What are the critical factors in determining the fetus' ease of passage through the maternal pelvis?
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Fetal attitude, lie, and presentation.
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What are the critical factors in determining the fetus' ease of passage through the maternal pelvis?
Fetal attitude, lie, and presentation.
What is osmosis?
The movement of water molecules through a semi-permeable membrane from an area of lower solute concentration to an area of higher solute concentration.
What type of membrane is involved in osmosis?
A semi-permeable membrane.
What drives the process of osmosis?
The concentration gradient of solutes.
What is the result of osmosis in cells?
Cells can gain or lose water, affecting their size and function.
What are the second stage cardinal movements in labor?
The fetal position changes that occur during labor.
What hormone increases the activity of aromatase?
FSH (Follicle-Stimulating Hormone).
What is the difference between true labor and false labor?
True labor has regular contractions that increase in frequency, duration, and intensity, producing cervical changes, while false labor has irregular, intermittent contractions with no cervical changes.
What triggers the neuroendocrine reflex during lactation?
Suckling by the infant at the breast.
What is the role of oxytocin in the reproductive system?
Essential for progression of labor, control of postpartum bleeding, and return of the uterus to its pre-pregnancy state (involution).
What is synthesized from androstenedione?
17-beta-estradiol.
What are Braxton-Hicks contractions?
They are also known as false labor contractions.
What is released from the posterior pituitary in response to suckling?
Oxytocin.
What hormone stimulates the proliferation of theca cells?
LH (Luteinizing Hormone).
What does GTPAL stand for in obstetric history?
G: number of pregnancies, T: number of term infants born, P: number of preterm infants born, A: number of spontaneous/induced abortions, L: number of currently living children.
Where is oxytocin synthesized and secreted?
Synthesized in the hypothalamus and secreted by the posterior pituitary.
Which tissues are target sites for 17-beta-estradiol?
Uterus, vagina, bones, and blood vessels.
What effect does oxytocin have during lactation?
It stimulates milk ejection from the alveoli (let-down reflex).
What is the duration of the early/latent phase of labor?
8–12 hours.
What is the first step in progesterone synthesis?
Cholesterol desmolase converts cholesterol into pregnenolone.
How long does a typical pregnancy last?
Approximately 280 days (40 weeks).
What is the function of prolactin (PL)?
Involved in the production and release of milk.
What is the cervical dilation range during the active phase of labor?
3–7 cm.
What hormone is released from the anterior pituitary to increase milk production?
Prolactin (PL).
What hormone is dominant during the luteal phase of the ovarian cycle?
Progesterone.
What are some presumptive signs of pregnancy?
Amenorrhea, breast fullness, tenderness, nausea/vomiting, urinary frequency, fatigue, fetal movement (16–20 weeks).
How is prolactin synthesis regulated?
Inhibited by dopamine during the non-pregnant/non-breastfeeding state.
Where is the uterus located?
Posterior to the bladder and anterior to the rectum.
What are the main sources of estrogen and progesterone in females?
Produced mainly by the ovaries, with some estrogen produced in the adrenal cortex, adipose tissue, and secreted by the placenta during pregnancy.
What is the function of the mucus plug in the cervix during pregnancy?
It seals the endocervical canal.
What characterizes the transition phase of labor?
Intense contractions every 1.5–2 minutes, lasting 60–90 seconds, with cervical dilation of 7–10 cm.
How does prolactin affect ovarian function?
It inhibits the release of GnRH, leading to decreased LH and FSH, which reduces ovarian follicle development and ovulation.
What is Naegele’s rule used for?
To calculate the estimated date of delivery (EDD) from the last menstrual period (LMP).
What does increased progesterone during the secretory phase of the menstrual cycle form?
Decidual tissue for implantation.
What causes the pregnancy 'glow'?
Increased cutaneous blood flow leading to enhanced heat dissipation.
What is the diagnosis criterion for menopause?
Menstrual cycles have stopped for an entire year with no identified pathological cause.
What are the main parts of the uterus?
Fundus, uterine body, uterine isthmus, and cervix.
What are the stages of follicular development?
Primordial follicles → primary follicles → secondary follicles → tertiary (Graafian) follicles.
What is transitional milk and when is it produced?
Transitional milk is produced 7–10 days postpartum; it is thinner than colostrum and has a light yellow color.
What are the three types of estrogen?
Estradiol (most biologically active), estrone, and estriol.
What is Goodell’s sign?
Mild softening of the cervix due to edema and hyperplasia.
What is the most critical fetal size factor during labor?
Fetal head size, particularly cephalopelvic disproportion.
What begins the second stage of labor?
It begins with full cervical dilation.
What role does oxytocin play in uterine health postpartum?
It stimulates contractile activity of the uterine myometrium, reducing postpartum bleeding and promoting uterine involution.
What are the two layers of the uterine endometrium?
A thin base layer and a functional layer.
What physiological changes occur in the uterus during pregnancy?
Increased size and capacity due to hypertrophy and hyperplasia, increased strength and distensibility, and softening of the uterine isthmus.
How does progesterone help maintain pregnancy?
By decreasing irritability of the myometrium, reducing the risk of spontaneous abortion.
What are stretch marks (striae gravidarum) a result of during pregnancy?
Decreased connective tissue strength due to increased adrenal steroid levels.
At what age does menopause usually begin?
Around age 50.
What are the characteristics of mature milk?
Mature milk is produced 2 weeks postpartum, has a watery, slight bluish color, and its fat content increases during feeding.
What happens during ovulation?
The dominant follicle ruptures and releases a secondary oocyte into the fallopian tube.
What are the cervical openings in the uterus?
External os (to vagina) and internal os (into uterine cavity).
What is the initial step in the synthesis of progesterone from cholesterol?
Cholesterol is converted to pregnenolone via cholesterol desmolase.
Where does the placenta develop?
Where the embryo attaches to the uterine wall.
What is macrosomia in the context of fetal weight?
Birth weight ≥ 90th percentile for gestational age or > 4500 g.
What are the three Ps that dictate navigation through the maternal pelvis during labor?
Power, passenger, passage.
What is the let-down reflex?
The contraction of myoepithelial cells surrounding alveoli in the breasts, leading to milk ejection.
What changes occur in the functional layer of the endometrium during the menstrual cycle?
Thickening and shedding.
What role does progesterone play in the cervix during pregnancy?
It forms a mucus plug.
What happens to the corpus luteum if fertilization does not occur?
It undergoes apoptosis and progesterone levels fall.
What is the effect of estrogen on vascular permeability during pregnancy?
It leads to spider nevi, angiomas, and palmar erythema.
What are some key components of mature milk?
Mature milk contains protein, fat, sugars (like lactose and oligosaccharides), vitamins, minerals, immunoglobulins, antibodies (especially secretory IgA), immune cells, and immune-modulating factors.
What ligaments anchor the uterus?
Uterosacral ligaments and round ligaments.
What precedes menopause?
Perimenopause, which lasts about 4 years before the final menstrual period.
What occurs during the luteal phase of the menstrual cycle?
The remains of the follicle turn into the corpus luteum, which produces progesterone if fertilization occurs.
How is androstenedione converted to testosterone?
Androstenedione diffuses to nearby granulosa cells and is converted to testosterone by 17-beta-hydroxysteroid dehydrogenase.
What percentage of the internal uterine surface does the placenta cover?
50%.
What is lactogenesis?
The initiation of milk secretion from lactating breast tissue.
What does fetal attitude refer to?
The relationship of fetal parts to one another.
What physiological factors stimulate uterine contractions?
Stimulation of uterine myometrium and alpha-receptors, along with numerous oxytocin receptors on the uterine fundus.
How does progesterone affect breast development during pregnancy?
It increases alveolar-lobular development and prevents milk production by inhibiting prolactin.
What hormone does embryonic tissue secrete if fertilization occurs?
Human chorionic gonadotropin (hCG).
What hormone is a powerful stimulant for uterine muscles during pregnancy?
Oxytocin.
What are the external organs of the female reproductive system?
Labia minora, labia majora, clitoris, and mons pubis.
What musculoskeletal change occurs due to abdominal distension during pregnancy?
Lordosis.
What is a common recommendation regarding vitamin D in breast milk?
Breast milk is low in vitamin D, so supplementation is often recommended.
What are the three layers of the uterine wall?
Perimetrium, myometrium, and endometrium.
What hormonal changes occur during menopause?
Decreased estrogen and progesterone lead to increased bursts of GnRH and elevated FSH and LH levels.
What happens to the corpus luteum if fertilization does not occur?
It stops making hormones after about ten days and becomes fibrotic, turning into the corpus albicans.
What regulates the secretion of estrogen and progesterone?
Regulated by the hypothalamic-pituitary-ovarian axis through feedback loops.
What hormones stimulate the growth of breast glandular tissue during pregnancy?
Human placental lactogen (hPL) and progesterone.
What hormones does the placenta secrete?
Estrogen, progesterone, relaxin, and hCG.
What is the ideal fetal lie during delivery?
Longitudinal, where the fetal spine lies along the maternal spine.
How is intrauterine pressure measured during contractions?
In millimeters of mercury (mm Hg).
What is the significance of the Hegar sign?
It indicates softening of the uterine isthmus, a probable sign of pregnancy.
What respiratory changes occur due to progesterone?
Increased sensitivity to CO2, mild hyperventilation, and decreased airway resistance.
What inhibits the action of oxytocin during pregnancy?
Rapid degradation by placental oxytocinase and progesterone-induced inhibition of oxytocin receptors.
What is the vulvar vestibule?
The space between the labia minora that includes the vaginal and urethral openings.
What are some contraindications to breastfeeding?
Contraindications include certain maternal medications (like chemotherapy), illicit drugs (such as cannabis and heroin), HIV infection, herpes lesions on the breast, and tuberculosis.
What is the function of the myometrium?
It is composed of smooth muscle that aids in uterine contractions.
What is diastasis recti?
Separation of abdominal rectus muscles due to an enlarging uterus.
What are hot flashes and what causes them?
Hot flashes are caused by hypothalamus-associated thermoregulatory dysfunction leading to vasomotor instability.
What are the effects of estrogen on female reproductive organs?
Maturation of female reproductive organs and development of secondary sexual characteristics.
What happens to progesterone levels after the delivery of the placenta?
Progesterone levels decrease, allowing milk synthesis in alveoli.
What physiological change occurs in the vagina during pregnancy?
Increased vascularity leading to a bluish-purple color.
What is the most common fetal presentation for delivery?
Cephalic presentation, specifically vertex position.
What systemic effect does progesterone have in conjunction with estrogen?
It promotes bone remodeling and increases bone density.
What is the estimated fundal height at 20 weeks of pregnancy?
At the level of the umbilicus.
How does estrogen affect oxytocin during labor?
It induces oxytocin receptor expression and increases myometrial sensitivity to oxytocin.
What are the primary functions of the ovaries?
To secrete estrogen and progesterone.
What is engorgement and how can it be treated?
Engorgement is caused by milk accumulation in breast tissue and can be treated by emptying the breasts through increased breastfeeding or pumping, using warm compresses before feeding, and cool compresses afterward.
What are some strategies to manage hot flashes?
Avoid triggers like hot drinks and spicy foods, maintain a cool environment, and wear lighter clothing.
What hormone increases joint mobility during pregnancy?
Progesterone and relaxin.
What is the vagina's connection to the uterus?
The vagina extends from the uterus and opens into the vulva.
How does estrogen prepare the uterus for implantation?
Increases endometrial proliferation and secretion in collaboration with progesterone.
What role does oxytocin play in breastfeeding?
Oxytocin is required for milk to be released from alveoli.
What is leukorrhea and its pH range?
A vaginal discharge with a pH of 3.5–6.0 that protects against bacterial infections.
What characterizes a frank breech presentation?
Hips flexed and knees extended, with the bottom presenting.
How does progesterone affect skin during pregnancy?
It promotes skin elasticity.
What is the positive feedback loop during labor?
Increased uterine contractions lead to fetal head pushing against the cervix, triggering more oxytocin release and further contractions.
Where are the ovaries located?
Superior and lateral to the uterus.
What causes sore, cracked nipples during breastfeeding?
Sore, cracked nipples are often caused by improper latch or positioning.
What is the 'diabetogenic state' of pregnancy?
Increased need for glucose and insulin production, leading to hypertrophy and hyperplasia of pancreatic beta cells.
What is vulvovaginal atrophy?
It is characterized by vaginal dryness and loss of vaginal rugae, leading to dyspareunia.
What is the fornix in relation to the vagina?
It is the superior, domed area that connects to the sides of the cervix.
What role does estrogen play during pregnancy?
Secreted by the placenta to support the uterus and stimulate development of the myometrium.
What are oogonia?
Primordial oocyte cells that undergo mitotic division to increase in number.
What is the let-down reflex?
A neuroendocrine reflex that triggers milk ejection from the alveoli.
What changes occur in the breasts during pregnancy?
Increased size, weight, nodularity, and vascular prominence.
What type of pelvis is optimal for vaginal delivery?
Gynecoid pelvis, which has a rounded pelvic inlet.
What happens to the uterus after labor?
Milder contractions continue to clamp down on placental arteries, reduce bleeding, and gradually decrease the size of the uterus (involution).
What is mastitis and how is it treated?
Mastitis is a bacterial infection that usually presents unilaterally with localized warmth and flu-like symptoms; treatment includes continued breastfeeding, NSAIDs, and antibiotics.
What ligaments hold the ovaries in place?
Ovarian, broad, and suspensory ligaments.
What is the recommended additional caloric intake during pregnancy?
300 kcal/day.
What type of epithelium lines the inner mucous membrane of the vagina?
Stratified squamous epithelium.
What are the risks associated with decreased estrogen during menopause?
Increased risk of cardiovascular disease and decreased bone marrow density, leading to osteoporosis and fractures.
What systemic effects does estrogen have?
Required for closure of epiphyseal plates, has an anabolic effect on bones, and maintains flexibility of blood vessels.
What happens to oogonia at 7 months of fetal development?
They begin meiotic division and become primary oocytes.
How does the amount of milk produced relate to feeding?
The amount of milk produced depends on the amount removed at feeding (supply meets demand).
What is the role of progesterone in breast development during pregnancy?
It increases alveolar-lobular development and prevents milk production.
What is the first cardinal movement of labor?
Descent, where the presenting part reaches the pelvic inlet.
What is menstruation?
The shedding of the uterine functional endometrium.
What is the structure of the ovaries?
Made up of an outer cortex containing ovarian follicles and an inner medulla with blood vessels and nerves.
What causes yeast infections in breastfeeding mothers?
Yeast infections are caused by Candida albicans and may occur if there is a history of infant oral or diaper candidal infection or maternal vaginal candidal infection.
How much weight gain is recommended during pregnancy?
25–35 pounds (11.5–16 kg).
What are some common psychological effects of menopause?
Mood instability, depression, anxiety, and decline in cognitive function.
What happens to estrogen levels during perimenopausal and menopausal years?
Estrogen levels decrease, leading to an increased risk of cardiovascular morbidity, osteoporosis, and sexual dysfunction.
What forms during infancy to puberty in follicular development?
Primary oocytes surrounded by granulosa cells form primary (primordial) follicles.
What is colostrum?
The small amounts of thick, yellowish fluid produced during the second half of pregnancy, rich in immune cells and antibodies.
What cardiovascular changes occur during pregnancy?
Increased heart rate, stroke volume, and cardiac output, with decreased blood pressure.
What happens during the extension phase of labor?
The fetal head passes under the symphysis pubis and emerges from the vagina.
What occurs during the follicular phase of the menstrual cycle?
Maturing follicles and proliferation of uterine mucosa, dominated by estrogen.
What are the components of the fallopian tubes?
Two tubes associated with each ovary, lined with smooth muscle and cilia.
What is the role of menopausal hormone therapy (MHT)?
MHT, including estrogen or estrogen plus progestin, can be helpful in managing menopausal symptoms.
What is the daily recommendation for folic acid during pregnancy?
600 mcg/day.
What are the stages of follicular development during the menstrual cycle?
Primary follicle → secondary follicle → tertiary (Graafian) follicle.
What are the benefits of breast milk for infants?
Breast milk has a higher whey to casein ratio, immunoglobulins, long-chain polyunsaturated fatty acids, and beneficial bacteria, aiding absorption and reducing infection risk.
What causes supine hypotensive syndrome during pregnancy?
The gravid uterus pressing on the inferior vena cava.
What marks the end of the second stage of labor?
The expulsion of the anterior shoulder followed by the posterior shoulder.
What triggers ovulation?
A brief surge of LH on Day 14.
Where does fertilization most commonly occur in the fallopian tubes?
In the ampulla region.
What are the three stages of labor?
Uterine contractions, cervical changes, and delivery of the baby and placenta.
What forms in Graafian follicles and what is its function?
Antrum (fluid-filled cavity) forms; granulosa cells secrete nourishing fluid for the primary oocyte.
What are the benefits of breastfeeding for mothers?
Breastfeeding accelerates uterine involution and reduces the risk of chronic diseases such as Type II diabetes and certain cancers.
What occurs during the third stage of labor?
Delivery of the placenta, umbilical cord, and fetal membranes.
What is fundal height and its significance?
The distance from the symphysis pubis to the top of the uterus, used to estimate gestational age.
What happens to the primary follicle during the follicular phase?
It develops into a mature follicle with an outer theca layer and produces estrogen.
What is the function of the cilia in the fallopian tubes?
To sweep the zygote towards the uterus.
What are the premonitory signs of labor?
Cervical changes including softening and expulsion of the mucus plug.
What do theca cells produce and what is its significance?
They produce androstenedione, which is converted into estradiol in granulosa cells.
What is the focus of the fourth stage of labor?
Physiological adaptation to blood loss and initiation of uterine involution.
What type of cells line the fallopian tubes?
Mesothelial, epithelial, secretory, and intercalary cells.
What occurs during the follicular phase of the menstrual cycle?
Graafian follicles grow, and the follicle with the most FSH receptors becomes the dominant follicle.
What happens during ovulation?
The dominant follicle ruptures, releasing the secondary oocyte into the peritoneal cavity, which is then pulled into the fallopian tube.
What is the role of the corpus luteum during the luteal phase?
It secretes inhibin, decreasing FSH, estrogen, and LH, while luteinized theca cells increase progesterone.
What happens if fertilization occurs?
The oocyte becomes a mature ovum, and progesterone is produced until the placenta forms.
What happens if fertilization does not occur?
The corpus luteum degenerates into the corpus albicans.
