Gynecological diagnosis and pathology . are four possible sites—the fimbriated end, the ampulla, theisthmus, or the interstitial portion. Owing to the absence of decidualreaction on the part of the tube, the trophoblast of the ovum penetratesmore rapidly and more deeply than in the case of an intra-uterine TUBA I- GESTATION 143 pregnancy, and blood extravasation is more abundant. The result is thatvery often the ovnm dies and, surrounded by coagulated blood, becomesconverted into a tubal mole. The patient, from whom the tubal moleshown in tig. 143 was removed, gave the following his
Gynecological diagnosis and pathology . are four possible sites—the fimbriated end, the ampulla, theisthmus, or the interstitial portion. Owing to the absence of decidualreaction on the part of the tube, the trophoblast of the ovum penetratesmore rapidly and more deeply than in the case of an intra-uterine TUBA I- GESTATION 143 pregnancy, and blood extravasation is more abundant. The result is thatvery often the ovnm dies and, surrounded by coagulated blood, becomesconverted into a tubal mole. The patient, from whom the tubal moleshown in tig. 143 was removed, gave the following history. A fortnightafter a normal period she began to bleed from the vagina, which sheattributed to a fall downstairs. There was no other symptom beyondthis slight continuous haemorrhage till a sudden attack of pain eightweeks later led her to seek advice. A dilated tube was recognised onthe left side and abdominal section performed. There was no blood inthe pelvis. If this molar formation has occurred at an early stage, the whole mass. Fio. 143.—Tubal Mole. The complete chorionic vesicle is seen in the centre and round it there is blood-clot. The tube is cut in transverse section. may ultimately become completely absorbed. If the ovum continues togrow, it causes thinning of the tube-wall, and very soon leads to rupture may occur into the lumen of the tube, into the peritonealcavity (Plate V. and Plate VI. fig. 3), or into the cellular tissue of thebroad ligament. If rupture occurs into the lumen, the ovum may escapeinto the interior of the tube and remain there as a tubal mole or beexpelled through the fimbriated end, usually accompanied by a good dealof hemorrhage—in some cases sufficient to cause the death of the is known as a tubal abortion (Plate VI. fig. 2). This mostfrequently occurs when the ovum is situated towards the fimbriated rupture occurs through the peritoneal aspect, a free intra-peritonealhaemorrhage follows which may lead
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
