OG17.1-3,OG18.1-4,OG19.{1-2,4} | Postnatal Care — Glossary

The neonatal cardiac compression-to-ventilation ratio: three compressions followed by one ventilation, yielding approximately 90 compressions and 30 ventilations per minute; distinct from the adult 30:2 ratio.

Intermittent cramp-like uterine contractions in the first 2–3 days postpartum, more pronounced in multiparae and breastfeeding women, caused by oxytocin-driven myometrial contractions.

Restricted tongue movement due to a short, tight lingual frenulum; causes inability to achieve peristaltic tongue action needed for effective milk extraction, presenting as persistent poor latch despite correct positioning.

India's national injectable contraceptive programme providing free DMPA (150 mg IM) through the public health system, launched 2017 under the National Health Mission.

A 5-parameter (0–2 each; max 10) assessment of newborn status at 1 and 5 minutes: Appearance (colour), Pulse (heart rate), Grimace (reflex), Activity (tone), Respiration. Scores 7–10 = normal; 4–6 = moderate depression; 0–3 = severe depression.

The correct breastfeeding attachment in which more of the lower areola than upper areola is in the infant's mouth, with the chin touching the breast first, enabling deep engagement of the nipple-areola complex.

WHO/UNICEF programme (1991, revised 2018) in which hospitals implement the 10 Steps to Successful Breastfeeding to promote breastfeeding initiation and duration globally.

Failure to establish adequate spontaneous respiration at birth resulting in hypoxia, hypercapnia, and metabolic acidosis; confirmed by cord blood arterial pH <7.0 and/or base excess more negative than -12 mmol/L.

A 5-parameter (max 13) assessment of cervical favourability for labour induction: dilatation, effacement, station, consistency, and position. A score ≥6–8 is considered favourable. Entirely distinct from APGAR — do not confuse.

A localised collection of pus within the breast, developing from untreated or inadequately treated infective mastitis; presents as a fluctuant, tender swelling; requires drainage (needle aspiration or I&D).

Bilateral breast overfilling occurring 2–5 days postpartum during lactogenesis II; managed with frequent effective feeds, warm compress before feeds, and cold compress after — not antibiotics.

Breast support technique in which the thumb is placed above the areola and four fingers below, well behind the areola, to present the breast for latch without compressing the ducts.

A long-acting dopamine agonist used for pharmacological lactation suppression after stillbirth or when breastfeeding is contraindicated; preferred over bromocriptine due to its superior safety profile.

Candidal infection of the nipple-areola causing burning pain throughout and after feeds; both mother and infant require simultaneous treatment with nystatin or miconazole.

Oedema of the scalp presenting part at delivery; crosses suture lines; resolves within 1–2 days; distinguished from cephalhaematoma by its diffuse nature and suture-crossing.

A first-generation cephalosporin with excellent Staphylococcus aureus cover; an acceptable alternative to cloxacillin for mastitis; 500 mg QID for 10–14 days; safe during breastfeeding.

Subperiosteal haemorrhage confined by suture lines (does NOT cross sutures); takes weeks to resolve; may calcify; does not require treatment but may contribute to neonatal jaundice as blood is reabsorbed.

A penicillinase-resistant (anti-staphylococcal) penicillin; the antibiotic of choice for lactational mastitis due to reliable coverage of community-acquired Staphylococcus aureus; given 500 mg QID for 10–14 days.

Oral contraceptive containing both oestrogen and progestogen; WHO MEC category 4 (absolute contraindication) in breastfeeding women <6 weeks postpartum due to oestrogen suppression of prolactin and breast milk volume.

The thick, yellow milk secreted in the first 2–3 days postpartum; characterised by high sIgA, protein, and beta-carotene with low fat and lactose; immunologically vital for the neonate.

Breastfeeding position in which the infant lies horizontally with the head in the crook of the same-side arm; suitable for established breastfeeding after the first few days.

Breastfeeding position using the opposite arm to the feeding breast; provides maximum head control and is recommended for newborns and primiparae learning to latch.

Abnormal development or dislocation of the hip joint; screened by Barlow and Ortolani manoeuvres in the newborn; risk factors include female sex, first-born, breech presentation, family history; early treatment (Pavlik harness) prevents long-term disability.

Protective redistribution of cardiac output during acute hypoxia in the fetus/neonate: blood flow reduced to skin, gut, kidneys, and muscle; maintained to brain, heart, and adrenals. Temporarily compensates for hypoxia but is finite.

Injectable progestogen contraceptive (150 mg IM every 3 months); safe in breastfeeding; WHO MEC category 1 from 6 weeks postpartum; delayed return of fertility 6-12 months after stopping.

A peripheral dopamine D2 antagonist used as a galactagogue; raises prolactin by blocking pituitary dopamine inhibition; preferred over metoclopramide due to minimal CNS penetration.

A validated 10-item self-report questionnaire for screening postpartum depression; a score of ≥13 is the standard threshold for further assessment.

Infection of the endometrium (uterine lining), the most common form of puerperal sepsis; characterised by fever, uterine tenderness, and offensive lochia.

0.01–0.03 mg/kg IV/IO (as 1:10,000 solution); used when HR remains <60 bpm despite 60 seconds of adequate CPR; preferred route is umbilical venous catheter.

Spontaneous displacement of the IUD from the uterine cavity; rates are higher with post-placental insertion (~10-15%) than interval insertion (~5%); diagnosed clinically (absent strings) or by ultrasound.

Breastfeeding position with the infant's body tucked under the mother's arm beside her; indicated after caesarean section, for large breasts, twins, and preterm infants.

Foremilk (watery, thirst-quenching, produced at the start of a feed) vs hindmilk (fat-rich, calorie-dense, produced as the alveolus empties); effective attachment and complete drainage are necessary for the infant to receive both.

An agent (pharmacological or herbal) that promotes or increases milk production, typically by raising prolactin levels; evidence-based examples include domperidone and metoclopramide.

The maintenance of established milk production, dependent on continued prolactin surges in response to infant suckling on a supply-demand basis.

Structured counselling framework: Greet, Ask, Tell, Help, Explain, Return — guides family planning consultations in a non-directive, patient-centred manner.

The first 60 seconds after birth in which all initial resuscitation steps must be completed and a breathing/heart-rate assessment made; PPV begins immediately if the baby is apnoeic or HR <100 bpm.

Manual technique for expressing breast milk using a C-hold 2–3 cm behind the nipple; preferred over pump in the early postpartum period; expressed milk stored safely in a clean cup for cup-feeding.

WHO/AAP simplified neonatal resuscitation programme for resource-limited settings, emphasising bag-mask ventilation and the Golden Minute without requiring intubation skills.

Placental hormone (also called human chorionic somatomammotropin) that along with progesterone drives alveolar development during pregnancy and primes the breast for lactation.

Brain injury from perinatal asphyxia; classified by Sarnat staging (I = mild, II = moderate, III = severe); moderate-to-severe HIE in term infants is treated with therapeutic hypothermia within 6 hours of birth.

Surgical procedure to evacuate a breast abscess: incision at the areolar margin or point of maximum fluctuance, finger-break of loculations, saline irrigation, and loose packing; sent pus for culture.

A rare but serious differential of mastitis presenting with breast erythema, oedema, and skin changes (peau d'orange); distinguished by absence of fever, absence of lactation correlation, non-response to antibiotics, and progressive course; biopsy required.

The period between delivery and the next conception; WHO recommends >=24 months to reduce risks of preterm birth, low birth weight, and maternal complications.

A natural contraceptive method exploiting prolactin-mediated suppression of GnRH pulsatility; effective only with exclusive breastfeeding, no menstruation, and infant <6 months.

The process of milk secretion initiation; Stage I = secretory differentiation (mid-pregnancy); Stage II = onset of copious milk production 30–72 h postpartum after progesterone withdrawal.

The transition from colostrum production to copious milk secretion, typically 30–72 h postpartum, triggered by the fall in progesterone following placental delivery and removal of its inhibitory block on prolactin action.

A temporary natural contraceptive method effective only when ALL THREE criteria are simultaneously met: exclusively breastfeeding, amenorrhoeic, and baby <6 months old; effectiveness ~98-99.5%.

A five-item (0–2 each; max 10) structured breastfeeding assessment tool: Latch, Audible swallowing, Type of nipple, Comfort, and Hold/positioning. Scores ≥8 indicate effective breastfeeding.

The milk-ejection reflex mediated by oxytocin; triggered by infant suckling; can be conditioned by non-suckling stimuli and inhibited by stress and pain.

The white or yellowish vaginal discharge from day 10 postpartum onwards, composed mainly of leucocytes, cervical mucus, and epithelial cells.

The blood-coloured vaginal discharge of days 1–4 postpartum, composed of blood, decidual debris, and fetal membrane remnants.

The pinkish-brown, serosanguineous vaginal discharge of days 5–9 postpartum as the blood component diminishes.

The process of mammary gland structural development under hormonal stimulation, occurring during puberty and pregnancy to prepare the gland for lactation.

Inflammation of the breast parenchyma in a lactating woman, typically caused by Staphylococcus aureus; characterised by unilateral erythema, warmth, tenderness, and fever with flu-like symptoms.

Aspiration of meconium into the lower airways causing chemical pneumonitis, airway obstruction, and potentially persistent pulmonary hypertension of the newborn; risk is higher in non-vigorous babies with MSAF.

Accumulation of milk in the alveoli and ducts due to incomplete or infrequent drainage; the primary predisposing factor for both non-infective and infective mastitis.

Surgical sterilisation via a small (2-3 cm) subumbilical incision used in the puerperal period when the uterus is still enlarged; fallopian tubes ligated/divided by the Pomeroy or Parkland technique.

Troubleshooting mnemonic when PPV produces no chest rise: Mask seal → Reposition head → Suction → Open mouth → Pressure increase → Alternative airway.

Staphylococcus aureus resistant to all penicillinase-resistant penicillins (cloxacillin, methicillin); should be suspected in hospital-acquired mastitis or mastitis not responding to 72 h of cloxacillin; treated with vancomycin IV or trimethoprim-sulfamethoxazole orally.

Contractile cells surrounding alveoli in the mammary gland; contract under oxytocin stimulation to propel milk into lactiferous ducts during the let-down reflex.

Ischaemic injury to the intestinal mucosa, seen in preterm and asphyxiated neonates; presents with abdominal distension, bloody stools, and pneumatosis intestinalis; represents gut ischaemia from the asphyxial diving reflex.

An alternative to I&D for small (<5 cm), unilocular breast abscesses; guided by ultrasound to confirm accurate drainage; may require repeat aspirations if the collection re-accumulates.

Gestational age estimation tool using 6 neuromuscular criteria (posture, square window, arm recoil, popliteal angle, scarf sign, heel-to-ear) and 6 physical criteria; range -10 to +50; each 2-point increment = 1 week of gestation; performed 12–96 h after birth.

A thin silicone nipple cover placed over the maternal nipple before latching; may help with flat nipples or pain relief but reduces milk transfer; should not be used long-term without specialist input.

The evidence-based neonatal resuscitation guideline published by the American Academy of Paediatrics and endorsed internationally, currently in its 8th edition (2021).

Posterior pituitary hormone released in response to nipple stimulation; causes myoepithelial cell contraction and milk ejection; also stimulates uterine involution.

An incision placed parallel to and at the margin of the areola for breast abscess drainage; preferred for cosmesis over a radial incision, provided the abscess is accessible.

Failure of postnatal PVR to fall, maintaining fetal circulation shunts and causing refractory hypoxaemia; a complication of MAS, asphyxia, and prematurity.

An oral contraceptive containing only a progestogen; does not suppress lactation; WHO MEC category 2 (<6 weeks breastfeeding) and category 1 (>=6 weeks breastfeeding); requires strict timing adherence.

PPIUCD insertion within 10 minutes of placental delivery; technically easiest window due to open os and large uterine cavity; expulsion rate ~10-15%.

A common (50–80%), self-limiting mood disturbance peaking days 3–5 postpartum with emotional lability and tearfulness; resolves by day 10 without treatment.

A clinical depressive episode (DSM-5 criteria, ≥2 weeks) with onset within 4 weeks postpartum, affecting 10–15% of women; screened using the Edinburgh Postnatal Depression Scale (EPDS ≥13).

Family planning services provided within 12 months of delivery; encompasses counselling and provision of LARC and other methods; a national priority under India's Reproductive and Child Health programme.

A copper or hormonal IUD inserted within 48 hours of delivery (immediate/early postpartum) or at 6 weeks (delayed); a flagship intervention of India's postpartum family planning programme.

Active lung inflation delivered via bag-mask device at 40–60 breaths per minute; the pivotal intervention in neonatal resuscitation when spontaneous breathing is absent or inadequate.

Oxygen saturation measured from the right hand (pre-ductal site — receives blood before the ductus arteriosus junction), reflecting cerebral and coronary oxygenation; the standard monitoring site during neonatal resuscitation.

The initial cessation of breathing after acute perinatal hypoxia, during which the infant still responds to tactile stimulation; heart rate is reduced but not critically low. Stimulation alone may be sufficient to restart breathing.

Anterior pituitary hormone secreted by lactotrophs under inhibitory dopamine tone; the primary hormone driving alveolar milk synthesis; surges with each suckling episode.

A rare (1–2/1000) but severe psychiatric emergency presenting within 2 weeks postpartum with hallucinations, delusions (often about the baby), and disorganised behaviour; risk of infanticide and maternal suicide.

Temperature ≥38°C occurring on any two of the first ten days postpartum (excluding the first 24 hours); a clinical alert requiring systematic differential diagnosis.

Infection of the genital tract occurring between onset of labour and 42 days postpartum with signs of systemic inflammation; a leading direct cause of maternal mortality.

Female sterilisation performed within 7 days of delivery via minilaparotomy (subumbilical incision); after 6 weeks, laparoscopic approach preferred; permanent method requiring adequate pre-procedure counselling and written consent.

The six-week (42-day) period following delivery of the placenta during which maternal reproductive organs and physiology return to their non-pregnant state.

The resistance to blood flow through the pulmonary vasculature; very high in the fetus (lungs collapsed), falls dramatically after the first breath to allow normal neonatal circulation.

Resumption of ovulation after contraception or postpartum; earliest in non-breastfeeding women (day 25); delayed by breastfeeding and DMPA; not permanently impaired by any reversible contraceptive method.

A technique for engorgement in which gentle digital pressure around the areola for 1–2 minutes displaces oedema fluid, allowing the nipple to protrude so the infant can latch.

The terminal phase of perinatal asphyxia following failed primary apnoea and gasping, characterised by complete apnoea, severe bradycardia, and non-responsiveness to stimulation; requires immediate positive pressure ventilation.

Excessive uterine bleeding occurring from 24 hours to 12 weeks after delivery; most commonly caused by retained products of conception or endometritis.

The dominant immunoglobulin in human milk, especially colostrum; coats the neonatal gastrointestinal mucosa providing passive protection against enteric pathogens.

Breastfeeding position with mother and infant lying face-to-face; useful for night feeds, after perineal trauma, and after caesarean section.

Failure of the uterus to involute at the expected rate, manifesting as a larger-than-expected, often tender uterus; principal causes are retained products of conception and endometritis.

Standard neonatal treatment for moderate-to-severe HIE; whole-body cooling to 33–34°C for 72 hours, initiated within 6 hours of birth in term/near-term infants; reduces risk of death and neurodevelopmental disability.

Breakdown of the epithelial barrier between alveolar cells under elevated intra-alveolar pressure, allowing milk proteins to leak into periductal tissue and initiating the inflammatory cascade of non-infective mastitis.

Preferred method for neonatal chest compressions: thumbs on the lower third of the sternum with fingers encircling the chest, allowing greater force and consistent depth compared to the two-finger method.

Emergency IV access in the neonate via the umbilical vein; the preferred route for epinephrine and volume resuscitation during neonatal CPR.

The process by which the uterus reduces from ~1,000 g immediately post-delivery to its non-pregnant weight of 60–80 g over six weeks, descending approximately one fingerbreadth per day.

The WHO framework assigning contraceptive methods a category 1-4 for each clinical condition: 1=no restriction, 2=advantages outweigh risks, 3=risks outweigh advantages, 4=absolute contraindication.