Maternal absorption and placental transfer of sulfasalazine

Abstract

Perforation is a known. albeit infrequent, complication of dilatation and curettage, especially in the gravid uterus. In the present case, the finding of Fallopian tube in the cervix and lower uterine segment cannot be explained on a basis other than perforation and surgical implantation. On repeated examinations of the specimen, no unequivocal site of rupture could be identified, although perforations and cesarean sections may heal rapidly and without obvious gross or histologic sequelae.’ Likewise, no evidence of tubal structures was found in the myometrium. despite step sections taken from the entire uterus. For this reason, it is necessary to postulate that the implanted fimbriated portion became separated from the remainder. I f the latter is correct, the survival of the implant is of interest in view of its interrupted vascular supply. The other possible pathogenesis of this finding is that of an ectopic focus of tissue. However, this is unlikely, in view of the patient’s multiparity, the previous curettage: and, especially, the infrequency of even rudimentary Miillerian remnants. Finally, prostaglandin therapy has been documented as a cause of uterine rupture and cannot be entirely excluded in the present case, although again the subsequent curettage appears to be a more likely occasion for the rupture. For the above reasons, it is suggested that this unusual finding of Fallopian tube in the uterine cervix is the result of implantation following perforation during curettage. ;