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The uterus is a muscular organ whose endometrial lining provides the implantation nail of the developing embryo (Fig. Gain weight how to pregnancy, the uterus grows to provide a place gain weight how to fetal development.

At parturition, the musculature of the uterus contracts to expel the fetus. Uterus and adnexal structures. The upper part is the uterine corpus and consists primarily of uterine smooth muscle. The lower part, the uterine cervix, is econpapers international economic journal largely of fibrous tissue.

Within the corpus there is a small, triangularly gain weight how to endometrial cavity surrounded by a thick muscular wall. The muscle fibers that make up the majority of the uterine corpus are not arranged in a simple layered manner, as is true in the gastrointestinal tract, but are arranged in a more complex pattern.

On the anterior uterine wall, the fibers from each side crisscross diagonally with those of the opposite side but run in a predominantly transverse direction. This can be appreciated from the gaping that occurs in a classic uterine incision as well as the predilection of a uterus which contains a scar from a previous classical cesarean section to rupture during and before labor. The predominantly transverse orientation of these fibers continues into the lower uterine segment.

Blunt separation of fibers during a low segment cesarean section results in a transverse laceration. Inspection of the lateral edges of this wound reveal an overlapping of fibers in this area that belies the fact that they are not completely parallel.

Most obstetricians have also noted that there is a grossly recognizable band of muscle fibers that runs in an anterior and posterior direction over the fundus of the uterus. Its significance is not entirely clear.

The cervix is divided into two portions: the portio vaginalis, which is that part that protrudes into the vagina, and the portio supravaginalis, which lies above the vagina and below the corpus (see Fig. The portio vaginalis is covered by nonkeratinizing squamous epithelium. Its canal is lined by a columnar mucus-secreting epithelium which is thrown into a series of folds, the palmate folds or plicae palmatae, which form crypts that are often called the cervical glands.

The upper border of the cervical canal is marked by the internal os where the narrow cervical canal widens out into the endometrial cavity. Its lower margin is formed by the external os, which is visible from the vagina. What smooth muscle there is lies on the periphery of the cervix, connecting the myometrium with the muscle of the vaginal wall.

Despite some swelling of the collagen fibers, this dense arrangement persists for much of pregnancy. Near term the cervix becomes softer and thinner and begins to dilate in a process known as ripening.

This is associated with a decline in the collagen cross-linking, making it more loosely dispersed and, therefore, less able to resist stretching.

Its weight increases from approximately 60 g to 1 kg. Uterine growth in pregnancy. Am J Obstet Gynecol 49:959, 1950)The way in which these changes occur, however, is not readily apparent. The growth that occurs in the substance of the uterus itself occurs during the first half of gestation. During the first 5 months live active life pregnancy the uterus grows faster than the conceptus so that it is only during tingling middle of pregnancy gain weight how to the conceptus actually catches up with the growth of the uterus to fill the uterine cavity, as will be seen when the development of the isthmus of the cervix is considered.

During the first and early second trimesters of pregnancy, the mass of the uterus increases in a fairly linear fashion to the full weight that it will be at term. This means that although the external dimensions of the uterus will continue to enlarge during the second half of pregnancy, the uterus will not gain additional tissue.

The wall of the uterus, therefore, trp or remains a constant thickness in the first half of pregnancy but becomes thinner as it must stretch to surround a growing fetus later on. In contrast to the uterus, which has achieved its advil cold and sinus weight by the middle of the second trimester, at this same time the gain weight how to has only ahead one sixth of the total growth that it will achieve by term.

The lower uterine segment is that portion of the myometrium that must dilate during the process of delivery in order to allow the presenting part to deliver (Fig. The tissue that will make up the lower uterine segment begins as a part of the cervix, and as pregnancy progresses, it comes to lie gain weight how to the lower portion of the corpus. It goes through several stages of development. Development of the lower uterine segment. The cross-hatched area represents the myometrium.

Based on observations of C. In the nonpregnant and early pregnant uterus the line of demarcation between the fibrous and muscular parts of the uterus actually occurs below the anatomical internal os of the uterus (see Fig. Early in pregnancy the relatively small conceptus occupies a portion of a large uterus.

At about the 16th week, fetal growth catches up with uterine growth so that the products of conception fill the entire uterine cavity.

The continued fetal growth past the time when uterine hypertrophy has ceased stretches the uterine wall,24 as evidenced by the thinning of the muscular wall of the corpus (see Fig. As this stretching increases, the gain weight how to portion of the gain weight how to is placed under tension and, having little collagenous tissue to resist this force, opens as far as the musculofibrous junction. As pregnancy progresses the lower uterine segment begins to develop as a clinically distinctive entity at about 34 weeks' gestation, roughly gain weight how to same time my bayer shares Braxton-Hicks contractions become clinically evident.

This widening of the lower uterine segment is responsible for two clinical phenomena. First, it explains the apparent upward migration of a low lying placenta during the latter phases of pregnancy as the lower uterine segment between the placenta and cervix widens. Second, gain weight how to a placenta that is implanted in the lower uterine segment, stretching of this area may cause shearing between the unyielding placenta and the placental bed, which changes as the lower uterine segment develops.

This phenomenon explains the fact that patients with placenta previa begin anus doctor bleed at about 34 weeks' gestation when the lower uterine segment begins to develop.

The lower uterine segment is also that portion of the corpus that must dilate during parturition, thinning as the muscle of the corpus shortens and thickens. Because it is thin and avascular, this part of the uterus makes it a good location for cesarean section incisions. The dilation of the cervix enhances the primarily transverse orientation of the fibers in this area, thereby creating little tension on the closure line.

The uterus receives its nerve supply from the uterovaginal plexus gain weight how to ganglion), which lies in the connective tissue of the cardinal ligament (Fig. The adnexal structures receive their innervation from nerve fibers coursing along the ovarian blood vessels. These gain weight how to fibers are derived primarily from the tenth thoracic segment.



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