S

Sabin vaccine oral vaccine against poliomyelitis consisting of three types of live, attenuated polioviruses given in capsule, on a lump of sugar or by medicine dropper.

sac pouch-like cavity.

saccharide carbohydrate, divided into monosaccharides, disaccharides, trisaccharides and polysaccharides according to number of saccharide groups.

sacculation of uterus rare complication of incarceration of retroverted gravid uterus; fundus remains under sacral promontory and anterior wall grows to accommodate fetus.

sacral relating to sacrum. S. promontory upper anterior border of body of prominent first sacral vertebra.

sacro- concerning sacrum. Sacroanterior and sacroposterior positions in breech presentation, sacrum is denominator.

sacrococcygeal concerning sacrum and coccyx. S. joint slightly movable pelvic joint between sacrum and coccyx.

sacrocotyloid concerning sacrum and acetabulum. S. diameter measurement from sacral promontory to nearest point of iliopectineal eminence; measures 9.5 cm.

sacroiliac concerning sacrum and ilium. S. joint or s. synchondrosis slightly movable joint between sacrum and ilium.

sacrum wedge-shaped bone of five united vertebrae between lowest lumbar vertebra and coccyx; forms posterior pelvic wall.

safeguarding relatively new term, broader than ‘child protection’; also includes prevention. All agencies working with children, young people and families must take all reasonable measures to ensure that risks of harm to children’s welfare are minimised; where there are concerns about children and young people’s welfare, all agencies must take appropriate actions, working to agreed local policies and procedures in full partnership with other local agencies.

Safe Motherhood Initiative World Health Organization campaign to reduce worldwide maternal mortality and morbidity.

sagittal arrow-shaped. S. section anteroposterior midline section. S. suture junction of parietal bones; sagittal or third fontanelle may be noted in sagittal suture, sometimes associated with down syndrome.

salbutamol beta-sympathomimetic drug to suppress preterm labour; contraindicated in pre-eclampsia and antepartum haemorrhage.

salicylate salt or ester of salicylic acid, e.g. aspirin, analgesic, antipyretic and anti-inflammatory drug; acts through inhibition of prostaglandin synthesis, blocking pyretic and inflammatory processes mediated by prostaglandin.

saline containing salt or salts. Physiological s. 0.9% sodium chloride solution, isotonic with blood, given intravenously to replace fluid in shock and haemorrhage; rapidly excreted.

saliva secretion of salivary glands, poured into mouth when food is eaten; moistens and dissolves certain substances and begins carbohydrate digestion with action of enzyme ptyalin, salivary amylase.

salivation normal flow of saliva. Excessive s. hypersalivation or ptyalism, disorder occurring in some women during pregnancy, particularly those of West African origin.

Salk vaccine preparation of killed polioviruses of three types given in series of intramuscular injections to immunise against poliomyelitis. See immunisation.

Salmonella genus of bacteria responsible for gastroenteritis.

salpingectomy excision of one or both fallopian tubes.

salpingitis fallopian tube inflammation.

salpingogram radiological outline of fallopian tube interior, used to detect patency and other disorders.

salpingography fallopian tube radiography after intrauterine injection of radio-opaque medium.

salpingo-oophorectomy removal of fallopian tube and ovary.

salpingotomy surgical incision of uterine tube.

salpinx fallopian tube.

salt 1. sodium chloride, common salt, used in solution as cleansing agent or for infusion into blood to replace fluid. 2. any compound of acid with alkali or base. S. depletion loss of salt from body because of sweating, persistent vomiting or diarrhoea.

sample selected group of population.

sandal gap exaggerated gap between first and second toes.

sanguinous pertaining to or containing blood.

saphenous two superficial veins carrying blood up leg from foot.

sarcoma highly malignant tumour develo ped from connective tissue cells and their stroma. Kaposi’s s. multifocal, metastasising, malignant viral reticulosis involving skin and visceral lesions, usually starting on toes or feet as reddish-blue or brownish soft nodules and tumours; occurs in acquired immune deficiency syndrome.

saturated solution liquid containing largest amount of solid that can be dissolved in it without forming precipitate.

Saving Mothers’ Lives confidential enquiry into maternal and child health, exploring causes and contributing factors to maternal and perinatal deaths and offering suggestions on how situations could be avoided or management improved.

Saving Newborn Lives global initiative led by Save the Children organisation to ensure that safe motherhood also includes neonatal care strategies.

scalp layer of tissue covering cranial bones. S. electrode small transducer applied per vaginam to fetal scalp during labour to monitor fetal heart rate; neonate may have small lesions apparent on scalp at birth at point where electrode was sited.

scan image of internal structures and tissues. See also computed tomography, magnetic resonance imaging, ultrasonography.

scapula large flat triangular bone forming shoulder blade.

scar dehiscence rupture of existing scar from previous surgery, as in uterus; cause of ruptured uterus.

Schilling test test used to confirm diagnosis of pernicious anaemia by estimating absorption of ingested radioactive vitamin B₁₂.

schizophrenia psychosis of unknown cause but showing hereditary links; sufferers feel influenced by external forces, experiencing delusions and hallucinations; pregnancy aggravates condition.

Schultze expulsion of placenta normal expulsion of inverted placenta with fetal surface appearing first at vulva; more common than matthews duncan expulsion with less bleeding.

sciatic nerve large nerve fibre beginning in lower back, running through buttock and down lower limb; longest and widest single nerve in human body supplying leg skin, muscles of leg, foot and back of thigh; derived from spinal nerves lumbar 4 to sacral 3.

sciatica severe pain down back of leg along course of sciatic nerve, caused by pressure of heavy uterus on nearby nerves and ligaments. Ergonomic advice should be offered; physiotherapy, transcutaneous electrical nerve stimulation or acupuncture may ease it in late pregnancy; usually resolves spontaneously following delivery.

sclera tough, white outer coat of eyeball, covering approximately posterior five-sixths of surface, continuous anteriorly with cornea and posteriorly with external sheath of optic nerve. Adj scleral.

sclerema uncommon neonatal disease characterised by hardening of skin and subcutaneous fat; occurs in hypothermia.

sclerosis hardening from overgrowth of fibrous and connective tissue, often resulting from chronic inflammation.

scoliosis abnormal curvature of spine, most commonly applied to lateral deviation. See lordosis and kyphosis.

scopolamine prescription anticholinergic medication sometimes used for hyperemesis gravidarum, usually in the form of skin patches.

screening means of identifying members of defined population at higher risk than normal from certain conditions, thus enabling further investigations to be undertaken; e.g. pregnant women are routinely screened for various diseases and fetal anomalies; some tests incorrectly identify proportion of unaffected individuals as being at higher risk (false positives) and fail to detect proportion of affected individuals (false negatives).

Scriver test biological test used for diagnosing inborn errors of metabolism, e.g. phenylketonuria. See also guthrie test.

scrotum pouch of skin and soft tissues containing testicles of male reproductive system.

scurvy disease caused by deficiency of vitamin C, characterised by weakness, anaemia, haemorrhage from mucous membranes, purpuric rash, joint swelling and pain and mouth ulceration; rapidly improves with diet containing adequate vitamin C.

sebaceous fatty or pertaining to sebum. S. glands sebum-secreting glands in skin communicating with hair follicles.

sebum fatty secretion of sebaceous glands.

second-degree perineal lacerations See perineal lacerations.

second stage of labour from full dilatation of uterine cervix to complete birth of baby.

secondary second in order of time or importance. S. care medical or surgical care, either elective or emergency, usually following referral from primary care professional. S. postpartum haemorrhage excessive genital tract bleeding that adversely affects mother’s health, occurring any time from 24 hours up to 6 weeks after delivery; usually caused by retained products of conception and/or infection. Treatment is dependent on cause but may involve evacuation of retained products, intravenous or oral oxytocics and antibiotics. See also postpartum haemorrhage.

secretin hormone secreted by duodenal and jejunal mucosa when acid chyme enters intestine, which is carried by blood and stimulates secretion of pancreatic juice, bile and intestinal secretion.

secretion substance produced by gland.

sedative calming substance, e.g. drug, often facilitating sleep, but not analgesic.

sedimentation formation of sediment. S. rate See erythrocyte sedimentation rate.

segment section or part. Upper uterine s. upper three-quarters of uterus, which contracts and retracts during labour. Lower uterine s. lower onequarter of uterus, including cervix, which becomes stretched and dilated in first stage of labour.

segmentation division of fertilised ovum into 2 cells, and then 4, 8, 16, etc., as it traverses fallopian tube.

seizure convulsion or attack of epilepsy.

selective feticide medical destruction of seriously abnormal fetus in continuing multiple pregnancy, using similar technique to multifetal pregnancy reduction, but usually later in pregnancy, enabling healthy fetus to grow and develop normally; counselling and bereavement care should be offered.

selective serotonin reuptake inhibitors (SSRIs) antidepressant drugs; may have adverse effects in pregnancy, including fetal anomalies and miscarriage; careful supervision of discontinuation in early pregnancy is required to avoid withdrawal effects.

Sellick’s manoeuvre application of backward pressure on cricoid cartilage in throat to occlude oesophagus and prevent regurgitation of stomach contents into pharynx with consequent risk of aspiration into lungs; undertaken during initiation of anaesthesia; pressure is not released until endotracheal tube has been inserted and respiratory tract sealed off.

semen male secretion of seminal fluid from prostate gland and spermatozoa from testis, produced at ejaculation.

seminferous tubules thin tubes in testes where production of spermatozoa takes place.

semipermeable property of membrane, permitting passage of some molecules and hindering others.

semi-prone lying face down with knees turned to one side.

senna (Senokot) laxative from cassia plant; can be too purgative in pregnancy.

sense faculty of perception, e.g. hunger, thirst, pain, equilibrium or well-being, and other senses. Five major senses: vision, hearing, smell, taste and touch.

sensitive reacting to stimulus.

sensitivity of tests measure of accuracy of screening test in identifying individuals who have condition; proportion of people with condition found to be positive (high risk) on screening test; also known as the detection rate.

sensitisation 1. initial exposure of individual to specific antigen, resulting in immune response. 2. coating of cells with antibody as preparatory step in eliciting immune reaction. 3. action of hormone on tissue or organ so that it will respond functionally to another hormone.

sensitised rendered sensitive.

sensory pertaining to sensation. S. nerve peripheral nerve that conducts impulses from sense organ to spinal cord or brain; afferent nerve.

sepsis infection by pathogenic bacteria. Puerperal s. genital tract infection occurring puerperium.

septic relating to sepsis. S. shock See toxic shock.

septicaemia presence and multiplication of pathogenic bacteria in blood, diagnosed by rapid temperature rise, later becoming fluctuating, rigors, sweating and signs of acute fever. See also endotoxic shock, puerperal sepsis.

septum division or partition, e.g. between right and left ventricles of heart.

septuplets seven offspring produced at one birth.

sequela morbid long-term consequences following and resulting from a disease, Pl sequelae.

serology study of antigen–antibody reactions in vitro. Adj serological.

serotonin amine present in blood platelets, intestine and central nervous system, derived from amino acid tryptophan and inactivated by monoamine oxidase; acts as vasoconstrictor.

serrated with saw-like edge, e.g. fetal skull bones.

sertaline selective serotonin reuptake inhibitor antidepressant drug, currently permitted for use in pregnancy in UK, but concerns regarding fetal adverse effects may change this. See also paroxetine, fluoxetine, tricyclic antidepressants.

serum clear straw-coloured fluid left after blood has clotted; clear residue of blood from which corpuscles and fibrin have been removed. Serum from blood of person recovering from disease may be used to protect another person from same disease. e.g. diphtheria, tetanus.

serum bilirubin bile pigment produced by breakdown of haem and reduction of biliverdin; normally circulates in plasma; taken up by liver cells and conjugated to form bilirubin diglucuronide, water-soluble pigment excreted in bile. High concentrations of bilirubin may result in jaundice. All neonates have transient rise in bilirubin but kernicterus may occur when unconjugated bilirubin levels exceed following levels, dependent on gestation.

service provider clinical institutions providing student midwife/nurse placement experiences, staff to support students and evidence of good practice from clinical audit.

sex 1. fundamental distinction based on type of gametes produced by individual. Union of female ova and male spermatozoa germ cells produces new individual. 2. to determine sex of organism. S. chromosomes pair of chromosomes, designated X or Y, that combine to determine sex and sexlinked characteristics of individuals; XX results in female and XY in male.

Under 27 weeks	250 μmol/L
28–30 weeks	280 μmol/L
31–34 weeks	310 μmol/L
35–38 weeks	350 μmol/L
39 + weeks	380 μmol/L

sex-linked gene gene on sex chromosome, usually X or female chromosome.

sextuplets six offspring produced at same birth.

sexual abuse abuse perpetrated on children or adults, involving sexual contact or rape; victims may suffer prolonged psychological trauma, e.g. depression, anxiety, self-harm, eating disorders, suicide and difficulty with making and maintaining relationships, particularly with opposite sex.

sexual behaviour, risky sexual activities which increase risk of sexually transmitted disease and human immunodeficiency virus, including numerous sexual partners, unprotected sex, anal sex.

sexual intercourse coitus. S. i. in pregnancy libido in pregnancy may be reduced or increased; some couples may require information and suggestions about changing coital positions or alternative means of sharing intimacy. S. i. to initiate labour thought to be effective in triggering contractions through prostaglandin content of semen, local prostaglandin release from cervix, breast stimulation increasing oxytocin output, release of endogenous oxytocin during maternal orgasm; not supported by research but acceptable unless there are medical indications to avoid intercourse in late pregnancy, e.g. grade 4 placenta praevia. Resumption of s. i. following delivery mothers should attempt coitus within 6 weeks of delivery, before postnatal examination, as difficulties with penetration may highlight inadequate perineal or vaginal wound healing or other pathological problems resulting from delivery.

sexually transmitted infection (STI) infection transmitted through heterosexual or homosexual sexual intercourse or intimate contact with genitals, mouth or rectum; STIs in pregnancy must be identified and treated early to avoid complications, e.g. preterm labour or neonatal death due to vertical transmission from mother to baby. Routine screening in pregnancy is performed to detect syphilis, hepatitis b and human immunodeficiency virus, chlamydia.

shaken baby syndrome presence of unexplained fractures in baby’s long bones plus evidence of subdural haematoma; caused by violent shaking, which produces whiplash effect, and rotational head movement, resulting in vomiting, convulsions, irritability, coma and death.

shared care antenatal care shared between midwife and obstetrician or general practitioner.

sheath tubular case. See condom.

Sheehan’s syndrome hypopituitarism; uncommon complication following severe prolonged shock after placental abruption or postpartum haemorrhage, with anterior pituitary gland necrosis leading to amenorrhoea, genital atrophy and premature senility.

shiatsu Japanese therapy similar to acupressure, involving pressure of practitioner’s fingers, hands, elbows, heels or feet applied to specific points on client’s body; useful for gestational sickness, facilitating uterine action in labour and easing pain, colic in babies.

shingles herpes zoster.

shock collapse resulting from acute peripheral circulatory failure caused by ante- or postpartum haemorrhage, uterine rupture or inversion, acid aspiration syndrome, pulmonary or amniotic fluid embolism, severe hypotension or endotoxic shock due to septicaemia. Signs: hypotension, tachycardia, fluctuating central venous pressure; woman appears cold, clammy, white and searching for air. Urgent resuscitation is required before condition becomes irreversible: airway must be maintained; oxygen is administered if dyspnoea is present; intravenous fluids are administered to combat dehydration; and plasma substitutes are given, amount dependent on central venous pressure reading. Foot of bed can be raised if baby is delivered; mother may be positioned on left side to prevent inferior vena cava pressure. Sedatives may be given, mother kept as quiet as possible; overheating must be avoided. Endotoxic s. occurs in serious infection by Gramnegative organisms, e.g. Escherichia coli, Clostridium welchii; widespread arteriole dilatation, venous return is diminished and shock occurs; signs are similar to hypovolaemic shock but rigors may also occur; infection must be treated urgently with appropriate antibiotics.

short femur shorter than average thigh bone when compared with other fetal measurements, usually visualised by ultrasounds scan.

shoulder dystocia rare complication occurring after delivery of fetal head; shoulders fail to rotate, descend and deliver, usually due to large baby or contracted pelvic outlet. Mother should be turned into left lateral position or asked to squat in attempt to enlarge outlet and deliver baby. mcrobert’s manoeuvre may be performed, in which woman lies on back, assuming exaggerated knee– chest position with thighs abducted, to enlarge pelvic outlet. External or internal rotation of shoulders may be necessary with wood’s manoeuvre

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