Book - Contributions to Embryology Carnegie Institution No.1
Contributions To Embryology
Volume I, No. 1
Washington, D. C.
Published By The Carnegie Institution Ok Washington
1915
Carnegie Institution Of Washington Publication No. 221
Press Of Gibson Brothers Washington, D. C.
On The Fate Of The Human Embryo In Tubal Pregnancy
By Franklin P. Mall Director of Department of Embryology, Carnegie Institution of Washington
Contents
Introduction
Acknowledgments
Cause of tubal pregnancy
Tubal pregnancy with normal embryos
Tubal pregnancy with pathological embryos
Tubal pregnancy with pathological ova
Fertility and sterility
Implantation in tubal pregnancy
Normal implantation in uterus
Normal embryos in the tube
The trophoblast
Normal embryos from 6 to 9 mm. in length
Normal embryos over 9 mm. long
Conclusions regarding normal implantation
Pathological embryos in tubal pregnancy
Pathological ova in tubal pregnancy
Degeneration of villi and chorion
Summary:
Cause
Normal implantation
Tubal pregnancy containing pathological embryos
Pathological ova
Addendum
Description of the individual specimens
Bibliography of papers cited
Explanation Plates 1, 2, and 3
Introduction
The following study on tubal pregnancy is to be regarded somewhat as ;i byproduct from our embryological collection. Originally we were of the opinion that the very earliest stages of human development would be found in a recent tubal pregnancy removed by the surgeon. Before 1897 physicians were under the impression that an embryological collection should consist only of normal specimens, and the first tubal pregnancy added to the collection (No. 109) was sent to us by Dr. Gushing because it contained a normal embryo. We soon found that we would not obtain very early specimens by this method from the fact that the diagnosis of tubal pregnancy is made much too late. The smallest normal specimen we have received (No. 808) contained an embryo 6 weeks old. The very small tubes which have been sent invariably contained pathological embryos or small ova without embryos. According to our records 59 per cent of tubal pregnancies fall in the latter class. In 46 carefully selected cases from Dr. Kelly's clinic this percentage is raised to 84.8; if we could collect all cases of tubal pregnancy, the probabilities are that it would be still higher.
The normal specimens accumulated slowly among the numbers of our collection below 500. In this group 21 out of 27 specimens, which had been examined by physicians before they were sent to the laboratory, contained normal embryos. Among the specimens that had not been previously examined, only 4 out of 19 were normal. (See table 1.)
