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Download Basic Sciences for Obstetrics and Gynaecology by Tim Chard MD, FRCOG, Richard Lilford MRCOG, MRCP (auth.) PDF

By Tim Chard MD, FRCOG, Richard Lilford MRCOG, MRCP (auth.)

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Glucose The placental transfer of glucose occurs by 'facilitated' diffusion. The polar glucose molecule combines with a carrier protein to form a lipid-soluble complex. The system becomes saturated at a maternal glucose concentration of around 25 mmol/l; below this threshold the gradient across the placenta is small. 100 Fetus (HbF) Oxygen % saturation 60 20 o 40 80 Po2 (mmHg) Fig. 23. Oxygen dissociation of adult and fetal haemoglobin. HbF constitutes 80% of all circulating haemoglobin in the fetus at term.

The anterior vaginal wall is in direct relation to the bladder and the urethra throughout its length. The upper quarter of the posterior vaginal wall is related to the peritoneal space (recto-uterine space or pouch of Douglas) and the middle half to the rectum. The lower quarter is separated from the anal canal by the anal sphincters and perineal body. The lateral relations of the vagina are shown in Fig. 1. 3. The lymphatics form a superficial mucosal and deep muscular plexus on the anterior and posterior surface of the vagina.

It is attached to the pubic arch by a suspensory ligament and is covered by stratified squamous epithelium with numerous sweat and sebaceous glands except on the glans itself. 1. The arterial supply is the dorsal artery of the clitoris (terminal branch of the internal pudendal), which divides into deep Anatomy 39 and dorsal branches as it enters the clitoris. A venous plexus beginning at the glans drains to the pudendal plexus and thence to the pudendal vein. Vestibule and Bartholin's gland The vestibule lies between the labia minora and the hymen (the latter is a perforated membrane which in the parous or postcoital individual consists of skin tags or carunculae myrtiformes).

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