Parenteral Nutrition (Total parenteral nutrition, partial parenteral nutrition, Hyperalimentation)
Substances necessary for life and growth such as carbohydrate, proteins, and
fat fed directly into a vein. Usually given to people who are not able to take food by mouth
.
Patent Ductus Arteriosus (PDA)
Failure of the blood vessel (called the ductus
arteriosus) to close after birth. The ductus arteriosus is a normal
structure in the fetus that diverts blood from the fetal lungs by connecting the
pulmonary artery directly to the ascending aorta.
Pediatrician
A physician who has completed specialty training in the development, care and
diseases of children.
Pelvic inflammatory disease (PID, acute
salpingitis)
A general term for inflammation caused by infection of the upper genital tract
not associated with pregnancy or pelvic operations.
Pelvis
The lower part of the abdomen, between the hip bones that contains the
uterus, bladder , and part of the large intestine
Percent transferrin saturation (TSAT)
Transferrin saturation (%) = {serum iron concentration (ug/dL)/TIBC (ug/dL)} x 100
(Serum iron/TIBC) X 100%
Percutaneous umbilical blood sampling (PUBS)
A procedure in which a needle is inserted into
the uterus and into the umbilical cord of the fetus at the base of
the placenta. A sample of fetal blood is then withdrawn.
Perinatal
Around the time of birth. As defined by the World Health Organization (WHO) ICD-10
the perinatal period is begins at " 22 completed weeks (154 days) of gestation (the time when birthweight is normally 500 grams) and ends seven completed days after
birth".
Perinatologist
A physician who has completed specialty training
in obstetrics and gynecology and additional subspecialty training in
high risk pregnancy and disorders of the fetus.
Also called a maternal-fetal medicine specialist.
Perinatal mortality rate (PNMR)
The number of perinatal deaths (fetal deaths at 22 weeks' or more gestation and neonatal
deaths to 7 completed days after birth) per 1,000 total births. It is
usually reported on an annual basis.
Pfannenstiel's incision (Bikini incision)
A horizontal cut made through the skin just above the joint of the pubic bones. The incision is carried down through the
underlying fat and through the fibrous tissue that surrounds the rectus muscles
of the abdomen (the anterior rectus fascia ).
The incision was developed by the German gynecologist Hermann Johannes
Pfannenstiel and provides an excellent cosmetic result. However, the incision
does not provide good access to the upper abdomen.
Placenta (Afterbirth)
A disk-shaped organ that develops during pregnancy. The placenta is attached to the uterus on one side by its large flat
surface and to the fetus by the umbilical cord on its other side. The placenta exchanges nutrients, wastes, and
gases between the blood of the mother and fetus as well as producing
numerous hormones. Normally the placenta is delivered after the birth of the
infant.
Placenta Accreta, Increta, Percreta
Abnormal penetration of the placenta beyond the lining of the uterus to
varying depths.
- Placenta accreta. The placenta adheres directly to the myometrium (muscular wall of the uterus)
- Placenta increta. The placenta grows into the myometrium.
- Placenta percreta. The placenta grows completely through the myometrium.
The abnormally firm attachment of the placenta to the uterus does not allow the placenta to
separate from the uterine wall spontaneously after delivery of the
fetus. Attempts to manually remove the placenta may sometimes cause
massive bleeding. In addition placenta percreta may cause damage to nearby
organs such as the bladder.
About two thirds of the patients with placenta previa/placenta accreta will
require cesarean hysterectomy at delivery. However, in the stable patient
attempts to avoid hysterectomy and preserve fertility by various means
(including leaving the placenta in place) have been successful.
Placement of catheters for embolization of pelvic vessels prior to elective
delivery has also been described.
Prior cesarean delivery or other uterine surgery and placenta previa are the
factors most often associated with placenta accreta, increta, and percreta.
In patients with placenta previa the incidence of placenta accreta appears to
correlate with the number of previous cesarean sections.
Placenta accreta may sometimes be diagnosed before delivery by sonogram.
Findings of accreta on ultrasound include:
- A thin and distorted uterine serosa-bladder interface.
- Multiple placental lakes (placental vascular lacunae) that give the placenta a "Swiss cheese" or "moth eaten" appearance.
- Loss of the normal hypoechic zone "clear space" beneath the placenta.
- Large blood vessels may be seen to invade the bladder wall with percreta.
Placental insufficiency
Failure or inability of the placenta to
normally exchange nutrients, wastes, and gases between the blood of the mother
and fetus.
The typical pathological finding in placental
insufficiency is obliteration of the small muscular arteries in the tertiary stem villi
of the placenta which is often associated with an abnormal uterine artery
waveform on pulsed-wave Doppler ultrasound.
See also: Umbilical Artery (UA) Impedance Indices