ECTOPIC PREGNANCY II. WITH SPECIAL REFERENCE TO ABDOMINAL PREGNANCY

Abstract

Abstract This study is based on a comprehensive review of the literature and on data obtained from 173 patients with histologically verified ectopic gestation treated surgically in the Sydenham Hospital during the fourteen-year period of 1934 to 1947. The varieties of ectopic gestation listed in the order of their frequency were as follows: isthmia1, ampullary, in the entire tube, at the fimbriated extremity, interstitial, cornual, tuboovarian, secondary abdominal and in a rudimentary horn. Historica milestones are discussed in their chronologic order. Comparative anatomy is discussed briefly. Discussion of the following topics is based on data obtained from this series and on the experience of other writers as recorded in the literature: incidence, etiology, symptoms and physica findings, diagnostic aids, differential diagnosis, pathologic anatomy, recurrent ectopic gestation, treatment, concomitant surgery, morbidity and mortality. Five fatal cases are discussed in detail. Detailed reports of nine cases are presented and illustrated. In the illustrations an attempt was made whenever possible to determine the age of the fetus from the ossification centers. This method is often very helpful, especially in the numerous instances in which the pregnant woman cannot remember the exact time of her last normal menstruation. The illustrations also show the changes in the fetal skeleton which signify fetal death.