Ad libitum ‘without restraint’ ie. milk available at all times with quantity and frequency being free choice (The Medical Dictionary 2013).
Amino acid analysis An analysis of the amino acid components of a protein (Preterm birth priority setting partnership steering group 2013).
Analgesia a deadening or absence of the sense of pain without loss of consciousness (The Free Dictionary 2013).
Antenatal means before birth – so the care and of the pregnant woman and unborn child before birth (Merriam-Webster Dictionary 2013).
Antenatal corticosteroids Steroids are given antenatally to mothers where the birth seems likely to occur early. The drug crosses the placenta and causes the baby’s lungs to mature for breathing (Bliss 2009)
Attachment is an emotional bond to another person. The central theme of attachment theory is that mothers who are available and responsive to their infant’s needs establish a sense of security in their children (Cherry 2013).
Banked preterm milk - human milk donated by mothers of preterm babies. The milk is collected by mothers of preterm babies who are making more milk than their babies require and these mothers donate to a human preterm milk bank. The milk in the milk bank is screened and given to preterm babies whose mothers are not able to express sufficient milk for their babies. Breast milk from mothers of premature babies has been shown to be different from breast milk from mothers of full term babies (preterm milk has more nutrients in it). (Wikipedia: http://en.wikipedia.org/wiki/Human_milk_banking_in_North_America)
Benefits and Risks/Harms Treatments can have benefits but also harms or risks. Evidence-based medicine seeks to assess the strength of the evidence of risks/harms and benefits of treatments and diagnostic tests. This helps clinicians predict whether a treatment will do more good than harm (Atkins 2004).
Benzylpenicillin This is an antibiotic, in the group of drugs knows as penicillins. It is also known as penicillin G.
Bonding The formation of a close relationship between mother and child especially through frequent or constant association (Merriam-Webster Dictionary 2013).
Caesarean section is a surgical procedure with incision in the walls of the woman’s abdomen and uterus for delivery of a baby or babies (Merriam-Webster Dictionary 2013).
Cardiotocogratography - a way of recording the babies heartbeat and the mother’s contractions whilst the baby is in the uterus or womb.
Cervical cerclage is a procedure in which stitches are used to hold the cervix closed— during pregnancy to help prevent premature birth (Mayo Clinic, 2013). The cervix being the lower part of the uterus that opens to the vagina.
Cervical length is the length of the cervix from the body of the uterus to the tip of the cervix. It is sometimes linked to preterm labour. If you have a short cervix, you might be at increased risk of preterm labour and premature birth (Harms, 2012).
Cervical weakness sometimes called ‘incompetent cervix’ means your cervix is softer and weaker and the weight of the growing baby puts increased pressure on it (Baby Center Medical Advisory Board)
Chlamydia is a sexually transmitted disease. Chlamydia is the most common in people younger than 25. Many women who have Chlamydia have no signs or symptoms (March of Dimes 2013).
Clinical outcome is a change in health that is attributable to a healthcare intervention. The measurement of clinical outcomes is important because it enables us to know how effective our services are at delivering treatment and care (Great Ormond Street Hospital for Children NHS Foundation Trust).
Clofibrate a drug that reduces lipids in the blood serum, used to treat some cardiovascular diseases (Vocabulary Dictionary 2013).
CPAP (Continuous Positive Airway Pressure) A form of treatment used to help a baby’s breathing and to reduce the number of apnoeic attacks. (when someone takes a very long pause between their outward and inward breath). Using a CPAP machine, the lungs are expanded by applying a small amount of pressure through small prongs just inside the nose or by a small mask over the nose. In some cases a premature baby may be on and off CPAP for several weeks (Bliss 2009).
Cycled Light vs continuous light Pregnant women are exposed to variable intensities of light and sound, which induces circadian rhythms for the baby, but after birth preterm babies are often exposed to environments where it is light all the time (on a neonatal unit). Cycled light refers to an environment on a neonatal unit which keeps a rhythm of light and dark (Morag 2011).
Developmental Care is all about making the baby’s surroundings as free of stress as possible. This is done in several ways: reducing the amount of light and noise that the baby is exposed to; in some cases covering the incubator with a sheet or specially made cover; creating a ‘nest’ to nurse a baby in which makes them feel comfortable and secure; reducing disruption to the baby; infant massage; parent involvement in caring for your baby on the unit – kangaroo care for example (Bliss 2009).
Drainage, irrigation and fibrinolytic therapy (DRIFT) Bleeding in the brain is a serious complication in babies born prematurely. This procedure aims to remove the blockage and reduce its harmful effects by draining excess cerebrospinal fluid from the brain, washing out the blood and breaking down blood clots using drugs (fibrinolytics) (National Institute for Health and Care Excellence (National Institute for Health and Care Excellence 2012).
Effectiveness the extent to which specific clinical interventions when deployed in the field for a particular patient or population do what they are intended to do, that is, maintain and improve health and secure the greatest possible health gain (Graham 2009).
Enteral feeding or tube feeding is a medical device used to provide nutrition to patients who cannot obtain nutrition by mouth, are unable to swallow safely, or need nutritional supplementation. The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding. (Guenter, 2001)
Ethamsylate is a drug that decreases blood loss in certain clinical situations. The potential to reduce bleeding suggests ethamsylate may have a role to play in reducing intraventricular haemorrhage in preterm infants (Hunt 2003).
Expectant management (also known as ‘watchful waiting’) A hands-off management philosophy in which certain conditions are closely monitored, but treatment withheld until symptoms either appear or the situation changes. Active management is the opposite of expectant management and is when treatment is given straight away.
Fibroids are non-cancerous growths that occur in or around the womb (uterus). The growths are made up of muscle and fibrous tissue and can vary in size (NHS Choices 2013).
Gestation the time period of carrying the baby (Wikipedia).
High flow nasal cannula (HFNC) are small, thin, tapered plastic tubes used to deliver oxygen or blended oxygen and air at flow rates of > 1L/minute (Wilkinson 2011).
History-indicated cerclage insertion of a cerclage as a result of factors in a woman’s obstetric or gynaecological history which increase risk of spontaneous second-trimester loss or preterm delivery (Royal College of Obstetricians & Gynaecologists 2011).
Hypertension is a chronic medical condition in which the blood pressure is raised. This requires the heart to work harder than normal to circulate blood through the blood vessels. Blood pressure is summarised by two measurements, systolic and diastolic, which depend on whether the heart muscle is contracting (systole) or relaxed between beats (diastole) and equate to a maximum and minimum pressure, respectively.(Wikipedia)
Immediate versus deferred delivery refers to when a baby is delivered immediately compared to waiting for a long as is thought to be safe (deferred).
Intervention The act or fact or a method of interfering with the outcome or course especially of a condition or process (Merriam-Webster Dictionary 2013).
Intrapartum occurring chiefly with reference to a mother during the act of birth (Merriam-Webster Dictionary 2013).
Intrapartum antibiotic prophylaxis Antibiotics given during labour aimed at preventing infection (National Institute for Health and Care Excellence 2012).
Intubated Intubation is the process of inserting a tube into the mouth and then into the airway. This is done so the baby can be placed on a ventilator to assist with breathing (Patient.co.uk 2013).
Intra-ventricular haemorrhage (IVH) This is a problem which affects babies born prematurely where there is bleeding into the ventricles of the brain. An IVH can be serious but in many cases it causes no long-term problems (Bliss 2009).
Jaundice-related neonatal morbidity – a sick baby due to jaundice (a condition where too much bilirubin in the blood makes the skin and whites of the eyes go yellow )
Kangaroo Care is the practice of holding your baby on your bare chest with a blanket draped over your baby’s back. This skin-to-skin contact benefits both you and your baby (March of Dimes 2013).
Ketamine A drug which is used as a for pain relief and for anaesthesia on the neonatal unit, it causes less suppression of breathing than other similar drugs (Preterm birth priority setting partnership steering group 2013)
Long-term use of sucrose According to The WHO Reproductive Health Library (RHL), “Administration of oral sucrose sugary liquid (in dosages of 0.5–2 ml of 12%–50% solution) before painful procedures is effective in providing pain relief in both term and preterm infants. However, the longer-term effects of sucrose, especially for extremely premature babies, who are at the greatest risk of receiving repeat doses, is not known.” (Murki et al, 2011)
Long-term ventilation Assisted ventilation is used to support breathing until the patient’s respiratory efforts are sufficient. For preterm infants, ventilation may be required during immediate care of the infant or during prolonged periods of respiratory failure (http://emedicine.medscape.com/article/979268-overview)
Lumbar puncture (LP) If there is evidence of a severe infection, doctors may want to take a sample of fluid that surrounds the spinal cord. This fluid flows down from the brain, so analysing it should show if the infection is present in this vital part of the nervous system (Bliss 2009).
Magnesium maintenance therapy This is one of the types of tocolytic therapy (drugs to reduce contractions of the uterus) used after an episode of threatened preterm labour in an attempt to prevent the onset of further preterm contractions (Han et al, 2013).
Morphine is a strong opiate drug (extracted from the opium poppy) that is used to relieve severe pain. It is a habit-forming drug which can lead to drug dependency (Wikepedia: http://en.wikipedia.org/wiki/Morphine).
Music therapy Researchers have speculated that being born prematurely could be traumatic (from an acoustic perspective) for two reasons (1) Baby being separated from the sound of mother’s heartbeat (2) Baby ‘plunged’ into the noisy environment of the neonatal care unit (NHS Choices 2013).
Necrotising enterocolitis (NEC) When a section of the wall of the intestine is swollen or inflamed because of damage to the linig. This is often linked to a period in which the blood flow to the gut wall has been reduced. The abdomen may swell up, and blood is passed through the bowels (Bliss 2009). This is a major cause of mortality and morbidity for preterm babies (Preterm birth priority setting partnership steering group 2013).
Neonatal mortality is death during the first 28 days after birth (March of Dimes 2010).
Neonatal morbidity a disorder in the neonate, child or family which occurs as a result of adverse influences or treatments acting either on the fetus during pregnancy and/or infant during the first four weeks of life (Australian Government National Health & Medical Research Council 1995).
Neuro-development care the process of developmental care involves creating an environment for the infant that minimises stress while providing developmentally appropriate experience for the infant and family (Neonatal Handbook 2010).
Neonatal Intensive Care Unit (NICU) a neonatal intensive care unit specializing in the care of ill or prenatal newborn babies (Preterm birth priority setting partnership steering group 2013).
Non-haemolytic significant hyperbilirubinaemia
Hyperbilirubinemia results from a higher-than-normal level of bilirubin in the blood. Neonatal hyperbilirubinaemia, where the newborn's liver is not able to properly process the bilirubin causing jaundice http://en.wikipedia.org/wiki/Bilirubin. Non-haemolytic hyperbiliubinaemia is when there is jaundice without any red cell breakdown (Preterm birth priority setting partnership steering group 2013).
Non-pharmacological is an approach to pain with techniques other than drugs / medication. It aims to prevent suffering by enhancing the psycho-emotional and spiritual components of care (Medscape 2013).
Nutritional deficiency an inadequate supply of essential nutrients (as vitamins and minerals) in the diet resulting in malnutrition or disease (Merriam-Webster Dictionary 2013).
Oro-motor development / Oral motor interventions These are methods designed to improve feeding. The focus of most interventions is to increase functional responses to pressure and movement and control of movements for the lips, cheeks, jaw and tongue (Lessen 2011).
Orogastric / nasogastric feeding and reflux Nasogastric feeding is when a baby is fed through a nasogastric tube (a tube with a narrow bore tube passed through the passages of the nose) into the stomach (Preterm birth priority setting partnership steering group 2013).
Pessary (progesterone) Progesterone is a hormone that stops the uterus from contracting and is involved in maintaining pregnancy (Dodd et al, 2009). A pessary is a medicated vaginal suppository such as progesterone put into the vagina where it dissolves and is absorbed (The Free Dictionary 2013).
Phototherapy is exposure to daylight or to specific wavelengths of light (Wikipedia: http://en.wikipedia.org/wiki/Light_therapy ).
There are two types of phototherapy: (1) Conventional phototherapy: where baby is placed under halogen, LED or fluorescent lamp with their eyes covered (2) Fibreoptic phototherapy: where baby lies on a blanket that incorporates fibreoptic cables. Light travels through the fibreoptic cables and shines onto baby’s back (NHS Choices 2012).
Placenta The placenta attaches to the wall of the uterus (womb) and supplies the baby with food and oxygen through the umbilical cord (March of Dimes 2012).
Pre-eclampsia Occurs in about 1 in 14 pregnancies and causes around a third of all premature births. It can be dangerous, particularly if it develops rapidly. The main symptoms are headaches and swollen feet, which are associated with high blood pressure. Although bed-rest can help, the only way to stop pre-eclampsia is to deliver the baby early (Bliss 2009).
Premature rupture of membranes Pre-term PROM is the rupture of membranes prior to the onset of labour in a woman who is at less than 37 weeks' gestation(Savitz, Ananth et al. 1997).
Preterm birth / preterm labour A baby born before reaching 37 completed weeks (Bliss 2009).
Progesterone is a hormone. It plays a key role during pregnancy. In early pregnancy, the hormone helps your uterus grow and keeps it from contracting. In late pregnancy, progesterone helps your breasts get ready to make breast milk (March of DImes 2013).
Psychosocial interventions These target the psychological and social factors that cause and maintain difficulties (Clinical Psychology Associates - Psychosocial Interventions 2013).
PVL Periventricular Leukomalacia. If parts of the brain are deprived of oxygen and blood flow for too long, the brain cells may die and be replaced by fluid cysts. These can be seen in the ultrasound examinations (ultrasound scan) of the baby’s brain and depending on the area affected, may indicate future developmental problems (Bliss 2009).
Resuscitation This is to revive from death or unconsciousness by providing first aid procedures (Bliss 2009).
Risks please see ‘benefits and risks/harms’ definition above.
Risk scoring systems a quantitative method used to screen populations to identify persons at increased risk of developing a specific adverse health condition. (Shiono 1993).
Screening To test or examine for the presence of something (Merriam-Webster Dictionary 2013).
Sensory Care / Sensory stimulation The physical environment of the neonatal intensive care unit (NICU) can influence the development of neonates. Examples of sensory care include tactile stimulation, kangaroo care, early exposure to mother’s scent, noise assessments, avoiding exposure of infant to direct light (Laudert 2007).
Service Provision – providing a service
Short uterine anomaly A small number of women have a uterus that differs in structure from normal (Babycentre Medical Advisory Board 2013).
Specialist prenatal and neonatal care is the care provided for newborn babies in neonatal units who need extra care (National Institute for Health and Care Excellence 2012).
Spontaneous preterm birth a birth as a result of spontaneous preterm labour (before 37 weeks) which is not medically induced (Preterm birth priority setting partnership steering group 2013)
Stem cell therapy is an intervention strategy that introduces new adult stem cells into damaged tissue in order to treat disease or injury (Lindvall, 2006). Stem cells can be collected form the umbilical cord at birth (Stem cell harvesting).
Stress-reduction techniques refers to various strategies and therapies that are available that help with relaxation and stress management (thefreedictionary.com).
Surfactant A mixture of chemicals that prevent the lungs from collapsing when the baby breathes out. Production of surfactant in the lungs starts at about 24 weeks but it is not well developed before 36 weeks gestation. This can be the cause of Respiratory Distress Syndrome (RDS). Replacement surfactant can be given as a liquid into the lungs of the premature baby (Bliss 2009).
Swedish care model, The Swedish healthcare system is mainly government-funded and decentralized, although private health care also exists. The health care system in Sweden is financed primarily through taxes levied by county councils and municipalities(Wikipedia: http://en.wikipedia.org/wiki/Healthcare_in_Sweden).
Thickening of feeds Thickening agents added to breast milk or formula aimed at helping milk to stay in the stomach (Bird 2012).
Tocolytic therapy (tocolysis) also known as anti-contraction medications or ‘labour repressants’ are medications used to suppress premature labour (deHeus et al 2009).
Total body hypothermia a below normal temperature of the body, under 36.6C (Medline Plus).
Transporting babies Transport of premature babies shortly after birth, usually to receive more intensive or specialist care than available at the unit where the baby was born. Usually performed by a special team of neonatal doctors and nurses in the UK(Bull 2013 revised ed).
Transvaginal scanning/ultrasound is an imaging technique used to create a picture of the genital tract in women. The hand-held device that produces the ultrasound waves is inserted directly into the vagina, close to the pelvic structures, thus often producing a clearer and less distorted image than obtained through transabdominal ultrasound technology, where the probe is located externally on the skin of the abdomen. (McGraw-Hill, 2002)
Trimester Pregnancy lasts about 40 weeks, counting from the first day of your last normal period. The weeks are grouped into three trimesters of about three months each (womenshealth, Office on Health, US Dept of Health and Human Services, 2010).
Umbilical cord clamping The umbilical cord is clamped before it is cut to help seal off the open blood vessels in the cord (Weeks 2007).
Universal pre-discharge transcutaneous bilirubin screening some studies have suggested that universal predischarge bilirubin screening prevents the development of very high bilirubin levels (Medscape 2013).
Urinary tract infections is an infection in any part of your urinary system – your kidneys, ureterss, bladder and urethra. Most infections involve the lower urinary tract – the bladder and the urethra (The Mayo Clinic 2013).
Validated pain measures Validation is the process by which any data collection instrument is assessed for its dependability (Howard 2008).