ANATOMY OF THE UTERINE/ PLACENTAL COMPARTMENT AT THE TIME OF BIRTH The cotyledons of the maternal surface of the placenta

a extend into the decidua basalis, which forms a natural cleavage plane between the placenta and the uterine wall. There are interlacing uterine muscle bundles, consisting of tiny myofibrils, around the branches of the uterine arteries that run through the wall of the uterus to the placental area. The placental site is usually located on either the anterior or the posterior uterine wall. The amniotic membranes are adhered to the inner wall of the uterus except where the placenta is located. ANATOMY OF FEMALE REPRODUCTIVE SYSTEM External Structures A. Visible Organs of the Vulva

Mons pubiscovered with pubic hairlocated over pubic bones, serves a protective function Labia major and labia minoratwo pairs of tissue surrounding the outer part of the vulva. Vestibulesurrounded by the labia it contains the vaginal opening and urethra. Vaginal opening Clitoriserectile tissue analagous to the penis Urethral orifice Perineumthe region of the genital area between the vulva and the anus. This is the location of an episiotomy if performed during birth.

B. Breastsmammary glands

Function is to secrete milk for infantlactation. After delivery, the withdrawal of estrogen and progesterone due to the expulsion of the placenta cause prolactin to be produced, which stimulates milk formation. Oxytocin is a hormone that stimulates the release of milk.

Internal Reproductive Organs A. Located in the Pelvic Cavity

Ovariesfemale gonads located on each side of the uterus. Functions include (1) Development and release of the ovum (egg) (2) Secretion of the hormones estrogen and progesterone Fallopian tubes (1) Carry the ovum from the ovary to the uterus. (2) Fimbriae sweep ovum into the tube.

Uterus (1) Hollow pear-shaped organ that stretches and enlarges during pregnancy to support the fetus. (2) Other functions include menstruation and expelling of the fetus during labor. (3) Divisions of the uterus are: fundusuppermost portion; corpusthe body; cervixlower third that exits into the vagina through the cervical os. Vagina (1) Curved tube leading from the uterus to the vestibule. (2) Functions as a passageway for menstrual flow, organ of copulation, and birth canal.

Pelvis A. Bonessupport and protect pelvic contents

Sacrumwedge-shaped bone formed by the fusion of five vertebrae Coccyxsmall triangular bone at bottom of the vertebral column. Innominate bones (1) Iliumupper prominence of the hip (2) IschiumL-shaped bone below the ischium. Distance between the ischial spines is the shortest diameter of the pelvic cavity. (3) Pubisslightly bowed front portion of the innominate bone. The pubis meet at the front of the pelvis to make up the joint called the symphysis pubis. Below the symphysis is a triangular space called the pubic arch, under which the fetal head passes during birth.

B. Pelvic floormuscular floor of bony pelvis, supports pelvic contents

Levator animajor portion, made up of four muscles (1) Ileococcygeus (2) Puboccygeus (3) Puborectalis (4) Pubovaginalis Coccygeal muscleunderlies sacrospinous ligament a thin muscular sheet which helps the levator ani support the pelvic contents

C. Pelvic shapesvaginal birth is never ruled out because of pelvic type without a trial of labor.

Androidnarrow, heart shaped, similar to shape of male pelvisnot favorable for vaginal birth Anthropoidwidest from front to backusually adequate for vaginal birth Platypelloidwidest from side to sidenot favorable for vaginal birth

Gynecoidclassic female pelvisapproximately 50 percent of women and its the best for vaginal birth