Implantation window[ edit ] The reception-ready phase of the endometrium of the uterus is usually termed the “implantation window” and lasts about 4 days. The implantation window occurs around 6 days after the peak in luteinizing hormone levels. With some disparity between sources, it has been stated to occur from 7 days after ovulation until 9 days after ovulation,  or days postovulation. These changes are collectively known as the plasma membrane transformation and bring the blastocyst nearer to the endometrium and immobilize it. During this stage the blastocyst can still be eliminated by being flushed out of the uterus. Scientists have hypothesized that the hormones cause a swelling that fills the flattened out uterine cavity just prior to this stage, which may also help press the blastocyst against the endometrium.
Acute endometritis[ edit ] Acute Endometritis is characterized by infection. The organisms most often isolated are believed to be because of compromised abortions, delivery, medical instrumentation, and retention of placental fragments. The clinical presentation is typically high fever and purulent vaginal discharge. Menstruation after acute endometritis is excessive and in uncomplicated cases can resolve after 2 weeks of clindamycin and gentamicin IV antibiotic treatment.
Chronic endometritis[ edit ] Chronic Endometritis is characterized by the presence of plasma cells in the stroma. Lymphocytes, eosinophils, and even lymphoid follicles may be seen, but in the absence of plasma cells, are not enough to warrant a histologic diagnosis.
During the first trimester of pregnancy, a unique and dramatic sequence of events occurs, defining the most critical and tenuous period of human development: the remarkable transformation of a single cell into a recognizable human being.
Hysteroscopy Test Overview A hysteroscopy is a way for your doctor to look at the lining of your uterus. He or she uses a thin viewing tool called a hysteroscope. The tip of the hysteroscope is put into your vagina and gently moved through the cervix into the uterus. The hysteroscope has a light and camera hooked to it so your doctor can see the lining endometrium on a video screen.
A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to see if a problem in your uterus is preventing you from becoming pregnant infertility. A hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps.
The synchrony calculations are based on the two assumptions that in the natural cycle: For more detail on embryo—uterine developmental synchrony. Despite such reports, the overwhelming view has remained that, wherever possible, embryo and uterus should be as close to each other as possible in terms of developmental synchrony.
It is highly unlikely for ethical reasons that systematic investigation of the length of the human implantation window will ever be undertaken.
The keyword ‘IVF culture media’ gave results in PubMed and ‘embryo culture media’ 12 results dating from until March , depicting the increased scientific activity in this field. ) and its receptors are detected in the endometrium and the preimplantation embryo (Knudson and Knudson, ; Campbell et al., ).
Download powerpoint Figure 1. Endometrial cancer risk factors in bold either influence inflammation directly or influence factors that increase inflammation estrogen, menstruation or decrease inflammation progesterone. Protective factors in italics exert the opposite effects. The effects of inflammation can cause mutagenesis, ultimately leading to endometrial carcinogenesis either directly a or indirectly b by increasing estrogen levels.
The Inflammation-Cancer Link Epidemiologic studies have documented a relationship between local tissue inflammation and cancer development at that site. Examples include hepatitis and liver cancer 28 and colitis and colon cancer The inverse association between long-term use of nonsteroidal anti-inflammatory drugs NSAID and reduced risk of several cancers 30 – 34 further supports an inflammation-cancer link.
Endometriosis Staging – The Four Stages of Endometriosis
To understand developing ureteroplacental circulation, a basic knowledge of the anatomy and physiology of uterine blood flow is helpful. Blood to the uterus is from the paired uterine arteries, which are branches of the anterior division of the internal iliac artery. As each uterine artery enters the uterus at the uterocervical junction, it ascends along the lateral uterine wall and produces multiple penetrating arcuate branches.
When these branches pierce the endometrium, they become the spiral arteries. With early embryonic development, the spiral arteries located within the decidua basalis become increasingly prominent.
Accurate gestational dating is essential to appropriately interpret. US findings. Gestational sac. Yolk sac. an intrauterine gestational sac containing a yolk sac and an embryonic pole, confirming an IUP. The decidua is the endometrium of the pregnant uterus. Intradecidual sac sign. rg__ppt [W].
Evaluation of the Couple as a Unit Infertility should be regarded as a two-patient disorder. Male and female partners must be thoroughly evaluated, counseled, and included in the therapeutic decision-making processes. Exclusion of the male partner may lead to feelings of isolation in the female and to disinterest and lack of cooperation of the male partner. A questionnaire is often helpful prior to the first visit and should include questions regarding prior conceptions, contraception, and coital frequency and techniques.
This document serves as a basis for review and in-depth questioning and does not replace the history. Both partners should be screened for the use of drugs or alcohol that may affect fertility.
ULTRASOUND EVALUATION DURING THE FIRST TRIMESTER OF PREGNANCY
Alternatively, combined OCs can be prescribed on an extended schedule to completely suppress the endometrium and prevent withdrawal bleeding. NSAIDs work by correcting prostaglandin imbalances and causing vasoconstriction. Regimens that have been shown to be effective for AUB include ibuprofen to mg every 4 to 6 hours, mefenamic acid mg to start with and mg every 6 hours thereafter, or naproxen mg every 8 hours.
Histological dating, αvβ3 integrin and osteopontin expression in spontaneous cycles in control fertile women and spontaneous and treatment mid-luteal endometrium specimens in the not-treated group. Each box represents the middle 50% of the data (25–75% range).
Setelah membaca handout ini mahasiswa dapat: Menjelaskan latar belakang pentingnya mempelajari komunikasi yang efektif. Menjelaskan pengertian komunikasi dengan lengkap. Menjelaskan jenis-jenis komunikasi dengan benar. Menguraikan bentuk komunikasi secara tepat. Menguraikan unsur-unsur dasar dalam komunikasi dengan benar. Menjelaskan tentang proses komunikasi dengan benar. KomunikasiEfektif ibu selamat, bayi sehat, keluarga bahagia.
L, Untung Sujianto, TatikIndrawati. Pendahuluan Angka kematian di Indonesia masih tinggi. Setiap tahun sejumlah Risiko kematian ibu akibat kehamilan,persalinan,dn nifas serat bayi, dapat dikurangi bila ada upaya persiapan persalinan dan kemudahan mendapatkan pelayanan kesehatan dasar. Salah satu ujung otmbak pelayanan kesehatan dasar bagi ibu dan bayi adalah bidan.
Case Presentation: Endometrial Cancer
Kebutuhan Dasar neonatus, bayi, balita, dan anak prasekolah Asih: Asah deteksi dan stimulasi Waktu: Ni Wayan Armini, M. Objektif dari Silabus Terminal Objective: Setelah mengikuti perkuliahan ini, mahasiswa mampu: Menjelaskan tentang apa yang dimaksud dengan Bonding Attachment dengan benar.
Long-term effects[ edit ] Menopause confers: A possible but contentious increased risk of atherosclerosis. Induced menopause occurs as a result of medical treatment such as chemotherapy , radiotherapy , oophorectomy , or complications of tubal ligation , hysterectomy , unilateral salpingo-oophorectomy or leuprorelin usage. The average age of the last period in the United States is 51 years, in the United Kingdom is 52 years, in Ireland is 50 years and in Australia is 51 years.
In India and the Philippines , the median age of natural menopause is considerably earlier, at 44 years. Coeliac disease can present with several non-gastrointestinal symptoms, in the absence of gastrointestinal symptoms, and most cases escape timely recognition and go undiagnosed, leading to a risk of long-term complications. A strict gluten-free diet reduces the risk. Women with early diagnosis and treatment of coeliac disease present a normal duration of fertile life span.
Other factors that can promote an earlier onset of menopause usually 1 to 3 years early are smoking cigarettes or being extremely thin. The functional disorders often significantly speed up the menopausal process. An early menopause can be related to cigarette smoking, higher body mass index , racial and ethnic factors, illnesses, and the surgical removal of the ovaries , with or without the removal of the uterus. The reasons for this are not completely understood.
Transplants of ovarian tissue between identical twins have been successful in restoring fertility.
Br J Obstet Gynaecol ; Fetal crown rump length: Primordial follicles are too small to see with US [ 4 ].
The uterus is made up of an external layer of smooth muscle called the myometrium, and an internal layer called the endometrium. The endometrium has three layers: stratum compactum, stratum spongiosum (which make up the stratum functionalis) and stratum basalis.
Severity Stage 1 Endometriosis Minimal The first stage of endometriosis is characterized by superficial implants that are sometimes mistaken for cysts or ovarian cancer. They resemble small, flat patches or flecks on the pelvic surface. The presence of these implants causes irritation and inflammation in surrounding tissues, leading to the formation of adhesions. Adhesions are bands of internal scar tissue that can bind tissues and organs that are normally mobile, causing pain and dysfunction.
Stage 2 Endometriosis Mild Most women are diagnosed with minimal or mild endometriosis. The attributes of first stage endo are present in the second stage as well, but more aggressively. During this stage, lesions also appear in the recto-uterine pouch — the area between the uterus and rectum. Chocolate cysts get their name because after time, the blood inside of the cyst turns dark red and brown.
If a cyst ruptures, it can cause extreme abdominal pain and inflammation in the pelvic region. Inflammation and infection, in turn, cause more adhesions. As endometriomas increase in size and number, so do the adhesions that form in response.
Endometrium: Secretory phase
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Embryo toxic serum Defective natural killer activity Endometriosis has been associated with ovulatory disorders such as luteal phase deficiency LPD , oligo-ovulation, and luteinized unruptured follicle LUF syndrome. In a prospective study of couples undergoing in vitro fertilization IVF , pregnancy rates were lower among couples in which the male had been exposed to high levels of the environmental pollutant bisphenol A BPA.
Such disorders include idiopathic hypogonadotrophic hypogonadism, prolactinomas, gonadotropin deficiencies, and Cushing syndrome. Testicular factors Testicular factors can be genetic or nongenetic in nature. Klinefelter syndrome is the most common chromosomal cause of male infertility and results in primary testicular failure. Nongenetic etiologies include drugs, radiation, infections, trauma, and varicoceles.
Aging also affects male fertility.
Lecture 5 PowerPoint Presentation, PPT – DocSlides
Onset and frequency Diagram illustrating how the uterus lining builds up and breaks down during the menstrual cycle. The first menstrual period occurs after the onset of pubertal growth, and is called menarche. The average age of menarche is 12 to The first day of menstrual bleeding is the date used for the last menstrual period LMP.
Measurement of endometrium with fluid in the cavity. In the presence of endometrial fluid, measurements of the 2 separate layers of the endometrium (calipers), excluding the fluid, are added to determine the endometrial thickness. _ 12/1/15 PM Page 6.
Reaffirmed Committee on Gynecologic Practice This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. The clinical approach to postmenopausal bleeding requires prompt and efficient evaluation to exclude or diagnose carcinoma. Women with postmenopausal bleeding may be assessed initially with either endometrial biopsy or transvaginal ultrasonography; this initial evaluation does not require performance of both tests.
Transvaginal ultrasonography can be useful in the triage of patients in whom endometrial sampling was performed but tissue was insufficient for diagnosis. When transvaginal ultrasonography is performed for patients with postmenopausal bleeding and an endometrial thickness of less than or equal to 4 mm is found, endometrial sampling is not required. Meaningful assessment of the endometrium by ultrasonography is not possible in all patients.
In such cases, alternative assessment should be completed. When bleeding persists despite negative initial evaluations, additional assessment usually is indicated. Cancer of the endometrium is the most common type of gynecologic cancer in the United States. In , an estimated 40, cases of cancer of the endometrium will occur and an estimated 7, deaths 1. The majority of patients with postmenopausal vaginal bleeding experience bleeding secondary to atrophic changes of the vagina or endometrium.
Thus, the clinical approach to postmenopausal bleeding requires prompt and efficient evaluation to exclude or diagnose carcinoma.