Medical brain Notes 3

  CONGENITAL ANOMALIES OF THE FEMALE GENITAL ORGANS At the end of this chapter the students will be able to:   ·          Mention the effect of female congenital anomalies on pregnancy ·          List different type of uterine abnormality.   The female genital tract is formed in early embryonic life when pair of ducts develop. These paramesonephric or mullerian ducts come together in the midline and fuse in to a Y-shaped canal. The open upper ends of this structure open in to the peritoneal cavity and the fused portions become the uterine tubes. The fused lower portion forms the uterovaginal area which further develops in to the uterus and the vagina.   Anomalies arise primarily from the alteration of the fusion process. Failure of the ducts to fuse normally results in two partially or completely separated tracts. Failure of one duct to mature results in a one-sided tract. Incomplete fusi...

  Uterine Abnormalities   Are manifested in variety of forms, but four simplified types are generally recognized.   The septate uterus:- appears normal from the exterior, but it contains a septum that extends partially or completely from the fundus to the cervix, dividing the uterine cavity in to two compartments.   The bicornuate uterus is roughly Y-shaped. The fundus is notched to various depths, and the patient may even appear to have a “double uterus”; however, there is only one cervix.   A true double uterus results from a lack of mid line fusion and two complete uterne, each with its own cervix, are formed. When both are fully formed, this is normally referred to as uterus didelphys. Occasionally, one of the uteri will not fully form, remaining as a rudimentary organ with out a cervix or a uterine cavity. A single remiuterus results when one mullerian duct fails to develop during embryonic growth, resulting in one uterine cavity and one oviduct.   ...

  Cervix Abnormalities   May also affect the course of labour and birth. Three general types of cervical abnormalities have been identified. The septate cervix consists of a ring of muscular tissue partitioned by a septum that either extends down ward from the uterus or up ward from the vagina or is contained completely with in the cervix itself.   A single hemi cervix or half-cervix results from incomplete and asymmetrical development in which only one mullerian duct matures. A double cervix has two separate cervices in one uterus vaginal abnormalities also occur. The most common abnormality is the presence of vaginal septa and some time there is an absence of vagina.   Causes   A. Errors of sinus canalization  -  Imperforated hymen o         Complete or paritial vaginal atresia   o         Parital transvers membreane (occurs in the upper vagina)     B. Failure of re-...

  Vaginal Abnormalities     Usually do not present serious problems in terms of normal reproductive function. They are easily accessible and can be easily dilated or removed surgically.   Treatment  - treatment depend up on the degree ofabnormality and whether it has interfered with coitus orpregnancy. Surgical treatment for structural abnormalities is generally done before conception, if possible. The nurse should also recognize that women with reproductive tract abnormalities may feel guilt and anxiety about their effect on pregnancy out come. By carefully assessing the woman’s knowledge and feeling about her progress in labour and possible obstetric interventions, the nurse can contribute to a more positive child bearing experience for the patient and her family