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Pregnancy Care Guidelines

Glossary

Aboriginal and Torres Strait Islander peoples
It is recognised that there is no single Aboriginal or Torres Strait Islander culture or group, but numerous groupings, languages, kinships, and tribes, as well as ways of living. Furthermore, Aboriginal and Torres Strait Islander peoples may currently live in urban, rural or remote settings, in urbanised, traditional or other lifestyles, and frequently move between these ways of living.
Acupressure
Acupressure is a noninvasive variation of acupuncture that involves application of constant pressure to specific points or areas.
Acustimulation
Mild electrical stimulation to specific points or areas.
Amniocentesis
A diagnostic test for chromosomal anomalies, such as trisomy 21 (Down syndrome), where an ultrasound guided needle is used to extract a sample of the amniotic fluid.
Antiretroviral treatment
The use of medicines to reduce growth of retroviruses, primarily HIV.
Auscultation
The detection of the fetal heart using Doppler or a Pinard stethoscope.
Cardiotocography
A technical means of recording the fetal heart rate and uterine contractions.
Chorionic villus sampling
(CVS) Diagnostic test for chromosomal anomalies such as trisomy 21 (Down syndrome) where an ultrasound guided needle is used to extract a sample of the placenta.
Chorionic villus sampling (CVS)
diagnostic test for chromosomal anomalies such as trisomy 21 (Down syndrome) where an ultrasound guided needle is used to extract a sample of the placenta.
Cleft lip and/or palate
Variations of a congenital anomaly caused by non-fusion of embryonic facial lobes.
Cognitive-behavioural therapy
Psychological therapy based on the assumption that faulty thinking patterns, maladaptive behaviours and “negative” emotions are all inter-related. Treatment focuses on changing an individual’s thoughts (cognitive patterns) or maladaptive behaviours in order to change emotional states. Cognitive-behavioural therapy integrates the cognitive restructuring approach of cognitive therapy with the behavioural modification techniques of behavioural therapy.
Ectopic pregnancy
A pregnancy in which implantation of the fertilised egg takes place outside the uterus, usually in a fallopian tube. Ectopic pregnancies usually result in miscarriage but can cause rupture of the fallopian tube and severe internal bleeding.
Edinburgh Postnatal Depression Scale (EPDS)
The EPDS was developed and validated as a screening tool for depression in the postnatal period. It has subsequently been validated for use in pregnant women and is therefore appropriate for use throughout the perinatal period.
Educational and motivational interviewing strategies
Education strategies given to all members of the intervention group. Counselling delivered by a number of means: through primary carer, medical professional, professional counsellor, targeted printed material etc.
External cephalic version
A procedure in which a health professional uses his or her hands on a woman’s abdomen to turn a breech baby.
First antenatal visit
The first visit specifically for antenatal care following confirmation of the pregnancy.
First contact
The visit in which a woman attends to confirm pregnancy, seek antenatal care or make arrangements for the birth.
Herbal medicines
Preparations such as tablets, tinctures and infusions that are made from plant parts. These preparations are usually formulated based on traditional uses of Western or Chinese herbs.
Induction of labour
A procedure to artificially start the process of labour by way of medical, surgical or medical and surgical means.
Interventions based on stages of change (smoking cessation)
Similar to cognitive behavioural and education strategies, except that these interventions were grouped separately as they involve assessment of “readiness” to change and exposure to the intervention may be more selective.
Low birth weight
Birth weight of less than 2,500 g.
Macrosomia
Birth weight higher than 4,000 g.
Maternal serum screening
A blood test performed during pregnancy to detect markers of chromosomal anomaly, such as trisomy 21 (Down syndrome).
Migrant and refugee women
The term ‘migrant and refugee’ is used in these Guidelines to refer both to women who are voluntary migrants and women who come to Australia as refugees, humanitarian entrants or asylum seekers.
Miscarriage
the spontaneous end of a pregnancy at a stage where the embryo or fetus is incapable of surviving independently, generally defined in humans as before 20 weeks.
Neonatal abstinence syndrome
A withdrawal syndrome occurring among newborns exposed to opiates (and some other substances) in utero.
Nuchal translucency thickness assessment
An ultrasound scan performed between 11 and 13 weeks of pregnancy that measures the thickness of the nuchal fold behind the baby’s neck – a marker of chromosomal anomaly, such as trisomy 21 (Down syndrome).
Oligohydramnios
A deficiency of amniotic fluid.
P6 (or Neiguan) point
(or Neiguan point). An acupuncture point located on the anterior aspect of the forearm near the wrist.
Passive smoking
The inhalation of smoke, called second-hand smoke or environmental tobacco smoke, from tobacco products used by others.
Perinatal period
For the purposes of these guidelines, ‘perinatal’ is defined as the period covering pregnancy and the first year following pregnancy or birth. It is acknowledged that other definitions of this term are used for data collection and analysis. The definition used here broadens the scope of the term perinatal in line with understanding of mental health in pregnancy and following birth.
Pernicious anaemia
An autoimmune condition that results in an inability to absorb vitamin B12.
Pharmacotherapies (smoking cessation)
Studies cited in Lumley et al 2009 used nicotine replacement therapy, as patches, gum or lozenge. Other studies considered bupropion or other pharmacological agents.
Placenta praevia
An obstetric complication in which the placenta is attached to the uterine wall close to or covering the cervix.
Placental abruption
A potentially life-threatening obstetric complication in which the placental lining separates from the uterus of the mother.
Polyhydramnios
Accumulation of excess amniotic fluid during pregnancy.
Preterm birth
Birth at less that 37 weeks gestation.
Proteinuria
The presence of an excess of serum proteins in the urine.
Psychological preparation
In the context of these Guidelines, this is defined as using psychological approaches (eg focusing on coping skills, cognitive restructuring, problem-solving and decision-making) to assist women and their partners to be prepared for parenthood.
Psychosocial support (smoking cessation)
Includes discussion groups, provision of support materials (unless CBT-based), provision of telephone support etc.
Psychosocial
In the context of these Guidelines, this refers to social factors that have the potential to affect a woman’s emotional well-being.
Pyelonephritis
An ascending urinary tract infection that has reached the pyelum (pelvis) of the kidney.
Rewards and incentives (smoking cessation)
Intervention group provided rewards or incentives (payment; one study provided a lottery for participants), usually based on smoking status evaluated by biochemical markers.
Singleton breech
A single baby whose buttocks (rather than head) is overlying the maternal pelvis.
Stillbirth
The birth of a baby that has died in the uterus after 20 weeks of pregnancy or reaching a weight of more than 400 g if gestational age is unknown.
Sudden and unexpected death in infancy
The sudden death of an infant that is unexpected by history and remains unexplained after a thorough forensic autopsy and a detailed death scene investigation.
Trisomy 13
A genetic disorder in which a person has three copies of genetic material from chromosome 13, instead of the usual two copies. Also referred to as Patau syndrome or trisomy D.
Trisomy 18
A genetic disorder caused by the presence of all or part of an extra 18th chromosome. Also referred to as Edwards syndrome or trisomy E.
Trisomy 21
Chromosomal anomaly due to an additional chromosome 21. Also referred to as Down syndrome.
Woman-focused communication skills
These involve techniques and attitudes that indicate respect for the woman, a willingness to listen to her perspectives, values and current life circumstances around antenatal concerns, and not direct the woman into any particular course of action. Woman-centred communication skills can include giving appropriate information, but always includes communication that views the woman as a capable and responsible person, and creates a respectful, supportive and effective alliance between the woman and the health professional.

Methodological terms

ADAPTE framework
A systematic approach to aid in the adaptation of guidelines produced in one setting to be used in a different cultural and/or organisational context.
AGREE
A framework for assessing the quality of clinical practice guidelines, including that the potential biases of guideline development have been addressed adequately and that the recommendations are both internally and externally valid, and are feasible for practice. This process involves taking into account the benefits, harms and costs of the recommendations, as well as the practical issues attached to them. Therefore, the assessment includes judgements about the methods used for developing the guidelines, the content of the final recommendations, and the factors linked to their uptake.
Citation bias
The citation or non-citation of research. Citing of trials in publications is not objective so retrieving studies using this method alone may result in biased results. Unsupported studies tend to be cited often which may also bias results.
Confidence interval
An interval describing the range of values within which there is reasonable certainty that the true effect lies. Uncertainty increases with the width of the interval.
Consensus-based recommendation
Recommendations based on systematic review of the literature where evidence is found to be limited or lacking.
Language bias
The publication of research findings in a particular language. Significant results are more likely to be published in English so a search limited to English-language journals may result in an overestimation of effect.
Mean difference
The absolute difference between the mean value in two groups in a clinical trial, which estimates the amount by which the intervention changes the outcome on average compared with the control.
Multiple publication bias
The multiple or singular publication of research findings. Studies with significant results tend to be published multiple times which increases the chance of duplication of the same data and may bias the results of a review.
Odds ratio
The ratio of the likelihood of an event occurring in one group to that of it occurring in another group. An odds ratio of 1 indicates that the condition or event under study is equally likely to occur in both groups. An odds ratio greater than 1 indicates that the condition or event is more likely to occur in the first group and an odds ratio less than 1 indicates that the condition or event is less likely to occur in the first group.
Outcome reporting bias
The selective reporting of some outcomes but not others. Outcomes with favourable findings may be reported more. For example, adverse events have been found to be reported more often in unpublished studies. This may result in more favourable results for published studies.
Practice point
For the purposes of these Guidelines, these cover areas of antenatal care that were beyond the scope of the literature reviews but where the EAC determined there was a need for advice. These points are based on best practice clinical judgement.
Publication bias
The publication or non-publication of research findings. Small, negative trials tend not to be published and this may lead to an overestimate of results of a review if only published studies are included.
Randomised controlled trial
A study in which participants are allocated at random to receive one of several clinical interventions. One of these interventions is the standard of comparison or control. The control may be a standard practice, a placebo or no intervention at all.
Recommendation
Evidence-based action statement developed through systematic review of the literature.
Relative risk
The ratio of the risk (rate) of an outcome in an exposed group (eg to a specific medicine) to the risk (rate) of the outcome in an unexposed group in a specified time period.
Sensitivity
The proportion of people with the condition who have a positive test result.
Specificity
The proportion of people without the condition who have a negative test result.
Systematic literature review
A systematic review of evidence focused on a research question(s) that aims to identify, appraise, select and synthesise all high quality research evidence relevant to that question.
Time-lag bias
The rapid or delayed publication of research findings. Studies with positive results tend to be published sooner than studies with negative findings and hence results may be overestimated until the negative studies ‘catch up’.
Last updated: 
20 November 2018