of body.


detection rate sensitivity of screening test’s performance; proportion of people found to be positive (or high risk).


detoxication process of neutralising toxic substances, liver function.


detrusor general term for body part that pushes downwards, e.g. d. muscle.


developmental pertaining to development. D. anomaly absence, deformity or excess of body parts due to faulty embryological development. D. milestones significant behaviours, which mark process of child development, e.g. sitting, walking, talking, etc.


image
Descent of fetal head estimated in fifths palpable above brim


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Jun 18, 2016 | Posted by in MIDWIFERY | Comments Off on D

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