A textbook of obstetrics . e oldest forty-seven years of age. Changes in Uterus and Vagina.—In all the forms thesechanges are rather constant. Most of the alterations character-istic f intra-uterine pregnancy are found : hypertrophy of thevagina] mucous membrane, with increased blood-supply (purpletinge) and increased secretion ; a soft cervix and a patulous os ;an enlarged uterus, and, in the vast majority of cases, a develop-ment of a deciduous membrane,undergoing the same change asin intra-uterine gestation pre-paratory to its separation andextrusion, which occurs in extra-uterine gestation
A textbook of obstetrics . e oldest forty-seven years of age. Changes in Uterus and Vagina.—In all the forms thesechanges are rather constant. Most of the alterations character-istic f intra-uterine pregnancy are found : hypertrophy of thevagina] mucous membrane, with increased blood-supply (purpletinge) and increased secretion ; a soft cervix and a patulous os ;an enlarged uterus, and, in the vast majority of cases, a develop-ment of a deciduous membrane,undergoing the same change asin intra-uterine gestation pre-paratory to its separation andextrusion, which occurs in extra-uterine gestation usually be-tween the eighth and twelfthweek, the membrane being ex-pelled as a complete cast of theuterus and even of the tubes,or in shreds. The usual clinicalhistory of ectopic gestation isabsmce ni menstruation until thedeath of the embryo or ruptureof the sac, when the mensesreturn with thethe decidua. which thus begins may continuefr a long time. discharge ofrhe metrorrhagia The other changes in the. Fig. 158.—Decidual cast of theuterine cavity in extra uterine pr gnancy (Zweifel . maternal organism may vanwith the situation of the develop-ing ovum. Clinical History and Pathology of Tubal Pregnancy Usually the woman has had children, but a long time haselapsed since the birth of the last child. The most frequentsituation of an extra-uterine gestation is the outer third of thetube (the ampulla1 ). In this position it may grow upward intothe abdominal cavity, distending the tube-walls to the point ofrupture, or it may grow downward between the layers of thebroad ligament, and then backward and upward behind theposterior parietal layer of the peritoneum (broad-ligament gesta-tion). The tubal walls grow thicker from the development ^i 1 Martins statistics of 55 cases of extra-uterine pregnancy give this situation in lj. PREGNANCY. their muscle-fibers, except at spots, especially on the upper andposterior surfaces, where rupture may occur, the woman experi-encing severe cr
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
