Chapter 10 Presentation

Scott Overly

Bio 120

Gestation

Length of time from conception to birth, generally nine months. Calculated from the first day of the last menstrual period, with a range of 259 to 280 days.

Premature is considered being born before completing 37 weeks of gestation

Embryo

The time the fertilized egg emplants in the uterus til the end of the eighth week

Organ systems of the body are formed

Fetus

Stage after embryo Lasts until birth Longest period of gestation Organs mature and start to function

1st Trimester

physical changes may include breast tenderness, fatigue and nausea. Emotions may range from excitement to anxiety. For your baby, the first trimester is a time of rapid growth and development. Your baby's brain, spinal cord and other organs begin to form, and your baby's heart begins to beat. Your baby's fingers and toes even begin to take shape.

2nd Trimester

During the second trimester of pregnancy — from months four to six

Second trimester signs and symptoms may include larger breasts, a growing belly and skin changes.

Baby, the second trimester often marks the ability to kick, make facial expressions and hear.

3rd Trimester

Third trimester signs and symptoms may include backaches, swollen ankles and mounting anxiety.

During the third trimester, the baby will likely open his or her eyes and gain weight. This rapid growth may lead to more pronounced fetal movements. By the end of week 37, your baby is considered full term.

During the third trimester, you'll continue to meet with your health care provider regularly. He or she may check the baby's position and assess cervical changes.

Uterus

It is placed between the bladder and the rectum. One end of the uterus opens into the vagina and is known as the cervix. The other end is connected to the fallopian tubes. The pelvic diaphragm, urogenital diaphragm and the perineal body primarily support the uterus. The ligaments and peritoneum also support it.

The organ in which the developing fetus resides.

Function

Once the egg is fertilized it will come to rest in the uterus. The lining of the uterus, the endometrium, will have prepared itself to receive the embryo and will then house the fetus for the next nine months.

The main purpose of the uterus is to nourish the developing fetus in the months leading up to birth.

Layers – Endometrium

Innermost lining of the uterine cavity. Damage to the endometrium can result in adhesions or fibrosis. The endometrium is the lining that is shed during menstruation if no pregnancy has occurred.

Reacts to hormonal changes which prepares it to receive fertilized ovum

Provides rich blood supply

Layers - Myometrium

This is the largest layer of the uterus. The innermost point of the myometrium is called the junctional zone.

Thick muscular wall that provides contractions which push the baby out of the birth canal during delivery

Layers - Parametrium

The loose tissue that surrounds the uterus is called the parametrium. The parametrium is where the uterine artery and the ovarian ligament are situated.

Layers - Perimetrium

Perimetrium, or peritoneum is the serous membrane that covers the outer most layer of the uterus. This layer supports the abdominal organs and serves as a channel for their lymph and blood nerves and vessels

Menopause

Cessation or ending of menstrual activity. Generally between ages 40-55

Symptoms

Technically, you don't actually "hit" menopause until it's been one year since your final menstrual period. In the United States, that happens at about age 51, on average.

But in the months or years leading up to that point, you might experience these signs and symptoms:

Irregular periods Decreased fertility Vaginal dryness

Symptoms

Hot flashes Sleep disturbances Mood swings Increased abdominal fat Thinning hair Loss of breast fullness

Causes

Natural decline of reproductive hormones. As you approach your late 30s, your ovaries start making less estrogen and progesterone. Fewer potential eggs are ripening in your ovaries each month, and ovulation is less predictable. Post-ovulation surge in progesterone becomes less dramatic. Your fertility declines, partially due to these hormonal effects.

These changes become more pronounced in your 40s. Your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent until your ovaries stop producing eggs, and you have no more periods.

Causes

Hysterectomy. A hysterectomy that removes your uterus, but not your ovaries, usually doesn't cause menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone. But an operation that removes both your uterus and your ovaries (total hysterectomy and bilateral oophorectomy) does cause menopause, without any transitional phase. Periods stop immediately, and you're likely to have hot flashes and other menopausal signs and symptoms.

Causes

Chemotherapy and radiation therapy. These cancer therapies can induce menopause, causing symptoms such as hot flashes during the course of treatment or within three to six months

Causes

Primary ovarian insufficiency. Approximately 1 percent of women

experience menopause before age 40. Menopause may result from primary ovarian insufficiency stemming from genetic factors or autoimmune disease, but often no cause for primary ovarian insufficiency can be found.

Testing

Under certain circumstances, your doctor may check your level of follicle-stimulating hormone (FSH) and estrogen (estradiol) with a blood test. As menopause occurs, FSH levels increase and estradiol levels decrease.

A blood test to determine your level of thyroid-stimulating hormone, because hypothyroidism can cause symptoms similar to those of menopause.

Treatments

Hormone therapy. Estrogen therapy remains the most effective treatment option for relieving menopausal hot flashes. Depending on personal and family medical history, the doctor may recommend estrogen in the lowest dose needed to provide symptom relief for you.

Low-dose antidepressants. Venlafaxine (Effexor), an antidepressant decreases menopausal hot flashes. Other SSRIs can be helpful, including fluoxetine (Prozac, Sarafem), paroxetine (Paxil, others), citalopram (Celexa) and sertraline (Zoloft).

Gabapentin (Neurontin). This drug is approved to treat seizures, but it also has been shown to significantly reduce hot flashes.

Clonidine (Catapres, others). Clonidine, a pill or patch typically used to treat high blood pressure, may significantly reduce the frequency of hot flashes, but unpleasant side effects are common.

Treatments

Bisphosphonates. Nonhormonal medications, which include alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva), to prevent or treat osteoporosis. These medications effectively reduce both bone loss and your risk of fractures and have replaced estrogen as the main treatment for osteoporosis in women.

Selective estrogen receptor modulators (SERMs). SERMs are a group of drugs that includes raloxifene (Evista). Raloxifene mimics estrogen's beneficial effects on bone density in postmenopausal women, without some of the risks associated with estrogen.

Vaginal estrogen. To relieve vaginal dryness, estrogen can be administered directly to the vagina using a vaginal tablet, ring or cream. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissue. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms