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Encyclopedia of Health and Medicine

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348 The Reproductive System<br />

threatening circumstance that typically occurs<br />

when a tube partially reanastomoses but the fertilized<br />

egg cannot pass through the tube to the<br />

uterus <strong>and</strong> instead begins to grow in the fallopian<br />

tube or the abdominal cavity.<br />

Outlook <strong>and</strong> Lifestyle Modifications<br />

Tubal ligation has no effect on a woman’s LIBIDO<br />

(sex drive), <strong>and</strong> in fact may increase a woman’s<br />

interest in sexual activity because she no longer<br />

worries about unintended pregnancy. However,<br />

tubal ligation does not protect against SEXUALLY<br />

TRANSMITTED DISEASES (STDS) or HIV/AIDS.<br />

The intent <strong>of</strong> tubal ligation is to establish permanent<br />

infertility (sterility), <strong>and</strong> a woman should<br />

consider tubal ligation to be permanent though it<br />

is sometimes possible to reverse a tubal ligation<br />

through a second surgery. The operation to<br />

reverse tubal ligation is usually major abdominal<br />

open surgery; its success depends on multiple factors,<br />

including the woman’s current age <strong>and</strong> the<br />

age at which she had the tubal ligation <strong>and</strong> the<br />

skill <strong>of</strong> the surgeon.<br />

See also CONCEPTION; FAMILY PLANNING; SEXUALLY<br />

TRANSMITTED DISEASE (STD) PREVENTION; VASECTOMY.<br />

Turner’s syndrome A spontaneous (nonhereditary)<br />

chromosomal disorder in which there are<br />

abnormalities <strong>of</strong> the X CHROMOSOME, the SEX CHRO-<br />

MOSOME that establishes female gender, resulting<br />

in various anatomic <strong>and</strong> physiologic anomalies.<br />

These abnormalities may include only a single X<br />

chromosome (X chromosome deletion) instead <strong>of</strong><br />

the normal pair <strong>of</strong> X chromosomes, or one complete<br />

<strong>and</strong> one fragmented or partial X chromosome.<br />

As well, the pattern may be mosaic, with<br />

some cells in the body carrying the normal paired<br />

X chromosome complement <strong>and</strong> others carrying<br />

the abnormality. Turner’s syndrome affects only<br />

females.<br />

Though symptoms <strong>of</strong> Turner’s syndrome vary<br />

depending on the severity <strong>of</strong> the chromosomal<br />

abnormality, characteristic traits include very short<br />

stature <strong>and</strong> loss or lack <strong>of</strong> ovarian function. An<br />

unusually short neck with webbed SKIN, <strong>and</strong> a<br />

broad, shield-shaped chest may be prominent at<br />

birth to suggest the presence <strong>of</strong> Turner’s syndrome<br />

though <strong>of</strong>ten the diagnosis comes later in childhood<br />

or early ADOLESCENCE when SECONDARY SEXUAL<br />

CHARACTERISTICS fail to develop. GENETIC TESTING<br />

(KARYOTYPE) confirms the diagnosis. Anomalies <strong>of</strong><br />

the HEART (coarctation <strong>of</strong> the AORTA) <strong>and</strong> KIDNEYS<br />

(HORSESHOE KIDNEY) are also common. As adults,<br />

women who have Turner’s syndrome have<br />

increased risk for type 2 DIABETES, HYPOTHYROIDISM<br />

(underactive THYROID GLAND function), HYPERTEN-<br />

SION (high BLOOD PRESSURE), <strong>and</strong> OSTEOPOROSIS.<br />

HORMONE THERAPY with ESTROGENS <strong>and</strong> progestin<br />

from PUBERTY through midlife (to the age<br />

MENOPAUSE would normally occur, around 50) is<br />

the st<strong>and</strong>ard course <strong>of</strong> treatment for Turner’s syndrome.<br />

This treatment causes relatively normal<br />

development <strong>of</strong> secondary sexual characteristics<br />

<strong>and</strong> sometimes <strong>of</strong> ovarian function to produce<br />

hormones, though the OVARIES do not produce<br />

normal OVA. In mosaic Turner’s syndrome, the<br />

woman’s ovaries may function until early adulthood.<br />

ASSISTED REPRODUCTIVE TECHNOLOGY (ART)<br />

techniques can make PREGNANCY possible. There<br />

are no measures to prevent Turner’s syndrome.<br />

See also CHROMOSOMAL DISORDERS; GENETIC DISOR-<br />

DERS; KLINEFELTER’S SYNDROME; MOSAICISM.

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