Синтопічні особливості внутрішніх жіночих статевих органів та сечового міхура плодів

Abstract

Congenital defects of development occupy the 3rd position among the causes of perinatal mortality. In addition, in Ukraine there is a tendency to the reduction of birth rate caused by increased morbidity which, in its turn, is connected with untimely diagnostics of prenatal disorders of development. Examination of perinatal topography of the urinary bladder and internal female reproductive organs is conducted on the preparations of fetuses from the museum of the Department of Anatomy, Topographic Anatomy and Operative Surgery. All the material was examined by means of micro- and macropreparation methods, histological samples were prepared from certain preparations. Photos were taken while preparing the results of examination. The following variants of the bladder shape were found in the fetuses of 4-6 months: cubic (34 %), round (28 %), elliptical (20 %), triangle (18 %). Cubic shape is characteristic of the majority of fetuses. For the fetuses of 7-9 months among the variants of the urinary bladder shape most frequently cubic and round shapes are found (33 % and 27 %), less – elliptical (13 %), triangle (10 %), pear-shaped (10 %), spindle-shaped (7 %). The examination found the following shapes of the uterine fundus: flat, concave, sulcate and specific – tuberous shape with two small tubers in the area of uterine tubes isthmus. The urinary bladder is located in the anterior portion of the pelvis. It is separated on both sides from the parietal pelvic cellular tissue by means of taenias of the pelvic fascia emerging from the posterior surface of the pubic symphysis to the pelvic surface of the sacral bone. In female fetuses the peritoneum extends between the urinary bladder and uterus forming depression between them. In front from the urinary bladder there is the pelvic symphysis, and from behind there is the uterine body, ovaries, rectum, laterally – the ureters. Bladder-urethral segment is presented by the triangle and cervix of the bladder and internal occlusive muscle of the urethra. The apex of the urinary bladder is declined forward to the anterior abdominal wall over the superior margin of the pubic symphysis. From the apex of the urinary bladder the medial umbilical fold extends covering urachus, from the lateral walls of the urinary bladder two lateral umbilical folds extend. The fundus of the urinary bladder in the fetuses of the second trimester is not clearly detected, and its body gets narrow like a funnel and is transmitted directly to the cervix. The cervix of the urinary bladder passes into the urethra. Behind the wall of the bladder-urethral segment there is vaginal venous plexus. In the majority of fetuses the urinary bladder occupies a medial position between the pubic symphysis and point of the sacral bone, sometimes in male fetuses it is dislocated to the left. The shape of the urethra in female fetuses is cylindrical or fusiform (spindle-shaped), in male fetuses it is arched. In female fetuses the bladder-urethral segment is presented by the triangle and cervix of the bladder and internal occlusive muscle of the urethra. It is arched in the sagittal plane with backward convexity on longitudinal cuts. In female fetuses behind the wall of the bladder-urethral segment there is the anterior wall of the proximal vaginal portion and vaginal venous plexus. Internal entrance of the urethra in female fetuses in the third trimester of the intrauterine development is detected on the level of the medial third of the pubic symphysis. Conclusions. Thus, the formation of a definite shape of the urinary bladder and internal female reproductive organs was found not to be completed in the fetal period of ontogenesis. Perinatal morphogenesis of the urinary bladder and internal female reproductive organs can be divided into several periods characterized by a certain shape. Prospects for further research. To explore perinatal topography and anatomy of the urinary bladder and internal female reproductive organs in newborns.