Alphabet soup! Your guide to pregnancy-related abbreviations
January 31, 2023
"36 yo AMA patient, LMP unknown, with h/o LTCS considering TOL."
Sound confusing? If so, don’t blame “pregnancy brain.” This is an example of a sentence you might find in your MyChart, now that federal rules require health care organizations to provide patients with digital access to their full health records, including clinicians’ notes.
We have historically used abbreviations and medical shorthand to communicate a lot of information to the care team in just a few words or letters. For example, the phrase above is doctor-speak for a “36-year-old patient who is considered advanced maternal age (35+), and who is uncertain of when her last period began. She has a history of the most common type of C-section and wants to try for a vaginal delivery.”
Patients rarely saw these notes until October 2020, when the 21st Century Cures Act took effect and required clinical notes be posted via your MyChart patient portal.
In many ways, this is a good thing for patients – you should be familiar with your medical records and having access to your doctors’ notes can help you make more informed health decisions. A 2018 study showed that people forget half of what their doctors say during an appointment. And a yearlong trial showed that 87% of patients who read at least one doctor’s note reported that they felt more in control of their own care.
Though our chicken scratch can help remind you about the doctor’s recommendations, seeing abbreviations in medical notes can resemble alphabet soup – a jumble of letters that don’t immediately make sense. Some entries might even be upsetting if people misunderstand an intended word or phrase.
The Joint Commission, a U.S.-based nonprofit that accredits more than 22,000 U.S. health care organizations and programs, requires institutions to develop and implement a Do Not Use list of abbreviations that are unsafe to use in clinical notes. However, there are many approved acronyms that make perfect sense to clinicians but might be confusing for patients. So, before you dive into the notes from your prenatal or postpartum appointment, let’s go over some of the abbreviations you might see.
Obstetric history or current pregnancy
- LMP: Last menstrual period, which is the first day that your last period began. During your first prenatal visit to the doctor, we’ll ask about your LMP.
- H/O: History of, such as a procedure or condition.
- PTB: Preterm birth, or delivery before 37 weeks of pregnancy.
- PTL: Preterm labor, which may result in a premature birth.
- PROM: Premature rupture of membranes, which is a fancy way of saying a woman’s water broke before the start of labor.
- PPROM: Preterm premature rupture of membranes (before 37 weeks of pregnancy).
- IUGR or FGR: Intrauterine growth restriction or fetal growth restriction, which are conditions that are suspected if the fetus isn’t growing as expected.
- GDM: Gestational diabetes mellitus, which is diabetes that is diagnosed during pregnancy using a GTT (glucose tolerance test) – a fasting test that requires you to drink a sugary liquid and provide a blood sample.
- DM (diabetes mellitus) or IDDM (insulin dependent diabetes mellitus): Diabetes that was present before pregnancy.
- SSE: Sterile speculum exam, which is used to check the vagina and cervix for leaking amniotic fluid.
Type of delivery
- CS or CD: Cesarean section (C-section) or cesarean delivery.
- LTCS: Low transverse C-section, in which the surgical incision is made in the lower section of the uterus, which doesn’t contract. This is the most common type of C-section and is generally safe for a later vaginal birth.
- VBAC: Vaginal birth after a previous cesarean.
- TOL: Trial of labor, which is allowing labor to progress with the hope of a vaginal delivery (usually after a previous LTCS).
- SVD: Spontaneous vaginal delivery – a birth that happens with a mom’s pushing only, no help needed by the doctor.
- FAVD: Forceps-assisted vaginal delivery, in which the doctor helps guide the baby’s head during vaginal birth using an instrument that resemble circular salad tongs.
- UPT: Urine pregnancy test, which is used to detect pregnancy hormones in a sample of your pee.
- UA: Urinalysis, a test to detect a wide range of disorders, including preeclampsia, urinary tract infection, and diabetes.
- UCx: Urine culture, which can detect infection with specific information about the bacteria causing the infection.
- FTS: First trimester screening, which looks for chromosome abnormalities. This test requires measurement of fluid underneath the skin of the fetal neck - the nuchal translucency (NT) – by ultrasound in combination with a blood sample from mom.
- NIPT or NIPS: Non-invasive prenatal testing or screening, technology that looks at the presence of placental DNA in a maternal blood sample and can indicate risk for chromosome abnormalities. It can be performed after 9 weeks of gestation.
Instructions for future visits
- R/O: Rule out, which means the doctor is determining whether a specific condition or disease is or is not to blame for symptoms.
- MFM: Consult with a maternal-fetal medicine specialist, or a high-risk pregnancy doctor.
- ROB: Return OB appointment.
- RTC: Return to clinic.
- Pre-E or PET: Preeclampsia or preeclampsia toxemia. SPE may be used to indicate severe preeclampsia.
- VB: Vaginal bleeding.
- LOF: Loss of fluid.
- CTXNs: Contractions.
Take the time to look through your medical records and doctor’s notes after each visit, and don’t despair if it looks like alphabet soup. If you have questions or notice a potential error, please call us or send a note through the patient portal. We’ll be happy to give you the information you need to manage your health. Learn more and log in to MyChart.
To talk with a pregnancy care provider, call 214-645-8300 or request an appointment online.