1. Pregnancy, Childbirth and Gynaecology Medical English

2. Today’s class We’re going to look at some of the following:  The technical language of gynecology and obstetrics  The art and literature of childbirth  There will be:  Pair work  Quizzes  Q&A

3. First question! 1. Say hello to your neighbour. 2. Does anyone know the difference between gynecology and obstetrics? Tell your neighbour if you do. 3. Be prepared to explain the difference to me in English.

4. Answer…  Gynaecology or gynecology  the science of women  female reproductive system  uterus, vagina and ovaries  Obstetrics  the care of a woman and her offspring during pregnancy, childbirth and the puerperium.

5. How quickly can you look up the definition of puerperium?

6. puerperium n.pl. puerperia 1. The state of a woman during childbirth or immediately thereafter. 2. The approximate six-week period lasting from childbirth to the return of normal uterine size. --------------------------------------------------------------- [Latin, childbirth, from puerpera, a woman in childbed; see puerperal.]

7. The science of women  Key stages in a young woman’s life:  Adolescence  Puberty  Menarche  Wu Yung-Chin (2009)

8. The science of women  Key stages in a young woman’s life:  Adolescence  the period of psychological and social transition between childhood and adulthood.  Puberty  the process of physical changes by which a child's body becomes an adult body capable of reproduction.  Menarche  The first menstruation or period.  Wu Yung-Chin (2009)

9. When things go wrong…  Cancer and pre-cancerous diseases of the reproductive organs  Menorrhagia (heavy menstrual periods).  Amenorrhea (absent menstrual periods)  Dysmenorrhea (painful menstrual periods)  Infertility  Prolapse of pelvic organs  Specialized hormone-modulating therapies

10. More questions!  Wu Yung-Chin (2009)How would you ask this girl about: 1. Menorrhagia 2. Amenorrhea 3. Dysmenorrhea How would you ask a general question? What follow-up questions would you ask?

11. Useful expressions  Are your periods regular?  How often do you get them?  How old were you when you started to get them?  When was your last period?  How long do the periods last usually?  Would you say they are light or heavy?  Do you get clots?  Do you get period pains?  Is there any discharge between the periods?  What colour is it?

12. Test your anatomical knowledge  Label the three missing parts…

13. Answers…

14. Procedures: which involve removal and which involve observation? 1. Dilation and curettage (D&C) 2. Hysterectomy 3. Oophorectomy 4. Salpingectomy 5. Hysteroscopy 6. Laparoscopy 7. Colposcopy 8. Laparotomy

15. Procedures: which involve removal and which involve observation? 1. Dilation and curettage (D&C) 2. Hysterectomy 3. Oophorectomy 4. Salpingectomy 5. Hysteroscopy 6. Laparoscopy 7. Colposcopy 8. Laparotomy

16. Procedures: removal 1. Dilation and curettage (D&C: widening of the cervix and removal of some of the lining of the uterus) 2. Hysterectomy (removal of the uterus) 3. Oophorectomy (removal of the ovaries) 4. Salpingectomy (removal of the fallopian tube) 5. Tubal ligation (clamping of fallopian tubes)

17. Procedures: observations 1. Hysteroscopy (inspection of uterus by endoscopy) 2. Laparoscopy (inspection of the uterus, fallopian tubes or ovaries; gives a definitive diagnosis of endometriosis, the spread of the uterine lining outside the uterus, e.g. to the ovaries ) 3. Colposcopy (inspection of the vagina by cameral) 4. Laparotomy (surgical procedure to gain access to areas of the abdomen, including the female reproductive organs)

18. Some internet research 1. What is the pap smear? 2. Who gave it its name? 3. What is it used for? 4. What are HPVs and what is their connection to pap smears? The clock is ticking!

19. Answers…  The Papanicolaou smear  Pap smear is a medical screening method invented independently by Georgios Papanicolaou (1883– 1962)  detects premalignancy and malignancy in the ectocervix  The dysplasias or cervical intraepithelial neoplasia are usually caused by sexually transmitted human papillomaviruses (HPVs).

20. The birds and the bees…

21. How would you describe conception?  To a 12-year old?  To a medical student?

22. How would you describe conception?  Pregnancy occurs as the result of the female gamete or oocyte (egg) being penetrated by the male gamete spermatozoon in a process referred to, in medicine, as "fertilization", or more commonly known as "conception".  Pregnancy is the carrying of one or more offspring, known as a fetus or embryo, inside the uterus of a female human.

23. Birth control…  What are these called?  What would you call a shop that sells them?

24. In Singapore…

25. Types of birth control  The Oral Contraceptive Pill  OCP  the Pill  a combination of an estrogen and a progestin  An intra-uterine device  an IUD or a copper coil.  A condom  is a device most commonly used during sexual intercourse.  can prevent pregnancy and transmission of sexually transmitted diseases (STDs).

26. Do you know?  How do we calculate the beginning of a pregnancy?  How do we calculate the estimated date of confinement (EDC) or the estimated delivery date (EDD)?

27. Do you know?  Though pregnancy begins at implantation, it is more convenient to date from the first day of a woman's last menstrual period (LMP), or from the date of conception (if known).  Counting from the LMP the EDD is 40 weeks later, 38 weeks after conception.

28. Doctor talk  One scientific term for the state of pregnancy is gravid, and a pregnant female is sometimes referred to as a gravida. (Both words are rarely used in common speech)  The term "parity" (para) is used for the number of previous successful live births.  Women who have never been pregnant are referred to as "nulliparous", during a first pregnancy as a "primigravida" and in subsequent pregnancies as "multigravida" or "multiparous".

29. The facts of birth I  Childbirth is the process by which an infant is born.  Most births are successful vaginal births (normal spontaneous delivery NSD), but sometimes complications arise and a woman may undergo a Caesarean section (C/S).

30. The facts of birth II  In a normal pregnancy, the fertilization of the egg usually will have occurred in the Fallopian tubes or in the uterus.  If the pregnancy is the result of in-vitro fertilization (IVF), the fertilization will have occurred in a Petri dish, after which pregnancy begins when one or more zygotes implant after being transferred by a physician into the woman's uterus

31. But is it enough just to know the facts?

32. Multiple gestations

33.  twins  triplets

34. Purpose of close reading  Close reading helps us understand patients’ fears, anxieties, guilt and shame.  We need to attend to more than clinical knowledge

35. Later in life…  The word menopause literally means the permanent physiological, or natural, cessation of menstrual cycles.  In humans this is usually indicated by a permanent absence of monthly periods or menstruation.  This span of time is also referred to as the change of life or the climacteric and more recently is known as "perimenopause".

36. Symptoms and treatment  The majority of women find that they undergo at least some symptoms of hormonal change, such as hot flashes or hot flushes, night sweats, mood changes, insomnia, fatigue, memory problems, etc.  Perimenopause is a natural stage of life, but when the symptoms are severe, they may be alleviated through hormone replacement therapy (HRT).

37. And finally…common > technical terms  Change  menopause  Period  menstruation  Period pains  dysmenorrhea  Heavy period  menorrhagia  Pill  contraceptive pill  Missed period  amenorrhea  Womb  uterus

38.  Morning sickness  nausea  Abortion  induced abortion  Miscarriage  spontaneous abortion  Childbirth  labor  Afterbirth  placenta  Expecting a baby  pregnancy

39. Thanks for your attention!