Definitions & Terms


miscarriage-05

Medical terminology can often be confusing, overwhelming and come across quite harshly. Here’s a simple explanation of what it all means. 

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TERMMEANINGADDITIONAL INFORMATION
AbdomenThe belly, that part of the body that contains all of the structures between the chest and the pelvis. The abdomen includes a host of organs including the stomach, small intestine, colon, rectum, liver, spleen, pancreas, kidneys, appendix, gallbladder, and bladder.
AbnormalOutside the expected norm, or uncharacteristic of a particular patient.
AcuteOf abrupt onset, in reference to a disease. Acute often also connotes an illness that is of short duration, rapidly progressive, and in need of urgent care."Acute" is a measure of the time scale of a disease and is in contrast to "subacute" and "chronic." "Subacute" indicates longer duration or less rapid change. "Chronic" indicates indefinite duration or virtually no change.
AMH (Anti-Mullerian Hormone)AMH is a hormone secreted by very early ovarian follicles. The concentration of this hormone in a woman’s blood has been shown to be a good predictor of a woman’s ovarian reserve - i.e. how many eggs she has left.Women with low ovarian reserve have decreased fertility and an increased risk of miscarriage, as it is believed that the eggs the woman does have may be of diminished quality.
AmniocentesisThis procedure is used in prenatal diagnosis of chromosomal abnormalities. In it, a needle is inserted into the amniotic sac and a sample of fluid which contains fetal cells is taken for testing. The need for an amniocentesis is normally determined after the 12 week pregnancy ultrasound, if blood tests and/or nuchal fold measurements indicate a high risk of chromosomal abnormalities in the fetus. Women of advanced maternal age may also elect to have an amnio for peace of mind - though it should be noted there is a 1 in 250 risk of miscarriage from the procedure.
ANA (Antinuclear Antibodies)The ANA test is used to diagnose an autoimmune disease or disorder.??
AnemiaThe condition of having a lower-than-normal number of red blood cells or quantity of hemoglobin. Anemia diminishes the capacity of the blood to carry oxygen. Patients with anemia may feel tired, fatigue easily, appear pale, develop palpitations, and become short of breath.Anemia can occur during or after miscarriage if there has been an extreme amount of blood loss.
AneuploidyWhen there is an abnormal number of chromosomes in a cell it is called Aneuploidy.An example of this is in Down Syndrome where there is an extra 21st chromosome. Aneuploidy of other cells can also occur, e.g. trisomy 13 and 18, but these are mostly associated with miscarriage.
AnovulationAnovulation is when you do not release an egg at ovulation, but you still have normal periods. Clomid or ovulation induction cycles with a fertility specialist can usually solve this issue. Though it is wise to have your thyroid, LH and FSH tested as these can be contributing factors in anovulation.
Antiphospholipid Syndrome:Antiphospholipid antibodies are present in the blood and these either attack the developing embryo or increase the risk of blood clotting. It is one of the most common causes of miscarriage/recurrent miscarriage, accounting for 15-20% of losses.There are 3 main types of Antiphospholipid Antibodies - Lupus Anticoagulant, Anticardiolipin Antibodies, beta2microglobulin - and all of these can be detected via a blood test. Treatment involves the use of a blood thinning medication such as Clexane.
Assisted Reproductive Technology (ART)ART encompasses the range of methods to assist with infertility or conception. These include IUI, IVF and GIFT.IUI - intrauterine insemination; IVF - invitro fertilisation; GIFT - gamete intra-fallopian transfer
Asherman’s Syndrome:Where the uterine cavity develops scar tissue or adhesions which can sometimes be a cause of miscarriage.Asherman’s Syndrome is most common in women who’ve had several D&Cs and subsequent scarring. In some cases a Cesarean or surgery to remove fibroids or polyps can contribute to Ashermans.
Assisted HatchingA technique sometimes used during IVF, whereby an embryologist manually forms a small hole in the outer layer of an embryo to assist the hatching/developing process. This is mostly used in cases where the mother is of an advanced maternal age, as it’s believed the outer layer of the fertilised egg can sometimes be too hard for the embryo to hatch out of. It can also be used in cases of repeated IVF failure.
Autoimmune Disorders
Balanced Chromosomal TranslocationWhen one partner has the correct number of chromosomes, but one or more of them are arranged incorrectly, it’s called a balanced translocation. This will almost always cause a miscarriage. Generally it’s not until after repeated miscarriages have occurred and thorough testing is done that a balanced translocation can be identified. Once it is, PGD is the recommended course of action to take, as each embryo can be individually tested for the translocation, and only a ‘normal’ embryo transferred - if there is one.
Basal Body Temperature (BBT)This is your lowest body temperature in a 24 hour period. Your BBT is normally taken when you first wake up, before you get out of bed.Women who are trying to conceive will sometimes use BBT as a way of tracking ovulation. Your BBT will rise as ovulation approaches and then peak, before dropping down before a period. If you are pregnant, your temperature will remain high.
Birth controlBirth control is the use of any practices, methods or devices to prevent pregnancy from occurring.
BlastocystIs an embryo on approximately day 5 or 6 of it’s development.When doing IVF, many clinics grow embryos to the blastocyst stage before transferring into a woman’s uterus as they are believed to have the best chance of survival.
Blighted OvumAlso known as anembryonic gestation a blighted ovum occurs when a fertilised egg implants in the uterus but does not develop into an embryo. The pregnancy will generally progress normally until an early ultrasounds detects the absence of an embryo.A blighted ovum is caused only by an abnormality in the fertilisation process between the sperm and the egg. It is completely random and not indicative of other issues.
Blood ClotsBlood that has been converted from a liquid to a solid state. Also called a thrombus.Conditions such as Antiphospholipid Syndrome and X X X can cause blood clotting and therefore miscarriage. Taking blood thinning medications such as Clexane can help.
Blood pressureThe blood pressure is the pressure of the blood within the arteries. It is produced primarily by the contraction of the heart muscle. Elevation of blood pressure is called "hypertension".In later pregnancy, a high blood pressure combined with protein in the urine can be a sign of pre-eclampsia.
Cervical MucousChanges in cervical mucous during your menstrual cycle generally indicate your fertile and non-fertile periods. In the days prior to ovulation, cervical mucous becomes lighter in colour and more stretchy, similar to egg-whites. This is your most fertile window to conceive. Sometimes a lack of cervical mucous can be a sign of a lack of oestrogen in the body and can hinder conception. Evening Primrose Oil is an effective and natural remedy to this. Also make sure you are drinking enough water.
CervixThe cervix connects the uterus to the vagina. It is also known as the ‘neck’ of the uterus.
CGHA highly sophisticated genetic test of eggs and embryos, unlike other genetic tests, CGH tests all 23 pairs of chromosomes, including X & Y for abnormalities or aneuploidy. CGH is extremely useful in the case of recurrent miscarriage, and also if a couple are found to have a genetic issue that needs ‘weeding out’ or a chromosomal translocation of some sort. Successful pregnancy rates are significantly increased.
Chemical PregnancyA chemical pregnancy is one where a woman gets a positive result on a pregnancy test but miscarries before anything can be seen on an ultrasound.A chemical pregnancy differs from an early miscarriage in that the HCG levels generally don’t rise very much, and a period/bleeding will occur usually within a week. Doctors estimate that as many as 70% of pregnancies are chemical, and most of the time, the woman’s period will just be a few days late, so they won’t realise they were pregnant at all.
ChromosomeChromosomes are genetic cells made up of DNA. There are 23 pairs of chromosomes in the human body.Chromosomal abnormalities are the most common reasons for miscarriage.
ClexaneClexane is a blood thinning medication that can be used in women with clotting disorders during pregnancy to protect the growing foetus in the early months. It is administered as a subcutaneous injection.Clexane is also a first line treatment for Natural Killer Cells.
Clomid (Clomiphene)Clomid is a drug that stimulates your ovaries to release an egg. It is the most commonly used fertility drug worldwide.It is important to have close monitoring while taking Clomid as too high a dose, can result in the release of more than one egg, increasing the chance of a multiples pregnancy.
Complete MiscarriageA miscarriage is ‘complete’ when all of the pregnancy tissue has been passed.
ConceptionConception takes place when a sperm fertilises an egg.It can then take a further 6-10 days for the fertilised egg to reach the uterus and implant itself into the uterine wall. It is at this time, HCG starts to be produced.
Corpus LuteumWhat is left of the follicle after a woman ovulates. It produces the hormone progesterone which helps to thicken the lining of the uterus, waiting for a fertilised egg to implant. If pregnancy occurs the corpus luteum keeps producing the progesterone needed to support the pregnancy. If pregnancy does not occur the corpus luteum will break down and fall away, causing a period to occur.
CVSCVS is a procedure that tests for specific abnormalities in an unborn baby. A small sample of the baby’s developing placenta is taken and tested.CVS, like amniocentesis, is generally offered if you are flagged as being at high risk for chromosomal abnormalities such as Down Syndrome after your 12 week scan.
Dilation and curettage (D&C)An operation performed on a woman where the cervix is dilated and the contents and lining of the uterus are removed/scraped away.A D&C can be performed after miscarriage instead of waiting to pass the pregnancy tissue naturally. It is a quick procedure but not without risk, which your healthcare professional can advise you on.
Ectopic pregnancyA pregnancy that is not in the uterus. The fertilized egg settles and grows in a location other than the uterus. The majority (95%) of ectopic pregnancies occur in the fallopian tube. However, they can occur in other locations, such as the ovary, cervix, and abdominal cavity.Approximately 1 in 200 pregnancies are ectopic. Sometimes it will shrink on its own but if it doesn’t, the options are surgery or medication. If your fallopian tube is at risk of rupturing, surgery will be the best course of action.
Endometrial ScratchA procedure used to help embryos implant more successful into the uterus after an IVF cycle.This is generally only done in the case of multiple unsuccessful IVF cycles, despite having transferred good quality embryos.
EndometriosisA condition resulting from endometrial tissue appearing outside the uterus, often found around the pelvic and abdominal organs.Endometriosis can be extremely painful and cause infertility. It can only be definitively diagnosed via laparoscopy. Studies have shown that women with endometriosis have an increased risk of both ectopic pregnancy and miscarriage.
Factor V LiedenA mutation of the Factor V protein that is linked with an increase in blood clots - and therefore an increased risk of miscarriage.Treatment is through blood thinning medication such as Clexane or Heparin.
FerningIt is a natural method of ovulation prediction whereby dried cervical mucous or saliva has a fern like pattern if viewed on a microscope slide. It’s said that women’s saliva changes in the 3-4 days leading up to ovulation.There are several saliva ovulation predictor kits on the market.
Fetal PoleA fetal pole is the term used for the developing embryo seen in an early pregnancy ultrasound.The very first sign that a baby is developing.
FibroidsFibroids are non-cancerous tumours that form in the wall of the uterus. They are quite common in women of reproductive age.Fibroids can be associated with reduced fertility and increased risk of miscarriage, although the evidence is controversial.
Folic Acid / FolateFolic Acid / Folate is part of the B group of vitamins and is used as a supplement before and during pregnancy to prevent neural tube defects.Most women don’t get enough folate in their diets, which is why supplements are necessary if you are planning to become pregnant.
Follicle Stimulating Hormone (FSH)A hormone produced by the pituitary gland to stimulate egg production in the ovaries.A high FSH level can indicate that a woman’s ovarian reserve is dwindling. In the case of IVF, FSH injections are given to a woman to increase her production of eggs in a given IVF cycle.
Gestational sacThe gestational sac is the large cavity of fluid surrounding an embryo and can usually be seen on transvaginal ultrasound at 4-5 weeks gestation.A smaller than normal gestational sac can sometimes be an indicator of potential non-viability of a pregnancy. It can also indicate a discrepancy in gestational dates - i.e. you may have ovulated later than you think.
Harmony TestA non-invasive prenatal test (NIPT) that assesses blood from the mother, looking at the baby’s DNA in her blood. It provides limited screening for chromosomes 21, 13, 18 and/or XY chromosomes.The Harmony test can be taken at approximately 10 weeks gestation. It is not diagnostic and therefore is not 100% accurate.
HCG (Human Chorionic Gonadotropin):HCG is the hormone that supports both the development of an egg inside a woman’s ovary and also the hormone produced by the placenta after implantation.The level of HCG in the blood can in some cases indicate the likely viability of the pregnancy. Click here to see what normal HCG ranges are in pregnancy.
HeparinSee ‘Clexane’.
HPTHome Pregnancy Test. These are generally either in-stream urine stick tests or dip tests used to detect HCG. It does not measure the level of HCG, merely it’s presence.Also called Pee Stick. It is recommended to wait until a missed period before taking a HPT, though many women will test much earlier.
HysteroscopyA hysteroscopy is a procedure that enables a doctor to be able to look inside the uterus. A thin, telescope-like device is inserted via the cervix into the uterus and it can help diagnose a uterine problem.A hysteroscopy is often combined with a curettage, whereby a sample of the lining of the uterine is also taken for testing.
ICSI (Intracytoplasmic Sperm Injection)ICSI is a specialised form of IVF whereby the embryologist selects a single sperm to be injected directly into an egg to assist with fertilisation.ICSI is most commonly used where there is male factor infertility such as low sperm count or poor sperm morphology (shape). If a previous IVF cycle has shown poor fertilisation rates of the eggs, a specialist will normally recommend ICSI for the next cycle.
Implantation bleedingIs when some slight brown or pink spotting appears very briefly around the time your period is due, as the embryo attaches to the wall of the uterus.Implantation bleeding can be an early sign of pregnancy, though many women have never experienced it.
ImplantationWhen the fertilised egg/embryo attaches to the wall of the uterus.
Incompetent CervixWhen the cervix begins to open early, without contractions, in the second trimester of pregnancy, it is termed as ‘incompetent’ and can cause later miscarriage or pregnancy loss. If diagnosed in time, a cervical cerclage (stitch) can be placed in your cervix to help keep it closed and prolong the pregnancy as long as possible.
Incomplete MiscarriageA miscarriage is ‘incomplete’ when some of the pregnancy tissue has been passed, but there is still some remaining inside the uterus. If it is left undetected for too long, it can cause infection.A D&C is usually required to remove any remaining tissue from the uterus.
InfertilityThe inability to achieve a pregnancy within 12 months (< age 35) or within 6 months (> age 35).
IUI (Intra Uterine Insemination):A doctor will place washed, prepared sperm into your uterus at the time of ovulation. It can be done in line with your natural menstrual cycle or cycle using fertility drugs to induce ovulation (OI).IUI can bypass any potential fallopian tube issues that are preventing the sperm from getting to the egg. It is often a first line of treatment when you initially visit a fertility specialist, as it is seen as less invasive than IVF.
IVF (In Vitro Fertilisation)IVF is a procedure where the egg and sperm are fertilised outside the body and transferred into the uterus after either 3 or 5 days.For more information about IVF, visit www.ivf.com.au or www.genea.com.au
KaryomappingA form of PGD (pre-implantation genetic diagnosis) that can test embryos for a specific single gene disorder such as Cystic fibrosis, Fragile-X, BRCA1/BRCA2, muscular dystrophy. Karyomapping is suitable for people who have a known inherited genetic condition. For those who have a disorder where the specific gene is not known, traditional PGD would be more suitable.
LaparoscopyA medical procedure where a laparoscope is inserted via the belly button into the abdomen or pelvic cavity to diagnose or treat an issue.Some infertility investigations are done through laparoscopy - for example diagnosis of endometriosis. Treatment of ectopic pregnancy can also be done laparoscopically.
Late MiscarriageOccurs between the 12th and 20th week of pregnancy.
LH SurgeLH means Luteinising Hormone, and its the hormone that triggers ovulation. 24-36 hours after the LH surge is generally when ovulation will occur.
LMP (Last Menstrual Period):This is the date that is used to calculate your pregnancy Estimated Due Date, until an ultrasound is done.Using LMP as a definitive means of EDD can be inaccurate if a woman’s cycle isn’t regular or if they ovulate later in their cycle than Day 14.
Luteal Phase DefectA luteal phase defect is when the period of time between ovulation and menstruation is less than 10 days. When this happens, there is not enough progesterone being produced, and therefore it will be harder to sustain a pregnancy.Progesterone treatment can help a luteal phase defect and increase your chance of sustaining a pregnancy.
MiscarriageThe loss of a pregnancy before 20 weeks gestation. Most of these (75%) occur within the first 12 weeks of pregnancy.
Missed MiscarriageA pregnancy has stopped progressing without any symptoms. It’s not until a scan, often at 12 weeks, that the missed miscarriage is discovered.It can be that there was a baby who stopped growing at an earlier stage, or in other cases there might be a blighted ovum, where a baby failed to develop.
Molar PregnancyA molar pregnancy is the unusual and rapid growth of part or all of the placental cells into an abnormal clump. All the usual signs of pregnancy, including HCG, are present, but there is no baby.A complete molar pregnancy stops a fetus from developing. In a partial molar pregnancy, the foetus starts to develop but it is abnormal and cannot survive. Generally molar pregnancies need to be surgically removed. Rarely, the abnormal tissue persists and can turn into a cancer.
MorphologyMorphology is the shape of the sperm.A high number of abnormally shaped sperm can prevent an egg from being fertilised. In this case, IVF with ICSI is normally recommended.
MotilityMotility of sperm is their ability to be able to swim or move forward.Sperm with poor motility can have trouble reaching and therefore fertilising an egg. In this case, IVF with ICSI is normally recommended.
MTHFR
Natural Killer Cells
Nuchal TranslucencyA collection of fluid under the skin at the back of a baby’s neck. It is traditionally measured between 11-13 weeks gestation and is part of the first trimester screening.The presence of a thickened nuchal fold can, but not always, indicate an increased risk of Trisomy 21 (Down Syndrome). In combination with blood tests results, the decision can be made to undertake an amniocentesis for diagnosis confirmation.
OestrogenOestrogen is the primary female hormone.
Ovulation Induction (OI)With the use of hormones, the ovaries are encouraged to release eggs to maximise your chance of conception through intercourse or artificial insemination (IUI). Ovulation induction is suitable for those who have irregular ovulation or none at all.
OvulationThe process whereby hormonal changes trigger the release of an egg from the ovary of a woman. This happens each month, roughly 12-14 days before your next period.
PCOS (Polycystic Ovarian Syndrome)An endocrine/hormonal condition that can cause problems with ovulation and fertility. PCOS affects 12-18% of women, though not all of these will have trouble conceiving.PCOS appears to be related to insulin resistance, and high insulin levels act of the on the ovaries and adrenal glands to cause them to produce more male hormones, therefore upsetting hormonal balance. A drug called metformin can increase pregnancy rates and also help prevent miscarriage in these women.
PGD (PreImplantation Genetic Diagnosis)PGD is a scientific technique which is used to test embryos for either a specific known genetic condition or chromosomal abnormality. It is used in conjunction with IVF.
PlacentaThe placenta is the organ that supports a baby during pregnancy. The umbilical cord connects the placenta to the baby.
ProgesteroneA steroid hormone that maintains the endometrial lining of the uterus and prevents premature labour.
Rainbow BabyA baby born following a miscarriage, stillbirth, neonatal death or infant loss. It is representative of beauty and hope.
Recurrent Implantation Failure (RIF)The repeated failure of an embryo to implant into the uterus.This is generally diagnosed during IVF treatment, where three or more good quality embryos have been transferred and no pregnancy has occurred. Causes can be related to egg, sperm, embryos, the uterus or a combination of all of these.
Semen AnalysisThe laboratory testing of freshly ejaculated sperm.It tests the number, hope and movement of the sperm and is vital in diagnosing male infertility.
Spontaneous Abortion/ MiscarriageThe loss of a pregnancy before 20 weeks gestation. Most of these (75%) occur within the first 12 weeks of pregnancy.
SpottingThe presence of vaginal blood at a time outside menstruation.During pregnancy, spotting is often cause for concern, and can be a sign of impending miscarriage. While many women have spotting during their first trimester and go on to have healthy babies, others unfortunately can miscarry. If you have spotting or light bleeding and are concerned, always contact your health care professional.
StillbirthOccurs any time from 20th week of pregnancy to full term.Reasons??
Subchorionic HematomaBleeding within the chorion, the membrane just inside the placenta. Some women will experience bleeding, ranging from light to heavy gushes. A subchorionic hematoma will not normally cause a miscarriage, though this is dependent on the exact location of the bleed in/near the sac.
Threatened MiscarriageA threatened miscarriage is vaginal bleeding with or without abdominal pain and cramping.A threatened miscarriage is one of the most common early pregnancy complications. While some pregnancies continue without further issue, others will sadly end in a complete miscarriage.
ThrombophiliaA inherited or acquired predisposition to blood clots.
TrisomiesA trisomy is a chromosomal disorder whereby there is an extra chromosome, i.e. a person will have 47 instead of 46.One of the most commonly known trisomies is Down Syndrome, where there is an extra 21st chromosome. Trisomy 18 and Trisomy 13 are also very common, however mostly seen as causes of miscarriage.
Unexplained InfertilityWhen a couple has been trying to conceive for 12 months without success and without an obvious reason.Up to 1 in 10 infertile couples are ‘unexplained’. The diagnosis is officially given only after extensive testing in both partners has been done. Generally IVF is undertaken by couples with unexplained infertility as it can sometimes bypass and/or identify an otherwise previously undiagnosed issue, e.g. fertilisation
ViabilityIn terms of an embryo in IVF, viability refers to the likelihood of it successfully developing into a baby. In terms of early pregnancy, viability refers to the likelihood of the fetus/pregnancy successfully continuing.An early ultrasound in pregnancy will usually give clues as to the potential viability of the foetus and therefore the likelihood of a pregnancy continuing. The size of the gestational sac and the foetus itself are two key indicators.
Yolk SacA membrane lined sac that provides nourishment in the early stages of a baby’s development in utero. It is generally the first anatomical structure identified in the gestational sac via early ultrasound.