Podcast
Questions and Answers
Which structure is covered with pubic hair and formed by a mass of fatty subcutaneous tissue?
Which structure is covered with pubic hair and formed by a mass of fatty subcutaneous tissue?
What type of epithelium is found in the mucosa of the structure described?
What type of epithelium is found in the mucosa of the structure described?
Which structure consists of erectile tissue and forms part of the female external genitalia?
Which structure consists of erectile tissue and forms part of the female external genitalia?
Which lymph nodes are involved in the lymphatic drainage of the female external genitalia?
Which lymph nodes are involved in the lymphatic drainage of the female external genitalia?
Signup and view all the answers
What arteries primarily supply the inferior regions of the female reproductive structures?
What arteries primarily supply the inferior regions of the female reproductive structures?
Signup and view all the answers
What hormone levels return to non-pregnant levels approximately 7 days postpartum?
What hormone levels return to non-pregnant levels approximately 7 days postpartum?
Signup and view all the answers
What is the estimated weight of the uterus at 6-8 weeks postpartum?
What is the estimated weight of the uterus at 6-8 weeks postpartum?
Signup and view all the answers
Which type of lochia is characterized by a blood red color and lasts for the first four days after birth?
Which type of lochia is characterized by a blood red color and lasts for the first four days after birth?
Signup and view all the answers
What is the typical mean weight loss associated with the delivery of the baby, amniotic fluid, and placenta?
What is the typical mean weight loss associated with the delivery of the baby, amniotic fluid, and placenta?
Signup and view all the answers
At what level is the fundus of the uterus located on the 10th day postpartum?
At what level is the fundus of the uterus located on the 10th day postpartum?
Signup and view all the answers
What is the purpose of the combined test performed between 11-13 weeks of pregnancy?
What is the purpose of the combined test performed between 11-13 weeks of pregnancy?
Signup and view all the answers
Which of the following is NOT a component measured in the triple or quadruple tests performed at 16 weeks?
Which of the following is NOT a component measured in the triple or quadruple tests performed at 16 weeks?
Signup and view all the answers
What is the main advantage of cell-free fetal DNA testing?
What is the main advantage of cell-free fetal DNA testing?
Signup and view all the answers
Which condition is indicated by a nuchal translucency (NT) measurement greater than 4mm?
Which condition is indicated by a nuchal translucency (NT) measurement greater than 4mm?
Signup and view all the answers
What hormonal changes signify the onset of labor?
What hormonal changes signify the onset of labor?
Signup and view all the answers
What is the gold standard for confirming chromosomal abnormalities during pregnancy?
What is the gold standard for confirming chromosomal abnormalities during pregnancy?
Signup and view all the answers
Which of the following statements about pre-labor signs is true?
Which of the following statements about pre-labor signs is true?
Signup and view all the answers
What is the typical frequency and duration of uterine contractions once labor is established?
What is the typical frequency and duration of uterine contractions once labor is established?
Signup and view all the answers
What is the primary focus of antenatal appointments during the second trimester at 16 weeks?
What is the primary focus of antenatal appointments during the second trimester at 16 weeks?
Signup and view all the answers
Which of the following is considered a medical factor related to high maternal risk?
Which of the following is considered a medical factor related to high maternal risk?
Signup and view all the answers
What is a potential fetal risk factor that could lead to unfavorable perinatal outcomes?
What is a potential fetal risk factor that could lead to unfavorable perinatal outcomes?
Signup and view all the answers
Why is it important to identify high risk pregnancies?
Why is it important to identify high risk pregnancies?
Signup and view all the answers
Which method is NOT typically used for the diagnosis of high risk pregnancies?
Which method is NOT typically used for the diagnosis of high risk pregnancies?
Signup and view all the answers
Which medication is used to sensitize the uterus to prostaglandins prior to termination of pregnancy?
Which medication is used to sensitize the uterus to prostaglandins prior to termination of pregnancy?
Signup and view all the answers
What is the primary risk associated with dilatation and evacuation after 13 weeks of gestation?
What is the primary risk associated with dilatation and evacuation after 13 weeks of gestation?
Signup and view all the answers
Which of these is NOT a differential diagnosis for bleeding in the first trimester?
Which of these is NOT a differential diagnosis for bleeding in the first trimester?
Signup and view all the answers
What is the legal limit for termination of pregnancy in the UK?
What is the legal limit for termination of pregnancy in the UK?
Signup and view all the answers
What is the recommended antibiotic regime to prevent infection after termination of pregnancy?
What is the recommended antibiotic regime to prevent infection after termination of pregnancy?
Signup and view all the answers
Which option describes the medical management of a non-viable miscarriage?
Which option describes the medical management of a non-viable miscarriage?
Signup and view all the answers
What complication is NOT commonly associated with termination of pregnancy?
What complication is NOT commonly associated with termination of pregnancy?
Signup and view all the answers
What is the main purpose of cervical preparation before surgical termination of pregnancy?
What is the main purpose of cervical preparation before surgical termination of pregnancy?
Signup and view all the answers
Study Notes
Female Anatomy: Vagina
- Parts: Anterior and posterior.
- Histology: Mucosa (folded, stratified squamous non-keratinized epithelium, lamina propria); Muscularis (inner circular, outer longitudinal layers); Tunica spongiosa.
- Arterial Supply: Superior – uterine artery branches; Middle and inferior – vaginal and internal pudendal arteries (internal iliac artery branches).
- Venous Drainage: Vaginal venous plexus to uterine veins to internal iliac veins.
- Lymphatic Drainage: Iliac, sacral, aortic, and inguinal lymph nodes.
- Innervation: Uterovaginal plexus.
Female External Genitalia
- Mons Pubis: Fatty eminence anterior to pubic symphysis, covered in pubic hair.
- Labia Majora: Skin folds protecting urethral and vaginal orifices, extending from mons pubis to anus; contain loose subcutaneous tissue, smooth muscle, and round ligament termination; covered in pubic hair; form anterior and posterior commissures.
- Labia Minora: Hairless skin folds surrounding the vestibule; contain erectile tissue; medial laminae form clitoral frenulum; lateral laminae form clitoral prepuce; posterior portion forms the frenulum of the labia minora.
- Clitoris: Located where labia minora meet anteriorly; consists of root, body (corpora cavernosa), and glans; solely for sexual arousal.
- Vestibule: Space surrounded by labia minora, containing external urethral and vaginal orifices, and ducts of greater/lesser vestibular glands (mucus secretion during arousal).
Prenatal Screening & Diagnosis
- Combined Test (11-13+6 weeks): Ultrasound (nuchal translucency measurement) + blood test (PAPP-A, hCG).
- Triple/Quadruple Tests (16 weeks): Dating scan + blood test (oestriol, hCG, AFP, inhibin A [quadruple only]).
- Cell-Free Fetal DNA Testing (10 weeks onwards): Fetal DNA isolated from maternal blood for genetic testing; identifies chromosomal aberrations and fetal sex.
- Invasive Testing: Chorionic villus sampling (10-13 weeks), amniocentesis (15-18 weeks), followed by fetal karyotyping (gold standard).
Chromosomal Abnormalities & Screening Markers
- Trisomy 21 (Down Syndrome): Increased nuchal translucency, low PAPP-A, high free β-hCG.
- Trisomy 18 (Edwards Syndrome): Increased nuchal translucency, low PAPP-A, low free β-hCG.
- Trisomy 13 (Patau Syndrome): Increased nuchal translucency, low PAPP-A, low free β-hCG.
- Turner Syndrome (45, XO): Note: Specific screening markers not detailed.
- Klinefelter Syndrome (47, XXY): Note: Specific screening markers not detailed.
Onset of Labor & Stages of Labor
- Onset: Endocrine maternal/fetal cross-talk, controlled by the fetus; hormonal changes include increased prostaglandin synthesis, myometrial gap junction formation, and myometrial oxytocin. Activation of the fetal-hypothalamic-pituitary-adrenal axis initiates labor. Signs include lightening (mother feels lighter in abdomen).
- Established Labor: Uterine contractions lasting 45-60 seconds every 2-4 minutes.
Normal Puerperium & Postpartum Care
- Puerperium: Period from delivery to approximately 6 weeks postpartum. Hormonal changes include rapid decline in human placental lactogen and β-hCG; estrogen and progesterone return to non-pregnant levels within 7 days postpartum; menstrual flow returns after 6 weeks.
- Uterine Involution: Weight reduces from 1000g at birth to 70g at 6-8 weeks; fundus at navel level on day 1, pelvic level by day 10.
- Lochia: Uterine discharge (endometrial cells, necrotic tissue, blood, serum, lymph): Lochia rubra (red, first 4 days), lochia serosa (brown-red, watery, 2-3 weeks), lochia alba (yellow-white, 1-2 weeks).
- Treatment of Postpartum Hemorrhage: Buscolysin, Oxytocin, Methergine.
- Weight Loss: Significant weight loss after delivery of baby, amniotic fluid, and placenta.
Antenatal Care & High-Risk Pregnancy
- Antenatal Appointment Schedule: Specific details for second trimester appointment at 16 weeks (screening results discussion, hemoglobin level investigation).
- Factors Associated with High Maternal Risk: Parity, lack of prenatal care, distance to hospital, pre-pregnancy diabetes, hypertension, endocrine/CVD/neurological/renal/pulmonary/autoimmune disorders, multiple pregnancy, high BMI, previous cesarean section, uterine scar, obstetric complications in previous pregnancies/deliveries.
- Fetal Risk Factors for Unfavorable Perinatal Outcome: Congenital anomalies (termination of pregnancy may be an option, prenatal screening and diagnosis necessary), preterm delivery, IUGR (increased perinatal mortality, neonatal adaptation problems, chronic pulmonary disease), intrauterine infections (HIV/AIDS, CMV, syphilis), birth trauma (adequate delivery assessment, shoulder dystocia management, emergency cesarean section access), Rh sensitization (anti-D immune globulin).
- Reasons for Identifying High-Risk Pregnancies: Eliminate risk factors, ensure adequate follow-up, prevent complications (e.g., preeclampsia – aspirin, maternal/fetal follow-up, delivery at 37 weeks), determine timing, place, and mode of delivery.
- High-Risk Pregnancy Identification Methods: Past obstetric history, detailed family history, physical/gynecological exam, adequate pregnancy follow-up.
- Diagnostic Methods: Ultrasound (3D and Doppler), prenatal screening, invasive prenatal testing, NIPT, cardiotocography (CTG), biophysical profile (BPP).
Postpartum Hemorrhage Management
- Ergometrine (to contract uterus, if non-viable pregnancy).
- Intravenous antibiotics if fever present.
- Anti-D for Rh-negative women.
Miscarriage Management
- Non-Viable Miscarriage: Medical management (vaginal/oral prostaglandin [misoprostol], repeat pregnancy test); surgical management (removal of products of conception with anesthetic, vacuum aspiration).
- Differential Diagnosis (1st-trimester bleeding): Ectopic pregnancy, hydatidiform mole, cervical polyps, cervicitis, neoplasm.
Artificial Abortion (Termination of Pregnancy - TOP)
- Definition: Methods for terminating unwanted pregnancy; legal limit of 24 weeks in the UK.
- Surgical Methods: <7 weeks (conventional suction termination should be avoided), 7-13 weeks (conventional suction termination), >13 weeks (dilation and evacuation after cervical preparation). Higher gestational age increases risks of bleeding, incomplete evacuation, perforation. Cervical preparation (misoprostol 400mcg PV 3 hrs prior, gemeprost 1mg PV 3 hrs prior, or mifepristone 600mg PO 36-48 hrs prior) reduces cervical dilation difficulty, especially for patients >10 weeks.
- Medical Methods: Used up to 20 weeks.
- Medications: Mifepristone (antiprogesterone, given 24-48 hours prior, causes uterine contractions, bleeding, and prostaglandin sensitization); Misoprostol (prostaglandin E1 analogue, stimulates uterine contractions); Gemeprost (prostaglandin E1 analogue, softens and dilates cervix before surgical TOP in the first trimester and for therapeutic TOP in the second trimester).
- Management Before TOP: Counseling/support, blood tests (Hb, blood group, antibodies), ultrasound scan, infection prevention (antibiotic regimens – metronidazole 1g + doxycycline 100mg PO for 7 days; metronidazole 1g PR + azithromycin 1g PO)
- Management After TOP: Anti-D to all Rh-negative women, follow-up within 2 weeks.
- Complications of TOP: Significant bleeding, genital tract infection, uterine perforation, uterine rupture, cervical trauma, failed TOP, retained products of conception, nausea/vomiting/diarrhea (due to prostaglandins), psychological sequelae (short-term anxiety and depressed mood).
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Explore the intricate details of female anatomy, focusing on the vagina and external genitalia. This quiz covers the structure, histology, arterial supply, venous drainage, and innervation of these vital areas. Test your knowledge on the components that contribute to female reproductive health.
