The ⒶⒷⒸ's of Reproductive Health

A GLOSSARY OF COMMONLY USED TERMS

S. Rogers

Oct 13, 2024

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The ⒶⒷⒸ's of Reproductive Health

A GLOSSARY OF COMMONLY USED TERMS

Search by alphabetical order:

A. B. C. E. F. H. I. L. M. O. P. S. T. U. V. Z.

A.

ABDOMINAL ECTOPIC PREGNANCY

“Abdominal pregnancy is a rare form of ectopic pregnancy with high morbidity and mortality.”1 “An abdominal ectopic pregnancy is a pregnancy that occurs outside of the uterus and instead in the abdominal cavity. Common forms of placental implantation in abdominal pregnancies include attachment on reproductive organs with subsequent rupture into the peritoneal cavity, as well as direct attachment to uterine serosa, omentum, bowel, and mesentery. Abdominal ectopic pregnancies increase the risk of fatal intraperitoneal hemorrhage. Therefore, it is important to diagnose and effectively manage this rare type of pregnancy in order to reduce morbidity and mortality.”2

ABORTIFACIENT

An abortifacient is “any substance that is used to terminate a pregnancy.”3 *Note: The word abortifacient is sometimes erroneously used in place of the word contragestive. It is not the same thing.

ABORTION

Abortion is a medical term defined as the ending, both spontaneous and induced, of an established pregnancy before fetal viability,4567 though "some medical dictionaries mention 20 weeks' gestation or 500 g as the limit.”8 (Learn more)

ASSISTED REPRODUCTIVE TECHNOLOGY (ART)

“Assisted Reproductive Technology (ART) includes in vitro fertilization-embryo transfer (IVF-ET), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), and frozen embryo transfer (FET). These techniques also apply to oocyte donation and gestational carriers.”9 “Procedures where only sperm are manipulated, such as intrauterine inseminations, are not considered under this definition. Additionally, procedures in which ovarian stimulation is performed without a plan for egg retrieval are also excluded from the definition.”10 (See also: IVF definition of embryo; in vitro fertilization; in vitro fertilization and embryo transfer)

B.

BARRIER METHODS (of contraception)

“Barrier methods of birth control act as barriers to keep sperm from reaching the egg. Some barrier methods also protect against sexually transmitted infections (STIs). A few barrier methods (spermicide, condom, and sponge) can be bought in most drugstores. Others (diaphragm and cervical cap) must be prescribed by a health care professional.”11

BIOCHEMICAL PREGNANCY

“When an individual's pregnancy test is initially positive but becomes negative before a pregnancy is visible on ultrasound.”12

BIRTH CONTROL PILLS

“Also called oral contraceptives, birth control pills have synthetic estrogens and progesterone. When used correctly, they stop ovulation and reduce the production of hormones, like androgens, from the ovaries.”13 Birth control pills are not contragestives. Nor are birth control pills abortifacients.

BLASTOCYST

⓵ (as referred to in pregnancy)

“In the uterus, the cells [within a fertilized egg] continue to divide, becoming a hollow ball of cells called a blastocyst.”14 “The wall of the blastocyst is 1 cell thick except in 1 area, where it is 3 to 4 cells thick. The inner cells in the thickened area develop into” what will eventually become an embryo, “and the outer cells burrow into the wall of the uterus and develop into the placenta.”15 The blastocyst begins to implant into and beneath “the wall of the uterus about 6 days after fertilization.”16 “Implantation occurs when the blastocyst burrows into the endometrium and begins to transform into the placenta and embryo.”17 The process of implantation is not completed until around day 9 or 10 post-fertilization, marking the beginning of pregnancy.18

⓶ (as referred to in in vitro fertilization)

“An embryo that has progressed and started to form the early placenta and a fluid-filled cavity, usually 5 to 6 days after ovulation or egg retrieval.”19 (see the IVF definition of embryo)

C.

CESAREAN SCAR ECTOPIC PREGNANCY (CSEP)

“Implantation of a pregnancy in a cesarean section scar or niche is becoming more common as the rate of cesarean delivery rises worldwide… [I]mplantation at this site carries a high risk of maternal morbidity and mortality, including uterine rupture and complications of placenta accreta spectrum.”20

CERCLAGE

“Placement of a nonabsorbable suture around an incompetent (weak) cervical opening in attempt to keep it closed and thus prevent miscarriage. Also known as a cervical stitch.”21

CERVICAL ECTOPIC PREGNANCY

“A pregnancy implanted in the endocervical mucosa is termed a cervical EP.”22

CESAREAN SECTION (c-section)

A cesarean section, also known as a C-section or cesarean delivery, is a surgical procedure used to deliver a fetus through incisions made in the pregnant person’s abdomen and uterus.23 The operation is typically performed when a vaginal birth poses risks to the pregnant person or to the fetus or when complications arise during active labor.24 “Common reasons for a cesarean section include fetal distress, abnormal positioning of the [fetus], placental issues, or [a patient history of] a previous cesarean delivery.”25 A cesarean section (C-section) is major abdominal surgery that puts the pregnant patient at increased danger of morbidity and mortality both during and following the procedure.26 “Decisions made during a cesarean section can affect women and their families for the entirety of their lives.”27 For patients who have had a prior cesarean birth, cesarean section “becomes riskier each time it is repeated. The risks of repeat C-sections include placenta problems such as placenta previa, blood transfusion, uterine rupture, damage to the bladder, infection, and hysterectomy.”28 Like labor induction abortion, cesarean section is contraindicated for some patients.29

CERVIX

“The lower, narrow end of the uterus that connects the uterine cavity to the vagina.”30

CLINICAL PREGNANCY

“A pregnancy confirmed by an increasing level of hCG and the presence of a gestational sac detected by ultrasound.”31

COMBINED HORMONAL CONTRACEPTIVES (CHCs)

Combined hormonal contraceptives (CHCs) are a category of hormonal contraceptives (HCs) “that contain both an estrogen and a progestin component.”32 The estrogen is added “to provide better cycle control,”33 though estrogen also contributes to ovulation suppression.34 “In today's CHCs, the estrogen component is most often EE (ethinyl estradiol), whereas there are many different types of progestins used.”35 The progestin component of both HCs and CHCs “provides the main contraceptive effect.”36 (Learn more)

COMPLETE EARLY PREGNANCY LOSS

“Completed EPL refers to complete passage of the GS (gestational sac) and chorionic tissue from the uterus following an EPL.”37

CONTRACEPTION

“Contraception is the act of preventing pregnancy. This can be a device, a medication, a procedure or a behavior.”38

CONTRAGESTIVE

Contragestives are “agents that prevent or interrupt implantation [of a fertilized egg] in the uterus.”39 A contragestive is not an abortifacient.

CRYOPRESERVATION

“The process of freezing and storing eggs, sperm, or embryos at extremely low temperatures to be used at a later date.”40

E.

ECLAMPSIA

Eclampsia is “the convulsive manifestation of the hyper tensive disorders of pregnancy and is among the more severe manifestations of the disease.”41 (See also preeclampsia)

ECTOPIC

“Out of place.” “The term ectopic is derived from the Greek word ektopos, meaning out of place.”42

ECTOPIC PREGNANCY

“[A] pregnancy implanted in an abnormal location, whether intrauterine or extrauterine.”43 This “is the result of a flaw in human reproductive physiology that allows the conceptus to implant and mature” in an abnormal location.44 “Without timely diagnosis and treatment, ectopic pregnancy can become a life-threatening situation.”45 “In ectopic pregnancy (the term ectopic is derived from the Greek word ektopos, meaning out of place), the gestation grows and draws its blood supply from the site of abnormal implantation. As the gestation enlarges, it creates the potential for organ rupture, because only the” endometrial cavity within the uterus “is designed to expand and accommodate fetal development. Ectopic pregnancy can lead to massive hemorrhage, infertility, or death.”46 Ectopic pregnancies can be intrauterine or extrauterine.47 Sites of ectopic implantation include the fallopian tubes, ovaries, abdominal cavity, cervix, and cesarean scars.48 “When an EP is described, the location should precede the term EP in the report. Ectopic locations include tubal, interstitial, cervical, cesarean scar, ovarian, abdominal, and intramural… Though tubal EP locations can be further characterized as isthmic, infundibular, and ampullary, these terms are optional since the precise location of a tubal EP is typically not evident at US (ultrasound)… In most scenarios, an EP should be described as probable if there is no yolk sac or embryo and definite if a yolk sac or embryo is present.”49

Image: American Journal of Obstetrics and Gynecology

EMBRYO

⓵ (as referred to in pregnancy)

“Inside the uterus, the blastocyst implants in the wall of the uterus, where it develops into” a placenta and an embryo surrounded by fluid-filled membranes.50 “Some of the cells from the placenta develop into an outer layer of membranes (chorion) around the developing blastocyst. Other cells develop into an inner layer of membranes (amnion), which form the amniotic sac. When the sac is formed (by about day 10 to 12), the blastocyst is considered an embryo. The amniotic sac fills with a clear liquid (amniotic fluid) and expands to envelop the developing embryo, which floats within it.”51

⓶ (as referred to in in vitro fertilization)

“The early stage of development after an egg, fertilized by sperm, begins dividing and growing.”52

EMBRYO CULTURE

“Growth and monitoring of embryos, formed by fertilizing eggs with sperm, in a specialized incubator outside the body. These incubators can support embryos’ development for up to 7 days, after which embryos can be transferred to the uterus or frozen for future use.”53 (see the IVF definition of embryo)

EMBRYO TRANSFER

“Placement of an embryo into the uterus.”54 (see the IVF definition of embryo)

Emergency Contraception (EC)

Also called emergency contraceptive pills (ECPs) or “the morning after pill,” Emergency contraception refers to methods of contraception that can be used to prevent pregnancy after sexual intercourse. These are recommended for use within 5 days but are more effective the sooner they are used after the act of intercourse.”55 “Using EC does not cause an abortion. An abortion ends an existing pregnancy. EC prevents pregnancy from occurring. EC must be used soon after unprotected sexual intercourse to be effective. It does not work if pregnancy has already occurred,” or if an egg has already been fertilized.56 “The morning after pill only works by preventing ovulation, it can not cause an abortion and it will not have any effect in a case where an egg has already been fertilized.”57 Emergency contraceptive pills are not abortifacients or contragestives.

ESTRADIOL

“The predominant estrogen (hormone) is produced by the follicular cells of the ovary.”58

ESTROGENS

“Female sex hormones made by the ovaries, which help develop female sex traits. During the menstrual cycle, estrogens help the lining of the uterus grow. Estrogens also play a role in keeping bones healthy and overall female well-being. Males also produce a bit of these hormones when testosterone changes into estrogen.”59

EXPECTANT MANAGEMENT

“Period of ‘watchful waiting' without active treatment.”60

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F.

FALLOPIAN TUBES

“A pair of hollow tubes is attached one on each side of the uterus through which the egg travels from the ovary to the uterus. Fertilization usually occurs in the fallopian tube. The fallopian tube is the most common site of ectopic pregnancy.”61

FERTILIZATION

“The fusion of sperm and egg.”62 “Fertilization occurs when a female egg and male sperm meet. Though it is commonly assumed that fertilization takes place during intercourse or very shortly thereafter, it can occur up to five days later. This means that a woman can become pregnant if she ovulates and then has intercourse, or if she has intercourse and then ovulates within the next five days.”63

FETUS

“At the end of the tenth week of pregnancy (8 weeks after fertilization and 7 weeks after the start of the pregnancy), the fetal stage begins.”64

H.

HETEROTOPIC PREGNANCY

“Heterotopic pregnancy describes coexistence of an IUP (intrauterine) and an EP (ectopic pregnancy).”65

HORMONE

“Substances secreted by certain organs of the body that act as messengers to manage important functions in the body like growth, metabolism, and reproduction.”66

HORMONAL CONTRACEPTIVES (HCs)

Hormonal contraceptives (HCs) are a method of contraception that acts on the endocrine system (the body's “messenger” system) through the use of hormones to prevent pregnancy.67 Hormonal contraceptives may contain both estrogen and progestin, or may only contain progestin.68 The way a contraceptive works is called its mechanism of action. (Learn more)

HYPOTHALAMIC-PITUITARY-OVARIAN AXIS (HPO axis)

“The menstrual cycle is controlled by a multitiered system, which involves both the hypothalamic-pituitary-ovarian (HPO) axis and the ovarian-endometrial compartment.”69 It is the HPO axis that “is responsible for hormonal cycling - producing the right amount of sex steroids at the right times in the cycle to… mature the oocyte (immature egg) for ovulation,” trigger ovulation, and “create the right conditions for fertilization to take place.”70 In this system, signals travel “from the hypothalamus to the pituitary, and then from the pituitary to the ovary.71 To understand how hormonal contraceptives work, it's important to understand the HPO axis. (Learn more)

I.

IMPLANTATION

“Implantation occurs when the blastocyst burrows into the endometrium and begins to transform into the placenta and embryo.”72 The process of implantation is not completed until around day 9 or 10 post-fertilization.73 Implantation begins a pregnancy.74

INCOMPLETE EARLY PREGNANCY LOSS

“[T]he presence of intracavitary tissue, typically with internal vascularity, or a persistent GS (gestational sac) following an EPL.” 75Alternate terms include retained products of conception (RPOC).”76

INDUCED ABORTION

"Induced abortion ends a pregnancy with medication or a medical procedure”77 — this includes inducing labor.7879

INDUCTION ABORTION

(See labor induction abortion)

INEVITABLE ABORTION (MISCARRIAGE)

The term inevitable abortion (inevitable miscarriage), a category of spontaneous abortions, “describes a live intrauterine pregnancy”80 with “ the leakage of amniotic fluid [and] an open cervical os (the cervical opening that separates the upper and lower parts of the reproductive tract).”81 Inevitable abortion “uniformly results in miscarriage when this occurs in the first trimester.”82

INTRAUTERINE DEVICE (IUD)

“A small device placed inside of the uterus that prevents pregnancy. Some IUDs contain hormones and some do not. Hormonal IUDs can be used to treat certain conditions like heavy menstrual bleeding.”83

INTRAUTERINE INSEMINATION (IUI)

“An office procedure in which prepared sperm are placed into the uterus.”84

INTRAUTERINE PREGNANCY (IUP)

“[A] pregnancy implanted in a normal location… [P]regnancies implanted in abnormal uterine locations, such as the cervix or a cesarean section scar, as well as those transiently located in the lower uterine cavity or endocervical canal in the process of expulsion, are not interpreted as normal in location despite their intrauterine position.”85

IN VITRO FERTILIZATION (IVF)

“A method of assisted reproduction that involves combining an egg with sperm in a laboratory dish. If the egg fertilizes and begins cell division, the resulting embryo (see the IVF definition of embryo) is transferred into the uterus, which hopefully will implant in the uterine lining and further develop. IVF bypasses the fallopian tubes and is usually the treatment choice for individuals with badly damaged or absent tubes.”86 “The basic steps in an IVF treatment cycle are ovarian stimulation, egg retrieval, fertilization, embryo culture, and embryo transfer.”87

IN VITRO FERTILIZATION AND EMBRYO TRANSFER (IVF-ET)

“A procedure in which eggs are fertilized in a laboratory and one or more embryo(s) are placed into the uterus.”88

L.

LABOR INDUCTION ABORTION

Labor induction abortion, also called induction abortion, “is ending a pregnancy by using medicines to start (induce) labor and delivery," a method sometimes "done because of a severe medical problem.”89 Because inducing labor and delivery prior to fetal viability ends a pregnancy, it is medically classified as abortion. The term labor induction abortion is used to distinguish abortions occurring after 10 weeks LMP from medication abortions occurring at or before 10 weeks LMP,90 though “relevant research and clinical guidelines use varying lower and upper gestation limits. In practice, the gestational parameters for induction vary depending on the facility, patient and provider preference, and state laws and regulations.”91 Induction abortions are performed in a “facility that has the capacity to closely monitor a patient and provide adequate pain management (e.g., intravenous pain medication or an epidural). Induction abortions can last anywhere from five hours to three days; are extremely expensive; entail more pain, discomfort, medical risks, and recovery time for the patient—similar to giving birth—than procedural abortion.”92 Labor induction abortion is medically contraindicated for some patients.93

LH SURGE

“The release of large amounts of luteinizing hormone (LH) from the pituitary gland, which triggers ovulation to occur.”94

LUTEINIZING HORMONE (LH)

“In females, the pituitary hormone that triggers ovulation and tells the ovary's corpus luteum to make progesterone and other hormones in the second part of the menstrual cycle. In males, the he hormone that tells the testes to make the male hormone testosterone.”95

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M.

MECHANISM OF ACTION (MOA)

In medicine, mechanism of action is “a term used to describe how a drug or other substance produces an effect in the body. Knowing the mechanism of action of a drug may help provide information about the safety of the drug and how it affects the body. It may also help identify the right dose of a drug and which patients are most likely to respond to treatment.”96 (Learn more)

MEDICATION ABORTION

Abortion primarily with medications, including mifepristone and misoprostol, misoprostol alone, and methotrexate, are medication abortions. Medication abortions are typically indicated up to 11.0 weeks LMP (last menstrual period), approximately 8 weeks after a person becomes pregnant.97 The most commonly used method for medication abortion in the United States involves a regimen of mifepristone and misoprostol "to terminate the pregnancy and expel it via vaginal bleeding, akin to a spontaneous miscarriage.”98 This same medication abortion regimen is also “the most effective regimen for medication management of early pregnancy loss,”99 including inevitable miscarriage. While “misoprostol alone can be used if mifepristone is not available… rates of effectiveness are lower.”100 Medication abortion is used to terminate intrauterine ectopic pregnancies that are diagnosed early, including cesarean scar101 102103 and cervical104 pregnancies, in which the fertilized egg implants into a dangerous location inside the uterus, as well as extrauterine ectopic pregnancies that occur outside of the uterus, such as tubal ectopic pregnancies.

MENSTRUATION

“The normal, cyclic shedding of the endometrial lining (lining of the uterus), which appears as a bloody discharge from the uterus.”105

METHOTREXATE

“Medication used for treating ectopic pregnancy, or non-viable pregnancies of unknown location. It works by slowing down and stopping the growth of pregnancy-related cells, allowing the body to naturally absorb them over time.”106

MIFEPRISTONE

Mifepristone is a versatile, competitive glucocorticoid (GR) and progesterone receptor (PR) antagonist. It is often referred to as “the abortion pill” because it is the first drug in a two-drug regimen used to terminate pregnancy. The drug was first approved for use in the United States in the year 2000, after a four-year long evaluation process by the U.S. Food and Drug Administration. “Overwhelming evidence [demonstrates] that mifepristone—which has undergone rigorous testing and review and has been safely used in the United States for [24] years—is conclusively safe and effective.”107 Over this time period, mifepristone has come to be used to treat patients with a variety of conditions not related to pregnancy termination. Mifepristone is a drug “used in a regimen together with misoprostol to end a pregnancy that is less than 70 days in duration (10 weeks),” dating from the first day of a person's last menstrual period.108 For the purposes of the early termination of pregnancy, mifepristone “works by stopping the supply of hormones that maintains the interior of the uterus. Without these hormones, the uterus cannot support the pregnancy.”109 The current medication abortion regimen is “200 mg of mifepristone-oral-route,” followed by “800 mcg of misoprostol taken buccally (in the cheek pouch).”110 Mifepristone, together with misoprostol, is also used to manage miscarriages (spontaneous abortions). According to the American Academy of Family Physicians, “The most effective regimen for medication management of early pregnancy loss is 200 mg of oral mifepristone followed by 800 mcg of misoprostol administered vaginally 24 to 48 hours later.”111 While “misoprostol alone can be used if mifepristone is not available… rates of effectiveness are lower.”112 For this reason, miscarriage patients “should be offered mifepristone pretreatment before misoprostol to increase the chance of successful miscarriage management, while reducing the need for miscarriage surgery.113 (Learn more)

MISCARRIAGE

(see spontaneous abortion)

MISOPROSTOL

“Misoprostol is a synthetic prostaglandin E1 analogue marketed as an oral preparation used to prevent and treat gastroduodenal damage” such as ulcers, “induced by nonsteroidal anti-inflammatory drugs (NSAIDs). However, misoprostol is used off-label for a variety of indications in the practice of obstetrics and gynecology, including medication abortion, medical management of miscarriage, induction of labor, cervical ripening before surgical procedures, and the treatment of postpartum hemorrhage. Misoprostol’s effects are dose dependent.”114 “Misoprostol’s advantages over other synthetic prostaglandin analogues are its low cost, long shelf life, lack of need for refrigeration, and worldwide availability.”115 Additionally, decades of research has shown that misoprostol is a safe drug with few contraindications.116117

MULTIFETAL PREGNANCY REDUCTION

“Also known as selective reduction. A procedure to reduce the number of fetuses in the uterus. This procedure is sometimes performed on women who are pregnant with multiple fetuses and who are at an increased risk of late miscarriage or premature labor. These risks increase with the number of fetuses.”118

O.

OVARIES

“The two female sex glands in the pelvis located on each side of the uterus. The ovaries produce eggs and hormones, including estrogen, progesterone, and androgens.”119

OVARIAN ECTOPIC PREGNANCY

“A pregnancy in or on an ovary is termed an ovarian EP. Ovarian EP is exceedingly rare and presents diagnostic challenges, as it often mimics a corpus luteum. Because the overwhelming majority of intraovarian thick-walled cysts represent a corpus luteum, the diagnosis of ovarian EP should not be made unless a yolk sac, embryo, or cardiac activity is definitely seen in the intraovarian lesion.”120

OVULATION

“The release of a mature egg from its developing follicle in the outer layer of the ovary. This usually occurs 14 days before the next menstrual period.”121

P.

PLACENTA

A disk-shaped vascular organ attached to the wall of the uterus and to the fetus by the umbilical cord. It provides nourishment to the fetus and carries away waste.122

PREECLAMPSIA

“A disorder occurring during pregnancy that affects both the mother and the fetus. Preeclampsia is characterized by high blood pressure, swelling, and protein found in the urine. This disorder, also know as toxemia, can restrict the flow of blood to the placenta.”123 Pre-eclampsia is a progressive, dangerous form of “gestational hypertension… in a woman with a previously normal blood pressure.” It is also known to cause “fetal growth restriction, oligohydramnios, placental abruption, and nonreassuring fetal status demonstrated on antepartum surveillance.”124 (See also eclampsia)

PREGNANCY

Pregnancy is “the state of carrying a developing embryo or fetus.”125 “According to both the scientific community and long-standing federal policy, a woman is considered pregnant only when a fertilized egg has implanted in the wall of her uterus.”126 The process of implantation is completed around day 9 or 10 post-fertilization.127

PREGNANCY OF UNKNOWN LOCATION (PUL)

“The term pregnancy of unknown location is used in the setting of a pregnant patient without evidence of a definite or probable IUP (intrauterine pregnancy) or EP (ectopic pregnancy) at transvaginal US (ultrasound).”128

Image: American Journal of Obstetrics and Gynecology

PROCEDURAL ABORTION

Abortion primarily with instrumentation, including uterine aspiration (manual or electric), dilation and curettage, dilation and evacuation, or dilation and extraction, is referred to as procedural abortion.129 The most commonly used method of procedural abortion is aspiration which uses a suction device to empty the uterus. Procedural abortions in the first trimester take only about 5 minutes.130 Procedural abortion treatment are frequently used to complete instances of spontaneous pregnancy loss such as in cases of PPROM. Procedural abortion such as D&C, is also “recommended when patients are bleeding heavily, are anemic, have blood-clotting issues or certain conditions that make them medically fragile.”131

PROGESTERONE

“A female hormone is usually secreted by the corpus luteum after ovulation during the second half of the menstrual cycle (luteal phase). It prepares the lining of the uterus (endometrium) for implantation of a fertilized egg and also allows for complete shedding of the endometrium at the time of menstruation. In the event of pregnancy, the progesterone level remains stable beginning a week or so after conception.”132

PROGESTIN

“A synthetic hormone that has an action similar to progesterone. Synonymous with progestational hormones.”133

S.

SALPINGECTOMY

“An operation in which one or both of the fallopian tubes are removed.”134

SALPINGOSTOMY

“A surgical procedure in which the wall of the fallopian tube is opened and the ectopic pregnancy is removed. The tubal incision heals spontaneously.”135

SPONTANEOUS ABORTION

Also called a miscarriage, a spontaneous abortion is the ending of pregnancy “before the fetus has attained extrauterine viability.”136 There are different types of miscarriage and, contrary to common misconceptions, not all miscarriages involve an already deceased embryo/fetus, such as in cases of inevitable miscarriage.137

T.

TUBAL ECTOPIC PREGNANCY

A tubal ectopic pregnancy occurs when a fertilized egg implants in a fallopian tube. “When an EP is described, the location should precede the term EP in the report. Ectopic locations include tubal, interstitial, cervical, cesarean scar, ovarian, abdominal, and intramural… Though tubal EP locations can be further characterized as isthmic, infundibular, and ampullary, these terms are optional since the precise location of a tubal EP is typically not evident at US (ultrasound)… In most scenarios, an EP should be described as probable if there is no yolk sac or embryo and definite if a yolk sac or embryo is present.”138 “Implantation in the fallopian tube distal to the interstitial segment accounts for the majority of EPs (84%–93%). The most frequent observation of a tubal EP is an adnexal mass of variable echogenicity and vascularity, separate from the ovary; the term extraovarian mass is used for this appearance. Adnexal mass is an alternate term that is favored when the ovary is not visualized. The second most common observation is a tubal ring, a round or oval fluid collection with a hyperechoic rim (representing the GS) in the adnexa separate from the ovary, with variable peripheral vascularity. Alternate terms for a tubal ring include adnexal ring and adnexal GS. The descriptors ‘blob,’ ‘bagel,’ and ‘donut sign’ are vernacular terms to avoid. When no IUP is visualized, an extraovarian mass or a tubal ring has a high likelihood of representing a tubal EP. Differentiating an empty tubal ring of an EP from a corpus luteum can be challenging. Because a ring of peripheral vascularity at color Doppler US may occur with both, color flow is not a discriminating feature. Usually, a tubal ring is more echogenic than a corpus luteum. The location completely within the ovary or the presence of a claw sign of ovarian tissue around the lesion may help to confirm a corpus luteum. The sliding sign, elicited with transvaginal probe pressure, may be helpful to confirm that a mass or tubal ring moves separately from the ovary.”139

IMAGE: “(A) Transvaginal sagittal grayscale and (B) color Doppler US image in a 31-year-old pregnant patient shows a round, hypoechoic, thick-walled structure (dotted arrow) with a central cystic space (∗) and peripheral vascularity (arrowheads), characteristic of a corpus luteum. This corpus luteum arises in an exophytic fashion from the right ovary (OV), which can mimic a tubal ring of ectopic pregnancy. A helpful feature to diagnose a corpus luteum is a claw sign (solid arrows) of partially surrounding ovarian parenchyma, which confirms an ovarian origin.”140

TUBAL LIGATION

“A surgical procedure in which the fallopian tubes are clamped, clipped, or cut to prevent pregnancy.”141

U.

UTERUS

“The hollow, muscular female reproductive organ in the pelvis… The lining of the uterus, the endometrium, produces the monthly menstrual blood flow when there is no pregnancy.”142

V.

VAGINA

“The canal in the female that leads to the cervix, which leads to the uterus.”143

Z.

ZONA PELLUCIDA

“The egg’s outer layer that a sperm must penetrate in order to fertilize the egg.”144

ZYGOTE

“A fertilized egg before cell division (cleavage) begins.”145

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George, R., Powers, E., & Gunby, R. (2021, March 5). Abdominal ectopic pregnancy. Proceedings (Baylor University. Medical Center). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8224208/

Abortifacient. ScienceDirect Topics. (n.d.). https://www.sciencedirect.com/topics/medicine-and-dentistry/abortifacient#:~:text=An%20abortifacient%20is%20any%20substance,commonly%20used%20to%20induce%20abortion

First- and Second-Trimester Pregnancy Loss.” AccessMedicine, https://accessmedicine.mhmedical.com/content.aspx?sectionid=263815963&bookid=2977#263816185

“Abortion: Taber's Medical Dictionary.” Abortion | Taber's Medical Dictionary, https://www.tabers.com/tabersonline/view/Tabers-Dictionary/766365/all/abortion

WILLIAMS OBSTETRICS ch. 11 at 198 (F. Gary Cunningham, Kenneth J. Leveno, Jodi S. Dashe, Barbara L. Hoffman, Catherine Y. Spong & Brian M. Casey eds., 26th ed. 2022).

Grimes, David A., and Gretchen Stuart. “Abortion Jabberwocky: The Need for Better Terminology.” Contraception, Elsevier, 21 Oct. 2009, https://www.contraceptionjournal.org/article/S0010-7824%2809%2900415-6/fulltext

Assisted Reproductive Technologies. SART, Society for Assisted Reproductive Technology. (n.d.). https://www.sart.org/patients/a-patients-guide-to-assisted-reproductive-technology/general-information/assisted-reproductive-technologies/

Jain, M., & Singh, M. (2023, June 7). Assisted Reproductive Technology (ART) techniques. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK576409/

Barrier methods of birth control: Spermicide, condom, Sponge, diaphragm, and cervical cap. ACOG. (n.d.-b). https://www.acog.org/womens-health/faqs/barrier-methods-of-birth-control-spermicide-condom-sponge-diaphragm-and-cervical-cap

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

Artal-Mittelmark, Raul. “Stages of Development of the Fetus - Women’s Health Issues.” Merck Manuals Consumer Version, Merck Manuals, 30 Aug. 2023, www.merckmanuals.com/home/women-s-health-issues/normal-pregnancy/stages-of-development-of-the-fetus

Frank, Rachel. “Miss-Conceptions: Abortifacients, Regulatory Failure, and Political Opportunity.” Yale Law Journal, vol. 129, no. 1, Oct. 2019, pp. 215. 2019-2020, https://www.yalelawjournal.org/pdf/FrankNote_nsp64s9w.pdf

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

Rodgers, S. K., Horrow, M. M., Doubilet, P. M., & Sohaey, R. (2024, August 27). A lexicon for first-Trimester us: Society of Radiologists in ... American Journal of Obstetrics and Gynecology . https://pubs.rsna.org/doi/abs/10.1148/radiol.240122

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

Sung, S. (2024, October 5). Cesarean section. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK546707/

Morris, T., & Robinson, J. H. (2017). Forced and Coerced Cesarean Sections in the United States. Contexts, 16(2), 24-29. https://doi.org/10.1177/1536504217714259

Sung, S. (2024, October 5). Cesarean section. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK546707/

Cox v. State of Texas. P. 35. Retrieved at: https://reproductiverights.org/wp-content/uploads/2023/12/Cox-v.-Texas-original-petition-FINAL.pdf

Sung, S. (2024, October 5). Cesarean section. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK546707/

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

Ramanadhan, S., & Edelman, A. (2025). Combined Hormonal Contraceptives (CHCs). In Contraceptive Technology (22nd ed., p. 401). essay, Jones & Bartlett Learning.

Ramanadhan, S., & Edelman, A. (2025). Combined Hormonal Contraceptives (CHCs). In Contraceptive Technology (22nd ed., p. 403). essay, Jones & Bartlett Learning.

Bansode OM, Sarao MS, Cooper DB. Contraception. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536949

Ramanadhan, S., & Edelman, A. (2025). Combined Hormonal Contraceptives (CHCs). In Contraceptive Technology (22nd ed., p. 403). essay, Jones & Bartlett Learning.

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

ACOG Practice Bulletin. 2018. Retrieved at https://www.preeclampsia.org/public/frontend/assets/img/advocacy_resource/Gestational_Hypertension_and_Preeclampsia_ACOG_Practice_Bulletin,_Number_222_1605448006.pdf

Sepilian, V. P., & Wood, E. (2024, September 30). Ectopic pregnancy. Practice Essentials, Background, Etiology. https://emedicine.medscape.com/article/2041923-overview#a3

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

World Health Organization. (2021, November 9). Emergency contraception. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/emergency-contraception#:~:text=What%20is%20emergency%20contraception%3F,after%20the%20act%20of%20intercourse

American College of Obstetricians and Gynecologists. (2019). Emergency contraception. ACOG. https://www.acog.org/womens-health/faqs/emergency-contraception

The ella® pill: All you need to know about ella®: Ella®. ellaone USA. (2020, July 20). https://www.ella-now.com/all-you-need-to-know-about-taking-ella/#:~:text=By%20taking%20ella%C2%AE%20as,egg%20has%20already%20been%20fertilised

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

Frank, Rachel. “Miss-Conceptions: Abortifacients, Regulatory Failure, and Political Opportunity.” Yale Law Journal, vol. 129, no. 1, Oct. 2019, pp. 214-15. 2019-2020, https://www.yalelawjournal.org/pdf/FrankNote_nsp64s9w.pdf.

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

NCI Dictionary of Cancer terms. Comprehensive Cancer Information - NCI. (n.d.). https://www.cancer.gov/publications/dictionaries/cancer-terms/def/hormonal-contraception

Nelson, A. L. (2023). Understanding the Physiology of the Menstrual Cycle. In Contraceptive Technology (22nd ed., p. 50). essay, Jones & Bartlett Learning.

Frank, Rachel. “Miss-Conceptions: Abortifacients, Regulatory Failure, and Political Opportunity.” Yale Law Journal, vol. 129, no. 1, Oct. 2019, pp. 215. 2019-2020, https://www.yalelawjournal.org/pdf/FrankNote_nsp64s9w.pdf.

Gold, Rachel Benson, and Guttmacher Institute. “The Implications of Defining When a Woman Is Pregnant.” Guttmacher Institute, 30 Aug. 2022, www.guttmacher.org/gpr/2005/05/implications-defining-when-woman-pregnant.

Abortion care. ACOG. (n.d.). https://www.acog.org/womens-health/faqs/induced-abortion

Casey, Frances E. “Induced Abortion - Gynecology and Obstetrics.” Merck Manuals Professional Edition, Merck Manuals, 14 Dec. 2022, https://www.merckmanuals.com/professional/gynecology-and-obstetrics/family-planning/induced-abortion.

“Induction Abortion.” Kaiser Permanente, https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.induction-abortion.tw2562

Joshua Broder, Chapter 12 - Imaging the Genitourinary Tract, Editor(s): Joshua Broder, Diagnostic Imaging for the Emergency Physician, W.B. Saunders, 2011, Pages 650-705, ISBN 9781416061137, https://doi.org/10.1016/B978-1-4160-6113-7.10012-2. (Relevant portion available at: https://www.sciencedirect.com/topics/medicine-and-dentistry/inevitable-abortion)

Hitzeman, N., & Albin, K. (2014, April 1). Misoprostol for incomplete first trimester miscarriage. American Family Physician. https://www.aafp.org/pubs/afp/issues/2014/0401/p523.html

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

Rodgers, S. K., Horrow, M. M., Doubilet, P. M., & Sohaey, R. (2024, August 27). A lexicon for first-Trimester us: Society of Radiologists in ... American Journal of Obstetrics and Gynecology . https://pubs.rsna.org/doi/abs/10.1148/radiol.240122

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

American Society for Reproductive Medicine . (2018). Assisted Reproductive Technologies Patient Education booklet. Assisted Reproductive Technologies patient education booklet | ReproductiveFacts.org. https://www.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/assisted-reproductive-technologies-booklet/

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

“Induction Abortion.” Kaiser Permanente, https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.induction-abortion.tw2562

Sciences, N. A. of, Engineering, & Medicine, and. (2018b, March 16). Introduction. The Safety and Quality of Abortion Care in the United States. https://www.ncbi.nlm.nih.gov/books/NBK507239/

Sciences, N. A. of, Engineering, & Medicine, and. (2018c, March 16). The safety and quality of current abortion methods. The Safety and Quality of Abortion Care in the United States. https://www.ncbi.nlm.nih.gov/books/NBK507232/

Center for Reproductive Rights, Blackman v. State of Tennessee. Retrieved at: https://reproductiverights.org/wp-content/uploads/2023/09/TN-Complaint-Final-9-12.pdf

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

National Cancer Institute . (n.d.). NCI Dictionary of Cancer terms. Comprehensive Cancer Information - NCI. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/mechanism-of-action

Coplon, Leah, et al. “Society of Family Planning Committee Statement: Abortion Nomenclature.” Contraception, Elsevier, 16 June 2023, www.sciencedirect.com/science/article/pii/S0010782423001786.

Center for Reproductive Rights, Blackman v. State of Tennessee. Retrieved at: https://reproductiverights.org/wp-content/uploads/2023/09/TN-Complaint-Final-9-12.pdf

MacNaughton, H., Nothnagle, M., & Early, J. (2021a, April 15). Mifepristone and Misoprostol for early pregnancy loss and medication abortion. American Family Physician. https://www.aafp.org/pubs/afp/issues/2021/0415/p473.html

100

101

Masten, M., & Alston, M. (2023, March 15). Treatment of recurrent cesarean scar pregnancy with oral mifepristone, Systemic Methotrexate, and ultrasound-guided suction dilation and curettage. Cureus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10104687/

102

Miller R, Timor-Tritsch IE, Gyamfi-Bannerman C. Society for Maternal-Fetal Medicine (SMFM) consult series #49: cesarean scar pregnancy. Am J Obstet Gynecol 2020;222:B2-B14. https://pubmed.ncbi.nlm.nih.gov/31972162/

103

Arey, W., Lerna, K., Beasley , A., Harper, L., Moayedi, G., & White, K. (2022, June 22). A Preview of the Dangerous Future of Abortion Bans — Texas Senate Bill 8. New England Journal of Medicine . https://www.nejm.org/doi/full/10.1056/NEJMoa2403365

104

Évora, F., Hundarova, K., Águas, F., & Carvalho, G. (2021, October 29). Cervical ectopic pregnancy: A multidisciplinary approach. Cureus. https://www.cureus.com/articles/74475-cervical-ectopic-pregnancy-a-multidisciplinary-approach#!/

105

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

106

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

107

American College of Obstetricians and Gynecologists . (2023, February 10). ACOG leads amicus brief calling mifepristone conclusively safe and effective. American College of Obstetricians and Gynecologists. https://www.acog.org/news/news-releases/2023/02/acog-leads-amicus-brief-calling-mifepristone-conclusively-safe-and-effective

108

Mayo Foundation for Medical Education and Research. (2024, January 1). Mifepristone (oral route) description and brand names. Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/description/drg-20067123

109

110

Center for Drug Evaluation and Research. (2023, September 1). Questions and answers on mifeprex. U.S. Food and Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation

111

112

113

Chu, J. J., Devall, A. J., Beeson, L. E., Hardy, P., Cheed, V., Sun, Y., Roberts, T. E., Ogwulu, C. O., Williams, E., Jones, L. L., La Fontaine Papadopoulos, J. H., Bender-Atik, R., Brewin, J., Hinshaw, K., Choudhary, M., Ahmed, A., Naftalin, J., Nunes, N., Oliver, A., … Coomarasamy, A. (2020, September 12). Mifepristone and Misoprostol versus Misoprostol alone for the management of missed miscarriage (MifeMiso): A randomised, double-blind, placebo-controlled trial. Lancet (London, England). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493715/

114

Allen, R., & O’Brien, B. M. (2009). Uses of misoprostol in obstetrics and gynecology. Reviews in obstetrics & gynecology. https://pmc.ncbi.nlm.nih.gov/articles/PMC2760893/

115

Allen, R., & O’Brien, B. M. (2009). Uses of misoprostol in obstetrics and gynecology. Reviews in obstetrics & gynecology. https://pmc.ncbi.nlm.nih.gov/articles/PMC2760893/

116

MediLexicon International. (2023, January 12). Misoprostol oral tablet: Dosage, side effects, uses, and more. Medical News Today. https://www.medicalnewstoday.com/articles/drugs-misoprostol-tablet

117

Kee, C. (2018, June 28). Why Misoprostol is so much more than a pill used for medical abortions. BuzzFeed News. https://www.buzzfeednews.com/article/carolinekee/heres-how-misoprostol-works-miscarraige

118

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

119

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

120

121

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

122

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

123

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

124

125

“Medical Definition of Pregnancy.” RxList, RxList, 29 Mar. 2021, www.rxlist.com/pregnancy/definition.htm.

126

Gold, Rachel Benson, and Guttmacher Institute. “The Implications of Defining When a Woman Is Pregnant.” Guttmacher Institute, 30 Aug. 2022, www.guttmacher.org/gpr/2005/05/implications-defining-when-woman-pregnant.

127

Artal-Mittelmark, Raul. “Stages of Development of the Fetus - Women’s Health Issues.” Merck Manuals Consumer Version, Merck Manuals, 30 Aug. 2023, www.merckmanuals.com/home/women-s-health-issues/normal-pregnancy/stages-of-development-of-the-fetus.

128

129

Coplon, Leah, et al. “Society of Family Planning Committee Statement: Abortion Nomenclature.” Contraception, Elsevier, 16 June 2023, www.sciencedirect.com/science/article/pii/S0010782423001786.

130

Coplon, Leah, et al. “Society of Family Planning Committee Statement: Abortion Nomenclature.” Contraception, Elsevier, 16 June 2023, www.sciencedirect.com/science/article/pii/S0010782423001786.

131

Coplon, Leah, et al. “Society of Family Planning Committee Statement: Abortion Nomenclature.” Contraception, Elsevier, 16 June 2023, www.sciencedirect.com/science/article/pii/S0010782423001786.

132

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

133

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

134

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

135

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

136

Miscarriage: Taber’s Medical Dictionary. miscarriage | Taber’s Medical Dictionary. (n.d.). https://www.tabers.com/tabersonline/view/Tabers-Dictionary/750940/all/miscarriage

137

TeachMe OBGYN. (2022, July 11). Miscarriage - threatened - missed - complete - septic. TeachMeObGyn. https://teachmeobgyn.com/pregnancy/early/miscarriages/

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

142

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

143

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

144

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/

145

American Society for Reproductive Medicine . (n.d.). Terms and definitions. ReproductiveFacts.org. https://www.reproductivefacts.org/browse-resources/terms-and-definitions/