• At the end of this lesson students should be able

to:
• Define the concepts.
• Discuss the causes .
• Describe the pathophysiology and etiology.
• Outline the clinical manifestations.
• Describe the types/classification/stages.
• Name the surgical procedures
• Recognise the possible complications.
 Infertility
• Inability to achieve pregnancy after one year
of adequate exposure to unprotected sex.
Can be :
• Primary
• Secondary
 Causes
Causes Related to female
• Tubal injury/blockage
• Endometriosis
• Ovulatory and hormonal disorder
• Structural abnormality of the uterus and ovarian
tubes.
• Fibroids,polyps and cyst in the uterus,vagina and
fallopian tubes.
• Lack of permability of the cervical mucus to allow
penetration of the sperm
Causes related to male:
• Semen production,volume and density
• Morbility and morphology of sperms.
 Assesment
• Couple must seen together at initial visit.
Take history:
medical,surgical,fertility,gynaecologic,urologic.
Information regards:
Menustruatrual cycle,obstetric history.
Risk factors:
PID,IUDs,pelvic surgery
 Assessment cont
From men:
• Genital surgery
• Mumps with orchitis
• Previous genital trauma
General information
• Ask about:
• Occupational exposure
• Coital frequency
 Assessment cont
• Dyspareunia(man and women)
 Subjective data
• Age of each partner at initiation of
relationship.
• Duration and frequency of unprotected sex
• Duration of relationship.
• History on menache,breast development,hair
distribution
• History of contraceptive use.etc
(Mogothlane,2010:521)
 Objective data
• Physical examination
Assess for:
• breast development
• Abdominal scars
• Any mass(palpate)
• Do vaginal examination-for anatomical
abnormality e.g. Imperforate vagina
 Diagnostic evaluation
• FBC
• Blood specimen for hormonal analysis.
• Laparascopy and hysterosalpingogram.
• Sperm analysis for male partner.
• Refer to urologist
 management
• Tuboplasty via laparoscopy.
• Surgery
• Hormonal supplement.
• Refer to psychotherapy.
• Artificial insemination.
 References
• Brunner,L,S.,& Suddaarth,(1992).The textbook
of Adult Nursing: London ,Chapman Hall.
• Sandra,M.N.(2010)Lippincott:Manual of
Nursing practice.(9th Ed)Lippincott:New york.
• Mogothlane,S,mots
• chedish C. ,Mokgadi,M.,Joyce ,M.,& Young,A.
(2014)Juta ‘s complete text book of medical
Surgical Nursing.Cape Town:Lebone Publisher
 Abortion
Objectives
• At the end of this lesson students should be able to:
• Define the concepts.
• Discuss the causes .
• Describe the pathophysiology and etiology.
• Outline the clinical manifestations.
• Describe the types/classification/stages.
• Name the surgical procedures
• Recognise the possible complications.
 Abortion
• Def. Termination of pregnancy or miscarriage.
Can be:
• Involunatery/Spontaneus –before 20th week
• Volunatry/induced.
• Missed
• Habitual
Risk factors
• Hormonal disorders
• Incompetent cervix
• Emotional instability.
• Uterine fibroids
• Uterine trauma
• Congenital abnormalities
• ABO blood incompatibility
 Types

1.Spontaneous
• Treatened
• Inevitable- complete or incomplete- both can
be septic
2.Missed abortion
3.Habitual abortion- spontaneus or or invetable
 Types cont
4.Induced abortion
Can be complete or incomplete
 Pathophysiology
• Read (Pathophysiology and
Management(Mogothalane,2010:514-518)
 References
• Brunner,L,S.,& Suddaarth,(1992).The textbook
of Adult Nursing: London ,Chapman Hall.
• Sandra,M.N.(2010)Lippincott:Manual of
Nursing practice.(9th Ed)Lippincott:New york.
• Mogothlane,S,mots
• chedish C. ,Mokgadi,M.,Joyce ,M.,& Young,A.
(2014)Juta ‘s complete text book of medical
Surgical Nursing.Cape Town:Lebone Publisher