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epidural

Childbirth

What is childbirth?

Childbirth is the process of giving birth to a baby. It includes labor and delivery of the fetus and the placenta. The placenta is the organ that supplies food and oxygen through the umbilical cord to your fetus during pregnancy.

A full-term pregnancy is 40 weeks. Labor usually begins between 37 and 42 weeks of pregnancy. It is how your body prepares to give birth to your baby. Preterm labor can start before 37 completed weeks of pregnancy. It can lead to premature birth. Premature babies may face serious health risks.

How do I know if I'm going into labor?

Signs that you might be going into labor include:

The signs of labor, when labor starts, and the time it takes to deliver your baby can vary with each pregnancy. Call your health care provider if you have any signs of labor, even if it is before your due date.

What are the stages of labor?

Labor happens in three stages.

Sometimes, mothers need to have labor induced. Medicines or other methods are used to start labor. This is usually only done when the due date has passed or if a problem with the pregnancy risks the health of the mother or the fetus.

Mothers and their babies are closely monitored during labor and delivery. Delivery can occur either vaginally through the birth canal, or if there are complications, the delivery may be done surgically by a Cesarean section. This is when the baby is taken out through your abdomen (belly) and uterus.

What are the options for pain relief during childbirth?

The amount of pain during childbirth can vary based on the size and position of the baby, your level of comfort with the process, and the strength of your contractions.

Options for pain relief during labor and delivery may include:

Discuss your options, risks, and benefits of pain relief during labor and delivery with your provider before your due date.

NIH: National Institute of Child Health and Human Development

Anesthesia

What is anesthesia?

Anesthesia is the use of medicines, called anesthetics, to prevent pain during surgery and other medical procedures. Medicine may be given by injection, inhalation, topical lotion, spray, eye drops, or a skin patch.

Anesthesia can cause a loss of feeling, awareness, or both. Sedation may be used with anesthesia. Unlike full anesthesia, sedation doesn't make you completely unconscious, and recovery is faster. It helps reduce pain, keep you calm, and make you less aware during procedures such as minor surgeries, endoscopies, imaging, or dental work.

Levels of sedation include:

What is anesthesia used for?

Anesthesia may be used for:

In some cases, a dentist, nurse, or doctor may give you an anesthetic. In other cases, you may need an anesthesiologist. This is a doctor who specializes in giving anesthesia.

What are the types of anesthesia?

There are several different types of anesthesia:

Your overall health, medical history, the procedure you're having, and other factors will help determine the type of anesthesia you receive.

What are the risks of anesthesia?

Anesthesia is generally safe. But there can be risks, especially with general anesthesia, including:

Talk to your health care provider about the benefits and risks of anesthesia.

Abscess

An abscess is a pocket of pus. You can get an abscess almost anywhere in your body. When an area of your body becomes infected, your body's immune system tries to fight the infection. White blood cells go to the infected area, collect within the damaged tissue, and cause inflammation. During this process, pus forms. Pus is a mixture of living and dead white blood cells, germs, and dead tissue.

Bacteria, viruses, parasites and swallowed objects can all lead to abscesses. Skin abscesses are easy to detect. They are red, raised and painful. Abscesses inside your body may not be obvious and can damage organs, including the brain, lungs and others. Treatments include drainage and antibiotics.

Bleeding

Bleeding is the loss of blood. It can be external, or outside the body, like when you get a cut or wound. It can also be internal, or inside the body, like when you have an injury to an internal organ. Some bleeding, such as gastrointestinal bleeding, coughing up blood, or vaginal bleeding, can be a symptom of a disease.

Normally, when you are injured and start bleeding, a blood clot forms to stop the bleeding quickly. Afterwards, the clot dissolves naturally. To be able to make a clot, your blood needs blood proteins called clotting factors and a type of blood cell called platelets. Some people have a problem with clotting, due to another medical condition or an inherited disease. There are two types of problems:

Sometimes bleeding can cause other problems. A bruise is bleeding under the skin. Some strokes are caused by bleeding in the brain. Severe bleeding may require first aid or a trip to the emergency room.

Cesarean Delivery

What is a cesarean delivery?

A cesarean delivery, also called a cesarean section or c-section, is surgery to deliver a baby. The baby is taken out through your abdomen (belly). In the United States, almost one in three babies are born this way. Some cesarean deliveries are planned. Others are emergency cesarean deliveries, which are done when unexpected problems happen during delivery.

When is a cesarean delivery needed?

You may need a cesarean delivery because:

Not everyone who has had a cesarean delivery before will need another one next time. You may be able to have a vaginal birth after cesarean (VBAC). Talk to your health care provider about what is right for you.

How is a cesarean delivery done?

Before the surgery, you will be given pain medicine. Depending on your circumstances, you might get:

During the surgery, the surgeon will:

What are the risks of a cesarean delivery?

A cesarean delivery is relatively safe for you and your baby. But it is still a major surgery, and it carries risks. They may include:

Some of these risks do also apply to a vaginal birth. But it does take longer to recover from a cesarean delivery than from a vaginal birth. And having a cesarean delivery can raise the risk of having difficulties with future pregnancies. The more cesarean deliveries you have, the more the risk goes up.

NIH: National Institute of Child Health and Human Development

Herniated Disk

Your backbone, or spine, is made up of 26 bones called vertebrae. In between them are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place. As you age, the disks break down or degenerate. As they do, they lose their cushioning ability. This can lead to pain if the back is stressed.

A herniated disk is a disk that ruptures. This allows the jelly-like center of the disk to leak, irritating the nearby nerves. This can cause sciatica or back pain.

Your doctor will diagnose a herniated disk with a physical exam and, sometimes, imaging tests. With treatment, most people recover. Treatments include rest, pain and anti-inflammatory medicines, physical therapy, and sometimes surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Sciatica

Sciatica is a symptom of a problem with the sciatic nerve, the largest nerve in the body. It controls muscles in the back of your knee and lower leg and provides feeling to the back of your thigh, part of your lower leg, and the sole of your foot. When you have sciatica, you have pain, weakness, numbness, or tingling. It can start in the lower back and extend down your leg to your calf, foot, or even your toes. It's usually on only one side of your body.

Causes of sciatica include:

In many cases no cause can be found.

Sometimes sciatica goes away on its own. Treatment, if needed, depends on the cause of the problem. It may include exercises, medicines, and surgery.

Spinal Cord Diseases

Your spinal cord is a bundle of nerves that runs down the middle of your back. It carries signals back and forth between your body and your brain. It is protected by your vertebrae, which are the bone disks that make up your spine. If you have an accident that damages the vertebrae or other parts of the spine, this can also injure the spinal cord. Other spinal cord problems include:

Symptoms vary but might include pain, numbness, loss of sensation and muscle weakness. These symptoms can occur around the spinal cord, and also in other areas such as your arms and legs. Treatments often include medicines and surgery.

Spinal Stenosis

Your spine, or backbone, protects your spinal cord and allows you to stand and bend. Spinal stenosis causes narrowing in your spine. The narrowing puts pressure on your nerves and spinal cord and can cause pain.

Spinal stenosis occurs mostly in people older than 50. Younger people with a spine injury or a narrow spinal canal are also at risk. Diseases such as arthritis and scoliosis can cause spinal stenosis, too. Symptoms might appear gradually or not at all. They include:

Doctors diagnose spinal stenosis with a physical exam and imaging tests. Treatments include medications, physical therapy, braces, and surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Spine Injuries and Disorders

Your backbone, or spine, is made up of 26 bone discs called vertebrae. The vertebrae protect your spinal cord and allow you to stand and bend. A number of problems can change the structure of the spine or damage the vertebrae and surrounding tissue. They include:

Spinal diseases often cause pain when bone changes put pressure on the spinal cord or nerves. They can also limit movement. Treatments differ by disease, but sometimes they include back braces and surgery.

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