1.

Chorion and amnion

Amnion chorion
• Inner layer of fetal membrane • Outermost layer of fetal
• thinner membrane
• smooth and shiny • thicker
• contains no nerves and vessels • friable and shaggy
• contains no nerves and vessels

2. Sinciput in fetal skull & occiput in fetal skull

Sinciput Occiput
• It is the area lying infront of • Lies at back of the head
anterior fontanelle • Corresponds to occipital bone
• Corresponds to area of brow • Part of it contribute to base of
• Sinciput forms the forehead skull
• Occification center of frontal • Occification center is occipital
bone is frontal prominence protuberance

3. Presumptive signs of pregnancy and positive signs of

pregnancy
Presumptive sign Positive sign
• It includes the features mainly • It is the confirmatory sign of
appreciated by the mother pregnancy
• Mass may felt through abdomen • Palpation of fetal parts and
without definitive shape perception of active movements
• Amenorrhoea • USG evidence
• Morning sickness • Auscultation of FHS
• Fatigue • Radiological demonstration of
• Breast changes fetal parts
• Quickening

4. Hegars sign and osianders sign

Hegar’s sign Osiander’s sign
• Upper part of uterus is enlarged • Increased pulsation felt on
and growing fetus, lower part lateral fornices of vagina in
empty and soft and cervix early pregnancy
comparatively firm
 • It is uterine sign • It is a vaginal sign
• Occurs at 6 -10 week • Occurs at 8th week

5. Amniocentesis and culdocentesis

Amniocentesis Culdocentesis
• Aspiration of amniotic fluid • It is the transvaginal aspiration
from a pregnant abdomen of peritoneal fluid from the
• Transvaginally or trans pouch of douglas
abdominally • Transvaginally
• It is used to diagnose obstetrical • It is used to diagnose
complication gynaecological complications

6. Fetal shouffle and uterine shouffle

Uterine souffle Fetal/ Funic souffle
• Is a soft blowing and systolic • Soft blowing murmer on the
murmer heard low down at the umbilical arteries
sides of uterus best on the left
side • Synchronous with fetal heart
• Sound is synchronous with the sound
maternal pulse
• Is due to increase in blood flow • Is due to rush of blood through
through the dilated uterine the umbilical arteries
vessels

7. Presentation and presenting part

Presentation Presenting part
• The part of fetus which occupies • The presenting part is defined as
the lower pole of the uterus the presenting part of
• Breech, shoulder presentation are presentation which overlies the
examples. internal Os and is felt by the
examining finger through the
cervical opening
• Vertex, brow, face, anterior
buttocks, are examples

8. False labour pain - true labour pain

 True labour pain False labour pain
• Pain felt in the front of abdomen • Dull pain and usually in lower
and radiating towards thighs abdomen
• Intermittent powerful contraction • Continuous uterine contraction
• Presence of show without hardening of uterus
• Progressive effacement and • Absence of show
dilatation • Pain revealed by enema and
• Pain not revealed by enema and sedatives
sedatives

9. Eutocia – dystocia
Eutocia Dystocia
• Labour is called normal if it • Any deviation from the
fulfils the following criteria definition of normal labour is
• Spontaneous in inset called dystocia/ abnormal labour
• With vertex presentation • Spontaneous onset maynot occur
• Without undue prolongation • Other presentations also occur
• With minimal aids • Labour duration may be longer
• Without having any • May result in caesarean section
complications affecting the
health of mother and or the baby

10. Partograph- cervicograph

Partogram Cervicogram
• One of the most effective means • It is the diagrammatic
of reading the progress of labour representation of the cervical
• Cervico gram is one part of dilatation charted against the
partogram hours in labour.
• It focus on both maternal and • Cervical dilatation shows in the
fetal status form of sigmoid curve
• Many components are noticed • It focus on maternal status
like fetal heart rate, maternal • Descent of fetal head and
pulse, BP, urine, temperature cervical dilatation noticed
and drugs given

11. Effacenment of cervix - dilatation of cervix

Effacement of cervix Dilatation of cervix
 • It is the process by which muscle • As a result of hormonal changes
fibers are pulled back cervix will be open to deliver
• It expresses usually in fetus
percentage • It usually expressed in
• Effacement precedes dilatation centemeters
in primi • Dilatation after effacement
• Expulsion of muscle plug occurs • Fetal presenting part will be able
to felt

12. First stage of labour - second stage of labour

Ist stage of labour IInd stage of labour
• It starts from onset of true labour • It starts from full dilatation of
pain and ends with full dilatation cervix and ends with expulsion
of cervix of fetus from birth canal
• Average duration is 12 hrs in • Average duration 2 hrs in primi
primi and 6hrs in multigravida and 30 minutes inmulti
• Cervical stage is the other name • Expulsion stage is the other
• Maternal bearing is not needed name
• Maternal bearing down efforts
are high

13. Lateral episiotomy - medio lateral episiotomy

Lateral Episiotomy Mediolateral Episiotomy
• Incision starts from about 1 cm • Incision made downwards and
away from the centre of forchette outwards from the midpoint of
and extends laterally forchette either to the right or
• It cuts bartholins duct left. It is directed diagonally in a
• It does not full fill the objectives straight line which runs about
of episiotomy 2.5cm away from anus
• It cuts bulbo spongioses and
transverse perineal muscles
• It full fills the objectives of
episiotomy

14. Lightening – quickening

Lightening Quickening
• A few weeks prior to the onset of • Perception of active fetal
labour especially in movement by the women
 primigravida, the presenting part • It’s appearance is an useful
sinks into true pelvis guide to calculate the EDD with
• It is due to active pulling up of reasonable accuracy
lower pole of uterus and the • It felt at 18th week in primi and 2
presenting part weeks earlier in multipare
• But frequency of micturition and
constipation occur
• It occur at late 3rd trimester
• It rules out CPD and other
conditions preventing head from
entering the pelvic inlet

15. General fluid pressure - fetal exis pressure

General fluid pressure Fetal axis pressure
• While the embranes are intact, • During each contraction uterus
the pressure of uterine rears forward and force of fundal
contractions is exerted on fluid contraction is transmitted to
as fluid is not compressible upper pole of uterus down the
pressure is equalized through out long axis of fetus & is applicable
• Equal pressure over fetus and by presenting part to cervix
fluid • Pressure through long axis of
• Membrane should be intact fetus
• Membrane may or not be intact

16. Lochia – leucorrhoea

Lochia Leucorrhea
• It is the vaginal discharge for the
first fortnight during puerperium
• Composition: blood, shreds of
fetal membrane, decidua, vernix, • Thick copious, tenacious mucus
lanugo & meconium
• Originates from uterine body, • Due to the effect of progesterone
cervix and vagina
• Is a normal physiological • Is a normal physiological change
changes after delivery in pregnancy

17. Threatened abortion - inevitable abortion

Threatened abortion Inevitable abortion
 • It is a clinical entity where the • It is the clinical type of abortion
process of miscarriage has where the changes have
started but has not progressed to progressed to a state from where
a state from which recovery is continuation of pregnancy is
impossible. impossible.
• Dull pain in lower abdomen • Aggravated colicky pain
• In pelvic examination the abdomen
external Os is closed and • Internal examination reveals
bledding through external Os. dialated internal Os of cervix
through which products of
conception are felt.

18. Vasa praevia - placenta praevia

vasa previa placenta previa
• fetal blood vesssels cross or ran • the placenta situates in lower
near the internal cervix segment partially or completely
• obstetrical emergency • high risk pregnancy
• extremely rare • common condition

19. Monozygotic - dizygotic twin

Monozygotic twin Dizygotic twin
• Single ova fertilized with single • Two ova fused with two sperm
sperm • Two placenta
• One placenta • 2amnion and 2chorion
• 2 amnions • Sex and appearance may differ
• Identical usaually

20. Spontaneous abortion - missed abortion

Spontaneous abortion Missed abortion
• Expulsion • Fetus will be dead and retained
• Bleeding present inside
• Pregnancy changes may • Absent and dark in colour
disappear and continue • Pregnancy changes sustained

21. Placenta previa- abruptio placenta

Placenta previa Abruptio placenta
 • Placenta is implanted partially or • One form of antepartum
completely over the lower haemorrhage where the bleeding
uterine segment occurs due to premature
separation of normally situated
• Bleeding is painless and always placenta
revealed • Bleeding is painful and revealed,
• Blood is bright red in colour concealed or usually mixed
• Uterus will be soft and relaxed • Dark coloured
• FHS – usually present • Tense, tender and rigid
• On USG – placenta in lower • Usually absent
segment • Placenta in upper segment

22. Oligohydramnious – polyhydramnious

Polihydramnious Oligohydramnious
• Liqour amnii more than 2000 ml • Liqour amnii less than 200 ml
• AFI more than 24 cm • AFI less than5cm
• Abdominal size is more than • Abdominal size is small
gestation • Amnioinfusionis the treatment
• Amnioreduction is the treatment • Easy to palpate fetus because full
• Difficult to palpate fetus of fetus

23. Hydatidiform mole - ectopic preganancy

Hydatidiform mole Ectopic pregnancy
• Is the abnormal condition of • Is the fertilized ovum is
pkacenta where there are partly implanted and develops outside
degenerative and partly the normal endometrial cavity.
proliferative changes in the • Fertilized ovum will be present
young chorionic villi. and alive at early weeks
• Ovum or embryo will be dead at • Mass not felt in examination
early weeks itself • Uterus seems normal in size
• Vesicles can be palpated
• Size of uterus is more than
expected.

24. Classical cesarean - lower segment cesarean

LSCS Classical CS
• Incision on the lower abdomen • Incision on the upper segment of
through a transverse approach uterus
 • Technically difficult • Technically easy
• Blood loss is less • Blood loss is more
• Post op haemorrhage and shock • Post op haemorrhage and shock
is less is more
• Scar is better healed • Scar healing is poor
• Future pregnancy scar rupture is • Future pregnancy scar rupture is
less more

25. Cord presentation - cord prolapse

Cord prolapse Cord presentation

• Umbilical cord will be in the protrude • Umbilical cord will be present below
through vagina before presenting part the presenting part during examination
• Membranes are not intact • Membranes are intact & can felt
• Vaginal examination identifies • Colour doppler usually diagnose
• Plaetal infraction are not common • Placental infractions are common

26. Kielland forceps - long curved forceps

Kielland’s forceps Long curved forceps
• Straight obstetric forceps without • Heavy and 37cm long
axis traction • Have axis traction
• No axis traction
• Can be used with advantages in
unrotated or face presentation
• Facilitates grasping and
correction of asynclitic head
because of its sliding lock

27. Obstructed - prolonged labour

Prolonged labour Obstructed labour
• When the combined duration of I • Is one where in spite of good
& II stage is more than arbitatory uterine contractions the
limit of 18 hours progressive descent of presenting
• Contraction may be weak or part is arrested due to
absent mechanical obstruction
• Maternal distress after a long • Good uterine contraction present
duration • Maternal exhaustion is present
28. Prostaglandin – oxytocin
Oxytocin Prostaglandins
• Is a non peptide • Derivative of prostanoic acid
• Gold standard for induction of • Gold standard for cervical
labour ripening
• Stimulate decidual prostaglandin • Sensitize the myometrium to
production oxytocin

29. Preterm infant - low birth weight infant

Preterm Low birth weight
• Baby born before completion of • Baby born with birth weight less
37 weeks than 2.5 kg irrespective of
• according to gestational age very gestational age
preterm, early and late preterm • IUGR & SGA types of babies
• less growth
• Usually no afftect on growth

30. Preterm infant - term infant

Term baby Preterm baby
• Baby born at 37-42 weeks • Born before 37 weeks
• Birth weight usually more than • Birth weight usually less than
2.5 kg 2.5 kg
• Posture will be flexed • Posture will be extended
• Skin will be thick, less lanugo & • Skin will be thin, abundant
pink coloured lanugo & shiny
• Hair will be firm, separate • Hair will be fine, feathery, fuzzy
strands and wooly
• Poorly developed cartilage
• Developed cartilage • Sole will be more turgid and
• Sole will be deeply creased have only fine wrinkles
• Grasp is weak
• Grasp is strong • Scarf sign will have no
• Scarf sign will have high resistence
resistence
31. Asphyxia livida - asphyxia pallida
Asphyxia Pallida Asphyxia Libida
• Newborn appears pale & limbs • Newborn will be cyanotic
shows sign of apnea
• Absence of reflex • Usually slow in rarely absent
• Baby is pale in colour • Baby is blue in colour (Blue
• Increased CO2 and decreased O2 asphyxia)
cause bradycardia and death • Heart is strong

32. Mortality rate - near miss mortality

Maternal Mortality rate Near miss mortality
Death of a women while pregnant or wthin 42 It is an event in which a pregnant woman
days of the termination of pregnancy irrespect comes close to maternal death but does not die
of the duration and site of pregnancy from any –a near miss.
cause related to or aggravated by the pregnancy
or its management, but not from accidental or
incidental causes.
. MMR indicates the number of maternal deaths Criteria of choice for evaluating womens health
per 100000 live births . and the quality of obstetric care

33. Menarche – menopause

Menarche Menopause
• onset of first menstruation • permananent cessation of
• starting of reproductive life menstruation
• 10 -16 years is the age group • end of reproductive life
• 45-55 is the age group

34. Menorrhagia – metrorrhagia

Menorrhagia Metrorrhagia
• Cyclic bleeding at normal intervals • Irregular ,acyclic
• Excessive bleeding • Amount is variable
• Underlying pathology – organic or functional • Bleeding can be any where from genital tract
• Due to fibroid • Contact bleeding /intermenstrul bleeding
uterus/adenomyosis/IUCD/retroverted uterus • Can be due to DUB/submucous fibroid/polyp
35. Amenorrhea – dysmenorrhea
Amenorrhea Dysmenorrhea
• Absence of menstruation • Painful menstruation of sufficient
• It is a symptom magnitudeso as to
incapacitateday to day activities
• It is a physiological process

36. Endometriosis – adenomyosis

Endometriosis Adenomyosis
• The presence of functioning endometrium in • A benign uterine condition in which
sites other than uterine mucosa. endometrial glands and stroma are found deep
• Pain starts few days prior to menstruation in the myometrium
Worsen during menstruation • Basal endometrial hyperplasia invading a
• Infertility (20-40% of infertile women) hyperplastic myometrial stroma.
• Cause: Inflammation of peritoneal • Excess of oestrogen (cystic glandular
implants,irritation of nerves hyperplasia endometrium)
• Menstrual disturbance • Hyperplasia of the myometrium producing
(menorrhagia,polymenorrhea,epimenorrhea) diffuse enlargement, Of the uterus

37. Cystocele – urethrocele

Cystocele Urethrocele

• Descent of upper one third of the • Descent of the lower one third of the
anterior vaginal wall along with bladder anterior vaginal wall along with the
displacement uretheral displacement.
• May appear independendently or along • May appear Independently or along with
with cystourethrocele Cystocele, and called Cystourethrocele
• Bladder herniates through it. • Urethra herniates through it

38. VVF – RVF

Vesico vaginal fistula Urethro vaginal fistula
• Communication between bladder • Communication between the part
and vagina whole of the urethra and vagina
• Patient has no urge to pass urine • Patient has urge to pass urine
• Urine escape into the vagina • Urine dripples out into the
causes to act incontinenece vagina a during the act of
micturation
39. Veneral – Non veneral
Veneral infections Non veneral infections
A disease that is contracted and transmitted by Non-venereal diseases are divided into
sexual contact, caused by microorganisms that contagious and non-contagious skin diseases,
survive on the skin or mucus membranes, or that that have sometimes different and unexplained
are transmitted via semen, vaginal secretions, or aetiology.
blood during intercourse.
Some diseases caused by viruses, fungi,
The genital areas provide a moist, warm bacteria, Candida albicans and parasites are the
environment that is especially conducive to the contagious skin diseases. The non-contagious
proliferation of bacteria, viruses, can be diseases include: contact dermatitis, erythema
transmitted this way, including AIDS, fixum, lichen sclerosus et atrophicus, Reiter's
chlamydia, genital warts, gonorrhea, syphilis, disease and some pre-neoplasmatic lesions.
yeast infections, and some forms of hepatitis.

40. Vasectomy – Tubectomy

Vasectomy Tubectomy
• Permanent sterilization operation done • Permanent sterilization operation done
in the male in the female
• A segment of vas deferens of both the • Occlusion of both fallopian tubes of
sides are resected and the cut ends are both sides
ligated

41. Apgar score – Bishop score

Apgar score Bishop score
• At 1 min and 5 min after the • Also known as cervix score, is a
neonates baby is completely pre labour scoring system to
born, 5 objective criteria should assist in predicting whether
be evaluated to determine the induction of labour will be
need for life saving support required
• It assess heart rate, respiratory • It assess the cervix and head of
effort, muscle tone, reflexibility position of fetus
and colour • Developed by Predward Bishop
• Developed by Virginia Apgar • Scoring for each component is
• Scoring for each component is 0,1,2,3
0,1,2 • Interpretation of total score is 13
• Interpretation of totalscore is 10 (6-13) favourable cervix
indicate newborn is normal 0-5 indicates unfavourable
 7-10 indicates no difficulty in
adjusting to life
4-6 indicates moderately difficult
less than 3 indicate severe
distress

42. GCT – CTG

GCT CTG
• Glucose challenge test • Cardiotocography
• Diagnostic test for • To assess fetal well being
GDM • Non invasive
• Invasive

43. Forewater – Hindwater

Forewater Hindwater
• The part of amniotic below the • The part of the amniotic cavity
girdle of contact containing small above the girdle of contact
amount of liquor called forewaters called hindwaters
• Containing small amount of liquor • Containsthe fetus with bulk of
the liqour

44. ARM – PROM

ARM PROM
• Artificial rupture of membrane • Premature rupture of membrabe
• Used as a method of induction of • Spontaneously occurring beyond
labour 28th weeks of gestation but before
the onset of labour

45. Uterine tetany – Uterine inertia

Uterine Inertia Uterine Tetany
• Hypotonic uterine activity • Hypertonic uterine activity
• Intervals between contractions as • Few contractions merge to form
long duration is short and a contraction lasting for 3
intensity is weak minutes or more
• Oxytocin can be infused if no • Oxytocin is stopped
complications are ruled out

46. Forceps – Vaccum

Forceps Vaccum
• A pair of instruments specially • Instrumental device designed to
designed to assist extraction of assist delivery by creating a
fetal head & there by vaccum between it and fetal
accomplishing delivery of fetus. head
• more expertise required • less expertise is needed
• more traction force required • less traction force needed
• more maternal trauma • less maternal trauma
• no autorotation • promote autotraction
• requires full dilatation of cervix • decent requires full cervical
dilatation