Gynaecology for students and practitioners . become freely deposited, converting it into a lithopcedion. Inthis condition it may be retained for many years with little disturb-ance to the patient. Pregnancy in the Accessory Horn of a Uterus Bicornis. Thisinteresting phenomenon has been repeatedly mistaken for tubalpregnancy, from which it is distinguished by the different relation- ANATOMY OF TUBAL PREGNANCY 215 ship borne by the round ligament in the two conditions {see Fig. 124).In the case of tubal pregnancy the round ligament is attached to theinner side of the gestation-sac, whilst in cor
Gynaecology for students and practitioners . become freely deposited, converting it into a lithopcedion. Inthis condition it may be retained for many years with little disturb-ance to the patient. Pregnancy in the Accessory Horn of a Uterus Bicornis. Thisinteresting phenomenon has been repeatedly mistaken for tubalpregnancy, from which it is distinguished by the different relation- ANATOMY OF TUBAL PREGNANCY 215 ship borne by the round ligament in the two conditions {see Fig. 124).In the case of tubal pregnancy the round ligament is attached to theinner side of the gestation-sac, whilst in cornual pregnancy it comes offthe outer side of the sac. In the majority of cases the band of union connecting the rudi-mentary or accessory horn to the uterus is solid, so that spermatozoacannot enter this horn direct. In such cases external migration ofthe spermatozoa across the peritoneal cavity must take place ifpregnancy occurs. The corpus luteum is then found in the ovaryof the same side as the gravid horn, as shown in Fig. 125. In other. Fig. 125. Pregnancy in Accessory Horn of a Bicornute Uterus seen FROM Behind. Rupture has occurred through the upper pole of the sac. The ovary contained a corpus luteum of pregnancy (Doran and Lockyer). instances, where the corpus luteum is in the opposite ovary, externalmigration of the ovum must have occurred, either before or afterfertilization. In Fig. 125 the accessory horn shows a broad pediclewhich was found on microscopic section to be blind. In the majorityof cases the pedicle is narrow and long, allowing a considerableamount of mobility to the horn. Rupture of a gravid horn generally occurs through its upper andinner wall, and is preceded by a gradual process of thinning {seeFig. 125). There is no decidual formation in an imperfectly developedhorn {see Fig. 126) so that the eroding power of the trophoblast actsdirectly on the muscle-fibres in a way similar to that seen in tubalpregnancy, where it is also unchecked by a decidua. C
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
