Gynaecology for students and practitioners . to uterine gestation breaks down. As the embryo grows, the eroding trophoblast destroys the maternaltissues and eats its way into maternal blood-vessels. Haemorrhagethus occurs within the gestation-sac or capsule and the . latterruptures in consequence at its weakest spot. In the majority ofcases the gestation-sac or capsules is thinnest towards the lumen andhence hsemorrhage into the lumen is a common event ; this accidentis spoken of as internal capsular hcemorrhage. Less frequently thecapsule gives way externally, through the peritoneum or i
Gynaecology for students and practitioners . to uterine gestation breaks down. As the embryo grows, the eroding trophoblast destroys the maternaltissues and eats its way into maternal blood-vessels. Haemorrhagethus occurs within the gestation-sac or capsule and the . latterruptures in consequence at its weakest spot. In the majority ofcases the gestation-sac or capsules is thinnest towards the lumen andhence hsemorrhage into the lumen is a common event ; this accidentis spoken of as internal capsular hcemorrhage. Less frequently thecapsule gives way externally, through the peritoneum or into thelayers of the broad ligament, and to this the term external capsularhcemorrhage is applied. The results of each type of haemorrhage willbe considered later on. When the ovum lodges in the ampullary portion, the abdominal 200 GYNECOLOGY ostium almost invariably becomes occluded before the end of thesecond month (eighth week) ; when the ovum lies in the isthmus orthe interstitial portion, the abdominal ostium does not close (see Fig. 109. Section through a Gravid Fallopian Tube, illustrating theResults of Internal Capsular Hemorrhage (Whitridge Williams). Theovum has escaped into the lumen of the tube ; the site of the embedding in thetube-wall is shown to the right of the figure. V, Villi which have penetrateddeeply into the wall of the tube ; , Blood clot containing chorionic villi seenin section ; in the centre of the mass is an irregular space representing the amniotic sac. 110 and 111). The condition of the ostium, as will appear later, hasan important clinical bearing. The ability of the Fallopian tube to continue to accommodate thegrowing ovum is by no means certain ; as a matter of fact it fails todo so except in extremely rare instances. It is, however, believedthat genuine cases are on record of gestation continuing to term,or nearly to term, in an unruptured Fallopian tube. Failing this ANATOMY OF TUBAL PREGNANCY 201 event, either the ovum is destroyed
Size: 1476px × 1692px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
