Female Reproductive System,Pregnancy

& Health Issues

Internal Structures• Ovary: releases eggs (females are born with about 1 million eggs - all

she will ever have)

• Fallopian tubes: pathway for egg from ovary to uterus (about 4” long)

• Ovulation: when the ovary releases an egg; avg life span = 24 hours

• Uterus: where fetus develops OR sheds endometrium (lining) each month (period) if not pregnant

• Cervix: opening at bottom of uterus

• Vagina: aka birth canal; where intercourse takes place; where a tampon is inserted

• Urethra: tube from bladder where urine is excreted

External Structures

• Vulva – describes all external parts• Labia Majora –outer folds of skin• Labia Minora – inner folds - Both become sensitive

during stimulation• Clitoris – located in front of urethra – many blood

vessels & nerve endings• Urethra - connects to urethra -eliminates urine• Vagina – opening to uterus – birth canal• Perineum – field of tissue between vagina & anus• Mons Pubis – pad of tissue covering pubic bone –

some sensitivity – covered w/ pubic hair• Hymen – membrane that sometimes covers vaginal

opening

Anatomy Diagrams

Menstrual Cycle• Average menstrual cycle = 28 days

– Menstruation (5-7 days): unfertilized egg disintegrates and is shed with endometrium.

– Pre-Ovulation (6-8 days): Increase in FSH causes several follicles to develop but usually only one will mature. Estrogen increases causing endometrium to thicken.

– Ovulation (1 day): Increase in LH causes follicle to release egg.– Post-Ovulation (10-14 days): Egg travels down fallopian tube.

Menstruation

Pre-Ovulation

OV

Post-Ovulation

Post-Ovulation

Menstruation

Health IssuesProblem What it is Symptoms Treatment

Cystitis

(Bladder infection)

Inflammation of bladder; usually due to bacterial infection

Burning during urination; strong smell; fever or blood in urine

Antibiotics

Vaginitis Vaginal infection by fungus, bacteria, or protozoa; may be from STI

Irritation or itching around vagina; secretions of unusual color &/or unpleasant odor

OTC vaginal cream or antibiotic

Problem What it is Symptoms Treatment

Amenorrhea

(Delayed puberty)

Late puberty due to anorexia, endocrine problems, excessive wt. loss, &/or

Over exercise

No breast development, &/or no Menstrual periods

Determined by doctor

Menstrual Cramps

Prostaglandins

(hormone like substance) produced during menstruation causes cramps

Contractions of uterine muscle, abdominal pain, some nausea/vomit

OTC meds, light exercise, warm baths, doctor

Premenstrual

Syndrome

PMS

Mental & physical changes related to menstruation

Irritability, mood swings, depression, abdominal bloating, breast tenderness

Doctor – possibly medications

Problem What it is Symptoms Treatment

Ovarian Cyst Failure of follicle to rupture & release an egg; may also be growths from cancer

Pain in lower abdomen or pelvis for a month or so

Mx by doctor; cysts often go away on own but may need surgery

Cervical Cancer

Abnormal division of cells in cervix; can be from STI (HPV)

Vaginal bleeding, discharge, pelvic pain, may be no symptoms

Surgery, radiation, chemo

Problem What it is Symptoms Treatment

Toxic Shock Syndrome

(TSS)

Poisoning of the body from bacterial toxins; usually related to tampon use

Fever, chills, weakness, rash on palms of hands

Antibiotics & immediate Mx treatment

Endometriosis Growth of tissue from uterine lining outside the uterus

Severe cramping and pain in lower abdomen or pelvis region

MX – hormone therapy or surgery

Healthy Practices

• Practice good-hygiene, self-exams, regular doctor visits– When should she start going to OB/GYN?– Annual pelvic exam– Mammogram (current debate on initial age for test)

• Balanced diet & exercise• Prevent STI’s • Vaginal irritation = redness, itching, mild pain around

vaginal opening; prevent by reg. bathing, loose cotton underclothes, not wearing wet clothes for long periods of time, etc

• Relieving menstrual cramps

7 Ways to Stay Healthy

1.Exercise regularly & maintain balanced diet2.Gently wash genital area w/ warm water &

soap daily- do not use hygiene sprays or powders. Douching is not recommended.

3.Wipe front to back after urination.4.Change pads and tampons regularly.5.Avoid wearing tight clothing that can cause

discomfort or irritation.6.Have annual pelvic exam.7.Perform monthly self breast exams.

Breast Cancer

• Mainly older women but can occur at any age

• At risk if it runs in the family but not the only factor (BRCA1 or BRCA2 gene )

• Can be treated effectively if detected early

• WAYS TO CHECK– Mammogram/ultrasound– Self-breast exam (see handout)

EATING DISORDERS

• American Psychological Association uses following diagnostic criteria to identify:

Anorexia – 15% or more below desirable weight– Fear of weight gain– Altered body image– 3 or more missed menstrual periods; in young adolescents,

no onset of menstruation

Bulimia– Binge eating 2 or more times a week for 3 months– A lack of control over eating– Purging– Concern about body image

Characteristic SymptomsAnorexia– Looks thin & keeps getting thinner– Skips meals, cuts food into small pieces, moves food around plate– Loss of menstrual period– Wears layered clothing – loss of hair from head– Growth of fine hair on face, arm – Sensitive to cold

Bulimia– Bathroom use immediately after eating– Inconspicuous eating– Excessive time/money spent food shopping– Menstrual irregularities– Excessive constipation– Swollen/infected glands, sore throat , bursting blood vessels in eyes,

damaged teeth & gums– Dehydration

EATING DISORDER TREATMENTS

• Anorexia• Can be complex & demanding• May include hospitalization to stabilize physical issues• Intravenous feedings• Drug treatments to treat depression, OCD, anxiety• Counseling – individual & family

• Bulimia includes family & nutritional counseling – hospitalization is not usually required

• Where to get help– Guidance– Bergen County Dept. of Health– Health Professionals

Male Reproductive System• Sperm are produced in the testis on a regular basis and stored in the epididymis. Once ejaculated, sperm have approximately 3-5 days to find and fertilize the egg or they will die. Of the estimated 100-300* million sperm in an ejaculation, only a few hundred will even come close to the egg. (*You may see estimates anywhere from 40-400 million sperm – use 300 million as our average)

• SEMEN =

+ Sperm (DNA)

+ fluid from seminal vesicles (nourishes)

+ fluid from prostate gland (motility)

+ fluid from Cowper’s Gland (pair of pea-sized glands at base of penis helps to neutralize residue of urine in the urethra, reduce acidity in the vagina and provide some lubrication during intercourse)

XY Chromosomes

•X sperm + X egg = girl

•Y sperm + X egg = boy

(Possible)Early Signs of Pregnancy

• 10. Tender, swollen breasts9. Fatigue8. Implantation bleeding7. Nausea or vomiting6. Increased sensitivity to odors5. Abdominal bloating4. Frequent urination3. A missed period2. Your basal body temperature stays high1. A positive pregnancy test (Home Preg Test v. Blood test)

Common Side Effects During Pregnancy

A woman might experience some, all or none of the following:

• Morning Sickness• Frequent urination• Constipation• Hemorrhoids• Fluid Retention

(Swelling)• Itchy skin• Insomnia• Tender/sore breasts or

nipples

• Backaches• Leg Cramps• Dizziness/Fainting• Heartburn• Varicose Veins• High Blood Pressure• Vivid dreams• Mood swings/emotional• Rib soreness

Key Terms and Definitions

Fertilization

• The union of a sperm cell with an ovum (egg)• Takes place in the fallopian tube• http://www.webmd.com/baby/ss/slideshow-conception

Ectopic Pregnancy

• 1 in 50 pregnancies ends this way.

• Fertilized egg travels down the fallopian tube on its way to the uterus. If the tube is damaged or blocked the egg may become implanted in the tube and continue to develop there.

• Ending the pregnancy is the only option. In fact, if an ectopic pregnancy isn't recognized and treated, the embryo will grow until the fallopian tube ruptures, resulting in severe abdominal pain and bleeding. It can cause permanent damage to the tube or loss of the tube, and if it involves very heavy internal bleeding that's not treated promptly, it can even lead to death.

How to Calculate a Due Date

• A typical pregnancy is 40 weeks long (or 280 days) from the start of the last menstrual cycle.

• Simply add nine months and seven days to the date and that is the due date.

• Example: First day of the last menstrual period was January 1st. Add 7 days to that and you get the number 8. Add nine months and you get October. Therefore the expected due date is October 8th.

• A pregnancy is divided into three trimesters. The first trimester usually carries the highest risk for miscarriage.

Zygote

• A fertilized egg/ovum

Blastocyst

• Ball of cells with a cavity in the center

Implantation

• Fertilized egg becomes buried in the endometrium

Embryo

• Called this until the 7th week, it is the implanted blastocyst.

Amnion• Fluid filled sac that surrounds the

embryo (a.k.a. – the bag of waters or amniotic sac)

Placenta• Forms along the lining of the uterus;

made of blood rich tissue that transfers oxygen and nutrients from mother’s body to the embryo

Umbilical Cord

• Connects from the mother’s placenta to the fetus.

Fetus

• The developing baby is referred to from the 8th week on as a fetus.

Prenatal

• Existing before birth (such as prenatal care)

HCG• Human Chorionic Gonadotropin; the

hormone secreted by a woman to signal to her body that she is pregnant

Episiotomy

• Incision made from the vagina toward the anus to enlarge the opening for delivery of a baby

What is prenatal care?

• Care given to a mother-to-be and baby before birth

• Includes: routine medical exams, proper nutrition, exercise, extra rest/relaxation, childbirth/childcare education, avoidance of drugs and other risk behaviors, and the practice of COMMON SENSE

Why is prenatal care so important?

• Important for both mothers and their babies

• Early treatment of problems

• Early detection of problems

See a clinician regularly

• Low Risk Pregnancy:– Once a month for first 28 wks – Every 2-3 wks from 28th – 36th week– Weekly from 36th wk until delivery

• High Risk Pregnancy:– More often depending on reason for high risk

(ex. Multiples, high blood pressure, etc.)

Clinician visits may include:• Urine tests at every visit (UTI’s; elevated sugar/gestational diabetes;

excess protein/preeclampsia; ketones/not enough carbs) • Check BP (elevated + protein in urine may mean preeclampsia)

– Preeclampsia: affects 3 to 8 percent of pregnant women. A woman is diagnosed with preeclampsia if she has high blood pressure and protein in her urine after 20 weeks of pregnancy. Only way to get better is to deliver the baby. Causes the blood vessels to constrict, resulting in high blood pressure and a reduced blood flow that can affect organs throughout the body, including the liver, kidneys, and brain.

• Examine for fluid retention• Measure growth of uterus• Examine abdomen to check position of fetus• Listen for sounds of fetal heartbeat• Tests

Ultrasound (Sonogram)

• Pictures of the fetus as it develops

• It may:

– Show position/size

– Confirm due date

– Detect multiple pregnancies

– Detect severe abnormalities

Chorionic Villus Sampling (CVS)• Examines the tissue that attaches

the fetus to the wall of the uterus• Optional test usually performed

between 11 and 12 wks• Advantage: earlier than

amniocentesis• Disadvantage: small risk of

miscarriage• Detects certain genetic birth

defects such as Down Syndrome, Sickle Cell Anemia, Tay Sachs Disease, etc. (see links below)

• http://kidshealth.org/parent/medical/genetic/tay_sachs.html

• http://kidshealth.org/kid/health_problems/blood/sickle_cell.html

• http://kidshealth.org/kid/health_problems/birth_defect/down_syndrome.html

Amniocentesis

• Optional test that examines fluid that surrounds and protects the fetus

• Usually performed between 16 and 18 wks

• Detects certain birth defects

Why is proper nutrition important?

• Premature Birth–Birth of baby before fully

developed/less than 37 wks• Low birth weight

– Weight at birth that is less than 5.5 lbs– Both are associated w/ increased risk of

mental retardation and infant death

Fetal Alcohol Syndrome (FAS)

• Severe birth defects due to alcohol consumption during pregnancy• There is no “safe amount” of alcohol to consume during pregnancy• Includes damage to nervous system, facial abnormalities, small head size, below normal IQ, poor coordination, heart

defects and behavior problems

Whose baby is this? • This is Everybody’s Baby! • Medical costs $ 1,496,000• Psychiatric care 530,000• Foster care costs 354,000• Orthodontia 12,000• Respite care 6,000• Special education 240,000• Supported employment 624,000• SSI 360,000• Residential placement 1,376,000• Total: $ 4,998,000• Lifetime costs for one child: $5 million* • Who pays for the effects of prenatal exposure to alcohol?

Everybody does! • * Figures do not include lost salary of mother and subsequent impact on

the local economy. © 1999-2007 Teresa Kellerman ~ Fasstar Enterprises www.fasstar.com

Teen Pregnancy

• Each year in the US, about 1 million teens become pregnant and about half a million teens deliver babies

• 4/10 females become pregnant before age 20

Teens are at risk for producing unhealthy babies

• Low Birth Weight: – Teen’s body is still developing and

maturing– Many teens lack healthful habits– Many delay or don’t receive prenatal

care– Habits of father also affect developing

baby (alcohol, smoking, drugs)

Inadequate parenting skills

• Parenting takes knowledge and skill• Parenting = 24 hour job• Teens have school, social

development, and other learning experiences to worry about

• Adding responsibility of a baby can be overwhelming – Baby suffers as a result

Risk associated w/ females

• Pregnancy places great demands on body

• Development of Anemia/ Toxemia– Anemia: oxygen carrying pigment in blood

is low (lack of O2 and nutrients for baby)– Toxemia: High BP, tissue swelling, and

protein in urine. Can progress to seizures and coma

• Disrupt education, career, finances, free time, social life (friendships/dating)

Risks associated with males

• Responsibility of providing for the care of their babies

• Child support up until 18 in some states

• Less likely to graduate HS/College

• Usually don’t marry the mother of child, but if do, usually divorce w/in 5 years

Faulty thinking about teen pregnancy

• I can have a baby now; my mother had a baby when she was a teen and she managed okay

• I’ll be the center of attention if I have a baby

• I (she) won’t get pregnant if it’s our first time

• I can drink and still stay in control of my decisions

Nutrition/Exercise

• Healthy diet including fruits, vegetables, grains and calcium rich foods

• Avoid alcohol, smoking and drugs• Avoid uncooked/undercooked meats and

fish• Ask physician about Rx/OTC medicines • Be physically active for at least 30

min/day most days of the week

Fetal Development1st Month (1st Trimester)

• http://www.webmd.com/baby/slideshow-fetal-development

• Baby is ¼” long• Heart, digestive system, backbone and spinal cord begin to develop• Placenta begins to develop

2nd Month

• Baby is 1 1/8” long • Heart is functioning (usually can be heard on ultrasound around week 6-7)• Eyes, nose, lips, tongue, ears and teeth are forming• If a boy, penis begins to develop• Baby is moving, although the mother can’t feel it yet

3rd Month

• Baby is 2 ½ - 3” long; weight is about ½ to 1 ounce• Develops recognizable form• Nails start to develop and earlobes are formed• Arms, hands, fingers, legs, feet, and toes are fully formed• Eyes almost fully developed• Most organs and tissues are developed

4th Month (2nd Trimester)

• Baby is 6 ½ - 7” long; weight is about 6-7 ounces• Developing reflexes such as sucking and swallowing (may suck it’s thumb)• Tooth buds developing• Sweat glands forming on palms and soles• Fingers and toes well defined• Gender identifiable (at 20th week)• Skin is bright pink, transparent, and covered in soft downy hair• Would not be able to survive outside the womb

5th Month

• Baby is 8-10” long; weight is about 1 pound• Hair begins to grow on head• Soft, woolly hair (lanugo) develops on baby’s body• Mother begins to feel movement (usually around 22nd week)• Internal organs maturing• Eyebrows, eyelids and eyelashes appear

6th Month

• Baby is 11-14” long; weight is about 1 ¾ -2 lbs.• Eyelids may begin to part and open for short periods of time• Skin is covered with protective coating (vernix)• Baby may hiccup

7th Month (3rd Trimester)

• Baby is 14-16” long; weight is about 2 ½ - 3 ½ lbs.• Taste buds have developed• Fat layers are forming; organs are maturing• Skin wrinkled and red• If born at this time, baby has a chance at survival but will need special care

(some as early as 22 weeks survive; most 27+ weeks will survive)

8th Month

• Baby is 16 ½ to 18” long; weight is about 4-6 lbs.• Overall growth is rapid this month• Tremendous brain growth• Most organs, except lungs, are developed now• Kicks may be visible from outside the mother’s body• Kidneys mature• Skin less wrinkled• Fingernails extend beyond fingertips

9th Month

• Baby is 19-20” long; weight is about 7-7 ½ lbs.• Lungs are mature• Baby is fully developed and can survive outside mother’s body• Skin is pink and smooth• Baby settles lower in abdomen to prepare for birth and may seem less active