OG20.1-3,OG21.1-2,OG22.1-2 | Medical Termination and Contraception — Glossary

Four clinical criteria for BV diagnosis; ≥3 of 4 required: (1) homogeneous grey-white discharge, (2) vaginal pH >4.5, (3) positive whiff test, (4) clue cells >20% on wet mount.

Passive immunisation given to Rh-negative women within 72 hours of MTP (or any potentially sensitising event) to prevent Rh isoimmunisation.

The authority designated by the Central or State Government to grant or cancel registration of genetic counselling centres/labs/clinics under the PCPNDT Act and to enforce the Act's provisions.

The affirmative agreement of a patient who lacks full legal capacity (e.g., a minor) to participate in a procedure; ethically required alongside the guardian's legal consent, and its absence is a clinical red flag.

Inflammation of the vaginal mucosa caused by oestrogen deficiency (postmenopause, postpartum breastfeeding); characterised by loss of glycogen, decline of Lactobacillus, elevated vaginal pH, and increased susceptibility to infection.

An ecological dysbiosis of the vaginal microbiome in which Lactobacillus species are replaced by a polymicrobial overgrowth of Gardnerella vaginalis and anaerobes; the most common cause of vaginal discharge in reproductive-age women.

Paired mucous glands at the posterior vaginal introitus; contribute lubricating mucus to the physiological vaginal secretions; when blocked, form Bartholin cysts or abscesses.

The four foundational principles: autonomy (respect for patient's right to decide), beneficence (doing good), non-maleficence (avoiding harm), and justice (fair treatment) — all four apply in MTP consent.

A synthetic prostaglandin F2α analogue used as a uterotonic for haemorrhage; contraindicated in bronchial asthma due to risk of severe bronchospasm.

The apex body under the PCPNDT Act at the national level responsible for reviewing and monitoring implementation, advising the Central Government, and reviewing the working of State-level Supervisory Boards.

Thick, viscous cervical mucus formed under progesterone dominance in the luteal phase and during pregnancy; physically occludes the cervical canal and is hostile to sperm penetration.

Preparation of the cervix before surgical evacuation using osmotic dilators (Dilapan-S, Laminaria) or misoprostol to reduce the force required to dilate the cervix and minimise the risk of laceration or perforation.

The number of girls per 1,000 boys in the 0–6 age group, used as a population-level proxy for sex-selective abortion and excess female child mortality; India's CSR was 914 in the 2011 Census.

Vaginal squamous epithelial cells whose surface and edges are densely studded with Gardnerella coccobacilli, giving them an indistinct, granular, stippled appearance on wet mount; the most specific Amsel criterion for BV.

A contraceptive pill containing both a synthetic oestrogen (ethinylestradiol) and a progestogen; primary mechanism is anovulation; WHO MEC 4 in migraine with aura, breastfeeding <6 weeks postpartum, and smokers ≥35 yr with heavy smoking.

Vulvovaginal candidiasis with any of: ≥4 episodes per year (recurrent), severe symptoms, non-albicans species, immunocompromised host, or pregnancy; requires extended treatment regimens and culture with sensitivity testing.

The length from the top of the head to the bottom of the torso of the embryo/fetus, measured on ultrasound; the most accurate method of gestational-age dating between 6 and 14 weeks (±5 days).

A copper-bearing IUCD with a surface area of 380 mm² of copper, effective for up to 10 years; the most widely used copper device in India's family planning programme.

A copper-wound intrauterine device effective for 10 years; mechanism: foreign-body reaction plus copper spermicidal effect; non-hormonal; also used as emergency contraception if inserted within 5 days of unprotected intercourse.

The cognitive ability to understand information relevant to a decision, appreciate the consequences, reason about the options, and communicate a choice; assumed present in adults without evidence of severe psychiatric illness or intellectual disability.

A long-acting injectable progestogen contraceptive (150 mg IM every 3 months); highly effective; return of fertility delayed 12–18 months after the last injection.

A second-trimester surgical MTP method requiring cervical priming and instrumental evacuation of the uterus under general or regional anaesthesia; performed at 13–20 weeks by trained operators.

Implantation of a fertilised ovum outside the uterine cavity (usually the fallopian tube); the relative risk is higher in IUCD failures because the device prevents intrauterine but not ectopic implantation.

A method used to prevent pregnancy after unprotected intercourse or contraceptive failure; options include levonorgestrel 1.5 mg within 72 h, ulipristal acetate 30 mg within 120 h, or copper IUCD within 5 days.

Columnar glandular epithelium lining the cervical canal; the primary source of cervical mucus, whose volume and physical properties are regulated by oestrogen and progesterone.

An ergot alkaloid uterotonic that causes sustained uterine contraction; contraindicated in hypertension and pre-eclampsia because it causes vasoconstriction and can precipitate hypertensive crisis.

Spontaneous displacement of the IUCD from the uterine fundus into the lower segment, cervix, or vagina; most common in the first year post-insertion and after postpartum insertion.

The selective termination of a female fetus following sex determination, a practice that the PCPNDT Act 1994 was specifically designed to prevent.

Arborisation pattern seen on microscopy of dried cervical mucus at mid-cycle; caused by sodium chloride crystallisation in the low-protein oestrogen-dominant mucus; absent in the luteal phase.

An oral triazole antifungal; first-line for uncomplicated VVC as a 150 mg single dose; inhibits fungal cytochrome P450-dependent ergosterol synthesis; avoided in first-trimester pregnancy.

The capacity of a fetus to sustain independent extra-uterine survival, generally accepted at 22–24 weeks with intensive neonatal care; the biological boundary underlying gestational-age thresholds in abortion law.

The compulsory declaration/consent form under the PCPNDT Act that must be filled by the pregnant woman and the clinician before any prenatal diagnostic procedure; must be retained for 2 years.

The index gram-variable coccobacillus most reliably associated with BV; forms a biofilm on the vaginal epithelium and triggers anaerobic overgrowth; its presence alone is insufficient for BV diagnosis (also found in healthy women).

Polysaccharide deposited in vaginal squamous epithelial cells under oestrogen stimulation; the primary substrate for Lactobacillus fermentation and hence the driver of the protective lactobacillus-pH axis.

Consent given by a legally appointed guardian on behalf of a person who cannot consent for themselves (a minor below 18 years or a person of unsound mind); required for MTP under the MTP Act.

Partial expulsion of the products of conception with retention of tissue in the uterus; the most common complication of medical MTP, managed by surgical re-evacuation or additional misoprostol.

A voluntary, deliberate decision made by a person with decision-making capacity, based on adequate information, to accept or refuse a proposed procedure — requires disclosure, comprehension, voluntariness, capacity, and authorisation.

IUCD insertion performed outside the postpartum or post-abortion period, preferably within the first 12 days of the menstrual cycle when pregnancy is unlikely and the cervix is slightly more patent.

A small T-shaped or other-shaped device inserted into the uterine cavity to provide long-term reversible contraception; may be copper-bearing or hormone-releasing.

Contraceptive protection provided by exclusive breastfeeding-induced suppression of ovulation; approximately 98% effective only when the infant is <6 months, the woman is amenorrhoeic, and breastfeeding is fully exclusive.

The dominant gram-positive rod-shaped bacteria of the healthy vaginal microbiome; ferment glycogen to lactic acid and hydrogen peroxide, maintaining the protective acidic vaginal pH.

The protective feedback loop in the vagina: oestrogen stimulates glycogen in epithelial cells → Lactobacillus ferments glycogen → lactic acid + H₂O₂ produced → vaginal pH 3.8–4.5 → pathogens inhibited.

The clinical term for white or whitish vaginal discharge; when physiological, refers to normal secretions from endocervical glands, vaginal transudation, and desquamated cells.

An intrauterine device releasing 20 mcg/day levonorgestrel locally; effective for 5 years; causes endometrial atrophy and amenorrhoea in most women; also used to treat heavy menstrual bleeding.

A first-trimester surgical MTP method using a hand-held syringe-based vacuum aspirator (Karman cannula) under local anaesthesia; WHO-preferred outpatient surgical method up to 12–14 weeks.

The intentional termination of a pregnancy by pharmacological or surgical means before viability, performed within the legal framework of the MTP Act 1971 (amended 2021).

A nitroimidazole antibiotic and antiprotozoal agent; first-line treatment for both BV (400–500 mg BD × 7 days) and trichomoniasis (2 g single dose); acts via toxic radicals formed by nitroreductase in anaerobes and protozoa.

A synthetic antiprogesterone agent (competitive progesterone-receptor antagonist) used as the first drug in the mifepristone-misoprostol medical MTP regimen; primes the uterus by blocking progesterone receptors.

A synthetic prostaglandin E1 analogue administered sublingually, vaginally, or buccally to cause uterine contractions and cervical ripening; the second drug in the medical MTP regimen and used alone in second-trimester protocols.

A sliding ring on the IUCD inserter tube set to the measured sounding depth, which provides tactile and visual confirmation that the device has reached the fundus during insertion.

The standard vasectomy technique in India's National Family Planning Programme, using a small puncture rather than a scalpel incision; lower complication rates (haematoma, infection) than conventional vasectomy.

An aseptic principle requiring that the portion of the inserter entering the uterine cavity does not contact the vaginal walls, speculum, or any non-sterile surface, preventing ascending infection.

A counselling approach in which the clinician provides balanced information about all options without promoting or discouraging any particular choice, respecting the patient's autonomy to reach her own decision.

A gram-stain-based scoring system for BV (0–10): score 0–3 = normal flora, 4–6 = intermediate, 7–10 = BV; the reference standard in research settings, based on morphotype densities of Lactobacillus, Gardnerella, and Mobiluncus.

The Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act 1994 (amended 2003) — Indian legislation prohibiting sex selection before conception and sex determination after conception, and regulating prenatal diagnostic techniques.

A measure of contraceptive failure rate: the number of unintended pregnancies per 100 woman-years of method use; expressed separately for perfect use (theoretical) and typical use (population-average with human error).

Ascending infection of the upper genital tract (endometrium, fallopian tubes, ovaries); post-IUCD insertion PID within 20 days implicates the procedure; managed with antibiotics, device removal only if refractory.

Increased white or yellowish non-offensive vaginal discharge during pregnancy due to elevated oestrogen stimulating endocervical glands and vaginal transudation; requires no treatment.

Repeated reinfection of a treated patient via an untreated sexual partner; particularly relevant to trichomoniasis, where the male partner is commonly asymptomatic but remains a reservoir; prevented by simultaneous partner treatment.

The recommended CuT 380A insertion method in which the outer tube is withdrawn 1–2 cm while the plunger rod is held stationary, releasing the T-arms at the fundal level without advancing the device further.

The Protection of Children from Sexual Offences Act 2012 — defines sexual offences against persons below 18 years and mandates reporting of reasonable suspicion of such offences by anyone who receives information about them, including healthcare providers.

A method of female sterilisation in which a loop of fallopian tube is ligated with an absorbable suture and the knuckle of tube is excised; widely used for postpartum tubectomy and minilaparotomy sterilisation.

Vulvovaginal candidiasis following a course of broad-spectrum antibiotics; occurs because antibiotics deplete Lactobacillus species, removing competitive suppression of Candida albicans.

An IUCD inserted within 48 hours of delivery (immediate) or at 4–6 weeks postpartum (interval); part of India's NRHM family planning programme.

Any technique used before conception to select or alter the sex of the resulting offspring, including sperm sorting and sex-specific embryo selection — prohibited under the PC & PNDT Act (2003 amendment).

Any technique listed in the PCPNDT Act used to assess the fetus, including ultrasonography, amniocentesis, chorionic villus sampling, foetoscopy, and maternal serum marker analysis.

An oral contraceptive containing only a progestogen; suitable for breastfeeding women and women with oestrogen contraindications; the desogestrel POP (75 mcg) reliably inhibits ovulation and has a 12-hour missed-pill window.

Elongated, branching filamentous forms produced by Candida albicans when it switches from commensal yeast to invasive tissue-penetrating form; identified on KOH wet mount preparation as branching filaments with budding cells.

A doctor registered under the Indian Medical Council Act (now NMC Act) with a recognised post-graduate qualification in obstetrics and gynaecology, or specified experience in MTP, as defined in MTP Rules 2003 (amended 2021).

The confidentiality provision of the MTP Act 1971 (amended 2021) that prohibits any registered medical practitioner from disclosing the identity or particulars of a woman seeking MTP, except on the order of a competent court.

Post-abortion infection characterised by fever >38°C persisting >24 h, uterine tenderness, and purulent discharge; requires IV antibiotics and uterine evacuation.

The number of female births per 1,000 male births; biologically normal is approximately 950–985 in the absence of sex selection. India's SRB fell well below this norm in many states due to female-selective abortion.

Any practice intended to change the probability of the sex of an offspring, including selective use of prenatal diagnosis to terminate pregnancies of the non-preferred sex.

The property of peri-ovulatory cervical mucus to be stretched into a continuous thread of 8–10 cm or more without breaking; reflects high hydration and low viscosity under peak oestrogen.

A government-constituted board including a gynaecologist, paediatrician, and radiologist/sonologist; the sole authority under MTP Rules 2021 to approve termination beyond 24 weeks for substantial foetal abnormality.

Punctate haemorrhagic spots (petechiae) on the ectocervix caused by the inflammatory reaction to T. vaginalis; present in approximately 10–20% of trichomoniasis cases and specific but not sensitive for the diagnosis.

A WHO-endorsed clinical approach to managing STI/RTI presentations on the basis of symptom and sign pattern alone, without laboratory confirmation; used in resource-limited settings; treats the most probable causative organisms for each syndrome.

A communication technique in which the clinician asks the patient to explain the key information back in their own words to confirm active comprehension rather than assuming passive understanding.

A small hook or loop instrument (e.g., Emmett's retriever) used to find and retrieve IUCD threads that have coiled into the cervical canal and are not visible at the external os.

Sexually transmitted infection caused by Trichomonas vaginalis (flagellated protozoan); presents with frothy yellow-green discharge, fishy odour, pH >4.5, and motile trichomonads on fresh wet mount; requires simultaneous partner treatment.

A selective progesterone receptor modulator used as emergency contraception (30 mg single dose); effective within 120 hours of unprotected intercourse; superior to levonorgestrel in the 72–120-hour window and in heavier women.

Penetration of the uterine wall by an inserter or the device itself at the time of insertion, a rare but serious complication requiring surgical removal if the device migrates into the peritoneum.

Measurement of the uterine cavity depth from the external os to the fundus using a graduated metal or plastic probe; essential before IUCD insertion to calibrate the flange and assess cavity size.

Irrigation of the vaginal canal with water or antiseptic solutions; harmful practice that disrupts the protective lactobacillus microbiome, raises vaginal pH, and predisposes to bacterial vaginosis.

A measure of acidity of vaginal secretions; normal is 3.8–4.5 (acidic, maintained by lactic acid from Lactobacillus fermentation); rises above 4.5 in bacterial vaginosis, trichomoniasis, and atrophic vaginitis.

Passive movement of plasma-derived fluid across the vaginal capillary mucosa in response to oestrogen stimulation; one of the four sources of physiological vaginal discharge.

The component of informed consent that requires the decision to be free from coercion, manipulation, or undue influence by any third party including family members or healthcare providers.

Infection of the vaginal mucosa and vulva by Candida species (predominantly C. albicans); characterised by thick white curdy discharge, intense pruritus, erythema, and vaginal pH ≤4.5.

Addition of 10% KOH to a vaginal discharge sample; a positive result (immediate fishy/amine odour) indicates the presence of volatile amines produced by anaerobic bacteria in BV or by T. vaginalis in trichomoniasis.

The World Health Organisation's evidence-based framework categorising the safety of contraceptive methods for women with specific medical conditions or characteristics, using a 4-category scale from no restriction (1) to unacceptable health risk (4).

A WHO framework grading contraceptive eligibility in clinical conditions on a 4-point scale (1 = no restriction, 4 = absolute contraindication); the standard reference for safe contraceptive prescribing.