REPRODUCTIVE SYSTEM

15.1 INTRODUCTION
Reproduction in one of the important characters of life. New species are produced as a
result of reproduction and genetic material is passed from one generation to the next i.e. from
parent cells to daughter cells.
15.2 MALE REPRODUCTIVE SYSTEM
 These organs are classified into external genital organs, i.e. scrotum,
penis and urethra and internal genital organs, namely, testes, vas deferens,
seminal vesicle and prostate gland.
1. Scrotum
It is a sac-like structure and hangs from the root of the penis. It
consists of loose skin and superficial fascia that support testes. There are
two sacs, which divide vertically, each one containing testis.
Muscle composed of smooth muscle fibres acts as a septum, A
temperature of 03°C is essential for survival of sperms which is obtained
due to contraction of muscle fibres.
In the spermatic cord, a small band of skeletal muscles is present,
which is known as the cremaster muscle.
The Testes
These are two in number. Each one is about 05 cm long and 21/2 cm
in diameter. The weight of each is 10-15 gm. The testes are covered by a
serous membrane called tunica vaginalis. Inside the tunica vaginalis, is
the tunica albuginea, composed of dense white fibrous capsule. The
tunica albuginea (goes inwards) forming a septum, so that the testis are
divided into several internal compartments known as lobules.
Tightly coiled tubules called somniferous tubules, are present in the
lobules. They serve as the site for the production of sperms.
The sperm forming cells are called spermatogenic cells. These cells
line the somniferous tubules along with supporting cells. They undergo
mitosis to eventually produce sperm. The immature spermatogenic cells
are known as speramatogonia. These lie next to the basement
membrane. Towards the lumen of the tubule more mature cells are
present. These are primary spermatocytes, secondary spermatocytes,
spermatids and sperms.
 As the spermatozoon reaches maturity, spermatozoon is released into
the lumen of the somniferous tubule. Between the spermatogenic cells,
sustentacular cells, are present which extend from the basement
membrane up to the lumen of tubule. Inside the basement membrane
tight junctions join the neighbouring sustentacular cells to one another
and these junctions form the blood testes barrier. For the development of
gametes, various substances are essential, which must pass through the
sustentacular cells. The spermatogenic cells contain surface antigens. By
isolating the spermatogenic cells from the blood, the blood-testes barrier
prevents an immune response against the surface antigens. In the space
between the somniferous tubules is occupied by interstitial cells that
secrete the hormone testosterone.
Activity of Testes
The activity of the testes is controlled by hormones.
The follicle stimulating hormone (FSH) controls spermatogenesis and
secretion of testosterone is controlled by the luteinizing hormone (LH).
Testosterone is derived from cholesterol in the testes and is a lipid soluble
hormone. The hormone which is produced in the interstitial cells diffuses
out to enter the interstitial fluid and finally the blood stream. The prostate
gland and seminal vesicles contain 5-alpha-reductase enzyme which
convert testosterone into dihydroxy-testosterone which is more potent
than the testosterone. Both these hormones are used for the
development of reproductive system.
Adrenal Cortex
It is believed to control the differentiation of sex in the foetus, the
growth of sex glands, sex organs and secondary sex characteristics after
birth. The adrenal cortex secretes sex hormones.
Thyroid
The thyroid glands and gonads stimulate each other. This relation is
mediated through the anterior pituitary.
The Semen
About 02-05 ml of semen comes out during each ejaculation and clots
after ejaculation. After about 15 minutes this clot liquefies. During
intercourse, the semen is deposited deep in the vagina. In normal human
beings the seminal fluid contains sperms and seminal plasma.
In a healthy person, the sperm count varies from 40 x 105-100 x 106.
About 65 per cent of the sperms remain motile after an hour in a hanging
drop preparation.
The semen is alkaline in reaction. It is composed of ascorbic acid,
citrate, acid phosphates and fructose. Fructose is the main fuel for the
spermatozoon; pH of semen is 07.2-07.7. For artificial insemination the
semen is stored under-78°C.
2. Penis
This is the male genital organ for reproduction. The penis also
contains the urethra. The urethra is used for ejaculation of semen and
excretion of urine. It has a cylindrical shape and consists of the glans
penis, the root and the body. The body of the penis contains three
cylindrical masses of tissue which are bound by fibrous tissues known as
tunica albuginea. The dorsolateral masses are called the corpora
cavernous penis. Inside the corpora cavernous is the midventral mass
called as the corpus spongiosum penis. This layer helps to form a spongy
urethra, and is kept open for ejaculation. This layer of urethra consists of
erectile tissue which contains blood sinuses. All the layers are covered by
fascia and skin. Sexual stimulation may occur by visual, tactile, auditory,
olfactory stimuli or even by imagination, whereupon the blood vessels
that supply blood to the penis dilate. The dilation of blood vessels
causes maximum blood to enter into the blood sinuses, there is
expansion of spaces, and the veins get compressed.
 The blood that enters into sinuses is trapped. These vascular changes
lead to erection. The penis comes to its original shape when the arteries
are constricted and pressure on the veins is relieved. Sympathetic reflex
action helps for ejaculation and the sphincter muscle at the base of the
urinary bladder closes, because of which urine is not expelled out during
ejaculation, and the semen does not enter the urinary bladder.
 The root of the penis is a proximal portion, containing bulb of penis.
The bulb is attached to the inferior surface of the urogenital diaphragm.
The bulb of the penis is the expanded part of the base of corpus
spongiosum (penis) and the curare of the penis. Due to contraction of
these muscles, ejaculation occurs.
The distal end of the corpus spongiosum (penis) is enlarged, and is
called as glens penis. The marginal part of the glens penis is known as
corona. The urethra at the end forms the enlarged external urethral
orifice. The glens are covered by the foreskin.
The Epididymis
It is a long comma shaped organ which is about 04 cm in length. It lies
on the posterior border of the testes and is coiled in appearance. Larger
part of the ducts is known as the head. The body lies in the middle part
and the tail lies to the inferior side. The tail continues as vas deferens. The
epididymis is a tightly coiled structure and is about 06 metres in length
tits walls are composed of pseudostratified columnar epithelium and
smooth muscles.
 Anthe surface of the columnar cells branching microvillus, called stereo
cilia are present. This structural feature enhances the surface area which
proves helpful in reabsorption of degenerated sperms.
Vas Deferens
The tail of the epididymis is known as vas deferens. It is about 45 cm in
length. Its dilated part is called the ampulla. Its walls are composed of three
layers of cells. The inner and outer layers are composed of longitudinal
muscle fibres and the middle layer is composed of circular muscle layer. Vas
deferens normally stores the sperms. These sperms remain viable for
several months. The ejaculatory duct which is about 02 cm long helps in
ejaculation. The semen is forcefully expelled from urethra to the outside.
3. Urethra
It forms the terminal part of the duct of the urinary and reproductive
system. Its function is to throw the semen and urine outside. It is 20-22 cm
long and passes through the prostate gland, the urogenital diaphragm and
the penis. The prostatic urethra which passes through the prostate gland is
02-03 cm. long. The spongy urethra at the end forms external urethral
orifice.
4. The Seminal Vesicles
These are two in number and are sac-like structures about 04-05 cm in
length. The seminal vesicles are present at the (posterior and up to base)
of the urinary bladder. The seminal vesicles secrete a viscous alkaline fluid
which contains the sugar fructose. The alkaline nature of this fluid assists in
neutralizing the acid in the female genital tract as it can be fatal for the
sperms. Fructose helps in ATP production by the spermatozoon. The
viability, motility of sperms and muscular contraction is controlled by
prostaglandins. After ejaculation, the semen clots due to a protein called
semenogelin. About 60-65% of the semen is secreted by the seminal
vesicles.
5. Prostate Gland
It is a small gland present inferiorly to the urinary bladder. The prostate
gland secretes milky and less acidic fluid of pH 064-06.5. The fluid briefly
contains ionized citric acid and is used for ATP production. Apart from this,
it also contains acid phosphates, prostate-specific antigen (proteolytic
enzyme), pepsinogen, amylase, lipase, and hyaluronidase.
The liquefaction of semen is facilitated by the prostate-specific antigen.
The prostate gland surrounds the urethra. Any infection to the urethra,
poses a risk to the prostate gland. The size of prostate gland is subject
to change. It may enlarge and obstruct the function. The secretion of
the prostate gland passes into the urethra to make proper volume of
the semen. It helps the sperms to remain motile and viable. The size of
the prostate gland increases up to the age of about 30 years and
remains constant up to the age of 45 years Any infection leads to an
increase in size.
15.3 FEMALE REPRODUCTIVE SYSTEM
BY MEHABIN CHOUDHARY
The female reproductive system consists of following organs:
1. External genital organ: Mons pubis, Labium majus (labium majus
podendi), Labium minus (labium minus podendi), clitoris and the
hymen.
2. Internal genital organs: Vagina, uterus, ovaries and fallopian tubes.
3. Accessory organs: Breast.

Vagina
• It is a tube like structure that works as a passage for childbirth and
menstrual flow. The semen is deposited during sexual intercourse in the
vagina.
• It is composed of fibromuscular tissues lined with mucous membrane.
It is about 04-06 inches in length and supplied with blood vessels and
nerves. It is present between the rectum and urinary bladder.
• Superiorly, it attached to the uterus. The vaginal mucosa is continuous
with the uterus. The mucosa is composed of nonkeratinised stratified
squamous epithelial cells and areolar tissues. These help for transverse
folds called rugge.
• The mucosa contains glycogen. After decomposition of glycogen it is
converted into organic acids. These acids assist in killing micro-organisms
(also) have the ability to destroy the sperms in vagina.
• The alkaline nature of the seminal fluid neutralizes the acidity in the
vagina and helps in maintaining their viability.
• The muscularis part is composed of circular that lies to outside and a
longitudinal layer on the inner side. This layer is composed of smooth
muscles which can stretch sufficiently during sexual intercourse to receive
the penis.
• The superficial layer of the vagina called the adventitia is composed of
areolar connective tissue. At the vaginal orifice, there is a thin membrane
called the hymen. It forms the border of the orifice.
Vulva
The various parts of the vulva are as follows:
Mons pubis
It lies anteriorly to the urethral and vaginal openings. It is chiefly
composed of adipose tissue and covered with skin and pubic hair.
Labia Majora
• These are two longitudinal folds, extending from the Mons pubis and
composed of adipose tissue, sebaceous glands, and sweat glands and
are covered by pubic hair.
Labia Minora
• These are two smaller folds lying medially to the labia Majora. These
are also composed of fatty tissue, sebaceous gland, and sweat glands.
Clitoris
• It is a small, cylindrical mass of erectile tissue, lined with nerves. It lies
anterior to the Labia Minora. The foreskin is present at the junction of
the Labia Minora which covers the clitoris. The clitoris is erotogenic.
Vestibule
• The space present between the two Labia Minora is known as vestibule.
This space is occupied by the vaginal orifice, the hymen and the external
urethral orifice.
• Deep within the labia, on both side of the vaginal orifice erectile tissues
are present. This tissue helps to narrow the vaginal orifice during sexual
intercourse which puts pressure on the penis.
• The external urethral orifice helps in expelling urine.
• Paraurethral glands are seen on the inside wall of the urethra. They
secrete mucous. Bartholdi's glands are present at the vaginal orifice.
• They secrete mucous during sexual contact which provides lubrication.
Mammary Glands
• These are modified sweat glands, responsible for production of milk.
The breast shows the presence of the nipple. Behind the nipple several
small ducts known as lactiferous ducts are present.
• Modified sebaceous glands are present around the nipple. This space is
known as the areola.
• The breast is supported by suspensory ligaments, which pass through
the skin lying deeply inside the breast tissues. Each breast consists of 16-
22 lobes.
• The lobes are separated by adipose tissue. The lobes consist of small
spaces known as lobules. These lobules show the presence of secreting
glands called alveoli which are supported by connective tissues.
• The alveoli are surrounded by myoepithelial cells. Due to contraction of
myoepithelial cells milk is pushed towards the nipple. Due to expansion
of ducts, sinuses are formed where the milk is stored.
• The lactogenic hormone assists in milk secretion. This function is
associated with childbirth. The hormone oxytocin assists in the
contraction of the myoepithelial cells, pushing the milk towards the
nipple in the process.
Ovary
• These are female gonads, lying in a shallow cavity on the lateral wall
of the pelvis, one on each side of uterus. These are attached to the
uterus by a broad ligament called mesovarium.
• The size of the ovary is variable. The length is 02.5-03.5 cm, the
breadth is 02 cm and thickness is 01.25 cm.
• The ovaries are divided into cortical part and medullary part.
• The medulla consists of fibrous tissues in which blood vessels,
lymphatic vessels and nerves are present.
The ovary shows different parts:
The Germinal Epithelium
• The surface of the ovary is covered by simple epithelial tissue. This
layer is called germinal epithelium. Below the germinal epithelium,
dense irregular connective tissue called as tunica albuginea is seen.
• Another layer of connective tissue, lying below the tunica albuginea
known as stroma is observed. The dense layer of the stroma is called
as cortex and loose layer of connective is known as medulla.
• The cortex shows the presence of ovarian follicles which contain
oocytes in various stages of development. The surrounding cells
provide nourishment to the oocytes and also secrete the hormone
oestrogen.
• A fully matured graafian follicle ruptures and releases the ovum. This
stage is known as ovulation. The empty ruptured ovarian follicle is
known as corpus enteum.
• This produces the hormone, progesterone until it degenerates and is
converted into the fibrous tissue known as corpus albicans.
Fallopian (Uterine) Tubes
• These are two tubes, lying one on each lateral side of the uterus.
They are approximately 10 cm in length, upper free border ligaments
of uterus. These oviducts are responsible for transport of oocytes as
well as fertilized ova from the ovaries to the uterus.
• The funnel shaped part of the fallopian tube at the opening end is
known as infundibulum. The infundibulum has finger-like projections
known as fimbriae.
• The uterine tube has three layers: the outer serosal, which is a serous
membrane, the middle layer, a muscularis layer containing circular
and longitudinal layers of smooth muscles and the inner layer which
is mucosa, containing ciliated columnar epithelial cells which help in
movement of the fertilized ovum.
• Due to peristaltic action of the muscularis, the ovum is propelled
along the tubes.
Uterus
• It is present between the bladder and the rectum. The uterus is the
site for implantation of the fertilized ovum, development of the
embryo and foetus and also for menstruation.
• The uterus is an inverted pear-shaped organ. It is 07.5 cm long, 05
cm wide and thickness of its wall is about 02.5 cm. The uterus is
divided into three parts, i.e. the fundus, body and cervix.
• The expanded superior part, lying above the opening of the
fallopian tube is known as the fundus.
• The narrow and constricted part towards the inferior side is the body. The
narrow part in the neck region that emerged into the anterior wall of the
vagina is called the cervix.
• The space within the uterus is known as the uterine cavity. The position
and range of movement of the uterus is controlled by three pairs of
suspensory ligaments. The wall of the uterus consists of three main
layers, the inner endometrium, the middle layer, the muscular
myometrium, and the outer layer, the serosal or perimetrium.
• The endometrium is a mucous membrane and contains three layers. The
stratum compactum is the outer compact surface layer of ciliated,
columnar epithelium. The spongy middle layer is the stratum spongiosum
which consists of loose connective tissue. The dense inner layer is the
stratum basal which underlies the myometrium.
• The functional part of the endometrium nourishes the developing
embryo. But after childbirth or during menstruation nourishment is
slowed down as the levels of the hormone, oestrogen and progestrogen
are reduced.
• The bulk of uterine wall is formed by the myometrium which is thick in
the fundic region and thin in the lower cervical part.
• This structure helps in expelling the foetus. The fundic region contracts
more forcibly than the cervical region, and it helps to dilate the cervix
and encourage childbirth.
Menstrual Cycle
• At the age of 12-14 years, the menstrual cycle starts. This is the age of
puberty. The onset of menstruation is known as menarche. The
reproductive organs, the uterus, the vagina and the breasts start
enlarging with increase in fat deposition, number of blood vessels and
connective tissues. There is appearance of secondary sex
characteristics.
Menopause
• At the age of 40-45 years, the reproductive system ceases to function.
The menstruation cycle stops and the ovary and breasts begin to
diminish in size.
Hormonal Regulation
• Hormones regulate the menstrual cycle. The hormone gonadotropins released
from hypothalamus controls the secretion of the follicle stimulating hormone
(FSH) and the luteinizing hormone (LH) from the anterior pituitary gland.
• The FSH is responsible for development of ovarian follicles, and stimulates
ovarian cells to secrete oestrogen. The LH stimulates further development of
ruptured follicles, and stimulates these cells to secrete, progesterone Relaxin,
and Inhibin
Oestrogen
• This hormone has some important functions. It influences development and
maintenance of the female reproductive system, and development of
secondary sex characteristics, like distribution of adipose tissue in the breasts,
hips, mons pubis, and abdomen, hair growth on the head and body, voice
pitch, and broadening of the pelvis.
• The hormone controls the electrolyte balance, assists in protein anabolism and
in lowering the blood cholesterol level. Progesterone secreted from the corpus
luteum, along with oestrogen prepare the endometrium for implantation of
the fertilized ovum and the mammary glands for milk secretion.
• The hormone relaxin helps in relaxing smooth muscles of uterus. The
hormone also relaxes the pubic symphysis. This enlarges the cervix
helping in easy delivery of the baby. The Inhibin hormone secreted by
growing follicle cells called granulose cells and by the corpus luteum,
inhibits secretion of FSH and to some extent of LH.
• The menstrual cycle takes place in a series of events which occur at
regular intervals over a period of about 28 days. There are mainly
three phases.
(a) The proliferative phase.
(b) The secretory phase.
(c)The menstrual phase.
(a) The Proliferative phase
• Various events take place during this phase. The gondatropic
hormone, FSH secreted from the pituitary gland, passes into the
blood stream and reaches ovary. The hormone exerts a local effect
upon the ovary. It stimulates the growth and development of the
ovarian follicle.
• The ovarian follicle contains the ovum, which starts to grow and
develop. Normally, one ovum grows and develops, but sometimes
more than one ovum also grows, develop and mature. After the full
maturation of the ovum, the ovarian follicle ruptures and the matured
ovum leave the ruptured follicle and enter the peritoneal cavity. This
process of release of the ovum from ruptured follicle is known as
ovulation. The released ovum is captured by the fimbriated end of the
fallopian tube and pushed along the fallopian tube towards the
uterus. This is carried out by peristaltic action.
• Under the effect of FSH, the ovarian follicle grows, and matures. At
the same time, under the influence of FSH, the cells of the ovarian
follicle secrete the hormone oestrogen. Oestrogen enters the blood to
reach the endometrium where it stimulates the cells of the
endometrium. As a result, the columnar cells of endometrium
reproduce more rapidly to form a thicker lining of the walls of
endometrium. The number of glands and blood capillaries also
increases.
(b) The Secretory Phase
• As soon as ovulation occurs, the walls of the ovarian follicle collapse. In
this phase, FSH is withdrawn by the pituitary gland as the levels of oestrogen
are high in the blood. Instead, it starts to secrete the second gondatropic
hormone, the luteinizing hormone. The LH enters the blood stream reaches
the ruptured follicle and influences the ruptured follicle to grow rapidly. The
ruptured follicle gets filled with a yellow substance called lutein.
• This body is known as corpus luteum. The cells of the corpus luteum under
the influence of LH start secreting the second ovarian hormone,
progesterone which is directly absorbed into the blood stream. It exerts an
effect on endometrium, assisting the action of oestrogen. This causes an
increase in the linings of columnar cells, and an increase in the number of
secretory glands and blood capillaries. Due to increase in the number of
blood capillaries, they form a network.
• The glands present in the uterine walls secrete a sticky fluid substance
Hence, this phase is known as the secretory phaseDuring this phase, the
endometrium becomes thick, soft, moist and rich in blood capillaries. The
endometrium undergoes these structural changes so that the fertilized ovum
can be received.
(c) The Menstrual phase
• If the ovum is not fertilized the activity of the pituitary gland is
reduced due to high levels of progesterone which inhibits the activity of
the pituitary gland also causing a reduction in the level of the luteinizing
hormone. Due to withdrawal of the luteinizing hormone, degeneration
of corpus luteum takes place. This in turn helps the level of
progesterone. Once the reduced progesterone levels fall, the
endometrium inside the uterus breaks down, the cells lining the uterus
disintegrate and blood capillaries break down.
• The extra secretion, lining endometrium cells blood from the broken
capillaries and the unfertilized ovum constitute the menstrual
flow.Once the progesterone level in the blood decreases to a certain
level, the pituitary gland begins to secrete the FSH [Follicle Stimulating
Hormones). Another ovarian follicle is stimulated and the cycle goes on
again.In the event when the ovum is fertilized, the endometrium does
not break down and there is no menstrual flow. The fertilized ovum
embeds itself within the endometrium and the chorionic gonadotropins
are produced.
• This hormone keeps the corpus luteum in an intact condition so
that it keeps secreting the progesterone continuously. The fertilized
ovum during the first twelve weeks is called as embryo and thereafter
it is known as foetus. This foetus is protected and nourished for nine
months within the uterus. After the full term is reached, the baby is
ready to be born.
Oogenesis:
• Formation of female gametes (eggs) in the ovaries is called as
oogenesis. It begins in foetal life. It starts at about 6.8 weeks of foetal
life. The primordial germ cells undergo differentiation (mitosis) and
about 6.7 millions of oogonia are formed at the 20th week of foetal life.
Most of these oogensis degenerate in a process known as atresia, and
at the time of birth of girl child about 2 millions of oogonia are available
in each ovary.
• However few of these oogonia develop into larger cells called primary
oocytes that enter prophase of meiosis I during foetal development but
their further development is arrested until puberty. At puberty, 60000
to 80000 primary oocytes are available in the ovaries. Out of these
primary oocytes only about 400 get chance to enter into the menstrual
cycle during reproductive life of female.
• The further growth of primary oocyte is long enough and may extend over
many years. The oogonium grows into huge primary oocytes by taking food
from surrounding follicle cells. It takes place after puberty. Each primary
oocyte is surrounded by a single layer of flat follicular cells and the whole
structure is called as primordial follicle.
• In the maturation phase, the primary occytes undergo two maturation
divisions, the first meiotic and second meiotic phases. In the first meiotic
division the primary occyte divides into two unequal haploid daughter cells, a
large secondary oocyte and a small first polar body. In second maturation
division, the secondary oocyte again divides into two unequal daughter cells;
a large cod (ootid) and a small second polar body.
• The ootid grows into a functional haploid ovum and thus three polar bodies
are formed. The ovum is released from ovary in the secondary oocyte stage.
• The maturation of secondary oocyte is completed in mother's oviduct
(fallopian tube) usually after the sperm has entered the secondary oocyte for
fertilization. If fertilization does not occur the cells degenerate.
• If sperms are present in the uterine tube and one of them penetrate
the secondary oocyte, the meiosis - II resumes. The secondary oocyte
splits into two haploid cells the larger one is the ovum and the smaller
one is the second polar body. The nuclei of sperm and ovum unite to
form a diploid zygote. The zygote begins to undergo cell divisions while
moving towards the uterus. After ovulation, it takes about 6-7 days to a
zygote to arrive in the uterus. The unfertilized secondary oocytes
disintegrate.
• Pregnancy and Parturition:
The sequential events occurring under the influence of hormones
from anterior pituitary leading to pregnancy are summarized in Fig.
5.13. The hormones that play role in the pregnancy are the female
gonadotrophins (FSH and LH) secreted by anterior pituitary gland, the
ovarian hormones (estrogen from ovarian follicle and progesterone
from corpus luteum) and the human chorionic gonadotrophin (HCG)
produced by fertilized ovum embedded in uterine wall. The
reproductive functions of the hormones are summarized in Fig. 2 and
3.
Role of Hormones in Reproduction/ Pregnancy
1. Estrogen:Development of secondary sexual characters at puberty.
• Thickening of uterine lining during proliferative phase.
• Trigger LH surge mid cycle stimulating ovulation.
• Stimulate anterior pituitary secretion of FSH and LH in first half of
cycle.
2. Progesterone:
• Support and enhance thickening of uterine lining during secretary
phase.
• Along with estrogen inhibits secretion of FSH and LH from anterior
pituitary in second half of cycle.
3. Human chrionic gonadotrophin:
• Act on corpus luteum and stimulate secretion of progesterone and
estrogen for first 3-4 months of pregnancy.
• Starting from the first day of last normal period, the pregnancy lasts for
about 40 weeks This time period is generally grouped into the three
trimesters each of about 12 weeks.
First Trimester (1 to 12 Weeks)
• Missing/stopping the period is the first sign of pregnancy. The significant
hormonal level changes, in the beginning of pregnancy and their effects on
almost all organ systems are experienced. Tiredness, mood swings, stomach
upset, headache, heart burn, constipation craving or distaste for certain
foods and tenderness/ swollen breasts are the most noticeable effects. Most
of these effects disappear as the pregnancy progresses.
• From 4th week the baby's brain, spinal cord and heart begins to form, the
arm and leg buds starts appearing and the embryo is less than half inch
long. At about 8th week the arm and legs grow longer and external body
structures begins to form.
• The rhythmic beating heart starts. Sex organs begin to form and eyes
moved forward on the face. At this stage baby looks more like human and is
about one inch long. At 12th week the co-ordinated movement of muscles
with nerves together begins.
• The external sex organs are clearly differentiated in
ultrasonography and baby's sex can be judged. The eyelids get
closed. The baby is about three inches long.
Second Trimester (13 to 28 Weeks)
• The effects experienced in first trimester disappear and new
noticeable changes appear. The first thing to be noticed is expansion
of abdomen to accumulate the growing baby. The effects such as
bodyaches (backache, abdominal pains, and thigh pains), stretch
marks on abdomen; breast and thigh shall be noticed.
• A typical line on the skin running from belly button to pubic hairline
is observed. Patches of darker skin on the face (forehead, lips, and
nose) popularly known as mask of pregnancy is observed. Darkening
of skin around nipples, swelling of ankles, fingers and face are the
other commonly observed changes. In the later part of this trimester
the movement of the baby shall be noticed.
• At 16th week muscle and bone tissue continues to grow to form
skeleton. Skin begins to form, muconium develops in the
intestinal tract, baby starts sucking motion with mouth. At this
stage the baby is about 5 inches in length.
• Further at 20th week, babt gets covered by the fine downy hair
and waxy coating and eyebrows, eyelashes, fingernails, toenails
starts appearing. At 24th week, the formation of blood cells
begins in the bonemarrow, Footprints and fingerprints are
formed. Lungs are formed and hair starts growing on head.
• In case of male baby, the testicles begin to move from abdomen
to scrotum. In case of female baby. the uterus and ovaries are
formed. The baby shows regular sleep cycles. At this stage the
baby is about 12 inches in length.
Third Trimester (29 to 40 Week)
• Some of the effects experienced in second trimester may
continue. Additionally increased frequency of urination, shortness
(difficult) breathing, heart burn, swelling of ankles, fingers and face
are the effects commonly observed. Importantly at this stage tender
breast with sometimes leaking of colostrum from it is experienced.
• Another very common observation is the sensation of baby dropping
i.e. moving down in the abdomen. The contractions mimicking
real/false labor and cervix becoming thinner and softer are observed
at this stage.
• At about 32 week, the bones are fully formed but are still soft. The
movement of the baby is quite strong; especially the kicks are
forceful. The eyes can be open or closed and are responsive to light.
There is faster gain in weight of the baby and at this stage baby is
about 16 inches in length. Further the vernix gets thicker and baby's
body fat increases with increases in weight to about more than six
pounds.
• At 39th week the baby is considered as full term. The organs are ready
to function on their own. The baby may turn into head down position for
birth. At the time of birth the baby may be up to nine pounds in weight
and about twenty inches in length.
Parturition
• The pregnancy ends in parturition i.e. giving birth to the baby. Let us
first see the meaning of the terms of parturition, parturient and
parturifacient. The dictionary meaning of the term parturition is
expulsion or delivery of the fetus from the body of the maternal
organism.
• Parturient means giving birth, a woman at child birth. Parturifacient
means a medicine which facilitates child birth.
Child birth also known as delivery is the ending of pregnancy where baby
leaves the uterus by passing through vagina. The most common methods of
child birth (delivery) include natural unassisted child birth, assisted child
birth and cesarean surgery (c-section).
The Lamaze method, Bradley method and Waterbirth method are the few
other methods of child birth.
• Stages of Labor: The exact mechanism initiating labor is not yet clear. However,
it is suspected that biochemical substances secreted by fetus induce labor. Fetal
hormone oxytocin is supposmened to induce labor.
• The prostagladins produced by placenta in greater amounts during labor induce
inflammation that assists labor.
1. First Stage of Labor (Dilatation Stage): Initially the uterine contractions start at
intervals of 20 to 30 minutes with each contraction lasting for about 40 seconds. As
labor progresses, the contractions become more strong and frequent. The
contractions lead to dilatation of cervix,.
• The duration of first stage varies widely with as low as one hour and as long as
14 hours. It is longer in case of women who are first time in labor while in case of
women who have given birth to 3-4 children may have first stage of one hour or
even less.
• The abnormal position of child, abnormally large child and abnormally small
pelvis may interfere with the descent of child and prolong first stage of labor. First
stage of labor is further subdivided into three parts viz. Early labor, Active labor
and Transition to second stage.
(a) Early Labor: In this part the cervix open up to 4 cm. A lady may
keep doing usual activities. The contractions may seem to go away
but over the time the contractions becoming stronger. When
contractions are severe, the next part viz. Active labor starts.
(b) Active Labor: The cervix opens further up to 7 cm. Slow easy
breathing, walking, standing or sitting upright will help progress
labor.
(c) Transition to Second Stage: The cervix further opens up to 10 cm,
contractions become stronger and last for about 60 to 90 seconds
and recur after every 2 to 3 minutes. The parturient may feel tired,
irritated, hot or cold.
2. Second Stage or Labor (Expulsion Stage): The stage begins
when cervix is completely dilated and the contractions push the baby
down the birth canal. The intense pressure similar to an urge to have
bowel movement is felt. The contractions are still stronger. The
duration of second stage depends on position and size of baby and
also on whether the lady has given birth before and how many times.
This stage ends with the birth of baby.
 3. Third Stage (After Birth): After birth the contractions continue to
push out the placenta. Usually it takes 5 to 15 minutes and sometimes
maximum of 30 minutes after birth to deliver the placenta. The lady
may feel chills.
4. Fourth Stage (Recovery): After the birth of baby and expulsion of
placenta the parturient may feel fatigue but relaxed. Breastfeeding the
baby shall stimulate the uterus to contract and may decrease the
bleeding.
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