Treatise on gynaecology : medical and surgical . entirely within the tube, we have a simpletubal pregnancy; if the uterine walls are also involved, it is a tubo-uterine or interstitial pregnancy; and if the foetus is partly within theabdominal cavity, a tabo-abdominal pregnancy; to these varieties EXTRA-UTERINE PREGISANCY. 239 may be added the tubo-ovarian. If the tube should rupture and thedevelopment of the foetus continue within the abdominal cavity, wehave a secondary abdominal pregnancy. Some authorities maintainthat abdominal j)regnancy may be primary. If the rupture occur inthe attached
Treatise on gynaecology : medical and surgical . entirely within the tube, we have a simpletubal pregnancy; if the uterine walls are also involved, it is a tubo-uterine or interstitial pregnancy; and if the foetus is partly within theabdominal cavity, a tabo-abdominal pregnancy; to these varieties EXTRA-UTERINE PREGISANCY. 239 may be added the tubo-ovarian. If the tube should rupture and thedevelopment of the foetus continue within the abdominal cavity, wehave a secondary abdominal pregnancy. Some authorities maintainthat abdominal j)regnancy may be primary. If the rupture occur inthe attached portion of the tube, the foetus may develop within thefolds of the broad ligament—a condition to which has been appliedthe name of subperitoneal.^ Finally, there exist several well-estab-lished cases of ovarian pregnancy in which the ovum has developedupon the surface of the ovary, but their number is smaller than hasbeen supposed. Certain anatomical characteristics make the diagno-sis between this variety and abdominal pregnancy Fig. 62.—Tubal Pregnancy of Two and a Half Months, Sac Closed (Bouillt), Pregnancy in a rudimentary horn of the uterus differs so essen-tially from normal pregnancy, and so resembles foetal cysts, that itsdescription should be included with that of extra-uterine this reason the term ectopic is preferable to that of extra-uterinepregnancy. Pathological Anatomy^Tuhal Pregnancy properly so called.—Hennig ^ found the ovum occupying the central portion of the tube in77 out of 122 cases. In 10 it was situated in the proximal portion,in 17 near the centre, 8 times in the outer third, and 6 in the exter-nal fourth. We know of at least 12 well-authenticated cases of tubalpregnancy carried to term. As soon as the ovum has become fairly attached, the mucous mem-brane of the tube undergoes a transformation similar to that of theuterine mucous membrane in the formation of the decidua. Roki- 240 CLINICAL AND OPERATIVE GYNJiCOLOGY.
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