Age in days and development events :
1. 2 days – Embryo at 2 cell stage
2. 3 days – Morula is formed
3. 4 days – Blastocyst is formed
4. 8 days – Bilaminar disc is formed
5. 14 days – Prochordal plate & primitive streak seen
6. 16 days - Intra-embryonic mesoderm is formed / Disc is three germ layers
LH surge tends to occur at around 3 AM.
2. Ovulation occurs in morning between (midnight and 11 AM) in Spring
3. Ovulation occurs in evening between (4 PM and 7 PM ) in Autumn and winter .
4. Ovulation occurs more frequently from Right Ovary
5. Ovulation occurs alternatively between the two ovaries in younger women
6. In women more than 30 yrs age .. ovulation occurs frequently from the same ovary.
Remember :
1. The primitive germ cells takes origin from Yolk sac at 3rd week of gestation and migrate to the Genital ridge by 4th week of gestation .
2. 1st meiotic division – arrested in Prophase – completed just prior to Ovulation releasing the 1st polar body.
3. 2nd meiotic division – arrested in Metaphase – completed at the time of fertilization releasing the 2nd Polar body.
4. Also, Primary Oocyte – 44XX; Secondary Oocyte – 22X;
5. Primary Oocyte(44X) – undergoes 1st meotic division – Arrested in prophase –completed just prior to ovulation – releases First polar body (22X) + Secondary Oocyte (22X)
6. Secondary Oocyte (22X) – 2nd meiotic division – Arrested in Metaphase – At the time of fertilization – releases Second Polar Body (22X) + Ovum (22X)
7. In Males : Primary spermatocyte (44XX) – undergoes 1st meiotic division – forms secondary spermatocytes (2 in number)
8. Secondary spermatocytes (22X) (2 in number) – undergoes 2nd meiotic division –forms Spematids (22X)(4 in number)
9. Spermatids undergoes transformation as spermeiogenesis – forms Sperma (4 in number)
10. Developmental process from Spermatogoonia to Sperma takes 74 days (Some books 61days)and entire process till the transit to the ductal system takes 90 days (3 months)
11. So, in case of infertility of males the repeat sperm analysis is done after 3 months.
Placenta 10 points [MRP=must remember points]
1. Weighs 500gm, 20 cms, 3cm thick. Placenta is from both maternal and fetal tissue; at term 80% is fetal origin
2. Maternal placenta:
1. 20% of placenta weight
2. Made of decidua basalis, margins of spongy decidua, cotyledons
3. Fetal portion placenta
1. Made of villi
2. Fetal surface is covered by amnion
4. Circumvillete:
1. circum marginate
2. Predispose to premature marginal seperation, IInd TM APH
5. Succenturate lobe:
1. Accessory cotyledon
2. Cause for PPH
6. placenta previa
1. Implanted lower than normal, in lower uterine segment, near zone of effacement
2. Mostly in parous females
3. Present as sudden painless profuse bleeding in IIIrd TM
7. Battledore placenta
1. Umbilical cord inserted in margins
2. Cord entanglement is risky
8. Membraneacea placenta
1. Decidua capsularis is vascularised, chorion does not show atrophy
9. Bi partite placenta
1. Divided placenta
2. Retention may lead to PPH, sepsis
10. Placenta accreta
1. Abnormal adherence to uterine muscle, decidua deficiency
2. Seen in Placenta previa, prev CS, prev DC, grand multi para
3. Placenta increta: invade myometrium
4. Placenta percreta: perforate myometrium
AbdominalTB- present in genital tb patients-45%
Patients of genital TB infertile: 40-80%(mc presenting complaint of genital tb -INFERTILITY >pain)
Incidence of genital tb in patients with infertility-17%
Mullerian anomaly assosiation with urinary tract abnormality-30%
Risk of endometriosis is 7 times more if 1st degree relative is affeced with endometriosis
Patient with history of ovarian ca in 1st degree relatives,so risk of ovarian cancer-7%(dnb 2014)
Recurrence rate ater incision and drainage of endometrial cyst-50%(€€therefore best t/t - cystectomy)
Rate for conversion to frank camcer
cin-1 : 1%
Cin-2 :5%
Cin-3 : >12%(22)
Cin 1 conver to CIS -11%
Cin 1 time to regress to normal-2yrs
Protection rate of hpv vaccine-70%
Risk of involvement of ovaries in ca cx-11%
BSO can reduce the risk of breast ca by 50%
Dermoid always benign but risk of cancer -less than 2%
Risk for lifetime
brca 1-ovarian ca-35-45%
Hnpcc-endometrial ca-75%
Post mentrual bleeding patients developing endometrial ca-10%
any abnormal uterine bleeding above 40yrs endometrial ca should be ruled out therefore endometrial biopsy to be done rather than PAP
Endometrial hyperplasia(pre invasive)
simple withOUT atypia-1% risk for endometrial ca
Complex WITHOUT atypia-3%
Simple with atypia-8%
Complex with atypia-20%
(Without atypia progestrogens to be given for MINIMUM 14 days)
Use of OCP for 5yrs decrease the risk ovavarian ca by 50%
Molar preg
partial-90% triploidy 10% tetra
Complete 80-90% monospermic 46xx,10% 46xy
Complete mole associated with-
pre eclamsia-27%
Hyperemesis-25%
Hyperthyroidism-7%
Trophoblastic embolization-2%
Theca letin cysts -50%
Partial mole to
gtn-4%
Chorioca-<1%
Complete mole to
gtn-15-20%
Chorioca-4%
Hcg levels becum normal in
partial-7weeks
Complete-9weeks
40%ovulate after taking POP
NORMAL MC BLOOD LOSS-35ml
Blood loss after cuT-80ml
Post placental IUD insertion within 10mins
Post placental sterlization within 48hrs(ideal),can be done upto 7 days.if not done in first 7 days do after 6 weeks.
Expulsion rate
cuT 5%
IUD-10%
Memory time-5min
Mini lap-3-4cm incision
FT damaged in mod. Pomeroy-3cm
Gas for pnemoperitoneum-2L,pressure-15mmhg(co2)
Rate of ectopic post sterlization-10%
Risk of ectopic
highest-bipolar cautery
Lowest-mod. Pomeroy
Average liquefaction time for semen-20min
Maximum time for liquefaction-60min
Speed of sperm in female tract-3mm/sec
Who parameters
Vol->1.5 ml ,ph >7.2
Sperm concentntration 15 million
Sperm count 39 million
Total motility 40%
Forward motility 32%
Wbc -lessthan 1 million
Normal morphology 4%
40% ppl taking POP ovulate normally
Safe period of POP-3hrs
Safe period of cerazette is 12hrs
Umbilical cord
1. Length is 55 cm (Ranges from 30 – 100 cm) (so less than 30 cm is considered abnormally short )
2. 2 arteries and 1 vein (Left is left)
3. The Umbilical Arteries exhibit “Transverse intimal folds of Hoboken”
4. Extracellular matrix – Wharton’s jelly
5. Anatomically Umbilical cord is considered as fetal membrane
PLACENTA
Diameter of placenta is 15 – 20 cm
About 2.5 cm thick
Weight 500 gms
Ratio of Placenta : fetal weight = 1:6
Maternal surface of placenta :
1. Formed by Decidua basalis
2. Dull red in colour, rough and spongy
3. 15 – 20 lobes or cotyledons
Fetal surface of Placenta :
1. Formed by chorion frondosum and chorionic plate
2. Fetal surface is covered by blood vessels .
Extra Points :
1. Nitabuch’s layer : Zone of Fibroid degeneration where Decidua and trophoblast meet
2. Hoffbaeur cells : Phagocytic cells in the connective tissue of Chorionic villi of placenta.
3. Placenta separates after the birth and the line of separation is – Decidua spongiosum
4. Human placenta is – Discoid (Hemochorial + Deciduate)
5. The chorion frondosum + Decidua basalis forms placenta
6. Formation of placenta begins at 6th week and completed by 12th week
HALBAN IN OBG
Halban disease :: corpus luteal defect
Halban theory :: metastatic theory to explain endometriosis
Halban sign :: symmetrical enlargement of uterus in adenomyosis
UPDATE 19 OBGY
IOCs for various conditions
fibroid - USG
tubal payency- HSG
Mullerian anomalies - MRI
Endometriosis - Laproscopy
post coital bleeding - PAPS
post menopausal bleeding -
endometrial biopsy
pid - USG
adenexal mass - USG
amenorrhoea - hormonal asessment
molar - USG
Ectopic - TVS
ovulation - follicular monitoring
hirsutism with menstrual irregularity- -serum testosterone
AUB USG
Adenomyosis - MRI
ovarian reserve - FSH
VVF - Cystoscopy
OBG: Rapid Fire:-
1. Cyclical hematuria suggests which type of fistula in females:
Uterine-vesical
2. Commonest site of secondary metastasis in Choriocarcinoma:
Lungs
3. Treatment of inevitable abortion in 10th week of pregnancy: Dilatation & evacuation
4. Commonest site of ectopic pregnancy:
Ampulla
5. Alpha-fetoprotein is low in:
Down syndrome
6. Heart disease having highest mortality in pregnancy:
Eisenmenger’s complex
7. Trial of labor is CONTRAINDICATED in:
Previous 2 or more Cesarean section
8. Commonest cause of breech presentation is:
Prematurity
9. Low Forceps are applied when the station of head is:
+2
10. Maximum breast milk secretion occurs at which month:
3 months
11. Use of steroids in neonates is required in:
Bronchopulmonary dysplasia
12. Karyotype in androgen insensitivity syndrome: 46XY
13. Size of uterus:
3 x 2 x 1 inches.
14. Stress incontinence is best corrected by:
Bladder neck repair
15. Gonococcal infection spreads by:
Involvement of adjacent structures/ Ascending route
16. OCP of choice in lactation period:
Minipill/ progesterone only pill
17. A woman has 20 ml menstrual blood loss every 35 days. She suffers from: Oligomenorrhea
18. MC site of Endometriosis:
Ovary
19. Commonest ovarian tumour complicating pregnancy:
Dermoid
20. Most definitive clinical sign of pregnancy is:
Fetal heart sounds
2. Involution of the uterus is completed by:
6 weeks
22. Earliest indication of concealed acute bleeding in pregnancy is:
Tachycardia
23. A patient presents at 28 weeks gestation with severe abdominal pain, bleeding and hypertension. The most likely diagnosis is:
Accidental hemorrhage
24. Feature suggestive of ectopic pregnancy in a young woman with acute abdomen:
Amenorrhoea,
Abdominal pain,
Vaginal bleeding.
25. MC type of pelvis associated with direct OccipitoPosterior position is:
Anthropoid
26. Most unfavorable presentation for vaginal delivery is:
Mento-posterior
27. Deep Transverse Arrest is commonly seen in which type of pelvis:
Android
28. An absolute indication for Classical Caesarean section is:
Central placenta previa
29. Best contraceptive method in a patient with heart disease is:
Barrier methods
30. MC complication of IUCD is:
Bleeding
31. Antituberculous drug CONTRAINDICATED in pregnancy:
Streptomycin, pyrazinamide
32. Safest drug in pregnancy is:
INH (also rifampicin)
33 Antithyroid of choice in pregnancy:
Propylthiouracil (also methimazole)
34. Chorionic villous sample is done at what time:
10-12 weeks
35. Fetus in a diabetic mother are at risk of developing which cardiac lesions:
ASD, VSD, COA
36. Menopausal hormonal change:
Increased Gonadotropins, Decreased estrogen
37. Progesterone is produced by: Granulosa luteal cells (corpus luteum)
38. Procedure of choice to diagnose uterus didelphis is:
Hysterosalpingography
39 Rarest complication in a fibroid uterus is: Sarcomatous change (0.5%)
40. Cryptomenorrhoea occurs due to:
Imperforate hymen
41. MC complication of an ovarian tumour is:
Torsion
42. MC complication of cryotherapy is:
Watery discharge
43 Most effective drug in Sheehan’s syndrome is:
Corticosteroids
44. MC indication of In-Vitro Fertilization is:
Abnormality of fallopian tube
45. Jaundice at birth or within 24 hours of birth is commonly due to:
Erythroblastosis fetalis
46. Genetic disorders are diagnosed at 11 weeks of pregnancy by:
Chorionic villous biopsy
47. Abnormal alpha -fetoprotein is seen in:
Open neural tube defects,
multiple gestation
48. Weight of placenta at term is: 500 gm
49. Associated with oligohydramnios:
Renal agenesis
50. Treatment of a 40 year old P(4+2) female, who has been diagnosed to H. mole is:
Total hysterectomy
51. Management of Choriocarcinoma is:
Methotrexate
52. Ectopic pregnancy is MC in:
Previous history of recurrent PID
53. In puerperium, uterus becomes a pelvic organ after:
2 weeks
54. PIH can be predicted by which test:
Gant’s rolling over test
55. Prognosis in Rh-incompatibility depends on:
Serum bilirubin
56. Anti-hypertensive NOT given in pregnancy:
ACE inhibitors
57. Antimalarial of choice in pregnancy:
Chloroquine
58. Pap smear in pregnancy is:
Routine as a part of screening
59. Fetal scalp pH: 7.3
60. Earliest conclusive evidence of intrauterine death:
Intra-aortic gas
61. Fetal blood loss in abnormal cord insertion is seen in:
Vasa previa
62. Fetal scalp edema on USG is suggestive of:
Rh incompatibility
63. Drug which may be used for post-coital contraception:
RU 486/ mifepristone
64. Activity of corpus luteum activity is maintained by:
LH
65. Hormone responsible for positive ‘Fern test’ is:
Estrogen
66. Drug used for induction of ovulation:
Clomiphene, Tamoxifen
67. Ovarian tumour likely to involve the opposite ovary by metastasis:
Granulosa cell tumour
68. Pelvic Ca which can cause Krukenberg’s tumour:
Ovarian Ca
69. LEAST observed laboratory finding in neonatal sepsis:
Neutrophilia
70. Site of fertilization:
Ampulla
71. Peak growth velocity in adolescent girls is seen just after:
Appearance of pubic hair and axillary hair
72. Phocomelia is:
Defect in long bones
73. Progress of labor is charted on:
Partogram
74. Score for checking need of induction of labor:
Bishop score
75. Shortest diameter for fetal skull:
1. Bimastoid
2. Bitemporal
76. MC heart disease associated with pregnancy:
Mitral stenosis
77. Common congenital malformation seen in a diabetic pregnant woman:
Cardiac defects
78. Feature of a contracted pelvis has a transverse diameter of:
10 cm
79. Type of pelvis associated with increased incidence of ‘Face to pubis’ delivery:
Anthropoid
80. Manoeuvre used for delivering after coming head of breech presentation is:
Burn Marshall technique
81. Rupture of membrane is said to be premature when it occurs at:
Prior to 1st stage of labor
82. Likely size of uterus at 8 weeks post-partum is:
100 gm
83. Post-partum decidual secretions are referred to as:
Lochia
84. IUGR is defined when:
Birth weight below 10th of the average gestational age
85. IUCD with half life of 10 years:
Cu T 380A
86. Asymptomatic carriage of gonococcal infection in female is commonly seen in:
Endocervix
87. Primary amenorrhoea with 45 XO, short stature suggest:
Turner syndrome
88. Karyotype of Klinefelters syndrome 47XXY
89. Carcinoma cervix extends upto lateral pelvic wall. The stage would be:
Stage III
90. A 42 year old female P3+0+0+3 is found to have carcinoma in situ. Best treatment would be:
Hysterectomy
91. Masculizing/ virilizing tumour of ovary:
Arrhenobloastoma
92. Best prognosis for reversibility is seen in which type of female sterilization:
Isthmic-isthmic type
93. A middle aged female presents with increasing visual loss, breast enlargement & irregular menses. Investigation of choice would be:
Serum prolactin
94. Failure rate of Pomeroys method:
0.4%
95. Copper eluted from Cu T daily:
50 microgram
96. Antispermal antibodies in cervical mucus can be checked by:
Post coital test
97. Genital ridge forms:
Ovary
98 Length of fallopian tube: 10 cm
99. Platelet count in pregnancy:
Decreases
100. Which disease carries high chances of transplacental transfer in first trimester:
Rubella
Outlet, low, mid or high
The accepted clinical standard classification system for forceps deliveries according to station and rotation was developed by ACOG and consists of:
Outlet forceps delivery, where the forceps are applied when the fetal head has reached the perineal floor and its scalp is visible between contractions.[8] This type of assisted delivery is performed only when the fetal head is in a straight forward or backward vertex position or in slight rotation (less than 45 degrees to the right or left) from one of these positions.[9]
Low forceps delivery, when the baby's head is at +2 station or lower. There is no restriction on rotation for this type of delivery.[9]
Midforceps delivery, when the baby's head is above +2 station. There must be head engagement before it can be carried out.[9]
High forceps delivery is not performed in modern obstetrics practice. It would be a forceps-assisted vaginal delivery performed when the baby's head is not yet engaged.[9]
Velamentous cord insertion is the insertion of the umbilical cord into the membranes of the placenta before reaching the placental margin
and it occurs in 1.5% of term singleton placentas;
. Velamentous cord insertion is associated with preterm labor-delivery, low birth weight, fetal growth restriction, abnormal intrapartum fetal heart rate patterns, low APGAR scores at 1 and 5 minutes, neonatal deaths and placental abruption [2, 3].
Furcate umbilical cord insertion is the separation of umbilical vessels prior to their attachment into the placenta. It is a very rare entity with the risk of intrapartum hemorrhage
🎋. Placenta accreta is the invasion of the decidual surface of the myometrium with placental villi.
OBG
o Rubin’s criteria: Cx pregnancy
o Studford criteria: Abdomianl criteria
o Speigelberg criteris: Ovarian pregnancy
o Bethesda: Ca Cx
o Amsel Criteria: Bacterial vaginosis
OBG (inclusions):
o Call Exner body: Granulosa cell
tumour
o Schiller Duval bodies: Yolk sac
tumour/ Endodermal sinus (aFP,
α1AT)
o Reinke’s crystals: Hilus cell
tumour, Leydig cell tumour
o Hobnail cells: Clear cell Ca
o Signet ring cell: Gastric Ca/
Krukenberg tumour
o Walthard/ Puffed wheat cell:
Brenner tumour
o Rokitansky body: Teratoma
OBSTETRICS AND
GYNAECOLOGY:🔵🔵
Bagel sign:
Ultrasonographic sign. Gestational
sac in the adnexa with hyperechoic
ring
Ball Sign:
Radiological sign of intrauterine
fetal death. X-ray shows crumpled
up spine of the fetus..
Banana Sign:
Ultrasound sign in open spina
bifida. Shows abnormal anterior
curvature of cerebellum. Due to the
associated Arnold-Chiari
malformation.
Chadwick’s Sign:
Bluish hue to the vestibule and
anterior vaginal wall. Seen in first
trimester of pregnancy. Cause is
increased blood flow to the pelvic
organs. Also known as jacquemier’s
Sign.
Cullen Sign:
Bluish discoloration of skin around
umbilicus. Occurs due to intra
peritonealhemorrhage. Seen in
ruptured ectopic pregnancy.
Double Bubble Sign:.
Useful in prenatal diagnosis of
duodenal atresia. Duodenal atresia
usually presents with
polyhydramnios and produces
dilatation of stomach and first part
of duodenum
Double decidual sac Sign:
Normal Ultrasonographic
appearance of intrauterine
gestational sac. Seen as
twoconcentric echogenic rings
separated by a hyperechoic space.
Goodell Sign:
Marked softening of the cervix in
contrast to non pregnant state.
Also due toincreased blood flow.
Hegar Sign:
An indication of Pregnancy.
Softening of the lower parts of the
uterus enablesapproximation of
vaginal and abdominal fingers in
bimanual pelvic examination.
Vaginalfingers are placed in the
posterior fornix and abdominal
hand pressed down behind
theuterus.
Jacquemier’s sign: Refer
Chadwick
SignKustner’s Sign:
Sign of placental separation. On
pushing the uterus upwards does
not move thecord with it due to
the separation.
Ladin’s Sign:
Softening in the midline of the
uterus anteriorly at the junction of
the uterus andcervix. It occurs at
about 6 weeks gestation
Lambda Sign:
Ultrasonographic sign seen in
dichorionic pregnancies. Due to
the chorionic tissuein between the
two layers of the membrane
between the twins.
Lemon Sign:
Ultrasound sign in open spina
bifida. Shows abnormal anterior
curvature of cerebellum. Due to the
associated Arnold-Chiari
malformation.
Osiander’s Sign:
Pulsations in the lateral fornix due
to the increased vascularity.
Palmer’s Sign:
Regular rhythmic contractions of
uterus felt as early as 6-8 weeks .
It is a sign of pregnancy.
Piskacek’s Sign:
Asymmetric growth occurs to the
uterus in initial stages of
pregnancy due to thelateral
implantation of the blastocyst. The
area of implantation feels soft
compared tothe other parts.
Robert’s Sign:
Radiological sign of intrauterine
fetal death. X-ray shows presence
of gas in thefetal great vessels.
Earliest radiological sign of
intrauterine fetal death
Schroder’s Sign:
A sign of placental separation.
Uterus rises up when the
separated placenta ispassed
downwards.
Spalding Sign:
Sign of intrauterine fetal death.
Overlapping of skull bones after
fetal demise.Observed by
ultrasonogrm.
Stallworthy’s Sign:
Slowing of fetal heart rate on
pressing the head down I to the
pelvis and promptrecovery on
release of pressure is termed
Stallworthy’s sign. This sign is
suggestive of posterior placenta
praevia.
Stuck Twin Sign:
Seen in twin to twin transfusion
syndrome. Due to the severe
oligohydramniossmaller twin is
held in a fixed position along the
uterine wall. This is called stuck
twinsign.
‘T’ Sign:
Ultrasonographic sign seen in
monochromic twins. As the
intertwin membranedoes not have any chorionic tissue it gives rise to ‘T’ sign in ultrasound
Pregnancy and infections
mc overall cause of abortion = genetic factors
mc related to 2nd trimister = anatomical abnormilities
maximum risk of transmission in 1st trimester = rubella
maximum risk if infection occus before 20 weeks = varicella zoster
maximum risk if infection occurs after 18 to 20wks = syphilis
no relation to gestational age =CMV
maximum risk of transmission during delivery = hiv & herpes
least risk of transmission during delivery = toxoplasmosis
rate of transmission increases as pregnancy advances = toxoplasmosis & hepatitis
866. Question: During pregnancy the maternal blood volume increases by (DNB) Options:
(1 ) 5 - 10%
(2 ) 15 - 20%
(3 ) 50%✅
(4 ) 70%
Important facts about physiological changes during pregnancy !
1. Net weight gain – 11 kg (24 lbs)
2. Blood volume increases by 40-50%
3. Blood volume reaches max at – 30-32 weeks
4. Plasma volume increases by 50%
5. RBC volume increases by 20-30%
6. TLC increases with Neutrophilic leucocytosis
7. Total plasma concentration decreases
8. Total plasma protein increases
9. Albumin decreases
10. Globulin (IgA especially) slight increases
11. Fibrinogen levels increases
12. ESR increases
13. All clotting factors increases except – XI and XII
14. Platelet count decreases (gestational Thrombocytopenia)
15. Cardiac Output (Stroke volume increases ) by 40-50% by 30-34 weeks
16. Peripheral vascular resistance decreases
17. Diastolic BP decreases
18. Uterine blood flow increases
19. Plasma insulin level increases
20. S. Prolactin level increase
21. Vital capacity and Respiratory rate – constant
22. Renal plasma flow and GFR increases
23. All LFT remaind unchanged but ALP increases (due to Heat stable ALP from placenta)
1 Question: After how many days of ovulation embryo implantation occurs (AIIMS) Options: (1 ) 3 - 5 days
(2 ) 7 - 9 days ✅
(3 ) 10 - 12 days
(4 ) 13 - 15 days
Important facts :
1. From the time of ovulation it takes 3-4 days(or 18-19 days from the last menstrual cycle) --- for Fertilized Ovum in the Ampulla (Tube) to reach the Uterus.
2. From the time of ovulation it takes 7-9 days (or 21 – 22 days from the last menstrual cycle) --- for Implantation (During this time the Uterine milk /secretions provide nutrition for early dividing Ovum) – The predominant morphological feature is edema of the endometrial stroma.
3. Oogenesis begins in ovary – 6-8 weeks of gestation
4. Maximum number of oocytes (6-7 million) are attained at 20 weeks (5th Month) of gestation.
5. At birth total content of Both ovaries is 2 million primary oocytes.
6. At puberty number is decreased further and is – 300000 – 500000 of which only 500 are destined to mature during an Individual’s life !
7. All the primary oocyte in the ovary of a newborn till puberty – arrested in Late prophase
8. First polar body is released just prior to ovulation
9. Second division starts just after it and is -- arrested in metaphase
10. Thus second polar body release occurs only at the time of fertilization.
11. LH surge precedes ovulation by 34 – 36 hrs.
12. LH peak precedes ovulation by 10 – 16 hrs
13. Prior to ovulation : a) Follicle reaches a size of 18 – 20 mm (KCET 2009) b) Endometrium is 9 – 10 mm thick c) Endometrium shows triple line on USG
14. Maximum action of Corpus Luteum is at 22 days of Menstruation
15. In the absence of fertilization – corpus Luteum persists for – 12–14 days
16. Maximum Growth of Corpus Luteum is at 8th week of Gestation and degenerates at 6th month of gestation
