Prefix Meaning

neo- New
endo- Inner
peri- external
primi- First
multi- More than one
nulli- Zero
dys- painful
a- absence
oxy- rapid

Combining form Meaning

gynec/o Female
obstetr/o Childbirth
nat/i Birth
ov/o, ovul/o, o/o The egg or ovum
ovari/o, oophor/o Ovary
uter/o, metr/o, hyster/o Uterus
salping/o, -salpinx fallopian tubes
cervic/o Cervix
metri/o lining of uterine
my/o, myom/o muscular
men/o Menses, menstruation
vagin/o, colp/o vagina
vulv/o, episi/o Vulva
bartholin/o The Bartholin glands
perine/o perineum
mamm/o, mast/o mammary glands
lact/o, galact/o Milk
gravid/o pregnancy
amni/o Amnion
chori/o chorion
fet/o fetus
metr/o uterine
olig/o scanty
leiomy/o smooth, visceral muscle
carcin/o malignant
chori/o chorionic
cervic/o the cervix
vers/o turned
hydr/o fluid
culd/o cul-de-sac
lapar/o Abdomen
 Suffix Meaning
-logy Study of
-ium mucous membrane or tissue
-arche the beginning
-cyesis, -gravida pregnancy
-para, -tocia delivery
- rrhagia bursting forth of blood
-oma tumor or mass
-dynia pain
-parous birth
-metry Measuring
-ine Pertaining to
-plasty Repair
If more than one egg is traveling through the uterine tube when sperm cells are present, then multiple fertilizations may occur.
Hormones are chemical messengers that play an important role in the female reproductive system.

Female Reproductive System ( Internal Genitalia )

Terms Definition
gynecology (GYN) is the study of the female reproductive organs, including the breasts.
Obstetrics (OB) is the branch of medicine concerned with pregnancy and childbirth, and
neonatology concentrates on the care of the neonate
Structures of the Female Reproductive System (Internal Genitalia)
Terms Definition
Ovum The ovaries (gonads) produce the female sex cell, or egg, called the ovum
gametes Is The egg or ovum and the male sex cell, the sperm
Fertilization is the union of sperm and ovum to form a zygote. Fertilization normally occurs in
the uterine tube, also known as the fallopian tube.
zygote is a single cell with a complete set of chromosomes that will develop into an
embryo.
The ovary is the gamete-producing organ of the female reproductive system. The ovaries
and other major organs of the female reproductive system are located in the
pelvic cavity. The ovaries are paired, almond-shaped organs that form part of the
internal genitalia. Each ovary weighs approximately 3 grams and has a puckered,
uneven appearance, caused by its contents thousands of small sacs, called
graafian follicles, or ovarian follicles, which contain the ova. The ovaries are
connected to another major reproductive organ, the pear-shaped uterus, by
bands of fibrous tissues called the utero-ovarian ligaments
fallopian tubes or There are two fallopian tubes. One end of each tube attaches to the uterus, and
oviducts the other end curves over the top of an ovary and opens into the abdominal
cavity.
After the expulsion of the ovum from the ovary during the process known as
ovulation, fringelike projections on the outer end of each fallopian tube called
fimbriae catch the egg. Once the egg is inside the tube, the cilia, small hairs in the
tube's lining, help move the ovum toward the uterus.
The fallopian tubes also serve as a passageway for sperm cells to move toward
the ovary. Together, the fallopian tubes, the ovaries, and the supporting
ligaments are known as adnexae uteri accessory structures of the uterus.
The uterus
Terms Definition
The uterus is a small, but very strong, fibromuscular organ that lies between the urinary
bladder and the rectum. It normally tilts forward and slightly upward. The body of
the uterus rounds into an upper prominence known as the fundus.

The uterus consists of two main parts:

the body or a wide upper portion
corpus
Cervix (CX) a narrow lower "neck"
The walls of the uterus are made up of three layers:
endometrium an inner lining of uterine mucous membrane or tissue
myometrium a thick, muscular middle layer
Perimetrium or an external membranous layer
uterine serosa
menstruation, or Each month that conception does not occur, the endometrial lining that has built
menses up in preparation for pregnancy is shed in the process. Menstruation occurs on
average every 28 days.

Terms Definition
The Vagina is an expandable muscular tube that extends from the uterine cervix to the
vaginal opening. It is 3 to 4 inches in length and is part of the internal genitalia,
lying between the urinary bladder and the rectum. Sometimes the vaginal
opening is covered by a fold of mucous membrane called the hymen. The vagina
is the organ through which sperm travel to unite with the ovum and through
which the fetus travels during childbirth. For this reason, the vagina is also called
the birth canal in the context of pregnancy.
Female Reproductive System (External Genitalia)
Terms Definition
vulva Is The external structures of the female reproductive system. These structures
include the Bartholin glands, mons pubis, labia majora and labia minora, clitoris,
and orifices which is the openings of the vagina and the urethra.
The Bartholin are two small, mucus-secreting organs that lie to the left and right of the vaginal
glands orifice. The Bartholin glands are also called the greater vestibular glands because
their ducts open into an area of the vulva known as the vestibule.
The mons pubis is a rounded, skin-covered pad of fatty tissue that overlies the connection of two
pubic bones the symphysis pubis. After puberty (the arrival of adolescence), the
mons pubis is covered with an inverted triangular pattern of pubic hair.
The labia majora are two elongated folds of fatty tissue on each side of the vaginal orifice that
extend back from the mons pubis. They are thicker in front and gradually become
thinner and flatter as they merge with other tissues in the perineum, which is the
area between the vagina and the anus.
the labia minora Two smaller folds of tissue lie parallel to, and are sometimes concealed by, the
labia majora. These smaller, hairless folds contain sebaceous glands. The urethral
and vaginal orifices are located within the vestibule, which lies between the labia
minora.
The clitoris is a small, rounded organ that is situated near the anterior folds of the labia
minora. The clitoris is composed of erectile tissue, which serves as a sensitive
receptor of sexual stimulation.
The breasts, or are accessory structures of the female reproductive system that lie on the upper
mammary glands chest between the second and sixth ribs. The primary function of the mammary
glands is lactation the production and secretion of nutrient-rich milk for the
newborn. The breasts are composed of glandular, fatty, and fibrous tissue. They
are attached to the overlying skin and to the muscles of the chest wall by
suspensory ligaments.
Divisions of the Each breast contains 15 to 20 glandular divisions, called lobes or lobules, which
Breasts house milk-secreting cells. These cells are activated for lactation (secretion of
milk) only after childbirth, or parturition. Small tubular structures the
lactiferous ducts extend from the milk-secreting cells, slightly expanding into
lactiferous sinuses as they converge in a spoke-like fashion toward the nipple.
The nipple also called the mammary papilla is surrounded by a pigmented
area known as the areola.
 The Female Reproductive Cycle
Terms Definition
Ovum At the time of birth, the ovaries of a female child contain approximately 1
million ovarian follicles, each enclosing an oocyte or immature ovum. By the
time a girl reaches puberty and experiences menarche (the beginning of
menses, or menstruation), the number of oocytes will have been reduced to
approximately 400,000. Over the course of a woman's reproductive life, only
400 to 500 of these sex cells will develop into mature ova.
Ovulation Throughout a woman's reproductive lifetime, her body repeatedly prepares
itself for conception. Each month, one or more of the ovarian follicles matures
and ruptures, releasing a developed ovum. Because of its fatty content, the
ruptured follicle develops a golden appearance, earning it the name corpus
luteum, meaning "yellow body." If fertilization does not occur, then the corpus
luteum becomes nonfunctional and disappears.
Estrogen Cells that surround the ovum within the ovarian follicles follicular cells
secrete the hormone estrogen. Our knowledge about the influences of
estrogen continues to grow. Some of estrogen's actions include promoting the
development of reproductive organs and secondary sex characteristics and
initiating the menstrual cycle.
Progesterone In addition to estrogen, the corpus luteum also secretes the hormone
progesterone. Progesterone stimulates growth of the endometrial lining of the
uterus to support the fertilized ovum should pregnancy occur. Production of
both estrogen and progesterone is controlled by two hormones released by the
pituitary gland.
The hypothalamus is an area of the brain that produces hormones that control, among other
things, the release of hormones from many glands in the body, including the
pituitary gland.
gonadotropin is any hormone that stimulates the gonads, especially the pituitary hormones
that stimulate the function of the ovaries.
Gonadotropin- is a hormone made by the hypothalamus that causes the pituitary gland to
releasing hormone release follicle-stimulating hormone (FSH) and luteinizing hormone (LH) after
(GnRH) menstruation begins. The spike in LH levels is called the LH surge. FSH induces
the development of ovarian follicles and their secretion of estrogen. LH causes
the mature follicle to rupture and release its ovum, usually within 24 hours of
the LH surge. LH also stimulates the maturation of the ovum and the formation
of the corpus luteum. Sustained high blood levels of estrogen and
progesterone, which occur during pregnancy and with the use of contraceptive
birth control pills, suppress the production of the pituitary gland hormones and
prevent ovulation.
 Menstrual Cycle
Days 1 to 5 During each month in which an ovum is not fertilized, menstruation occurs, and
patches of dead cells, torn tissue, and blood from torn arteries are shed from the
endometrium and discharged from the uterus through the vagina.
Days 6 to 12 Now the cells of the uterine lining reproduce, and the endometrium undergoes a
period of repair. At the same time, another ovarian follicle containing a maturing
ovum is developing, and the follicle-stimulating hormone (FSH) is causing estrogen
production to increase toward its peak level.
Days 13 and As the estrogen content in the blood increases, the pituitary gland is stimulated to
14 secrete luteinizing hormone (LH), causing the mature follicle to eject the ovum.
Ovulation often occurs on day 14.
Days 15 to With the ovum moving through the fallopian tubes for possible fertilization, the
28 uterine lining again begins to prepare for pregnancy. LH triggers the corpus luteum to
secrete an increased level of progesterone, and, in response, the uterine lining
becomes thicker and develops a greater blood supply. When fertilization does not
occur, secretions from the corpus luteum diminish, progesterone levels drop,
endometrial cells die, and the reproductive cycle repeats with the onset of menstrual
bleeding.
Menopause Between 30 and 40 years after menarche, a woman's reproductive life comes to a
close during what is known as menopause or the climacteric. Menopause is marked by
decreased estrogen production, which gradually causes ovulation and menstruation to
become less frequent. Once a woman has not menstruated for 12 consecutive months,
she is said to be menopausal.
 Pregnancy and Fetal Development
Terms Definition
coitus If coitus (sexual intercourse) has occurred, then sperm cells deposited in the
vagina will be carried through the uterus and into the fallopian tube. The seminal
fluid that is ejaculated during intercourse and the flagellating tail-like projections
of the sperm cells help propel the sperm toward the ovum. If the sperm and
ovum unite that is, if fertilization takes place then the fertilized ovum will
lodge, or implant, in the nutrient-rich and highly vascular uterine wall.
Development of When an ovum is fertilized, it signals the beginning of pregnancy, or gestation.
the Embryo Fertilization is the union of sperm and ovum to form a zygote. A zygote is a single
cell with a complete set of chromosomes that will develop into an embryo. After
fertilization, the zygote continues its journey through the fallopian tube until it
implants in the uterine wall, approximately 10 days after fertilization. The corpus
luteum helps support the implanted fertilized ovum, now called an embryo.
Yolk Sac and As the embryo develops, it forms an outer layer of cells and an inner cell mass.
Amnion The inner cell mass becomes a structure with two cavities the yolk sac, which
produces blood cells, and the amniotic cavity, which is the inner membranous
layer and is called the amnion. This amniotic cavity becomes a fluid-filled,
protective sac of amniotic fluid, in which the embryo floats during development.
Chorion and The outermost layer of the membranes surrounding the embryo is called the
Placenta chorion. Along with the endometrial lining of the uterus, the chorion gives rise to
the placenta, a highly vascular organ that serves as a bridge to the maternal
circulation for the exchange of nutrients and wastes. The embryo which after
the sixth to eighth week of pregnancy is called a fetus is anchored to the uterine
wall by the placenta. The placenta is connected to the embryo by the umbilical
cord.
Human Chorionic The placenta secretes a hormone called human chorionic gonadotropin (hCG).
Gonadotropin hCG is the chemical component present in the urine of a pregnant woman, which
is detected by pregnancy tests. hCG promotes the continued secretion of
estrogen and progesterone by the corpus luteum until around the third month of
pregnancy, when the placenta itself assumes that function.
Childbirth In humans, the average pregnancy lasts approximately 9 months. When labor
begins, the pregnancy stage is over. Labor begins with strong uterine contractions
that cause the cervix to dilate and thin (effacement), which allows the fetus to
pass from the uterus through the vagina. After the birth of the child, or
parturition, the placenta, then called the afterbirth, is expelled from the uterus.
primigravida A woman who is pregnant for the first time.
multigravida is a woman who has had more than one pregnancy
nulligravida is a woman who has had zero pregnancies.

These pre xes can also be paired with the su x -para, meaning delivery, to create terms that describe how many
children a woman has delivered. Thus a primipara woman (primip) has given birth once, and a multipara woman
(multip) has delivered more than one baby (multi- = more than one). A woman's reproductive history is recorded in
terms of "para," followed by a series of numbers that lists (1) full term, (2) preterm, (3) aborted, and (4) living biological
children. For example, para 2-0-1-1 means that the woman has delivered two babies at full term, no preterm babies,
has had one abortion, and has one living biological child.
 Pathologic Conditions
Terms Definition
menorrhagia heavy menstrual periods
metrorrhagia is uterine bleeding between menses
menometrorrhagia is excessive uterine bleeding that occurs both during and between
menstrual periods.
dysmenorrhea abnormal bleeding symptoms can include painful menstrual discharge
amenorrhea is an absence of menstrual discharge
oligomenorrhea is light, scarce, or scanty menstrual flow.
fibroids, or are the most commonly occurring pelvic tumor. These benign growths
leiomyomas consist of smooth muscle and fibrous connective tissue. The cause is
unknown, although their development is believed to be stimulated by
estrogen. Fibroids are often asymptomatic; however, if symptoms are
present, then they may include abnormally long or heavy menstrual periods
called menorrhagia. Depending on their location, fibroids can also interfere
with fertility.
Endometrial is a malignant tumor of the endometrium, or the inner lining of the uterus. It
carcinoma is the most commonly occurring gynecologic cancer, usually developing in
women after menopause. As with cervical cancer, endometrial carcinoma
tends to be preceded by abnormal changes in uterine tissue. Overgrowth of
the endometrium caused by sustained estrogen stimulation, a condition
known as endometrial hyperplasia, is a precursor to this malignancy.
Cervical dysplasia is a change in the size, shape, and/or appearance of the cells that form
cervical tissue. This condition is most often caused by infection with the
human papilloma virus (HPV). If left untreated, then cervical dysplasia may
develop into cancer. HPV can also cause cancer of the vagina, vulva, anus,
penis, head, and neck; some type of HPV cause genital warts to grow on the
vulva, cervix, vagina, or anus.
cervical intraepithelial Dysplasia that is observed on a biopsy of the cervix is called cervical
neoplasia (CIN) intraepithelial neoplasia (CIN) and is grouped into three categories: CIN I is
mild dysplasia; CIN II is moderate-to-marked dysplasia; and CIN III is severe
dysplasia to carcinoma in situ.
Carcinoma in situ (CIS) is a strong predictor of cervical cancer. With CIS, the cells are more
abnormal than those with dysplastic changes, but they have not yet invaded
adjacent structures.
Choriocarcinoma is a malignant neoplasm of the uterus that arises from the chorionic
membrane, or placenta. The tumor may appear during a normal pregnancy,
in association with an ectopic pregnancy, or after an abortion, whether
spontaneous (miscarriage) or induced. Choriocarcinoma is an uncommon
but often curable cancer that occurs during pregnancy. A fetus may or may
not develop in these types of pregnancies.
Endometriosis is a condition in which the endometrial tissue that lines the uterus
proliferates and is transferred to sites outside the uterine cavity. One
possible cause for this condition is the backward flow of endometrial
fragments during menstruation. These fragments can then attach to the
fallopian tubes, ovaries, and other structures in the pelvic cavity.
In fact, infection and in ammation of any of the pelvic organs may be generally referred to as pelvic in ammatory disease (PID). PID is most
frequently caused by repeated bacterial infections or sexually transmitted diseases (STDs), such as chlamydia or gonorrhea. Characteristics of
PID include fever, a foul-smelling vaginal discharge, pain in the lower abdomen, and abnormal bleeding.

Pelvic inflammatory is an inflammation and infection of any number of organs in the pelvic
disease (PID) region including the ovaries, fallopian tubes, uterus, and cervix. PID can
include inflammation of the endometrium, called endometritis
endocervicitis is an inflammation of the inner lining of the cervix
Cervicitis an inflammation of the lower necklike portion of the uterus that protrudes
into the vaginal cavity.
vaginitis Inflammation of the vagina
vulvitis Inflammation of the vulva
vulvovaginitis inflammation of both the vulva and the vagina
Vulvodynia is chronic pain with no identifiable cause that affects the vulvar area labia,
clitoris, and vaginal opening.
Ovarian cysts are globular sacs filled with fluid or semisolid material that develop in or on
the ovaries.
Ovarian carcinoma a malignant neoplasm of the ovaries, is the most deadly gynecologic cancer
among women in the United States because it tends not to be diagnosed
until it is far advanced. The cause of the condition is not well understood,
If symptoms are present, but its development is associated with hereditary, environmental, and
then they may include
menstrual irregularities and
dietary factors. Early stages of the disease produce few, if any, symptoms.
complaints of dull pain or As it progresses, ovarian cancer may cause ascites (accumulation of fluid in
heaviness in the lower
abdomen. Because cysts
the abdominal cavity), weight loss, abnormal bleeding, and pelvic pain.
often arise in response to Some ovarian cysts are lined with tumor cells that must be removed to
hormone stimulation, many
spontaneously resolve
distinguish between malignant (cystadenocarcinomas) and benign
when hormone levels (cystadenomas) growths.
Two types of ovarian cancer are most common: serous (clear fluid) and
mucinous (thick, pasty fluid) cystic adenocarcinomas.
Dermoid Cysts are ovarian tumors that contain different kinds of tissue, including fatty
material, hair, teeth, bits of bone, and cartilage. Ovarian cysts can be
asymptomatic for long periods.
salpingitis When the fallopian tubes are affected a condition called salpingitis
purulent material can collect, causing a partial or complete tubal
obstruction. PID can also take the form of oophoritis, or inflammation of the
ovary.
Ectopic Pregnancy Obstruction of the fallopian tubes can lead to an ectopic pregnancy
implantation outside of the uterus and to infertility. Tubal pregnancy, as it
is also called, constitutes a surgical emergency, as continued development
of the embryo within the fallopian tube can lead to rupture. Other sites of
ectopic pregnancy, which also require surgical intervention for removal of
the implant, include the ovaries, cervix, and the abdominal cavity.
preeclampsia an abnormal condition of pregnancy characterized by high blood pressure,
large quantities of protein in the urine (proteinuria), and swelling of the legs
and feet (edema). Preeclampsia may be mild or severe.
Eclampsia is the final and most severe phase of untreated preeclampsia and often
causes seizures and even death of the mother and baby.
Placenta Previa is a condition in which the placenta has developed in the lower portion of
the uterus in such a way as to partially or completely cover the cervical
opening.
Surfactant allows the easy movement of air in and out of the lungs. Without this substance, small air sacs within the lungs collapse because of increased
tension, a problem indicated by the baby's labored breathing. Treatment includes measures to maintain adequate oxygenation.

Abruptio placentae is another potentially life-threatening condition that may occur during
pregnancy. This condition involves the separation, or tearing away, of a
normally implanted placenta from the uterine wall and often results in
severe hemorrhage.
Dystocia Difficult labor and delivery
oxytocia Rapid labor and delivery.
oxytocin is administered to promote uterine contractions and to ensure that the baby
is delivered within 24 hours
Erythroblastosis is a hemolytic disease in the newborn (HDN) caused by a blood group (Rh
Fetalis factor) incompatibility between the mother and the fetus.
Down Syndrome a chromosomal abnormality known as trisomy 21 is the most well-known
chromosomal abnormality.
episiotomy surgical incision in the perineum (the area between the vaginal opening and
the anus) to surgically enlarge the space through which the baby is
delivered. This procedure is also called a perineotomy.
Apgar score developed by anesthesiologist Virginia Apgar, evaluates five factors that may
indicate a need for immediate intervention. These factors include the
infant's heart rate, respiration, muscle tone, color, and response to skin
stimulation.
Meconium aspiration occurs when the fetus' lungs become blocked by meconium, the first stools
syndrome of a fetus or newborn. At birth the lungs fail to expand, causing respiratory
distress.
Infant respiratory formerly called hyaline membrane disease (HMD), is an acute lung disorder
distress syndrome often associated with prematurity and low birth weight. This condition is
(IRDS) caused by a lack of surfactant, a substance formed from protein and
produced by special cells in the lungs.
Hydrocephalus Interference with the flow of cerebrospinal fluid (CSF) can result in its
abnormal accumulation. The resulting condition, known as hydrocephalus,
exhibits an enlarged head, an abnormally small face, and eyes that appear to
be depressed within their sockets. Treatment consists of the insertion of a
tube, called a shunt, to drain the excessive fluid and to relieve pressure on
the brain.
cerebrospinal fluid a protective fluid circulates throughout the brain and spinal
(CSF)
Pyloric Stenosis is characterized by a narrowing of the muscular ring that separates the
stomach from the first portion of the small intestine. Surgical correction of
the disorder may be required.
Fibrocystic Breast involves the presence of numerous small sacs of fluid (cysts) surrounded by
Disease dense strands of fibrous tissue and is the most frequently occurring breast
disorder. The causes that give rise to the formation of these benign cysts are
not fully known. Fibrocystic changes of the breast are often most evident
before and during menstruation and subside afterward, indicating that they
are influenced by hormonal changes. Incidence of the condition is greatest
among nulliparous women women who have never given birth and those
who are between 40 and 50 years of age.
Carcinoma of the is the most common malignancy in women in the United States. The most
Breast common form is invasive ductal carcinoma. Although its causes are not
 completely understood, risk factors associated with the development of
breast cancer include heredity, early menarche, late menopause, nulliparity,
environmental influences, diet and body weight, and, possibly,
postmenopausal hormone replacement therapy.
A precursor exists that can aid in preventing this type of cancer; ductal
carcinoma in situ (DCIS) is a precancerous lesion that indicates a higher risk
for invasive ductal breast carcinoma.
mastitis an inflammation of the breast which can affect women who are nursing. It is
characterized by swelling, redness, and pain.
galactorrhea is an abnormal discharge of milk from the breasts.
During a Pap test, the physician collects a small sample of cells from the cervix using a swab and smears the sample onto a microscope slide.
The slide is sent to a laboratory where it is examined for changes in the cells that could indicate cancer or a precancerous condition.
If the visual examination reveals anything unusual, then a small tissue sample (biopsy) may be taken from the cervix or from inside the opening
of the cervix (endocervical canal) for microscopic examination.
Terms
Pap Smear
Colposcopy
culdoscopy
hysteroscopy
laparoscopy
Cervical conization, or
cone biopsy
loop electrosurgical
excision procedure (LEEP)
Hysterosalpingography
pelvic ultrasonography
Transvaginal ultrasound
Dilation and curettage
(D&C)
Endometrial biopsy (EMB)
amniocentesis
Fetal cells contained in the uid are cultured
for microscopic analysis, and a karyotype is
made to analyze chromosomes. The uid can
also be tested for chemical signs of fetal
spinal cord and spinal column defects.
culdocentesis
Chorionic villus sampling
(CVS)
Fetal monitoring
Pelvimetry
Diagnostic Procedures
Definition
The Pap (Papanicolaou) smear, or Pap test, is a diagnostic tool for
detecting abnormal changes in the cells of the cervix. The Pap test can
detect infections, abnormal cervical cells (dysplasia), or cervical cancer.
is a common follow-up procedure for abnormal Pap smears. This
procedure uses a special magnifying device with a light called a
colposcope to examine the vulva, cervix, and vagina
uses a culdoscope to examine the Douglas cul-de-sac
can also use the hysteroscope to remove fibroids or polyps from the
uterus
uses a laparoscope to remove abdominal lesions or to perform a
hysterectomy or biopsy the ovary.
is the removal of a cone-shaped sample of tissue from high in the
cervical canal. Conization may be used for either diagnostic purposes or
for therapeutic purposes to remove precancerous cells.
a carbon dioxide (CO2) laser, or a surgical knife (scalpel).
a diagnostic test that involves the radiographic imaging of the uterus
and fallopian tubes after the injection of contrast dye.
the process of imaging deep body structures by measuring and recording
sound waves to detect leiomyomas.
involves placing a transducer in the vaginal canal, offers a sharper image
of internal structures than transabdominal ultrasonography.
is the widening of the uterine cervix and scraping off of the endometrial
lining of the uterus. This procedure helps diagnose uterine disease and
may be therapeutically performed to temporarily halt prolonged or
heavy uterine bleeding.
is a procedure during which a tissue sample is taken from the
endometrial lining of the uterus and checked under a microscope for any
abnormal cells or signs of cancer.
Between 14 and 19 weeks, a maternal alpha-fetoprotein (AFP) test is
often performed. This test can reveal multiple gestations and can detect
conditions such as neural tube defects. In the 16th week of pregnancy,
the woman may undergo a procedure called prenatal amniocentesis.
This procedure involves the insertion of a needle through the abdomen
for aspiration of amniotic fluid
fluid is removed through a needle inserted through the vagina into the
cul-de-sac. The presence of blood in the aspirated fluid can help signal a
ruptured ectopic pregnancy.
is the aspiration of placental tissue, can be performed to diagnose
genetic abnormalities.
is the continuous recording of the fetal heart rate and maternal uterine
contractions to assess fetal status and the progress of labor.
is the process of measuring the dimensions of the maternal pelvis to
help evaluate the mother's capacity for a vaginal delivery.
 The initial signs of breast cancer are usually a small, painless lump (most often located in the upper outer quadrant of the breast), thick or dimpled
skin, and/or retraction of the nipple. Most of these signs are discovered by the woman herself during a monthly breast self-exam (BSE).

MRI is very useful for detecting masses in young women with dense breasts. Ultrasound imaging is useful for evaluating a speci c area of
cancer visualized on a mammogram.

mammography x-ray imaging of the breast and biopsy help to either establish or rule
out a diagnosis of a breast tumor. Breast ultrasound imaging and breast
magnetic resonance imaging (MRI) are other imaging techniques that
can confirm the presence of a mass and can also distinguish a cystic
from a solid mass.
Stereotactic core biopsy uses mammography to guide a biopsy needle into an area of concern.
lumpectomy a procedure during which the tumor and immediate surrounding tissue
are removed while preserving the remaining breast tissue. During this
procedure, the surgeon will also perform a sentinel node biopsy (SNB)
(sentinel lymph node [SLN] biopsy) to determine whether the tumor has
spread to the lymph nodes.

This procedure involves injecting a blue dye or radioisotope into the site and tracking it to identify the sentinel node(s). The sentinel node(s)
are removed for microscopic study to see if they are a ected. If they are not, then the procedure stops there; if they are a ected, then more
nodes are removed to determine the extent of involvement. The surgery is then followed by radiation to the a ected tissues to kill any
remaining tumor cells.

Carcinoma of the breast is classi ed in terms of its growth and progression using a method called staging. In the earliest stage of cancer, the tumor is
localized or con ned to a duct or lobe within the breast. As the disease advances, the tumor invades the surrounding breast tissue and is carried—either
by lymphatic drainage or systemic circulation—to other sites in the body.

Diagnosis of brocystic breasts will begin with your physician asking you questions about your pain and any medications you take, as well as performing a
physical examination. Depending on your age and symptoms, further diagnostic testing may be recommended. A biopsy may be used to distinguish uid-
lled cysts from broadenoma or cancer. Ultrasound can show whether a lump is a uid- lled cyst or a solid tumor.

If imaging tests reveal a uid- lled cyst, then a ne-needle aspiration (FNA) procedure may be performed to remove the uid. This procedure can alleviate the
pain of the cyst and con rm that the lump is benign.

Many di erent types of treatment, including dietary changes and hormone therapy, are used to try to alleviate breast pain caused by brocystic changes.
 Therapeutic Procedures
Terms Definition
Treatment of Fibroids depends on the presence and severity of symptoms. Asymptomatic
fibroids may warrant only monitoring. Drug therapy the route that
worked for Jackie may help reduce levels of circulating estrogen, which
helps shrink the size of the tumors. Surgical interventions include
myomectomy and hysterectomy.
myomectomy Excision of the fibroids
Hysterectomy the surgical removal of the uterus. Two kinds of hysterectomy
procedures are most common: (1) total abdominal hysterectomy (TAH),
in which the uterus and cervix are removed through an abdominal
incision, and (2) total vaginal hysterectomy (TVH), in which the uterus is
removed through the vagina. When a laparoscope is used to perform this
procedure, the procedure is called laparoscopically assisted vaginal
hysterectomy (LAVH). In da Vinci surgery
salpingectomy is the resection of a fallopian tube; total abdominal hysterectomy with a
bilateral salpingo-oophorectomy (TAH-BSO) is a procedure involving the
surgical removal of the fallopian tubes and ovaries on both sides
cystectomy surgical removal of the cyst
oophorectomy excision of one or both ovaries
cautery, or cauterization, is the destruction of tissue by burning with chemicals (silver nitrate) or an
or cryosurgery, also electrically heated instrument. Cryosurgery uses cold temperatures to
called cryocauterization destroy tissue. A liquid nitrogen probe produces the freezing
temperature.
vitro fertilization (IVF) during which ova and sperm are combined in a glass laboratory dish (in
vitro). In this procedure, if fertilization is successful, then the fertilized
ova are injected into the woman's uterus through the cervix after 2 or 3
days. Between 30% and 50% of all IVF procedures are now associated
with intracytoplasmic sperm injection (ICSI), which is the direct injection
of sperm into harvested ova.
Cesarean Section The most common intervention is a cesarean section (C-section). In this
procedure, a surgical incision is made across the belly just above the
pubic area. The uterus and amniotic sac are opened, and the baby is
delivered. Medical reasons for an emergency C-section include fetal
distress, fetal developmental problems such as hydrocephalus or spina
bifida, placenta abruptio, placenta previa, umbilical cord prolapse, stalled
labor, preeclampsia, or an active genital herpes infection in the mother.
intrauterine device (IUD) prevents implantation of an embryo. Birth control pills work by
preventing ovulation. For women who want a more permanent
contraceptive
tubal ligation is a surgical option. Tubal ligation is the cutting, burning, or tying off
(ligation) of the fallopian tubes, which prevents ova from entering the
fallopian tubes and prevents sperm from reaching an egg. This procedure
effectively sterilizes the woman.
Hormone Replacement particularly estrogen replacement therapy (ERT) is sometimes
Therapy (HRT) recommended to relieve these discomforts. Low estrogen replacement
Treatment for ovarian cancer involves tumor debulking, or surgically removing as much of the tumor as possible. The patient may also require a total
abdominal hysterectomy with a bilateral salpingo-oophorectomy and removal of the omentum, followed by chemotherapy.
 appears to contribute to improved cardiovascular health and prevents
the loss of bone mass that occurs with aging; however, it may increase a
woman's risk for stroke and thromboembolism. Estrogen is also believed
to increase the risk of breast and endometrial cancers. A physician can
help determine whether the benefits outweigh the risks for an individual
patient.
Mastectomy is the surgical removal of one or both breasts
radical mastectomy is the removal of the breast, lymph nodes, and adjacent chest wall
muscle if the lymph nodes are involved. In a modified radical
mastectomy, the pectoral muscles are preserved. Adjuvant
chemotherapy (treatment with chemical agents or drugs) is given after a
lumpectomy or mastectomy procedure if any lymph nodes were found to
have been involved.
mammoplasty refers to any type of surgical repair of the breast
TRAM flap After a mastectomy, breast reconstruction is an option many women will
choose. This figure illustrates reconstruction performed with the use of
tissue flaps from the back or lower abdomen. This procedure is called a
TRAM flap because the transrectus abdominis musculocutaneous tissue
is used for the reconstruction.

We learned earlier that dilation and curettage (D&C) is a useful diagnostic procedure, but this procedure is sometimes therapeutically used. One
therapeutic use of D&C is when the contents of the uterus need to be removed as, for example, in the case of an incomplete spontaneous abortion
(miscarriage) or if fetal or placental tissue is not completely expelled from the uterus during childbirth.

Treatment of cervical cancer depends on the degree to which the disease has progressed but may involve the administration of medications,
irradiation, surgery, or a combination of these therapies. Surgical interventions may range from hysterectomy to pelvic exenteration. Exenteration is
the removal of the contents of a body cavity. Pelvic exenteration involves the removal of all the organs and adjacent structures of the pelvis. Pelvic
exenteration is usually performed to surgically destroy cancer involving the urinary bladder, uterine cervix, and rectum.

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