At this section of the AWHONN 2014 conference, I learned about the importance of standardizing definitions. Dr. Kate Menard, Vice-Chair of Obstetrics at the University of North Carolina, and co-chair of the reVITALize Obstetric Data Definitions project was the speaker for this topic. Over 80 national leaders in women’s health care, including Dr. Debra Bingham Vice President for Research, Education and Publications at AWHONN, came together with the common goal of standardizing clinical obstetric data definitions that will be used in registries, electronic medical record systems and vital statistics.
p.s. This woman has the best laugh I’ve ever heard. It’s contagious!
To learn more about the reVITALize project: reVITALize Obstetric Data Definitions project
- Gravida – a woman who currently is pregnant or has been in the past
- Gravidity – the number of pregnancies, current and past, regardless of the pregnancy outcome
- Parity – the number of pregnancies reaching 20 weeks and 0 days of gestation or beyond, regardless of the number of fetuses or outcomes
- Nulliparous – a woman with a parity of zero
- Multiparous (multip) – a woman who has given birth more than once
Labor Phases –
- Latent phase – from the onset of labor to the onset of the active phase
- Active phase – accelerated cervical dilation typically beginning at 5 cm for multiparious women and at 6 cm for nulliparous women
Avoid the phrase “prodromal labor.”
Gestational Age –
- Preterm – Less than 37 weeks and 0 days
- Late Preterm – 34 weeks and 0 days through 36 weeks and 6 days
- Post term – Greater than or equal to 42 weeks and 0 days
Postpartum Hemorrhage – cumulative blood loss greater than or equal to 1000ml OR a blood loss accompanied by sign/symptoms of hypovolemia within 24 hours following the birth process (including the intrapartum period).
Signs and symptoms of hypovolemia:
- altered mental satus
A cumulative blood loss of 500-999ml should trigger increased supervision and surveillance of patient. A hematocrit drop of more than 10% can be supportive data but does not make the diagnosis of postpartum hemorrhage alone.
Chorioamnionitis – usually includes otherwise unexplained fever at or above 100.4° with one or more of the following:
- uterine tenderness and/or irritability
- Fetal tachycardia
- Maternal tachycardia
- Malodorous vaginal discharge
The current version of the reVITALize Obstetric Data Definitions can be found here.
The reVITALize Obstetric Data Definitions are formally endorsed by the following organizations:
- American College of Nurse-Midwives
- The American College of Obstetricians and Gynecologists/The American Congress of Obstetricians and Gynecologists
- Association of Women’s Health, Obstetric and Neonatal Nurses
- Society for Maternal-Fetal Medicine