M

maceration softening of solid by soaking, e.g. dead fetus retained in uterus for over 24 hours; characterised by discoloration, tissue softening, peeling and disintegration of skin; may cause disseminated intravascular coagulation.

Mackenrodt’s ligaments transverse or cardinal ligaments supporting uterus in pelvic cavity.

macro- prefix meaning ‘large’.

macrocyte abnormally large red blood corpuscles found in megaloblastic anaemia of pregnancy resulting from folic acid deficiency.

macronutrient essential nutrient with daily requirement > 100 mg, e.g. calcium, phosphorus, magnesium, potassium.

macrophage large, mononuclear, highly phagocytic cells derived from monocytes, occurring in blood vessel walls and loose connective tissue; components of reticuloendothelial system; actively mobile when stimulated by inflammation; interact with lymphocytes to facilitate antibody production.

macroscopic discernible with naked eye.

macrosomia large baby, birthweight above 97th centile for gestation or over 4–4.5 kg at term.

magnesium metal, symbol Mg; found in intra- and extracellular fluids; excreted in urine and faeces; minute quantities are essential for enzyme activity. Normal serum level approximately 1 mmol/L; deficiency causes nervous system irritability, tetany, vasodilatation, convulsions, tremors, depression, psychotic behaviour.

magnesium sulphate intravenous or intramuscular saline purgative for controlling eclamptic fits through cerebral dilatation, reversing cerebral vasospasm and increasing cerebral blood flow. Blood levels must be monitored regularly to prevent toxicity, occurring above 5 mmol/L. Side effects include flushing, nausea, vomiting, palpitations, headaches; toxicity causes loss of patellar reflexes, muscle paralysis, slurred speech, and, in rare cases, pulmonary oedema, respiratory and cardiac arrest. Antidote is calcium gluconate given intravenously.

magnetic resonance imaging (MRI) imaging technique that passes magnetic and radio waves through body with signals converted into computer image. Useful for examination of brain and spinal cord – fetal brain can be seen in utero, although fetal movements may adversely affect image quality.

maintenance order court order requiring person to give regular payment to someone for whom they have responsibility, e.g. father of child.

mal- prefix meaning ‘impaired’ or ‘ill’. Grand m. generalised convulsive seizure with loss of consciousness. Petit m. momentary loss of consciousness without convulsive movements. See epilepsy.

malabsorption impaired intestinal absorption of nutrients. M. syndrome disorders with subnormal intestinal absorption of dietary constituents, with excessive nutrient loss in stools.

malacia softening of tissues. Osteomalacia softening of bone tissue, one effect being deformity of pelvic bones.

malaise feeling of general discomfort and illness.

malar pertaining to malar bone of face or adjacent area.

malaria notifiable tropical infection contracted from mosquito bites, leading to protozoan parasites in red blood cells; occurs in sub-Saharan Africa, Asia and Americas; periodic bouts of fever, sweating, chills, rigors may occur over several years. Incidence increased greatly in nonaffected countries due to worldwide travel. Women should take prophylactic measures before, during and after travelling to malaria areas; proguanil and chloroquine are safe in pregnancy but maloprim should be avoided in first trimester; adequate precautions to avoid being bitten by mosquitoes should be taken, including sleeping nets, anti-malarial sprays, creams or plug-in repellants, and wearing clothing which covers arms and legs in evenings.

male reproductive system two spermproducing testes within scrotum; sperm are collected by fine tubular epididymis, conveyed by vas deferens to seminal vesicles for storage. At ejaculation prostate gland adds fluid to sperm, which pass into urethra inside erect penis; during intercourse, sperm are deposited in posterior vaginal fornix.

malformation congenital or acquired anatomical abnormality or deformity.

malignant tending to become progressively worse resulting in death, as in tumours; having properties of anaplasia, invasiveness and metastasis. M. disease in pregnancy approximately 1:1000–1500 pregnancies are complicated by cancer, with incidence increasing in older mothers; pregnancy may adversely affect course of disease; abnormal cells may metastasise to placenta and fetus. Cancer should be treated before conception if possible, but diagnosis during pregnancy requires careful balancing of effects of disease and treatment on continuation of pregnancy, and on overall condition of mother and baby.

malnutrition defective quantity or quality of nutrition, causing deficiency syndromes.

Malpighian body glomerulus and Bowman’s capsule of kidney.

malposition misplaced situation of organ or part in relationship to neighbouring structures or parts; Fetal m. cephalic presentation other than normal well-flexed anterior position, e.g. occipitoposterior.

malpractice professional misconduct or negligence, unreasonable lack of skill or fidelity in professional duties, illegal or immoral conduct, either by omission or inclusion. In midwifery, malpractice results in injury, unnecessary suffering, or death of mother or baby.

malpresentation fetal presentation other than vertex, i.e. breech, face, brow or shoulder presentation; failure to diagnose condition can lead to obstructed labour, uterine rupture, fetal or maternal death.

malrotation developmental abnormality in baby in which incomplete rotation of small bowel occurs, leading to obstruction, vomiting, abdominal distension; surgical correction is usually necessary.

Malström vacuum extractor See vacuum extractor.

maltase sugar-splitting enzyme that converts maltose to glucose, present in pancreatic and intestinal juice.

maltose sugar (disaccharide) formed when starch is hydrolysed by amylase.

mamma breast.

mammal member of division of vertebrates, including all that possess hair and suckle their offspring.

mammary pertaining to breasts.

mammilla nipple.

mammography breast radiography; routine screening procedure to diagnose cancer and other breast disorders.

mandelic acid ketoacid used as urinary antiseptic in nephritis, pyelitis and cystitis.

mandible bone forming lower jaw.

mania psychiatric disorder; acceleration of mental processes, associated with bipolar disorder; may follow childbirth.

manipulation using hands, e.g. to change position of fetus.

mannitol osmotic diuretic used for forced diuresis and in cerebral oedema; not recommended in pregnancy but may be used for acute tubular necrosis after postpartum haemorrhage. Not to be added to whole blood.

manoeuvre procedure performed with hands, e.g. to facilitate delivery of baby or placenta. See lövset’s manoeuvre and mauriceau–smellie–veit manoeuvre.

manometer instrument used to measure pressure or tension of liquids or gases. See sphygmomanometer.

Mantoux test intradermal injection of old tuberculin to determine susceptibility to tuberculosis; weal developing within hours indicates positive reaction, signifying that previous infection has conferred degree of immunity.

manual with hand. M. removal of placenta introducing hand into uterus to remove retained placenta; midwife may need to perform procedure in isolated areas in emergency when no medical aid is available. Antiseptic cream is applied to gloved hand, which is introduced into vagina; umbilical cord is followed up to uterus and placenta; other hand supports uterus through abdominal wall. After finding separated edge of placenta remainder is peeled off uterine wall and withdrawn; bimanual compression may be required to control bleeding; risk of shock is greater when procedure is performed without anaesthetic. See also placenta.

maple syrup urine disease genetic disorder caused by deficiency of enzyme necessary for metabolism of branched-chain amino acids; marked clinically by physical and learning disabilities, feeding difficulties and characteristic odour of urine.

marasmus severe malnutrition and weight loss in babies associated with protein–calorie deficiency, usually with normal appetite and mental alertness; related to kwashiorkor.

Marcain See bupivacaine.

Marfan’s syndrome hereditary disorder of connective tissue characterised by abnormal length of extremities, especially fingers and toes, subluxation of lens, congenital heart anomalies, other deformities.

marijuana, marihuana preparation of Cannabis sativa; hemp, hashish. Contains several pharmacologically active principles, used therapeutically or recreationally for euphoric properties; more potent when smoked and inhaled than when ingested. Increases risk of miscarriage and birth defects.

marker indicator of increased risk of disease or disorder; several markers are often combined to provide more detailed clinical picture or to increase sensitivity and specificity of screening test.

marrow soft, organic, sponge-like material in bone cavities that assists in manufacture of erythrocytes, leucocytes and platelets; occasionally subject to disease, e.g. aplastic anaemia, caused by destruction of marrow by chemical agents or excessive X-ray exposure, leukaemia, pernicious anaemia, myeloma and metastatic tumours.

mask of pregnancy See chloasma.

massage systematic therapeutic stroking or kneading of body to aid relaxation, stimulate circulation and excretion and lower blood pressure; may relieve pain in labour, as touch impulses reach brain before pain impulses. Cardiac m. intermittent heart compression by pressure applied over sternum (closed cardiac massage) or directly to heart through opening in chest wall (open cardiac massage). Infant m. promotes bonding between mother and baby; aids growth and physical and psychological development, especially in preterm babies.

mast cells large connective tissue cells in heart, liver and lungs containing granules that release heparin, serotonin and histamine in response to inflammation or allergy.

mastitis inflammation of breast. Puerperal m. infection caused by staphylococci or streptococci, entering through cracked nipples; wedgeshaped area of breast becomes tender, red and warm; mother feels unwell; responds quickly to antibiotics but delay in treatment may lead to breast abscess.

MAT B1 maternity certificate certificate signed by midwife or doctor confirming estimated date of delivery; required when claiming financial and employment benefits related to pregnancy.

materia medica science of source and preparation of drugs used in medicine. Homeopathic m.m. resources detailing actions and effectiveness of homeopathic remedies, used to determine most appropriate remedy for client. See homeopathy.

maternal pertaining to mother. M. mortality death due to pregnancy or childbearing. M. mortality rate number of maternal deaths per 1000 registered live births and stillbirths; confidential enquiry into m. deaths triennial report detailing all maternal deaths in UK.

maternity pertaining to childbearing. M. benefits in UK, pregnant women are entitled to paid time off work to attend antenatal appointments, free dental care and prescriptions during pregnancy and for 1 year following delivery, maternity allowance; if employed, women are entitled to statutory maternity pay and right to return to work. M. support worker healthcare practitioner specifically trained to assist midwives and support mothers.

maternity services liaison committee local committees set up to serve interests of maternity service consumers through two-way communication between obstetric, paediatric, anaesthetic and midwifery representatives and prospective and retrospective service users.

matrix intercellular substance of tissue, e.g. bone matrix, or tissue from which structure develops, e.g. hair or nail matrix.

Matthews Duncan expulsion of placenta placental expulsion in which maternal side appears first at end of third stage of labour, often due to low-lying placenta; more severe haemorrhage is likely than with schultze expulsion.

maturation process of ripening or developing, as in cell division when number of chromosomes in germ cell is reduced to half the number characteristic of species.

Mauriceau–Smellie–Veit manoeuvre method of delivering aftercoming head in breech delivery; flexion is increased and jaw and shoulder traction applied; allows for better control over delivery of head than burns– marshall technique.

Maxolon See metoclopramide.

McRobert’s manoeuvre manoeuvre to rotate angle of symphysis pubis anteriorly, in which mother brings knees up to chest, in order to release impacted fetal shoulders in shoulder dystocia. See also appendix 4.

mean average; numerical value intermediate between two extremes. M. corpuscular haemoglobin (MCH) indicator of mean (average) amount of haemoglobin in red blood cells. Low levels indicate reduced oxygen-carrying capacity of blood; MCH concentration of < 25 pg may indicate alpha thalassaemia trait. M. corpuscular volume (MCV) measurement of red blood cell size, usually decreased (microcytic) in iron deficiency anaemia and increased (macrocytic) in vitamin B12 deficiency anaemia.

measles highly infectious notifiable viral disease; rubeola or morbilli. See immunisation.

meatus opening or passage. Auditory m. opening leading into auditory canal. Urinary m. where urethra opens to exterior.

mechanism of labour sequence of movements made by fetus during labour to facilitate passage through maternal pelvis.

meconium greenish-black material in fetal intestinal tract, passed per rectum in first few days of life; contains bile pigments and salts, mucus, intestinal epithelial cells, amniotic fluid. M. aspiration syndrome inhalation of fluid containing meconium, as in babies who have been hypoxic in utero, especially if growth-retarded; causes severe respiratory distress. M. ileus gross distension of bowel with inspissated meconium found in cystic fibrosis.

median situated in median plane or midline of body or structure. M. nerve nerve originating in brachial plexus that innervates muscles of wrist and hand. M. plane imaginary plane passing longitudinally through body from front to back, dividing it into right and left halves.

mediastinum 1. median septum or partition. 2. mass of tissues and organs separating sternum in front and vertebral column behind, containing heart and large vessels, trachea, oesophagus, thymus, lymph nodes and other structures and tissues; divided into anterior, middle, posterior and superior regions.

medicine

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