NCM 107 | CARE OF WELL MOTHER CHILD AND ADOLESCENT (LEC)
Normal 28 day cycle
First 14 days - 1st phase of menstruation
14th day - ovulation (release of the egg cell)
If fertilization occurs it will stop here. If there is, it will
continue
PHYSIOLOGY OF MESTRUATION
3rd Day of Menstruation
the estrogen and progesterone level is very low It will
send signal to hypothalamus to stimulate Follicle Stimulating
Hormone Releasing Factor that triggers the APG Anterior
Pituitary Gland to produce the first hormone the Follicle
Stimulating Hormone. FSH will activate the ovary to
produce estrogen (so that the level of estrogen will increase)
Why estrogen is needed? For the maturity of the egg cell. To
promote the development of Graafian Follicle (where the egg
cell mature). Graafian follicle will rupture during the ovulation
period.
 Ovum/ Oocyte - mature egg cell
 Nagrelease ng oxygen, the level will rise. And if the
estrogen is high, the lining of the uterus (endometrium)
will thicken in preparation for implantation.
13th Day of Menstruation
the level of estrogen is high, progesterone is low
sends signal to hypothalamus it will trigger Luteinizing
Hormone Releasing Factor(LHRF) to active the APG to
produce the 2nd Hormone the Luteinizing hormone which
promotes ovulation.
14th Day of Menstruation
estrogen and progesterone are both high (level) the
new mature ovum will push into the surface of the ovary
then; Graafian Follicle ruptures thereby releasing the
mature ovum (oocytes) this process is called OVULATION /
OVULATORY PHASE
ZYGOTE
o if there’s sexual contract, fertilization, union of egg
cell and sperm cell it will become one (1) cell.
o the first human cell
o beginning of pregnancy/conception
 if there is no sexual contact or fertilization the cycle will
continue in 2nd phase
 after ovulation if there is sexual activity and fertilization
it will become one (1) cell (sperm and egg cell) called
zygote
 the conception/pregnancy will start and the
menstruation stop.
Amenorrhea
o first sign of pregnancy
o absence of menstruation
Spotting
o (implantation bleeding) - small amount of
menstruation
OVULATION SYMPTOMS
1. mittelschmerz - sticky secretion. highly elastic. changing
the discharges or the mucus. tenderness in lower abdomen
2. spinnbarkeit - tenderness in lower abdomen. increasing
temperature
Natural method of planning
 mucus
 basal body temperature
 mittelschmerz
thick lining of endometrium
- for preparation of pregnancy. abundant by blood
supply. rich in nutrients from blood supply
- to protect the sperm cell during for possible
fertilization
2nd stage
 corpus luteum - graafian follicle raptured transformed to
yellowish body. process for 7 days after ovulation
 luteal phase (post ovulatory phase) - period after
ovulation
if there is no fertilization in corpus lutuem it will start again in
earlier stage. the progesterone and estrogen will rapture
again because of no fertilization. the progesterone and
estrogen will low again
the thick lining will generate to collapse because the vessel
will rapture because of the no blood supply and the tissue will
die. it happens during the 24th and 25th day of pregnancy
 necrosis - dead tissue
 ischemic phase - the lining will fall and will start again in
cycle of menstruation
 APPEARS DURING MENSTRUATION
 blood from raptured
 blood vessels
 mucus
 fragments (endometrial tissue)
 in fertilized ovum
 many and big blood clots - not normal
 menstrual flow does not contain blood clot unless heavy
flow
FERTILIZATION
 during ejaculation millions sperm cells release
 deposited in female reproductive system during sexual
activity
 with the aid of semen travel to cervix or uterus. they
will penetrate the egg cell to fallopian tube and ampulla
 while on the way the other sperm cells decline or die.
only hundreds can make until fallopian tube to meet the
egg cell
Capacitation
 during the process the head of sperm cell changes
 there’s oval shaped head and small head
 1 sperm cell can enter egg cell. the tail of the sperm cell
will be removed and only the head will remain
 in order to penetrate the sperm release chemical to
destroy the protective layer of egg cell called ZONA
PELLUCIDA (inner)/CORONA RADIATA (outer)
PROCESS OF FERTILIZATION & IMPLANTATION
 Ovulation- fertilization-Zygote –Mitosis- Blastomeres-
Morula-Blastocytes
During ovulation on the 14th day of menstruation the
ovary will release mature cell called ovum/ oocytes and
this will be transfer/ catches by the fimbriae/ fallopian
tube. Once there’s FERTILIZATION (process of the union
of egg and sperm cell ), this cell now become ZYGOTE
(the first human cell ) and this zygote will undergo
MITOSIS (into 2 daughter cells) and this will developed
into many more cells inside called BLASTOMERES
(about 16-50)- kapag marami na syang na release
magiging MORULA na sya ( Stage of MORULA- (3rd – 4th
day this will travel towards uterus/ implantation
namagiging BLASTOCYST and later on will developed
into placenta and fetus.
Zygote – embryo – fetus – 280 days = birth/delivery
SUMMARY
 Ovulation on the 14th day of menstruation
o ovary will release mature cell called ovum/
oocytes
o transfer/ catches by the fimbriae/ fallopian
tube.
 Fertilization- is the union of the eggcell and spermcell.

ST
Byproduct of fertilization is Zygote- (1 HUMAN CELL)
 Mitosis – is the process in which a cell will become 2 daughter
cells
 Blastomeres – development of the multiplication of many more
cells. Every 22 hours it multiplies into 16-50 cells
 Morula – travels to the uterus for implantation
th th
 8 – 9 day of fertilization = implantation
 Blastocyst
o EMBRYOBLAST DISK- inner cell mass
o TROPHOBLAST CELL- an outer layer
o The trophoblast will later on develop the placenta and
fetus
After implantation, this will be secreted: When getting tested if
pregnant this hormone will be looked for: (HCG) Human Chorionic
Gonadotropin
 HCG signals the corpus luteum to continue producing
progesterone which helps to maintain pregnancy.
Implantation – occurs in the upper uterine segment (fundal portion)
- 2/3 cases implants are in the Posterior surface
- 1/3 cases at the Anterior surface
 Partial Placenta Previa = partially covers the cervix
 Complete Placenta Previa = completely covers the cervix
Spermcell – determines the gender of the offspring
(XX) = Gynosperm – oval head (X chromosome = with FEMALE)
(XY) = Androsperm – small head (Y chromosome = with MALE)