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PROCREATION - The term procreation will

always be understood as the sexual union of a


man and a woman united in legitimate
marriage, and capable of fulfilling the
conditions for the conception of a new human
person.


Human Reproduction is any form of sexual
reproduction resulting in the conception of a
child, typically involving sexual intercourse
between a man and a woman.

Risk Factors That Will Lead to Genetic
Disorders:
Abnormalities in genes
Environmental exposures
Specific substances
Inheritance

Genetic Disorders are physical defects or
illnesses that are caused by problems in your
bodys genetic code

Common Tests for Determination of Genetic
Abnormalities:

Blood and saliva
Pregnancy tests
Ultrasound
Amniocentesis
Chorionic villi sampling (CVS)
Percutaneous umbilical blood sampling
Common Genetic Disorders:
Downs Syndrome is characterized by delayed
physical and mental development
Sickle Cell Anemia is a hereditary disorder that
is passed down from both parents
Tay Sachs Disease is a devastating illness that
causes severe mental and physical
incapacity
Phenylketonuria (PKU) a genetic disorder that
affects children who have parents who
carry the PKU genetic defect
Fragile X Syndrome is caused by a defect in one
of your babys X chromosomes


SCREENING OF THE PREGNANT
WOMAN
1. First-Trimester Screening
Blood tests to estimate the risk of Down
syndrome are done at about 11 to 14 weeks of
pregnancy
These tests involve measuring levels of
pregnancy-associated placental protein A
(produced by the placenta) and beta-human
chorionic gonadotropin in a pregnant womans
blood

Ultrasonography is done to measure fluid-
filled space near the back of the fetuss neck
(called fetal nuchal translucency)
Abnormal ultrasound measurements indicate
an increased risk of down syndrome
Abortion, if desired, is safer when done earlier

2. Second-Trimester Screening
Ultrasonography can do the following:
Confirm the length of the pregnancy
Locate the placenta
Indicate whether the fetus is alive
It is done before chorionic villus sampling
and amniocentesis
Important markers : (pregnant womans blood
are measured)
Alpha-fetoprotein a protein produced by the
fetus
Estriol this hormones precursors are
produced by the fetus
Human chorionic gonadotropin a hormone
produced by the placenta
Inhibin A a hormone produced by the
placenta
3. Triple and Quad Screening:
Measuring estriol, beta-human chorionic
gonadotropin plus alpha-fetoprotein is called
triple screening, inhibin A may also be measured -
--- measuring these four markers is called quad
screening
Triple or quad screening is done around 15 to 20
weeks of pregnancy
Combining 1
st
and 2
nd
Trimester Screening:
Combination of 1
st
trimester and 2
nd
trimester
tests are done and results from both are analyzed
together


Chorionic Villus Sampling:
a doctor removes a small sample of the
chorionic villi, which are tiny projections that
make up part of the placenta, through the
cervix
between 10 12 weeks of pregnancy
Amniocentesis:
offered to women over 35 to estimate their risk
of having a baby with down syndrome
a sample of the fluid that surrounds the fetus
(amniotic fluid) is removed and analyzed
usually done at 15 weeks of pregnancy or later
Percutaneous Umbilical Blood Sampling:
is used when rapid chromosome analysis is
needed, particularly toward the end of
pregnancy when ultrasonography has detected
abnormalities in the fetus

FEMALE REPRODUCTIVE SYSTEM:

External Genitalia Vulva is the
collective term of female external
genetalia

Pudenda is the term used to denote the
external genetalia of either sex


a.Mons Pubis also called Mons Veneris,
meaning mountain of venus, is a mound of
fatty tissues that lies over the symphysis
pubis covered by skin and at puberty is
covered by pubic hair that serves as
cushion or protection to the symphysis
pubis

b. Labia majora large lips; longitudinal
fold of pigmented skin that extends from the
symphysis pubis to the perineum

Dartus muliebris responsible fro the
wrinkle-like appearance of the labia majora
c. Labia minora nymphae; soft and thin
longitudinal fold located in between labia
majora

Clitoris Greek word means key; pea-
shaped composed of erectile tissues and
sensitive nerve endings which is the site of
sexual arousal and eroticism in females
Fourchette formed by the posterior
joining of the labia minora and majora
which is very sensitive to manipulation,
often torn during vaginal delivery; common
site for episiotomy

d. Vestibule an almond shape area that
contains the urinary meatus, Skenes glands,
hymen, vaginal orifice and Bartholins gland

Urinary Meatus urethral opening for
urination

Skenes Glands (Paraurethral Glands or
lesser vestibular)
- secretes small amounts of mucous which
functions as lubrication during sexual
intercourse or coitus
-
Bartholins Glands (Paravaginal or
Vulvo-vaginal glands or greater
vestibular)
- secretes alkaline substance responsible
for neutralizing the acidity of vagina to
keep the sperm alive


Doderleines bacillus responsible for maintaining
the acidic environment of the vagina

Vaginal Orifice external opening of the vagina
Hymen membranous tissue that covers vaginal
orifice

* Carunculae myrtiformes (hymenal caruncles)
term for the residual tags of the torn hymen post-
instrumentation, use of tampons, coitus or vaginal
delivery

e. Perineum muscular structure in between
vagina and anus
- contains and arteries and
veins that supply blood

2. Internal Genitalia
a. Vagina female organ for copulation
- passageway of menstruation and
fetus
- 3 4 inches or 8 10 cm long of
dilatable canal containing rugae

Rugae - thick folds of membranous stratified
epithelium which permits considerable amount
of stretching without tearing

Purposes of the Vagina
Receives a males erect penis and semen during
sexual intercourse.
Pathway through a woman's body for the baby
to take during childbirth.
Provides the route for the menstrual blood
(menses) from the uterus, to leave the body.
May hold forms of birth control, such as a
diaphragm, FemCap, Nuva Ring, or female
condom.


b. Uterus a hollow, thick walled muscular
organ designed for the implantation,
containment and nourishment of the
developing fetus
- varies in size, shape and weight
- its functions are mainly for
menstruation, pregnancy and labor
Size: 1 thick x 2 wide x 3 long
Shape:
* Non-pregnant: pear shape or inverted avocado
* Pregnant: ovoid

Weight:
* Non-Pregnant; 50 60 g
* Pregnant: 1000 g
* 4
th
stage of labor: 1000 g
* 2 weeks after delivery: 500 g
* 3 weeks after delivery: 300 g
* 5 6 weeks after delivery; 50 60 g


Three Portions of the Uterus
* Fundus upper cylindrical layer
* Corpus/body - upper triangular portion
Isthmus called the lower uterine
segment during
pregnancy
- it the portion that joins the
cervix to the Corpus
* Cervix lower cylindrical layer
- lowest and narrowest end of
uterus


Muscular Layers of the Uterus
* Endometrium it lines the non-pregnant
uterus; muscle layer for menstruation; sloughs
off during menstruation

*Decidua it lines the pregnant uterus

*Endometriosis (Ectopic Endometrium)
abnormal proliferation of endometrial lining
outside the uterus causing pain or infertility
a. Sites: ovaries (most common), fallopian tubes
or rectal area
b. Outstanding signs: dyspereunia, low back
pain and persistent dysmenorrheal which is
intensified during menses
c. Diagnostic tests: laparoscopy and Biopsy
d. Drugs of choice:
Danazol (Danocrine) stops menstruation
and inhibits ovulation
Leuprolide (Lupron) inhibits FSH and LH
production


Oral contraceptive Pills suppress LH and
FSH and inhibits ovulation
NSAIDS to relieve pain (ex. Mefenamic
acid, Naproxen)

* Myometrium its smooth muscles are
considered to be the living ligature of the
body; largest portion of the uterus; the power
of labor; muscle layer for delivery process

* Perimetrium protects the entire uterus,
(parietal peritoneum)

c. Ovaries two almond-shaped female sex glands for
ovulation and production of two hormones
progesterone and estrogen

d. Fallopian Tubes two to three inch long
passageway which conveys the ova to the uterus

Four Significant Segments of the Fallopian Tubes:
Infundibulum most distal part which is funnel or
trumpet-shaped
- has fimbria which are finger-like
projections that catches the mature
ovum

Ampulla outer 3
rd
or 2
nd
half
- common site for fertilization and
ectopic pregnancy
Isthmus common site for female
sterilization which is also known as
Bilateral Tubal ligation (BTL)
Interstitial most dangerous site for ectopic
pregnancy because of its narrow
lumen about 1 mm in diameter