FALLOPIAN TUBE

ADVANCE DIPLOMA IN MIDWIFERYGROUP 1/2012

REENA ROSS LUDU NATHANADMW 1/2012

DESCRIBE THE ANATOMY AND STRUCTURE MENTION THE FUNCTIONS OF FALLOPIAN TUBE BLOOD SUPPLY,NERVE AND LYMPHATIC SYSTEM TO

THE FALLOPIAN TUBE DESCRIBE CHANGES IN FALLOPIAN TUBE DURING PREGNANCY AND PUERPERIUM THE ABNORMALLITY PREGNANCY IN FALLOPIAN

TUBE AND MANAGEMENT SUMMARIZE THE RELATION WITH MIDWIFERY

The female reproductive system consist a pair of ovaries and fallopian tube, uterus, vagina, mons pubis, labia majora, labia minora and clitoris

Is production of the new life (fertilization)

Involve in ovulation and passage of mennnorhea

The fertilization process usually occurs in the fallopian tube

An essential structure in female reproductive system

Serve an extreme purpose in fertilization

known uterine tube, oviducts or salphingo tube.

Location : pelvic cavity with free margin of the broad

ligament

Size : Estimated Length is 10-12cm Diameter of 5-6mm

Cont….

Appearance : Each tubule has got two openings

uterine opening

pelvic opening (abdominal ostium)

Anterior, Posterior and Superior of the fallopian tube peritoneum cavity and intestines

Laterally pelvic, infundibulopelvic ligament and the round ligaments 

inferiorly attached with broad ligament and ovary medial of the tube is the uterus

Macroscopic structure:

Fallopian tube is divided into 4 parts with different type of function and layers

Picture shows the segments of the fallopian tube

Interstitial

narrowest lumen lying in the uterus wall. It is also known as intramural.

 Isthmus

almost straight the lower one-third region  

Ampulla tortuous middle part & the lengthiest part Infundibulum widest and the most distal part it ends into a tiny hair like cilia line – fimbriaemillions of fimbriae and one of the 1 longest

fimbriae rest and attached outer pole of the ovary called ovarian fimbriae

MICROSCOPIC STRUCTURE

consist 4 tunics

tunica mucosa

tunica submucosa

tunica muscularis

tunica serosa

 Tunica mucosa

Infundibulum And Ampulla

helps to capture the ovum from the surface of the ovary

bathes it in a supportive fluid and helps move it towards the uterus.

provides proper environment for fertilization.

In both infundibulum and ampulla the tunica mucosa is thick and highly developed.

Cont tunica mucosa…

which contain two types of cells at uterine tubes Ciliated cell Non Ciliated Cell

Secretory product is produced by the movement of the cilia at the ciliated cell which called ‘plicae’

The secretion is to protect and nourishes the ovum or zygot.

Extensive fold -↑ surface area to provide more epithelial cells which helps in propel of fertilized ovum

Tunica Muscularis

That provides the strong contractions provide

the movement of embryo towards the uterine cavity.

The thickness at the isthmus

consist of an inner circular and outer longitudinal layer of the smooth muscle.

both involuntary muscle contraction help in the peristalsis movement of the mature ovum

Tunica submucosa

consist lamina propria, is a typical loose areolar connective tissue

no glands and it blends the underlying layer

Tunica serosa is a vascular connective tissue which is placed under

the epithelium layer

This layer is highly vascular

binding agent and insulation that supports the fallopian tube structure and to protect the transportation.

Microscopic view of ampulla in oviducts where it is lined with the ciliated which known as ‘plicae’

Scanning electron microscopic photograph of ciliated and secretory cells within the human Fallopian tube epithelium known as ‘plicae

FUNCTION OF THE FALLOPIAN TUBE

A place where fertilization take part(ampulla)

important organ for ovulation process and menstrual,

Act as a bridge and provide a connection between ovary and uterine

The lymphatic richly anastomosed with the adjacent organs drain into the ovarian lymphatic and lumbar lymph nodes.

 

Showing lymphatic drainage system in fallopian tube

The blood supply comes from the uterine and ovarian arteries and the venous return is through the corresponding veins that is the uterine and

ovarian veins

The nerve supply is derived from the inferior hypogastric plexuses. The tube is provided with both the sympathetic and parasympathetic

innervation.  

Tube

Supported with 3 ligaments

round ligament which stretches from the cornua to the labia mojara.

infundibulopelvic ligaments

Folds of the broad ligament which support superior of fallopian tube

CHANGES IN PREGNANCY

↑ Hormon oestrogen

the ciliated epithelial cells increase in the height and number in cilia (plicae)

.At the time of pregnancy the blood vessels will

be become engorged under the influences of oestrogen.

↑ hormone progesterone

the size of the non-ciliated cells become taller and produce greater secretory rate

The fallopian tubule becomes more hyperplasia and hypertrophy.

the inner circular layer and outer longitudinal layer will constrict and create the peristalsis.

↑ gestation ↑ uterus cavity - push the both fallopian tubes out the pelvic cavity to the abdominal cavity.

CHANGES DURING PUERPERIUM

During the puerperium, the fallopian tube will be back into its original place at pelvic cavity within 6 week as the uterus contract and retract after the birth.

The muscle of the uterine tubes will change back to it original elasticity as formed during the non-gravid stage.

Ectopic pregnancy An ectopic pregnancy is a pregnancy that develops

outside a woman's uterus

known as ‘tubal pregnancy

This happens when the fertilized ovum from the ovary does not reach or implant itself normally in the uterus.

Instead, it develops somewhere else in the abdomen. The products of this conception are abnormal and cannot develop into fetus.

Severe case : rupture severe bleeding maternal death

A surgery is required if the bleeding is severe inside the abdomen or indicated condition.

laprascopic laparotomy salphingectomy

MID WIFERY MANAGEMENT

Essential to detect ectopic at the early stage

Midwifes have to act in a manner that promote and safeguard the woman and her partner by giving health education

Identify the predispose factor such as users of IUCD and previous ectopic pregnancy

To identify the sign and symptom of suspected condition of ectopic pregnancy is vaginal bleeding, amenorrhea, lower abdominal pain and syncope if worsen.

This is to ensure fertility of the woman for future pregnancy

According to A Guide for Midwifes and Doctors (WHO 2000) as a midwife:

It is our accountability to identify and bring to view the fallopian tube with the ectopic gestation and its ovary.

Proper health education in given among the mother’s and their partners.

Appropriate guidelines, care and management of midwife has to be conducted in order to save motherhood

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