Functions of progesterone
Inhibits FSH LH
Thickens endometrial lining
Maintain pregnancy
Contribute development of ovum prior to implantation
Prepare breast for lactation
⬇️Contractility of myometrium
Fibroadenoma
M/c benign tumor of breast occurs among young 20-35 yrs
Symptomless ,self palpated B/L
Uniform frim mobile painless well defined mass felt on palpation
Histology - they have epithelial, stromal component
Surgical excision,biopsy mass big
Senile vaginitis or atrophic vaginitis
Vaginitis in postmenopausal women
#Atrophy of vulvovaginal structures due to estrogen deficiency
Vaginal defence lost,vaginal mucosa thin susceptible to infection trauma
C/f :post menopausal yellow/blood stained vaginal discharge
Dryness discomfort soreness
Dysperuina
Bartholin Abscess
End result of acute bartholinitis ducts get blocked by fibrosis, exudate pent up inside produce Abs
C/f : local pain discomfort,pt can’t walk or sir , associated © fever
Ex: unilateral tender swelling beneath post 1/2 of labia majora extending to labia minora
Overlying skin looks red,odematous
Gartner cyst
It is vaginal wall cyst
Situated in ant.lateral wall of vagina
#Epithelium is low columnar, secretes mucinous material which pent up forming a cyst. Tx - surgical excision
Features: margin well defined not reducable, no cough impulse
Vaginal mucosa become tense shiny
Ovarian cyst complications
Torsion of pedicle axial rotation
Intracystic haemorrhage
Pseudo myxoma peritonii
Infection
Rupture
Malignancy
Vulvar pain syndrome
Pain may be burning stinging irritation, due to several reasons :
Apthous ulcer ,herpes genitalis
Psychological,
pudendal nerve neuralgia
Referred pain from urethra/vagina
# vulvodynia - burning vulva syndrome
Poly menorrhea or epimenorrhea
Cyclic bleeding where cycle reduced to less than 21 days & remain in that constant frequency
Frequent cycle+ excess bleed - epim
Causes : 1)dysfunction-before menopause,duringadolescence, after delivery/ abortion, hyper stimulation of ovary by pitut horm.
#ovarian hyperemia -PID , ovarian endometriosis
Pseudocysesis
Present in women having problem of infertility or approaching menopause with intense desire to have a baby
H/o amenorrhea
Abd Ex : -ve signs of pregnancy
Sonography: empty uterus
Bartholin cyst
Small fluid filled sac located just inside opening of vagina
Cause - infection trauma followed by fibrosis, occlusion of lumen
C/f : discomfort, dysperuina unilateral swelling on post half of labia majora ,cyst is fluculant & non tender
Pap smear or papanicolous smear
Test for cervical cancer in women involves collecting cells from cervix
Test look for precancer cell changes on cervix that may become cervical cancer
Pesaary
It is indicated in
Subinvolution of uterus
In pregnancy when spontaneous correction to anteversion fails
Hodge smith pesaary:
Acts by stretching uterosacral ligament so as to pull the cervix backwards
Laproscopy sterilization
Commonly employed method of endoscopic sterilization
Becoming popular in cramps
Done under local anesthesia
Operation done 6weeks aft delivery should not be done before 6weeks
Sims position or lateral position
Pt lies on her left side with right knee drawn up towards chest ,left arm along back.
Ideal for inspecting lesions in ant vaginal wall as vaginal balloons with air as soon as introitus is opened by speculum
Functions of oxytocin vasopressin
Course of ureter in pelvis
L - 13 cm, diameter - 5 mm
Ureter cross pelvic brim in front of bifurcation of iliac artery ➡️
Runs downwards on lateral wall of pelvis ➡️ pass through uterine cavity ➡️ enter trigone of bladder
Granuloma inguinale or venereum
Chronic progressive granulomatous disease of vulva vagina cervix
Causes :
gram -ve donavania granulomatis
Diagnosis: bipolar (safteypin) appearance found in cytoplasm of mononuclear cells
Tuboplasty
Surgical procedure to restore anatomy physiology of the tube
Operation done by microsurgical techniques employed aft laproscopy
Microsurgery - better result due to minimum damage
Tuboplasty operation - adhesiolysis fimbrioplasty salpingectomy tubotubal anastomosis tubocornual anastomosis
Complete perineal tear
Tear of perineal body involving spincter ani with or without involvment of anorectal mucosa causes : gynec - direct injury due to fall or trauma to perineum
Obs- perineal injury by over stretching during child birth
Precipitate, prolonged labour
Forceps delivery
Macroscomic babies
Shoulder dystocia
Fern test
During mid cycle cervical mucus obtained by platinum loop spread on clean glass slide & dried
Low power microscope-fern pattern
Due to⬆️ Nacl low protein content in mucus due to ⬆️estrogen
Aft ovulation - fern disappear aft 21 days , +nce of fern even aft 21st day -suggest anovulation
Virilism
Presence of one or more following features: deepening of voice
Amenorrhea
Temporal balding
Clitorometry
Breast atrophy
Increase muscle mass
Due to androgen excess,adrenal hyperplasia or tumor of adrenals
Ovulation
Hirsutism
• Excess growth of androgen dependent sexual hair in facial & central part of body that worries pt
# Hypertrichosis - excess growth of non sexual hair
