Reproductive & Embryology

Embryologic development, the menstrual cycle, pregnancy complications and reproductive oncology.

Exam weight 5–7% · 2 QBank items · 3 flashcards

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Embryology

Week 3 gastrulation; weeks 3–8 organogenesis is the period of maximal teratogen susceptibility.
Neural tube defects follow failure of closure by week 4 — folate supplementation before conception is protective, AFP is elevated.
Branchial arch derivatives: arch 1 muscles of mastication (CN V3), arch 2 facial expression (CN VII), arch 3 stylopharyngeus (CN IX).
Müllerian duct forms the uterus, fallopian tubes and upper vagina; Wolffian duct forms epididymis, vas deferens and seminal vesicles.

Follicular phase is variable; luteal phase is a fixed 14 days ending with corpus luteum regression.
The LH surge triggers ovulation about 36 hours later; progesterone from the corpus luteum maintains the endometrium.
PCOS: high LH:FSH ratio, insulin resistance, hyperandrogenism; treat with weight loss, combined oral contraceptives, letrozole for fertility.
Menopause is 12 months of amenorrhea with high FSH — the most sensitive marker.

Preeclampsia: new hypertension after 20 weeks with proteinuria or end-organ damage; definitive treatment is delivery, magnesium prevents eclampsia.
Placenta previa is painless bleeding; placental abruption is painful bleeding with a rigid uterus.
Ectopic pregnancy: β-hCG that fails to double appropriately with an empty uterus on transvaginal ultrasound.
Gestational diabetes screening at 24–28 weeks; risks macrosomia, shoulder dystocia and neonatal hypoglycemia.

HPV 16 and 18 drive cervical squamous cell carcinoma via E6 (p53) and E7 (Rb).
Ovarian: serous cystadenocarcinoma is most common with psammoma bodies; CA-125 monitors recurrence.
Endometrial carcinoma risk rises with unopposed estrogen — obesity, nulliparity, late menopause, tamoxifen.
Testicular: seminoma is radiosensitive with a good prognosis; yolk sac tumour raises AFP, choriocarcinoma raises β-hCG.