OB Flashcards
Estrogen
- Effects secondary sex characterists
- Follicle Maturation
- Proliferation of endometrial Mucosa
Progesterone
- Decreases uterine motility and contractillity
- Build up the endometrium
- Proliferation of the endometrium
- Secretion of thick viscous mucus by the cervix.
Phases of Female Reproductive Cycle
A. Hypothalamus secretes
gonadotropin-releasing hormone (GnR)
What causes the anterior pituitary to relase FSH and LH?
GnRH
FSH-Follicle Stimulationg Hormone causes what?
Maturation of follicle.
(LH) Lutenizizing Hormone does what?
Increases production of progesterone, relase of mature follicle from the ovary.
OVARIAN CYCLE Follicle phase (days 1-14)
- Graafian follicle appears by day 14 under dual control of FSH and LH
Ovulation
What is Mittleschmerz
Discomfort of pain during ovulation
Does body temperature increase after ovulation.
Yes it increase 0.4 degrees as a reult of progresterone causing blood to come to the area.
Luteal phase
(days 15-28)
Begins when the ovum leaves follicle.
What are the phases of the endonmetrial cycle.
- Menstrual phase
- Proliferative phase
- Secretary phase
- Ischemic phase
- Menstrual phase again
Menstrual phase
Menstruation occurs in response to low levels of estrogen and prgesterone
Proliferative phase
The endometrial glands enlarge in response to increasing estrogen levels
Secretary phase
The endomtrium undergoes slight cellular growth due to estrogen, and progesterone cause marked swelling and growth.
Ischemic phase
Begins if fertiliaztion does not occur.
Fertilization
- Women usually ovulate 14 days before their menstrual period.
- After ovulation the ovum may remain viable for approximately 24 hours
- Sperm may remain ferlile for 72 hours (even up to 5 days)
- Fertilty
The caluclation of ferlie period based on the cycle calendar can be quite inaccurate, especially in the case of women with irregular cycles.
- Fertility
Monitoring of bilogical femal body changes helps to predict fertile and infertile periodss.
- Fertility
Changes in Cervical Mucus
- Fertility
During most of the cycle is scant, thick and sticky
- Fertility
Just before ovulation it becomes thin clear and elastic to promost the passage of sperm into the uterus and fallopian tubes.
- Fertility
Women may assess the elasticyt of their cervical mucus either to avoid or to promote conception. (Spinnbarkeit)
- Infertility
“Infertility is a disease defined by the failure to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
- Infertility
Is complex and often frustrating experience for the patient, as well as the clinician.
- Infertility
The reasons for infertility are varied and can sometimes be idiopathic in orgin.
4 Infertility
There are medical, ethical, as well as psychological components associated with it.
5 Infertility
Nurses need to be comfortable with own sexualty.
Sterility
Inability to achieve pregnancy
Primary Infertility
Those who have never conceived
Secondary Infertility
Those who have conceived in the past
Fecundity
The state of being ferfile; capable of producing offspring.
Etiology
- Ovulatory dysfunction (20-40%)
- Tubal and peritoneal pathology (30-40%)
- Male factors (30-40%)
- Uterine pathology is relatively uncommon
- The remainder is unexplained.
Ovulatory dysfuntion
-increases with age:aging on female fertility is clear; the fertility peak is between the ages of 20 and 24 years, decreases slighlty by age 32, and then declines progessively and more rapidly after age 40.
Spontanioius miscarrage increases from
10 percent in younger women, to 40% at age 40, even with assisted reprodductive technology.
This increase is due to progressive follicular depletion and a high incidence of abnormalities in aging oocytes.
Polycystic ovarian syndrome (PCOS) is another cause of ovarian dysfunction.
- PCOS is one of the most prevalent endocrine disorder inwoen, affecting 6% to 10% of women of childbearing age and accounting for 70% of anovulatory subfertily.
- PCOS requires work up for proper diagnosis.
- One of the most common causes is obesity, but PCOS is also found in normal weight women. Its diagnosis is importan not longer-term considerations, such as metabolic or insulin resistance syndrome and its associated consequences.
Hypothyroidism and Hyperprolactinemia
Can result in ovulatory dysfuction.
Tubal and Pelivic Problems include:
Endometriosis occurs when cells from the lining of the uterus grow in other areas of the body. This can lead to pain, irregular bleeding, and infertilty.
Tubal Scaring
From PID-Gonorrhea and Chlamydia
Asherman’s syndrome
Utererine currette (D & C)
Other causes are
endometritis and uterine surgery.
Smoking and drug use:
exposure to passive smoke have almost the same effect on infertilty-accelerated follicular depletion, abnormal menstrual cycles, and mutagenesis of the gamate or embryo.
Marijuana
inhibits secretion of GnRH and can suppress reproductive function of men and women.
Cocaine
can impair spermatogenesis in men and is associated with tubal disease in women.
Heavy alcohol consumption in men
can decrease semen quality and cause impotence it may decrease fertilty.
Environment factors
repeated exposure to chemicals, radiation, and heavy metals can cause repeated miscarriages and infertility in men and women.
Obesity
In women and men have a profound efect on infertity.- Men obesity is associated with abnormal semen parameters, such as motility and numbers.
Women obesity can cause repeated miscarriage, obulatory dysfuntion, neonatal and obsteric complications.
- Male factors
Abnormalities in the number, shape, swimming motion, and viscosity of sperm.
- Endocrine disorders
such as hypothalamic dysfunction, pituitary failure (surgery, tumor, radiation), hyperprolactinmia (tumor, drug); Thyroid disorders
- Adrenal hyperplasia
-excessive or deficient production of sex steroids
- Sexual Dysfunction
Retrograde ejactulation, Impotence, decreased libido.
Anotomic Disorders
Congential absence of vas deferens, obstruction of vas deferens, congenital abnormalites of ejaculatory system.
INFERTLITY STATS
Women age 15-44 with imparied fecunity is 6.7 million.
Percent of women ages 15-44 that have imparied fecudity is 10.8%
Number of married women 1.5 million.
Percent of married women 6%.
Number of women who have ever used fertility services 7.4 million.
Polycystic ovarian syndrome is treated with
the birth control pill
If Polycystic PCOS is not treated
women has a higher chance of getting type 2 diabetes down the line.
ABORTION -If D & C not complete
Dilation of Cervix- they go up and manual scrape the conceptions.
it can influence fertility later on in life.
Most common uterin currette
IS D & C
Oncofertility-Cancer treatment
Affects Fertility so they may seek out saving sperm and eggs before they undergo treatment.
Assisted Reproduction Technologies
Outcome of Pregnancies
15%-Miscariage
82%- percent live Births
(28% multiple, 54% single)
Meisosis of gametogenis
Production of new organsm
- Two cell state cell reduction
First Division
-Chromosomes replicate, pair and exchange information.
-Chromome pairs seperate, and cell divivides.
Second PART-
-Chromatids separate and move to opposite poles.
Cells divide, forming four daughter cells.
-Haploid cells (23 chromosomes: 22 autosome +1 sex chromosome
-Mutations (trisomy)
Gametes (sperm and ovum) unite to form a zygote (back to 46 chromosomes)
Fertilization
Occurs when one spermatozoon enters the ovum and two nuclei containing the parents chromsome merge Actual fertization takes place in the ampulla (outer third) of the fallopian tube.
GERMINAL STAGE
First 14 days of human development
Morula
(formed 12-16 cells)
Blastocyst
(100 cells)
Blastocyst is TWO PARTS
The INNER CELL MASS Develops into FETUS.
TROPHOBLAST (the OUTER LAYER OF CELLS that SURROUNDS the BLASTOCYST) Develops into placenta and fetal membranes.