Gynaecology for students and practitioners . Tl 13 3 s ,^ c O © rC a ft -tJ o aj tt u -(J o p^ Q a p +i c •S -1-^ ?T3 ?+-3 o a a TJ rO a o cS <D ft > o i=l d ^ H 3 03 P& S C s _o 0) Fh •^ -(J ft cc _c ^ a C/3 CD eg i^ 0) rt 0) 03 03 -fj a a t4_| C/3 cS be o u .SP <B rO S <a cS ft <1 O U _C 52 -P cS 5;^ c tUD ^ ^ o <B « tic T3 0 0 -^ M o ^ CO -p >i oi s -0 CM ^ o <« t» ANATOMY OF TUBAL PREGNANCY 213 almost as freely as is possible with the gravid uterus, so that, as Taylorhas pointed out, this variety of intra-ligamentary pregnancy is notentirely extra-peritoneal. In cas
Gynaecology for students and practitioners . Tl 13 3 s ,^ c O © rC a ft -tJ o aj tt u -(J o p^ Q a p +i c •S -1-^ ?T3 ?+-3 o a a TJ rO a o cS <D ft > o i=l d ^ H 3 03 P& S C s _o 0) Fh •^ -(J ft cc _c ^ a C/3 CD eg i^ 0) rt 0) 03 03 -fj a a t4_| C/3 cS be o u .SP <B rO S <a cS ft <1 O U _C 52 -P cS 5;^ c tUD ^ ^ o <B « tic T3 0 0 -^ M o ^ CO -p >i oi s -0 CM ^ o <« t» ANATOMY OF TUBAL PREGNANCY 213 almost as freely as is possible with the gravid uterus, so that, as Taylorhas pointed out, this variety of intra-ligamentary pregnancy is notentirely extra-peritoneal. In cases of intra-ligamentary gestation the relation of the placentato the foetus is of importance. It was seen that in the secondary \,. Fig. 123. Tubo-abdominal Pregnancy, from a sketch by one of the authors of a specimen shown by Dr. J. B. Hellier. A, Ampulla of tube ; B, Primary tubal gestation-sac ; C, Foot of foetus within gestation-sac. The rest of the foetus had escaped into the peritoneal cavity. abdominal (intra-peritoneal) pregnancy the foetus generally lies abovethe placenta. In the intra-ligamentary variety the foetus lies generallybelow the placenta {see Fig. 122). By the growth of the foetus theplacenta becomes displaced progressively upwards which causes itsdetachment from its original connections with consequent death of thefoetus. A point of importance in posterior subperitoneal gestation isthe close relationship of the sac to the rectum, which leads to frequentinfection. Hence it is that in this variety suppuration and the dis-charge of foetal bones per rectum is known to occur. In a true broad-ligament gestation the ovary and its ligamentwill lie outside the sac, stretched out either on its posterior
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
