pack large swab or tampon used to control bleeding in wound or abdominal contents during surgery.
packed cells fresh blood for transfusion from which some plasma content has been removed to facilitate cell haemolysis; given when necessary to replace blood cells without overloading circulation with fluid.
packed cell volume (PCV) percentage of blood cells to plasma; normal PCV is about 45%.
PaCO2 partial pressure of dissolved carbon dioxide which has moved out of cells into bloodstream; accurately reflects alveolar ventilation.
paediatrician doctor specialising in paediatrics – study of infant and child health and disease.
paedophilia abnormal fondness for children; sexual activity of adults with children. Adj paedophiliac.
pain suffering and distress, resulting from stimulation of free nerve endings in small myelinated or unmyelinated nerve fibres in superficial skin layers and some deeper tissues, which transmit impulses along sensory nerve fibres to spinal cord, then along sensory pathways to thalamus, main sensory relay station of brain. Conscious perception of pain probably occurs in thalamus and lower centres; interpretation of pain intensity occurs in cerebral cortex. Abdominal p. in pregnancy may indicate threatened miscarriage, ectopic pregnancy, placental abruption, retroversion of uterus, urinary tract infection, uterine fibroids, ovarian cysts or other incidental conditions, e.g. appendicitis or cholecystitis. Labour p. increasingly frequent and intense intermittent spasmodic abdominal pain caused by contractions of upper uterine segment dilating cervix and expelling fetus through birth canal; sacral back pain originates in cervix and, if severe, may indicate poor cervical dilatation and prolonged labour. P. control in labour midwives are responsible for helping mother to cope with contraction pain, using various techniques, including inhalational analgesia, transcutaneous electrical nerve stimulation, comfort and mobility measures such as massage and hydrotherapy; they are permitted to administer pharmacological analgesia, e.g. pethidine, meptazinol, and assist and monitor mothers requiring epidural anaesthesia; increasingly midwives use complementary therapies such as aromatherapy, reflexology and hypnotherapy. See also afterpains, gate control theory of pain, referred pain.
palate roof of mouth. Hard p. bony palate at front. Soft p. muscular area behind hard palate. See also cleft palate.
palliative agent that relieves but does not cure disease.
pallor pale skin, may be mottled; in newborn, sign of poor peripheral perfusion; associated with low circulating blood volume or circulatory adaptation and compensation for hypoxaemia; also occurs in anaemia.
palpation physical examination by touch; using light finger pressure on skin surface to determine condition of parts beneath surface, aiding diagnosis. See abdominal examination and vaginal examination.
palpitation abnormally rapid beating of heart, of which person is conscious.
palsy paralysis. Bell’s p. facial paralysis due to lesion of facial nerve, resulting in characteristic facial distortion. Cerebral p. persistent qualitative motor disorder appearing before age 3. Erb’s p. limp inwardly rotated arm with half-closed hand turned outwards; caused by damage to upper roots of brachial plexus. Klumpke’s p. paralysis of hand and wrist drop caused by damage to eighth cervical and first thoracic nerve roots.
Panadol See paracetamol.
pancreas racemose gland about 15 cm (6 in) long, located behind stomach with its head in curve of duodenum and its tail in contact with spleen; secretes insulin from islets of Langerhans and digestive juice, which enters duodenum through pancreatic duct and common bile duct.
pancreatic duct main excretory duct of pancreas, uniting with common bile duct before entering duodenum at major duodenal papilla.
pandemic epidemic spreading over wide area.
panhysterectomy total hysterectomy, i.e. removal of body and cervix of uterus.
PaO2 partial pressure of oxygen in arterial blood; reflects how the lung is functioning, but does not measure tissue oxygenation.
Papanicolaou test (smear) simple test used to detect uterine and cervical cancer. Ayre’s wooden spatula is passed through cervix and rotated 360° near internal os to scrape off surface cells, which are transferred to glass slide and examined microscopically.
papaveretum (Omnopon) analgesic drug; mixture of opium alkaloids.
papilla small nipple-like eminence. Pl papillae.
papilloma benign tumour derived from epithelium. P. virus sexually transmitted infection causing anogenital warts (condylomata acuminata), associated with increased incidence of cervical carcinoma. Laryngeal p. rare neonatal condition caused by infection acquired during vaginal delivery.
papule small solid raised elevation of skin.
papyraceous like parchment. Fetus p. very rare abnormality of multiple pregnancy in which one fetus dies very early in pregnancy and becomes flattened; usually delivered with placenta.
para 1. woman who has produced one or more viable offspring, i.e. over 24 weeks’ gestation, including stillbirths: para 0 nullipara, woman who has not delivered viable baby; para 1 primipara, has delivered one viable baby; para 2 or more, multipara has delivered two or more viable babies. grande multipara woman who has delivered five or more viable babies. Miscarriages and terminations are not counted but usually identified by adding + 1 after number designating viable deliveries, e.g. para 3+1. Adj parous. 2. prefix meaning ‘near’, e.g. parametrium.
paracentesis puncture of cavity wall to draw off fluid. P. uteri amniocentesis; puncture of abdominal and uterine walls to draw off amniotic fluid. See polyhydramnios.
paracervical block infiltration of lee–frankenhauser plexus with local anaesthetic through lateral fornices to relieve cervical dilatation pain in labour, effective for up to 3 hours. Inadvertent injection into uterine artery, which is in close proximity to plexus, may cause fetal bradycardia and intrauterine fetal death.
paracetamol oral analgesic and antipyretic drug to relieve moderate pain and reduce pyrexia; acute paracetamol overdosage can cause severe, potentially fatal, hepatic necrosis. Considered relatively safe in pregnancy.
paraesthesia disorder of sensation, e.g. feeling of ‘pins and needles’; may occur with carpal tunnel syndrome; occasionally felt in feet following epidural analgesia.
paralysis palsy; failure of nerve function, especially of motor nerve, leading to impairment of voluntary or involuntary muscles supplied by affected nerve. Facial p. see birth injury. Infantile p. poliomyelitis. See also erb’s paralysis and klumpke’s paralysis. Adj paralytic.
paramedic healthcare professional working in emergency medical care; ambulance service personnel with specialist training to perform in emergency settings certain procedures normally undertaken by doctors. In UK, USA and Germany, title is legally protected.
parametritis inflammation of parametrium; pelvic cellulitis in tissues surrounding uterus; may occur if infection has been introduced into genital tract, as complication of septic abortion or following labour.
parametrium pelvic connective tissue surrounding lower part of uterus, filling spaces between uterus and related organs. Adj parametric.
paranoia psychiatric disorder, characterised by delusions of persecution, illusions of grandeur focusing on fears for future; often combined with schizophrenia; may be feature of postnatal depression. Adj paranoid.
paraplegia central nervous system paralysis of legs and, occasionally, lower body, affecting all muscles within local area. Adj paraplegic.
parasite plant or animal living in or on another living organism (host), from which it satisfies all needs. Infections caused by parasites include toxoplasmosis, scabies, giardiasis and many tropical diseases.
parasympathetic nervous system part of autonomic nervous system; postganglionic nerve fibres with almost 75% being in vagus nerves, which serve thoracic and abdominal regions; remainder are distributed to heart, smooth muscles, head and neck glands and pelvic viscera; acetylcholine is secreted from nerve endings, acting either to excite or inhibit certain activities.
parathyroid glands four small endocrine (hormonal) glands associated with thyroid gland; help to maintain plasma calcium levels. P.g. disorders rare causes of hypo- or hypercalcaemia in neonates, possibly hereditary or occurs in association with deletions of chromosome 22 (digeorge syndrome).
paratyphoid notifiable infection caused by Salmonella.
parent–infant relationship ‘bonding’; relationship that develops between parents and their baby.
parenteral outside alimentary tract. P. feeding introduction of nutritional substances by any route other than alimentary tract.
parenthood education antenatal education to help parents prepare for labour and parenthood, usually offered as series of classes in groups, which provides social environment for couples approaching parenthood; may also be given on one-to-one basis.
paresis partial paralysis affecting muscular action but not sensation.
parietal related to or attached to wall of cavity. P. bone one of two thin flat bones forming major part of vault of skull. See also fetal skull.
parity 1. para; condition of woman with respect to her having borne viable babies. See para. 2. equality; close correspondence or similarity.
Parlodel See bromocriptine mesylate.
paronychia common neonatal inflammation of folds of skin surrounding fingernail, usually staphylococcal in origin.
parotid near ear. P. glands largest of three main pairs of salivary glands, located on either side of face, just below and in front of ears.
parous having borne one or more viable offspring. See also nullipara and primiparous.
paroxetine (Seroxat) selective serotonin reuptake inhibitor antidepressant drug with fewer side effects than previously used tricyclic antidepressants; unlike fluoxetine, may cause significant weight gain; used for major depression, obsessivecompulsive disorders, post-traumatic stress disorder, panic and anxiety disorders, premenstrual dysphoric syndrome; contraindicated in pregnancy, as may cause miscarriage, fetal cardiac anomalies in first trimester or, if taken in third trimester, neonatal withdrawal effects.
paroxysm 1. sudden recurrence or intensification of symptoms. 2. spasm or seizure. Adj paroxysmal.
partial pressure See po2.
partogram graphical record of labour progress obtained from cardiotocograph printout, enabling assessment of visual patterns of cervical dilatation and descent of presenting part in conjunction with records of maternal and fetal well-being.
parturient being in labour; relating to childbirth.
parturition labour, childbirth.
parvovirus B19 (human parvovirus B19) causes so-called slapped cheek syndrome, also called fifth disease, or erythema infectosum; droplet-spread viral infection attacking mainly schoolchildren in 3-yearly outbreak cycles, characterised by facial rash, causing appearance of ‘slapped cheeks’, general malaise, fever. 50% of adults show evidence of previous infection. Antenatal infection can cause miscarriage and fetal death due to virus attacking erythroid progenitor cells, causing fetal anaemia. hydrops fetalis may also occur, detectable on ultrasound scan. Diagnosis is confirmed from maternal serum; intrauterine transfusion may be necessary to correct fetal anaemia, leading to recovery in 85% of cases.
pascal (Pa) international (SI) unit of pressure, corresponding to force of 1 newton per square metre.
passages birth canal, including bony pelvis and soft tissues of vagina and vulva, through which fetus must pass during birth.
passenger fetus, as it traverses passages.
passive not active. P. immunity See immunity. P. movements manipulation by therapist without active movement by patient.
pasteurisation heating of milk or other liquids to 60°C for 30 minutes, which kills pathogenic bacteria and delays other bacterial development.
Patau syndrome (trisomy 13) congenital disorder due to additional chromosome 13, occurring in approximately 1 in 10 000 live births, with risk increasing with advancing maternal age. Affected babies may have weak muscle tone, cleft lip/palate, heart defects and skeletal abnormalities, rarely survive infancy. Mosaic Patau syndrome, in which only some cells have additional chromosome, is usually less severe.
patella small, circular, sesamoid bone forming kneecap.
patent open. P. ductus arteriosus abnormal persistence after birth of open lumen in ductus arteriosus between aorta and pulmonary artery, which burdens left ventricle of heart, causing diminished blood flow in aorta. In preterm infants, administration of prostaglandin inhibitor, indometacin, may close ductus; however, in those with severe congenital heart defects in which open ductus arteriosus could be beneficial, prostaglandins are given to keep channel open.
paternity biological fatherhood; analysis of DNA in blood will confirm paternity in cases in which unsupported mother applies for maintenance payments from baby’s biological father.
patho- prefix denoting ‘disease’.
pathogen micro-organism or material that causes disease. Adj pathogenic.
pathological pertaining to study of disease.
pathology branch of medicine diagnosing and treating essential nature of disease, especially structural and functional changes in tissues and organs in body.
patient controlled analgesia (PCA) means by which mother may selfadminister analgesia, usually intravenously via mechanical pump, e.g. pethidine. Transcutaneous electrical nerve stimulation (TENS) is also PCA.
Patient Group Directions (PGD) NHS documents permitting supply of prescription-only medicines (POMs) to groups of patients, without individual prescriptions; clarified under POMs Amendment Order 2000.
patulous distended, open, as in external os of multiparous woman or cervical incompetence.
Paul–Bunnell test test for presence of serum heterophil antibodies, used to diagnose infectious mononucleosis.
Pavlik harness special harness which maintains infant’s hips flexed and abducted to 60% in cases of congenital hip dysplasia; should not be removed for bathing or napkin changing; parents require support to learn how to care for baby; requires special attention to skin care and checking for signs of excoriation or chafing.
Pawlik’s grip, manoeuvre during abdominal examination, midwife grasps lower pole of uterus between fingers and thumb, spread sufficiently wide apart to accommodate fetal head, to estimate size, flexion, mobility and engagement/non-engagement of fetal head; uncomfortable if not performed gently and slowly.
pectineal pertaining to symphysis pubis.
pectoral 1. pertaining to chest or breast. P. muscle pectoralis major band of muscle separating breast tissue from ribs. 2. relieving disorders of respiratory tract, as expectorant.
pedicle stem of tumour.
pediculosis lice infestation of skin or hair.
pediculus louse.
pedigree chart or diagram of individual’s ancestors, used in genetics to analyse Mendelian inheritance.
peduncle large stalk or pedicle. Adj pedunculated.
peer review system of ensuring quality, in which midwifery care or professional publications are evaluated according to defined criteria established by peers.
pellagra syndrome caused by niacin deficiency usually resulting from inadequate vitamin B intake or inability of body to convert tryptophan to niacin, e.g. in alcohol and drug abuse; other vitamin deficiencies often co-exist, e.g. vitamin B2 (riboflavin).
pelvic pertaining to pelvis. P. bone hip bone, comprising the ilium, ischium and pubis. P. capacity assessment evaluation of size and shape of pelvis in relation to size, flexion and position of presenting part, performed either during abdominal examination or vaginal examination, ultrasound or, rarely, with X-rays. P. cellulitis See parametritis. P. diameter any diameter of bony pelvis. P. floor or diaphragm strong sheets of muscle fibres, principally levator ani muscles, forming support for pelvic organs. P. floor exercises women should be encouraged to perform these regularly in pregnancy and postnatally, to reduce risk of urinary or faecal incontinence and urging. See also perineum. P. girdle innominate bone and sacrum. P. girdle pain abnormal relaxation of ligaments supporting pubic joint, due to relaxin and progesterine, biomechanical and genetic factors; affects 1 in 300 women, previously called symphysis pubis discomfort. Increased joint mobility and sacroiliac joint strain causes pubic pain, backache, sciatica and abdominal pain as the muscles attempt to stabilise the bones. Can be severly debilitating; exacerbated by obesity, previous spinal injury or surgery, multiple pregnancy, grande multiparity. Mother should restrict weight-bearing exercise, avoid movements which abduct hips, e.g. squatting, correct posture. Obstetric girdle may be offered to encourage appropriate posture and provide support, but this may not be sufficient. Osteopathy, chiropractic or physiotherapy may be necessary. P. inflammatory disease infection involving uterine tubes, ovaries, parametrium gut. See also pelvis.
pelvimetry See pelvic capacity assessment.
pelvis bony girdle formed anteriorly and laterally by innominate bones, and posteriorly by sacrum and coccyx, with muscular floor and containing uterus, fallopian tubes, ovaries, urinary bladder and rectum. False p. part lying above brim bounded by iliac fossae laterally, lumbar spine posteriorly and abdominal wall anteriorly, of little significance in obstetrics. True p. bony pelvis from level of brim and below, forming bony canal through which fetus must pass to be born normally. Consists of brim or inlet, bounded by sacral promontory and alae, upper sacroiliac joints, iliopectineal lines, upper inner borders of upper pelvic rami and symphysis pubis; cavity, bounded by sacral hollow, sacrospinous ligaments, ischial and pubic bones and symphysis pubis; and anatomical outlet, bounded by coccyx, sacrotuberous ligaments, ischial tuberosities and pubic arch. Obstetrical outlet is bounded posteriorly by lower aspect of sacrum and laterally by ischial spines and is lowest level of bone surrounding fetus in birth canal. Inclination of p. brim slopes at approximately 55° to horizontal, and bony outlet slopes at about 15°. See also curve of carus. Normal pelvic shapes include: android p. pelvis with masculine characteristics, including roughly triangular or heart-shaped brim and narrow funnel shape, with outlet that is narrower than in gynaecoid pelvis; anthropoid p. pelvis with brim that is long anteroposteriorly and narrow transversely, the reverse of gynaecoid pelvis but usually large enough to accommodate fetus; gynaecoid p. normal female pelvis, almost round at brim, cavity and outlet, roomy, shallow and ideally shaped for childbearing; platypelloid or flat p. pelvis with oval brim, small anteroposteriorly and wide transversely. Pelvic deformities resulting from disease, accident or rare inherited characteristics include high assimilation p. in which 5th lumbar vertebra is fused to sacrum and angle of inclination of pelvis brim is increased; asymmetrical Naegele p. in which one sacral alae has failed to develop; extremely rare; Robert p in which both sacral alae are undeveloped and symphysis pubis is sometimes split; spondylolisthetic p. in which fifth lumbar vertebra has slipped forwards on sacrum, creating false promontory; rachitic p. brim of which is markedly flattened and kidney-shaped. Assessment of p. undertaken through observation of mother’s gait, by consideration of previous obstetric history, measurement of pelvic capacity. See pelvic capacity assessment. Diagonal conjugate of p. 12–12.5 cm measured from apex of pubic arch to sacral promontory. Obstetric conjugate of p. extends from inner upper border of symphysis pubis; 11 cm. True or anatomical conjugate of p. measures slightly more than obstetric conjugate; extends from sacral promontory to centre of upper surface of symphysis pubis, but extra space is not available for passage of fetus.
pemphigus autoimmune acute or chronic skin disease characterised by watery blisters. P. neonatorum bullous impetigo; extremely infectious, usually caused by infection
with Staphylococcus aureus; requires immediate medical attention and isolation of baby. Syphilitic p. may, rarely, occur in neonate.
pemphigoid gestationis See herpes gestationis.
pendulous hanging down. P. abdomen condition of multigravid women with extremely lax abdominal muscles in which uterus falls forwards and abdomen hangs below symphysis pubis, causing discomfort and, often, fetal malpresentation.
penicillin antibiotic substance obtained from cultures of mould Penicillium.
penicillinase enzyme that inactivates penicillin, produced by many bacteria, particularly staphylococci.
penis male erectile organ of reproduction and urination; carries urethra, passage for both semen and urine. Erectile tissue layers include corpus cavernosa, one on either side of urethra and corpus spongiosum, posterior column containing urethra, with tip expanded to form glans penis. Lower two-thirds are covered in skin; at the tip this is folded back on itself above glans penis to form prepuce or foreskin, movable double fold which is sometimes excised in circumcision.
pentazocine hydrochloride (Fortral) synthetic narcotic analgesic, rarely used in obstetrics. See pethidine, meptazinol or diamorphine.
pepsin proteolytic enzyme, principal digestive component of gastric juice; acts as catalyst in chemical breakdown of protein to form polypeptides; has milk-clotting action similar to rennin, facilitating digestion of milk protein.
peptides constituent parts of proteins: di-, tri-, tetrapeptides, etc., according to number of amino acids in molecule.
per through (Latin), e.g. per vaginam, via vagina.
percentile statistical term used to show incidence of characteristic; diagrammatic line representing percentage of population with specific characteristic, e.g. babies’ weights or lengths, 90th percentile/centile means that 90% of population will have measurements below that figure; 50th percentile is median or average.
percussion tapping surface with fingers to elicit sound; helps to determine condition of underlying organs. Also, tapping technique used in massage.
percutaneous umbilical cord blood sampling (PUBS) See cordocentesis.
perforation hole or break in wall or membranes of organ or structure, occurring when erosion, infection or other factors create weak spot in organ and internal pressure causes rupture.
performance indicators ‘package’ of routine statistics derived nationally and presented visually to highlight relative efficiency of health services in each health authority compared with other authorities.
peri- prefix meaning ‘around’.
pericardium smooth membranous sac around heart, with an outer fibrous and inner serous coat. P.6 acupressure point Precise point on inner wrists, part of the Pericardium meridian, or energy line, used in traditional Chinese medicine. Useful antenatally for nausea and vomiting; stimulation with fingers, wearing of special wristband or insertion of acupuncture needles sedates excessive internal energy which causes symptoms. To locate P6 point, use mother’s own fingers on opposite wrist, measuring from the crease where wrist and hand meet, three finger-breadths up and slightly to side of tendons in wrist, dip is felt which, when pressed, will feel bruised; intermittent pressure to point or application of button on inside of wristbands (both wrists) will ease symptoms. Midwives should be adequately trained to advise on acupressure techniques.
pericranium external periosteum of cranial bones.
perimenopause time approaching and immediately after complete cessation of menstrual periods (menopause), during which some women experience symptoms, e.g. menorrhagia, hot flushes, mood swings.
perimetrium peritoneum of uterus.
perinatal around birth. P. period first week of life. P. mortality rate number of stillbirths plus deaths of babies under 1 week old per 1000 total births in any 1 year.
perineal pertaining to perineum. P. body pyramid of muscles and fibrous tissue between vaginal introitus and anus; apex is formed from pubococcygeus muscle fibres crossing at this point; base is formed from transverse perineal, bulbocavernosus and anal sphincter muscles; downwards movement is limited by supporting ligaments, but if these are damaged during childbirth, increased mobility of perineal body can lead to rectocele and prolapse P. infiltration appropriately trained midwives are permitted to perform this prior to episiotomy and perineal repair, by injecting local anaesthetic into perineum P. laceration tear occurring in perineum at delivery. Firstdegree p. laceration involves skin of fourchette only, muscle remaining intact. Second-degree p. laceration involves fourchette skin and superficial perineal muscle, but not anal sphincter. Third-degree p. laceration tear extends through whole of perineal body and through anal sphincter into rectum. Fourth degree p. laceration involves disruption of anal sphincter muscles with breach of rectal mucosa P. repair suturing of perineal lacerations or episiotomy
by midwife or doctor; involves inserting tampon to ensure clear visual field followed by suturing of vagina with interrupted sutures, commencing just above apex of incision or tear; suturing of deep and superficial muscle layers, starting in centre of incision to give good approximation; suturing of perineal skin; tampon is removed and gloved finger is passed into rectum to ensure no sutures encroach into it.
perineorrhaphy repair of perineal body following injury sustained during childbearing.
perineum area extending from pubic arch to coccyx, with underlying tissues; obstetrically, fibromuscular pyramid between lower third of vagina anteriorly, anal canal posteriorly and ischial tuberosities laterally. See also pelvic floor.
periosteum specialised connective tissue covering all bones of body, possessing bone-forming potentialities; serves as point of attachment for certain muscles.
peripheral relating to periphery. P. cyanosis blueness of extremities, often seen in neonate immediately after delivery; accounts for loss of one mark in apgar score, usually of no clinical significance and resolves spontaneously.
periphery outer surface or circumference.
peristalsis wave-like contraction that travels along walls of tubular organ, pressing its contents onwards; occurs in muscle layer of alimentary canal and fallopian tubes; visible peristalsis may occur in pyloric stenosis.
peritoneal pertaining to peritoneum. P. dialysis treatment for end-stage renal failure, using peritoneum as membrane across which fluids and dissolved substances (electrolytes, urea, glucose, albumen etc.) are exchanged from blood; fluid is introduced through permanent tube in abdomen and flushed out regularly; alternative to haemodialysis. Renal condition causes infertility but where woman has conceived and chooses to continue pregnancy, there is significant risk of adverse maternal and fetal outcomes, including hypertension, superimposed pre-eclampsia, miscarriage, preterm delivery, fetal loss.
peritoneum serous membrane lining abdominal cavity and covering abdominal organs. Parietal p. lines abdominal cavity. Pelvic p. covers pelvic organs, in female forming pouch of Douglas between rectum and uterus and shallow uterovesical pouch between uterus and bladder; peritoneum hanging over fallopian tubes is broad ligament. Visceral p. inner layer closely covering organs, including mesenteries. Adj peritoneal.
peritonitis inflammation of peritoneum caused by infection. General p. affecting whole abdominal cavity. Pelvic p. restricted to peritoneum of pelvic cavity; occasional complication of puerperal sepsis.
periventricular haemorrhage serious complication of preterm babies, notably those under 34 weeks’ gestation with bleeding in the brain; grade 1 is bleeding into germinal matrix, also called subependymal haemorrhage; grade 2 involves bleeding into lateral ventricles of brain, which if complicated by blockage to outflow of cerebrospinal fluid, leads to posthaemorrhagic hydrocephalus; grade 3 haemorrhage extends into cerebral tissue leading to grade 4 parenchymal haemorrhage. P. h. infarction (PVI) intraventricular clot in grade 3 haemorrhage disrupts venous drainage, leading to grade 4 haemorrhage and infarction, with necrosis of white matter in brain.
permeable able to be penetrated, as in membranes that allow fluids to pass through, e.g. capillary walls (also semipermeable).
pernicious highly destructive; fatal. P. anaemia megaloblastic anaemia occurring in middle age, caused by failure of gastric secretion of intrinsic factor; treated with vitamin B12; not to be confused with megaloblastic anaemia caused by lack of folic acid.
peroxide compound of any element with more than normal quantity of oxygen required to form oxide. P. of hydrogen compound of hydrogen and oxygen.
perphenazine (Fentazin) oral antiemetic; avoid in first trimester.
persistent mentoposterior face presentation in which sinciput rotates forwards and chin rotates backwards to sacral hollow; rare cause of obstructed labour, when thorax must present at pelvic brim with head.
persistent occipitoposterior deflexed vertex presentation with sinciput rotated forwards and occiput rotated backwards to hollow of the sacrum; common cause of delay in second stage of labour; spontaneous face-topubes delivery is possible.
persistent pulmonary hypertension of newborn (PPHN) compromised transition from fetal to adult circulation, previously termed persistent fetal circulation, in which blood flow mimics fetal circulation, possibly due to primary defect in pulmonary vasculature or secondary to factors which raise pulmonary vascular resistance, e.g. meconium aspiration syndrome. Treatment is with nitrous oxide (vasodilator).
Personal Identification Number (PIN) on registration with Nursing and Midwifery Council, midwives are given PIN for use by employers or public to ascertain eligibility to practise as midwife; also required by midwife when signing Mat B1 certificates.
perspiration 1. sweating; excretion of moisture through skin pores. 2. sweat; salty fluid, largely water, excreted by sweat glands in skin; in cystic fibrosis sweat has raised sodium chloride levels.
pertussis whooping cough; potentially serious respiratory tract infection caused by Bordetella pertussis, particularly serious in babies under 3 months and children with asthma; immunisation is offered to all infants aged 2, 3 and 4 months and before starting school.
pessary object inserted into vagina, e.g. antifungal or contraceptive drug in solvent base, device to maintain anteversion of uterus in early pregnancy. Prostaglandin p. pessary of prostaglandins, inserted into posterior vaginal fornix to facilitate cervical ripening and onset of labour.
petechiae small spots caused by minute subcutaneous haemorrhages, seen in purpura and sometimes on face of normal neonate due to venous congestion during delivery; feature of congenital rubella, toxoplasmosis and cytomegalovirus when it covers entire body.
pethidine hydrochloride
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